THE EFFECTS OF TRAINING 
A Study of the Harvard University Crews 
BY 
EUGENE A. DARLING, JW.D. 
CAMBRIDGE, MASS. 
Reprinted fro7n the Ration Medical and Surgical Journal of 
August j/ and September 7, lBgg 
DAMRELL & UPIIAM, PUBLISHERS 
BOSTON 
253 Washington Street 
1899 S. J. PARKHILL A. CO.. BOSTON, U.S.A 
PRINTERS THE EFFECTS OF TRAINING. 
A Study of the Harvard University Crews. 
EUGENE A. DARLING, M.D., CAMBRIDGE. 
This investigation -was undertaken at the sugges- 
tion of the Harvard Athletic Committee, by whom it 
was felt that a knowledge of the physiological changes 
occurring during severe training would be of value, 
and that incidentally data might be obtained throwing 
light on the obscure subject of overtraining. It is in- 
tended to make a similar study of the effects of train- 
ing for several other forms of athletic contests besides 
rowing, especially foot-ball and running. Since no 
similar research had, as far as known, been attempted, 
this first series of observations on the effect of row- 
ing was regarded as tentative. It was doubtful how 
far the subject would lend itself to study and hence it 
was thought best not to attempt too much until the 
more promising lines on which to work had been deter- 
mined. Much of the work has been somewhat barren 
of result, while in other directions unexpected facts 
have been learned and the necessity for further study 
revealed. For example, it early became apparent 
that one of the most important parts of the investiga- 
tion would concern the nutrition and tissue metabol- 
ism, but for want of suitable apparatus and in the ab- 
sence of a chemist to analyze the food and excreta, 
this part of the work was done only in the most su- 
perficial way. It is hoped that a subsequent investi- 2 
gation will include a much more complete study of 
these important points. The greater part of the work 
which was thought to be feasible this year was a 
study of the changes taking place in the heart and 
kidneys, and a series of observations on the weight 
and temperathre and their relation to the general 
condition of the men. The observations covered the 
months of May and June, and hence included only 
the more strenuous part of the training period, for 
which all the men had been prepared by long prelim- 
inary work, as detailed below. 
There were certain difficulties which limited the 
scope of the inquiry and which must be borne in 
mind in estimating the results obtained. The chief 
one was the impossibility of maintaining constant 
supervision over the men, and the consequent loss of 
much valuable information. This was not true, how- 
ever, during the two weeks at New London, where 
the opportunities for observation were excellent. A 
second difficulty was that circumstances sometimes 
compelled the use of cruder methods of examination 
than would be necessary for the most accurate work. 
For instance, the most accurate method of determin- 
ing the size of the heart and the method least liable 
to error from the “ personal equation ” is by means 
of the fluoroscope, but owing to the impossibility of 
setting up an elaborate x-ray machine at New Lon- 
don, one had to fall back on the less certain method 
of combined auscultation and percussion aided by the 
phonendoscope. A third limitation to the inquiry 
was the obvious one that all the observations had to 
be arranged so as not to interfere in any way with 
the main objects of the training, which were to learn 
to row and to get into the best possible condition. 
Consequently, nothing in the way of experiment could 
be attempted nor any examination which would fa- 3 
tigue the men or distract their attention from their 
rowing. 
These limitations were unavoidable, but were coun- 
terbalanced in a way by the active co-operation of 
the coach and of the individual members of the crews. 
Their courtesy and interest were unfailing and alone 
made it possible to carry on the observations, involv- 
ing as they did a considerable expenditure of time and 
a certain amount of irksomeness. 
Preliminary training. The large number of can- 
didates who began training in the winter were gradu- 
ally weeded out by a process of natural selection, 
based on numerous trial races, until but sixteen re- 
mained. These men were organized into two crews 
late in April, and practised daily until early in June. 
Shortly before going to New London a new man was 
taken from one of the Weld crews, and five of the 
squad were dropped. The remaining twelve com- 
prised the two crews the eight-oar and the four-oar 
which took part in the races, and most of the sta- 
tistics of this paper refer to them. The observations 
on the five who stopped training early in June were 
eliminated, so that more accurate comparison could be 
made. 
Of these twelve men all had done considerable pre- 
vious rowing in their class crews or in the Weld crews. 
Four had rowed on former Varsity crews and one 
had been a substitute. Several had begun rowing in 
preparatory schools. Six out of the twelve had played 
football and two had practised running. The period 
of active training for these sports had been from two 
to six years, so that all the men may fairly be called 
trained athletes, and the changes effected by training 
would not be expected to be as marked as in the case 
of inexperienced men. 
The previous health of all the men had been good 4 
with one exception, who gave a history of typhoid six 
years ago and rheumatism a year later. 
General statistics. The following table gives in 
brief the ages, weights, heights, chest and abdominal 
measurements and vital capacities of the lungs of the 
individual members, with averages for the eight and 
four, and, finally, the averages for the entire squad: 
Table I. 
> 
► 
► 
rr. < 
<i 
t t 
& S 
P S3 
hh xj 
O 05 
Ctjq 
tOMOO 
Pto 
QO-POSOX^COtOM 
c 
Pi® 
c+ ® 
O 
o 
to 
to 
to to to to 
to 
toto<-*tototototo 
M^COHOOOO 
> 
QfQ 
<*• 
St-oi <J ox 
Weight 
s 
Is 
<10 05 0 
top 
da 
top tap tapwp 
May 8-17. 
qx 
Ox 
05 at aii qx 
05 
05050505050X0101 
iWw 
O 
*-* 00 
O B|H 
top 
o 
w- 
►"*H-tOt3t-*COI-*CD 
tap tap 
Height. 
03 
CO 
CO CO CO 
CO 
COCOCO^CO^COrf^ 
S.B 
"5 
“1 
*PW£ 5 
‘f 
5 
Sg-P 
a 7 ' 
P- 
CO 
CO 
OX 
CO CO CO CO 
CO 
£8g?S§i3S28? 
SSH 
3 !T 
® 3 
2 
wwo-p 
§ S *f 
H. ® 
05 
> 
’ 1 
? 8 
ki|M 
43-16 
a^qico 
bSP 
Jfe 
Ot>POxC0*PhPiP05 
*>p 
Ex- 
pan- 
sion. 
s 
*i 
? 
CO 
CO 
CO CO CO CO 
CO 
MMMWMUMW 
H» o to w O 
Circum. of 
l5 
Op 
cdH 
5 
abdomen. 
Vital ca- 
CO 
306 
to to CO to 
CO 
COCOCOCOCOCOtO<W 
pacity. 
ox 
OOOOt 
ooooooooc 
Cu. ins. 
Daily rowing. During May and the first ten 
days of June the daily exercise consisted of rowing 
on the Charles in the latter part of the afternoon. 
I. GENERAL, SKETCH OF THE TRAINING. 5 
The distance covered varied according to circum- 
stances from five to eight miles, occasionally more. 
At New London there was added a short morning 
row of two to four miles. Between the middle of 
May and the race there were five time-rows three 
on the Charles of three and three-eighths miles each, 
and two on the Thames over the four-mile course. These 
time-rows were designed to accustom the men to row- 
ing long distances at high speed and to enable the 
coach to judge of their form and endurance, but inci- 
dentally they afforded excellent opportunities to study 
the effects of long-continued exertion, and were, more- 
over, striking demonstrations of the effects of train- 
ing. The earlier time-rows, though shorter than the 
later ones, were much more exhausting, and their ef- 
fects on the hearts and kidneys the organs showing 
most evidence of strain were considerably greater. 
For the purposes of this inquiry, however, the time- 
rows had to be regarded as factors disturbing the reg- 
ular process of development which might be expected 
were the daily exercise uniform or slowly increased, 
and hence it became necessary to divide the observa- 
tions into two parts, the first directed to the changes 
in the daily condition, eliminating the effects of the 
time-rows as far as possible, and the second directed 
to the immediate effects of the time-rows. 
Diet. The diet allowed was a very generous one, 
consisting of a hearty breakfast at 7.30, lunch at one 
and dinner after the evening row. For breakfast the 
fare consisted of fruit, oatmeal or shredded wheat, eggs, 
some form of meat, bread and butter, potato and 
milk. At noon there was cold meat, potato, bread 
and butter, marmalade, preserved fruit and milk.. 
Dinner comprised soup, occasionally fish, roast beef 
or some other hot meat, several vegetables, bread and 
butter and a simple dessert. No tea or coffee was 6 
allowed, but ale or claret was permitted at dinner, also 
water in small amounts as desired. During the last 
week before the race each man received a dish of 
calves’-foot jelly with sherry wine after the morning 
row, and a light lunch of oatmeal, milk and bread 
was served at four o’clock in the afternoon. 
Sleep, bathing, etc. The ordinary allowance of 
time for sleep was nine hours, from ten to seven. 
General plunge baths were prohibited, but after row- 
ing the men were allowed a cold shower bath in 
Cambridge and a bucket bath (for want of a shower) 
at New London. 
Besides rowing the men indulged in very little ex- 
ercise. While at New London a five-minute walk 
before breakfast, an occasional game of quoits or 
spasmodic efforts to play baseball were the only other 
forms of exercise indulged in. When not rowing, 
sleeping or eating the men passed the time in reading, 
writing or in pure and simple loafing. 
11. EFFECTS OF TRAINING. 
Weight. —lt has long been recognized by athletic 
trainers that the weight is one of the best indicators 
of condition. The average weight of the eight men 
constituting the crew from May 18th to June 29th is 
shown in Chart I. 
During the first ten days of this period there were 
no marked variations, and in spite of two hard time- 
rows the average on May 29th was exactly the same 
as on May 18th, 171.4 pounds. Beginning May 30th, 
when there was a third time-row, there was a steady 
fall in weight for a week. The weather at this time 
was very hot and oppressive, and owing to the fact 
that the crew rowed for a few days on Spy Pond, 
Arlington, there was much delay in getting dinner. 
These two factors, added to the hard work the men Chart I. Average Daily Weight of Varsity Eight. 8 
were then doing, contributed to the fall in weight. 
From June 6th until the day of the race the average 
was very constant, fluctuating between 167 and 169 
pounds, although individuals showed more or less 
variation. Losses in some men were usually balanced 
by gains in others. Chart II illustrates the range of 
variation in three of the crew. In the case of No. 7, 
whose condition was uniformly good, the variation 
was slight and, leaving out of consideration the sharp 
fall during the time-row and race, amounted to but 
three pounds. In Nos. 6 and 3, on the other hand, 
the range of variation was ten and eight pounds re- 
spectively. No. 6 began hard training in April and 
was somewhat slower in getting down to his normal 
training weight than the others. The sharp fall in 
No. 3’s line between May 30th and June 2d was ac- 
companied by some insomnia and general malaise, but 
unfortunately he was not under immediate observa- 
tion at the time. One of the commonest causes of 
fluctuation in weight was diarrhea. In several in- 
stances slight attacks caused a fall of three or four 
pounds in twenty-four hours, though in every case 
this was quickly restored soon after the diarrhea 
ceased. 
Tables II and 111 show the effect of the last time- 
row and of the races on the weight. The prelimi- 
Tablb 11. Loss of Weight in Time-row of June 21st. 
1 
2 
3 
4 
5 
6 
7 
8 
Total. 
Average. 
Preliminary loss. 
1 
1 
0 
1 
1 
i 
i 
6i 
%+ 
Loss during time- 
row. 
1% 
2* 
2% 
4 
2 
2% 
3 
2 
20% 
2f — 
Total loss. 
2% 
3i 
2% 
5 
3 
3 
3i 
3J 
27 
3| Chart 11. Weight Chart of Nos. 3, 6 and 7, showing Daily Variations. 10 
nary loss means that which is always noticed during 
the twenty-four hours before a race. It may be at- 
tributed to nervousness, affecting the appetite and 
urinary secretion. This preliminary loss, as might 
be expected, was considerably greater before the race 
than before the time-row, being 12 \ and pounds 
respectively, while the actual losses during the time- 
Table 111. Loss of Weight in Race, June 29th, 
1 
2 
3 
4 
5 
6 
7 
8 
Total. 
Average. 
Preliminary loss. 
2 
1% 
2i 
i 
1 
2i 
0 
2i 
12i 
ii+ 
Loss during race. 
2J 
2 
3i 
3 
2 
3 
3i 
2% 
22 
2% 
Total loss. 
4i 
3% 
5* 
3i 
3 
5£ 
3i 
5i 
34i 
4i+ 
row and race were nearly the same, 20| and 22 
pounds respectively. 
Through an oversight, the weights of the Varsity 
four-oared crew were not recorded during the last 
two weeks of training. A comparison of their 
weights immediately before and after the two-mile 
race showed an aggregate loss of 13 pounds, aver- 
aging 3J pounds. 
Table IV. Twenty-four-hour Gain after Time-row of June 21st. 
1 
2 
3 
4 
5 
6 
7 
8 
Total. 
Average. 
Total loss. 
2% 
3i 
2% 
5 
3 
3 
3i 
3i 
27 
3| 
Gain in 24 hours. 
4i 
5 
4% 
6i 
3% 
3i 
3i 
33J 
43-16 
Net Gain. 
li 
U 
2 
i 
i 
% 
0 
0 
6i 
13-16 11 
Compensating for the rapid loss before and during 
the time-rows and races, there was noticed after those 
events an equally rapid recuperation ; this is shown 
in Table IV, in which are given the total losses and 
corresponding gains for the time-row of June 21st. 
Every man recovered all or more than he had lost in- 
side of twenty-four hours. 
A loss of several pounds during prolonged exertion 
does not by any means imply an undue degree of ex- 
haustion, provided the individual is in good condition. 
The men who lost most were in fully as good condi- 
tion as their companions both before and after the 
race. It is generally accepted on experimental 
grounds that during active exercise the energy is 
largely if not wholly derived from the oxidation of 
fat and glycogen, and that the muscles themselves are 
not used up in the process. The end products of this 
combustion chiefly water and carbon dioxide 
are rapidly excreted through the lungs and skin. 
The loss of weight represents very closely, therefore, 
the amount of fuel used up. Hence the man who 
has an adequate supply of reserve fuel in the form of 
fat and glycogen is in better condition to withstand a 
prolonged exertion than one who is deficient in 
those substances. This corresponds with the experi- 
ence of all athletes. There is always a loss of weight 
during the early part of training, while a man is get- 
ting rid of superfluous fat, but every athlete knows 
that when a certain point is reached his so-called 
“ weight in training ” any further reduction is ac- 
companied by a feeling of lassitude and an incapacity 
to sustain prolonged exertion without excessive fa- 
tigue. This form of over-training, known as “ stale- 
ness,” is in all probability due to a deficiency of re- 
serve fuel. These facts emphasize the importance of 
maintaining at a proper proportion the fat and carbo- 12 
hydrate constituents of the diet instead of sacrificing 
them for an excess of nitrogenous material a mistake 
which is undoubtedly often made, and which will be 
discussed more in detail later. 
Temperature. The temperatures were taken in 
the mouth twice daily, at 8 a. m. and 9.30 p. m., dur- 
Chart 111. Temperature Chart of Entire Squad. 
ing the last two weeks of training. The chief points 
brought out by the routine readings were the great 
variation in individual cases and the persistent ten- 
dency to subnormal temperatures. The average for 
the entire squad remained near 98° F., as shown in 
Chart 111. 
A few individuals maintained approximately a nor- 
mal average of 98.5°, but the majority showed wide 
variations. It was not uncommon to find a tempera- 
ture of 96° in the morning and 98° or more in the 
evening in the same man. Charts IY and Y are fair 
sample charts. 
The individual variations could not be shown to 
have any definite relation to the general condition 
beyond the coincidence that those men who varied 
most in weight also varied in temperature. The body 
temperature is dependent on so many circumstances 13 
that variations within limits are to be expected. The 
heat production during muscular and other metabolic 
action is constantly balanced by the heat loss in 
warming the expired air, the urine and feces, by 
evaporation of perspiration and by conduction and 
Chart IV. Temperature Chart of No. 8. 
radiation from the skin. During training the greater 
part of heat production by muscular action (supposed 
to be its main source) is confined to a comparatively 
brief portion of the twenty-four hours and during 
that same portion the heat loss is also great. It is 
not surprising that the heat balance is not stationary 
and the charts show that in fact in the majority of 
cases it is not maintained at a fixed point. 
On the day of the races the temperatures were taken 
three times, first, at 8 a. m., second, while the men 
were dressing for the race, and finally, from ten to fif- 
teen minutes after the race while returning to the 
quarters in the launch. There was an average pre- 
liminary rise in temperature, corresponding to the 
preliminary fall in weight, amounting to about 1.5° F., 
followed by a slight rise of .2° during the four-mile 14 
race. In the case of the four-oared crew the average 
preliminary rise was .7° and a further rise during the 
two-mile race of .7°. A glance at the Table (V) 
shows that on the whole those men who had the 
greatest preliminary rise had either a stationary or 
falling temperature during the race (Nos. 2, 4 and 5). 
The other extreme was seen in No. 9, who had a pre- 
liminary rise of only .2° and a rise during the race of 
2.6°. In several instances the net variation was very 
slight. 
It was hoped that the temperature observations 
Chart V. Temperature Chart of No. 4. 
would throw some light on the remarkable results ob- 
tained by Drs. Williams and Arnold in their observa- 
tions of the Marathon runners.1 They found a uni- 
form drop during that race (a 25-mile run) of 2° to 
That race, however, was run in the middle of 
April at a temperature of 44° F. and against an 
easterly wind the conditions all favoring rapid 
cooling by conduction and evaporation. Further- 
more, the temperatures were all taken in the mouth 
1 Philadelphia Medical Journal, iii, 1,233.  
Varsity Eight. 
Varsity Four. 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
11 
12 
Av. of 
8. 
Av. of 
4. 
Temperature at 8 
97.8 
97.7 
98.3 
96.6 
97.6 
99.0 
99.0 
98.6 
97.0 
98.4 
98.3 
98.4 
98.1 
98.0 
A« M • 
Temperature bef ore 
99.2 
100.0 
99.2 
98.6 
99.7 
100.6 
100.2 
98.9 
97.2 
98.7 
99.8 
99.2 
99.55 
98.73 
Temperature after 
race. 
100.7 
98.7 
100.3 
98.7 
99.4 
100.6 
100.2 
99.2 
99.8 
98.4 
100.2 
99.3 
99.73 
99.43 
Preliminary rise. 
1.4 
2.3 
0.9 
2.0 
2.1 
1.6 
1.2 
0.3 
0.2 
0.3 
1.5 
0.8 
1.5 
0.7 
Variation in race. 
+1.5 
—1.3 
+1.1 
+0.1 
-0.3 
0.0 
0.0 
+0.3 
+2.6 
-0.3 
+0,4 
+0.1 
+0.2 
+0.7 
Total variation. 
+2.9 
+1.0 
+2.0 
+2.1 
+1.8 
+1.6 
+1.2 
+0.6 
+2.8 
0.0 
+1.9 
+0.9 
+1.7 
+1.4 
Table V. Variations in Temperature during Races. 16 
and after nearly three hours of rapid breathing of air 
at 44° F. it is not unreasonable to assume that the 
mouth cavity may have been cooler than the body 
generally. One cannot accept as proved their asser- 
tion that after prolonged exertion the temperature is 
invariably lowered. It is the same with their implica- 
tion that a subnormal temperature during training 
means “ staleness.” This idea was apparently based 
on the single observation that the temperature of one 
of the contestants was 97.5° before and 97° after a 
practice run; that the man was advised to rest and to 
partake of more carbohydrates ; that on the morning 
of the race his temperature was 98.2°, and finally that 
he was among the winners. This observation proves 
nothing except that a rest and some carbohydrates are 
good things before a race. The temperature varia- 
tion was quite within normal limits. If subnormal 
temperature means overtraining, then nearly every 
man in the Harvard crew squad was overtrained at 
one time or another during the last two weeks before 
the races, a statement which certainly would not be 
borne out by the other facts in their condition nor by 
the vigor which they all displayed during the last 
time-row and especially during the races. The rise 
of temperature observed just before the races certainly 
did not mean a rapid recovery from a condition of 
“ staleness,” but simply indicated that for some reason, 
probably a nervous one due to excitement, the heat 
production was greater than the heat loss. During 
the boat races, which were rowed on a clear, sunny 
day at a temperature of about 80° F. and low hu- 
midity, the conditions were favorable for rapid heat 
loss by perspiration and radiation, so that the exces- 
sive heat production which, according to all physio- 
logical experience, must have taken place was readily 
dissipated and the temperature balance maintained. 17 
On the whole we must admit that a subnormal tem- 
perature, while of possible significance, cannot yet be 
regarded as a positive proof of overtraining. 
Circulatory system. Periodic examinations of the 
heart and pulse were made, special attention being 
given to the size of the heart, to the occurrence of 
abnormal sounds and to the rate and character of the 
pulse. Examinations were also made after several 
time-rows and both races. 
Inspection of precordia, etc. All of the men 
showed a prominence of the precordial region and a 
more diffuse pulsation than normal. The apex beat 
when visible was usually located in the fifth intercos- 
tal space, just inside the mammillary line. After the 
time-rows and races the apex beat was visibly dis- 
placed to the left, and in many instances a marked 
precordial and epigastric pulsation was noted. There 
was also in most cases visible pulsation in the per- 
ipheral arteries, most marked in the subclavians and 
carotids. The color was uniformly good, there being 
no instances of noticeable pallor or cyanosis, in spite 
of considerable disturbance of the heart’s action in 
some cases. 
Size of heart. The routine examinations were all 
made in the middle of the afternoon, before rowing, 
so that the hearts might have recovered as far as pos- 
sible from the rowing of the day before, and. might be 
taken at their minimum size. Further examinations 
were made after the time-row of June 21st and after 
the races. The method pursued was as follows. The 
heart sounds were first examined and the apex beat 
located with the man standing. The man then lay 
flat and the apex beat was again located by sight and 
auscultation. Then, by combined auscultation and 
percussion, using the phonendoscope, the right, left 
and upper borders were found and outlined. The 18 
method is open to objection, as already stated, but 
seemed to be the most accurate under the circum- 
stances, and by considering averages it was hoped 
that individual errors might, to a certain extent, be 
eliminated. The outlines were transferred to tracing 
cloth, the position of the nipples marked and the 
chart then made was kept for comparison. In meas- 
uring variations it was found that two fixed lines were 
necessary, one connecting the nipples the inter- 
mammillary line and the other bisecting the first at 
right angles the median line of the chest. The 
ordinary terms employed clinically giving the position 
of the borders in relation to the sternum, ribs, or nip- 
ples are so variable in different individuals that no 
mean can be determined. The position of the apex 
beat was measured both from the median line and the 
intermammillary line ; the right and left borders were 
measured from the median line, the former at the level 
of the nipples, the latter at the apex. The upper 
border was measured from a line drawn through the 
apex parallel to the intermammillary line. By aver- 
aging these various measurements it was easy to con- 
struct a chart representing the average heart of the 
squad and also to estimate the average variation. 
The following Table (VI) and Chart (VI) give the 
measurements and variations of the average heart of 
the entire squad. They show that there was a pro- 
gressive enlargement affecting both sides of the heart 
during May and reaching its maximum early in June. 
After this there was a considerable shrinkage, espe- 
cially of the left side, both the left border and the 
apex beat receding towards the median line until 
their positions were not very different from those of 
early May. The right side of the heart also showed 
shrinkage but to a less degree than the left. The 
position of the upper border varied considerably in 19 
the different examinations, depending apparently 
partly on the fulness of the stomach and partly on 
the depth of respiration. The relative rise and fall 
of the apex beat could not be followed as closely as 
its lateral movement, owing to the ribs. 
The period of greatest enlargement corresponded 
to the period of the most arduous work, late in May 
and early in June, when the final selection of men 
was being made, and when consequently every man 
was pulling his hardest. Probably the individual 
c 
5 
CD 
g 
B 
B 
g 
3 
g 
3 
0 
S- 
CO 
to 
00 
cp 
CD 
£;o 
S. 
00 
to 
O ** 
& ® 
o 
• 
• 
3 
h 
• 
• 
T. 
S 
p 
• 
to 
to 
to 
M 
B 
Men examined. 
CO 
CO 
CO 
CO 
00 
From med- 
> 
ox 
CO 
b 
bx 
ian line, cm. 
CD 
M 
From inter- 
cr 
Cl 
pc 
4.5 
mam. line, 
a> 
So 
cm. 
** 
5.8 
5.7 
6.0 
5.1 
3.9 
Eight border 
, cm. 
M 
Left border, 
to 
to 
05 
to 
to 
cm. 
05 
CO 
to 
bo 
b 
CO 
I-* 
p° 
CO 
pi 
Total breadth, cm. 
bi 
Jo 
b 
b 
or 
ox 
05 
C5 
<01 
At middle 
d 
bi 
b 
b 
b 
b 
point, cm. 
§*® 
05 
05 
05 
** 
05 
At quarter 
•* g 
00 
to 
00 
# b 
point, cm. 
►jl 
Table YI. Average Heart Measurements of Squad. 
strain was greater at this time because the crew had 
not yet learned to pull as a unit. Then too, as al- 
ready mentioned, the weather was very unfavorable, 
and the effort required to do the work was consider- 
ably greater than was needed later. The better 
weather conditions prevailing at New London, the 
more uniform rowing as the form of the crew was 
perfected and the more accurate adaptation of each 
man’s rigging to his peculiarities, all tended to lessen 20 
the strain on the individual oarsman and by enabling 
him to do his work with less muscular effort propor- 
tionately diminished the labor demanded of the heart. 
How much of the enlargement was due to hyper- 
trophy and how much to dilatation is difficult to say. 
Probably there were both hypertrophy and dilatation. 
The accompanying change in the heart sounds in cer- 
tain cases to be described later would indicate that 
there was considerable dilatation at first, but that sub- 
Chart VI. 
sequently the hearts gradually recovered tone and a 
true compensatory hypertrophy took place. 
During the races, both four-mile and two-mile, a 
considerable dilatation took place, as shown in Charts 
(YII) and (VIII). The average increase in breadth 
of the cardiac dulness was nearly the same in the 
two crews —1.4 centimetres for the eight and 1.5 
centimetres for the four. The marked rise of the 
upper border relative to the intermammillary line 
may be attributed to the fact that the examinations 
after the race were unavoidably delayed until after 
dinner, and consequently allowance must be made for 
the full stomach. 21 
Heart sounds. The twelve men in the squad may 
be divided into three groups according to the effect of 
the training and races on their heart sounds and action. 
In Group I, numbering five men, may be placed 
those whose hearts developed no markedly abnor- 
mal condition. The pulse rate at rest varied from 
60 to 80, and after the time-rows and races, rose to 
120 or thereabouts. The sounds remained normal, 
except that the first sound became somewhat louder 
and rougher than normal. Both the first and second 
sounds were occasionally reduplicated. 
In Group 11, including two men, the routine ex- 
amination showed nothing abnormal, but after the 
time-rows and race both developed a faint blowing 
systolic murmur, loudest at the left margin of the ster- 
num in the second and third intercostal spaces, but also 
audible at the apex. As in Group I, there was some 
tendency to reduplication of the sounds, but the 
rhythm remained normal. 
In Group 111 may be placed the remaining five 
men, whose hearts showed abnormalities of sound or 
action at several different examinations, both before 
and after unusual effort. The most extreme case 
deserves a detailed description. This man had had 
rheumatism and typhoid and had been informed sev- 
eral years before that his heart was weak. 
Following are the notes as taken: 
May 10th. Pulse 96 ; irregular. Diffuse precor- 
dial and epigastric pulsation ; pulmonic second sound 
accentuated; blowing systolic murmur audible over 
entire cardiac area, loudest in pulmonic area and at 
apex. 
May 18th. Pulse 84; irregular; heart sounds as 
above but murmur inaudible at apex. 
May 2oth, after time-row of 3| miles. Pulse 138; 
very irregular; two sounds of equal intensity at 22 
apex; rhythm embryonic; murmurs very loud over 
entire precordia. 
May 30th, before time-row. Pulse 84, somewhat 
irregular; murmur faint. After time-row of 3$ 
Chart VII. 
miles. Pulse, 128; fairly regular; murmur much 
fainter than after previous time-row. 
June 7th. Pulse 88; sounds as before time-row of 
Chart VIII. 
June 17th. Pulse 78; regular; murmur very 
faint. 
June 21st. Pulse 82; regular; no murmur. Two 23 
hours and a half after four-mile time-row. Pulse 98; 
regular ; no murmur. 
June 29th, before race. Pulse 84; regular; no 
Chart IX. 
murmur. Three hours after race. Pulse 88; mur- 
mur audible but very faint. General condition ex- 
cellent. 
Chart X. 
The changes in the size of this heart correspond- 
ing to the changes in sounds and action are shown in 
Chart X, while the comparatively slight increase 
during the race itself is brought out in Chart IX. 24 
The gradual improvement in this heart was one of 
the most instructive points in the entire investigation. 
After the time-row of May 25th it was in had shape. 
The irregularity, accentuated pulmonic second sound, 
embryonic rhythm and rapid action, together with the 
enlargement, which was well marked, all pointed to 
an acute dilatation. During June the establishment 
of a compensatory hypertrophy was indicated by the 
return to normal rhythm and rate, the practical dis- 
appearance of the murmur and the stationary size. 
With all the disturbance shown by examination of 
this man’s heart, there was nothing in his appearance 
or capacity for work which would have called atten- 
tion to his heart. If he had been advised to stop 
rowing when his heart was first examined the best 
demonstration of the beneficial effects of training 
would have been missed and the crew would have 
lost a very valuable man. 
The four other hearts in this group showed much 
the same conditions, though in a less degree. All fin- 
ished the race in good condition and without any more 
exhaustion than their companions. 
Pulse. The character and rate of the pulse have 
already been mentioned in several instances, and it is 
only necessary to add that it was invariably of high 
tension after unusual effort. There was no confirma- 
tion of Williams and Arnold’s observation of dimin- 
ished tension in the Marathon runners. It is possi- 
ble that the exhaustion of the latter was extreme, and 
their hearts may have been much more affected than 
was the case with the crews. It is to be regretted 
that circumstances forbade the taking of sphygmo- 
graphic tracings. 
The cause of the murmur in acutely dilated hearts 
is ably discussed by Williams and Arnold; no evi- 
dence was secured in this study opposed to their con- 25 
elusion that the bruits are of mitral origin and are 
due partly to a relaxation of the circular muscular 
fibres surrounding the orifice and partly to fatigue of 
the papillary muscles which control the movements 
of the valve-cusps. 
The chief deduction to be made from this study of 
the hearts is that the heart is a muscular organ and 
that it shows with the other muscles both the fatigue 
due to violent and prolonged exertion and also the 
increase in size and power due to proper exercise and 
nutrition. The fatigue results in dilatation, the in- 
creased power in hypertrophy, and one of the main 
objects of training is the establishment of this hyper- 
trophy. The physiological capabilities of the heart 
are enormous, and in judging of the effect of any 
undue exertion on it we must not regard the mur- 
murs and irregularity alone, but must also consider 
carefully the way in which the heart is doing its 
work, its strength, as shown by its ability to maintain 
a proper arterial tension, and its recuperative power. 
As with other muscles, not size but quality tells in 
the long run. 
Kidneys. Periodic examinations of the urine were 
made coincidently with the heart examination. An 
attempt was made to estimate the twenty-four-hour 
amount, specific gravity, urea percentage and total 
urea, to test for albumin and sugar and to examine 
the sediment microscopically. The figures given 
below, as far as they refer to the twenty-four-hour 
amount and calculations based thereon, are probably 
considerably less than they should be. Even with 
the best intentions, slips of memory were liable to 
occur, and the full amount of urine passed was not 
always saved. Perhaps ten to twenty per cent, 
should be added to the urea excretion for this reason. 
The urea was estimated by Squibb’s areometer. 26 
For albumin both the nitric-acid and heat tests were 
employed, and in case of doubt the picric-acid test 
was resorted to. When an appreciable amount was 
found, Esbach’s albuminometer tube was used. The 
sugar test used was Fehling’s. 
The main facts ascertained are summarized in 
Table VII, subject to correction as noted above. 
These figures denote a moderate increase in the urea 
secretion above the normal and by implication a mod- 
erate increase in nitrogenous metabolism, but by no 
means as great an increase as one would expect if all 
Table VII. Average Urine Tests. 
Date. 
No. 
exam. 
24-hour 
amount. 
Specific 
gravity. 
Urea, % 
Total 
urea. 
May 9-17 . . , 
ii 
1181 c. c. 
1.028 
3.42 
39 5 gms. 
May 18-26. . . 
u 
1396 c. c. 
1.027 
2.68 
36.9 gms. 
June 2-8 . . . 
12 
1028 c. c. 
1.027 
2.76 
27.3 gms. 
June 18... . 
12 
1403 c. c. 
1.022 
2.53 
34.2 gms. 
June 20. . . . 
12 
1374 c. c. 
1.024 
2.66 
36.3 gms. 
the proteids eaten were absorbed and utilized. Phy- 
siologists have proved that an increase in the urea 
elimination above normal limits is usually caused by 
an increase in proteid digestion and not by an in- 
crease of muscular action. 
Sugar. The tests for glucose were invariably 
negative. 
Albumin. An unexpected fact brought out in the 
routine examination was the presence of traces of 
albumin in the urine of a large proportion of the squad 
under ordinary conditions of training. The twenty- 
four-hour amounts were examined six times, the tests 27 
being made intentionally only after a lapse of several 
days after the time-rows, to eliminate their effects as 
far as possible. In 83 specimens examined albumin- 
uria was present 48 times. The amount of albumin 
was never more than a trace. 
Sediments. The albuminuria was, with but few 
exceptions, always accompanied by renal casts and 
epithelium and occasionally by a considerable excess 
of leucocytes. In several instances a few casts were 
found in urines which gave negative albumin tests. 
In the few cases of albuminuria without casts partial 
decomposition had taken place before the microscopic 
examination, so that casts may have been present but 
obscured. 
Albuminuria after time-rows and races. After 
three of the time-rows and after both races the first 
urine passed was examined for albumin and casts. 
The specimens were all small in quantity one to 
three ounces highly concentrated, and invariably 
contained considerable amounts of albumin, as shown 
in Table VIII. The largest percentage observed 
(0.9 per cent., Esbach) was in the urine of one of 
the four-oared crew after the two-mile race. The 
sediments contained correspondingly large numbers 
of hyaline and finely granular casts, many having 
renal cells and red blood corpuscles adherent. In 
many of the sediments there was also a considerable 
number of red blood corpuscles and an excess of 
leucocytes. The sediment in many cases was exactly 
that of the first stage of acute nephritis, and if exam- 
ined without a knowledge of the conditions might 
easily have caused anxiety. 
To find out how long the albuminuria and casts con- 
tinued after the time-row of May 30th single speci- 
mens were examined the following day before the 
afternoon row, with the result that of 14 samples  
Varsity Eight. 
Varsity Four 
Substitutes. 
Date. 
Occa- 
sion. 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
11 
12 
13 
14 
15 
16 
17 
May 25 
Time- 
row. 
Trace 
0.12* 
0.12* 
0.12* 
0.12* 
Trace 
0.25 
0.25 
0.25 
0.12* 
0.25 
0.12* 
Trace 
0.12* 
Trace 
May 30 
Time- 
row. 
0.08 
0.38 
0.05 
0.12* 
0.10 
0.05 
0.15 
0.05 
0.15 
0.05 
0.05 
0.05 
0.10 
Trace 
0.05 
0.05 
June 21 
Time- 
row. 
Trace 
Trace 
0.25 
Trace 
0.05 
0.07* 
0.07* 
0.07* 
June 29 
Races. 
0.07* 
0.25 
0.10 
0.05 
Trace 
0.20 
0.05 
0.90 
0.15 
0.10 
0.07* 
Table VIII. Albuminuria after Time-rows and Races. Figures Represent Percentages by Esbach’s Albuminometer. 29 
two contained a trace and one had 0.025 per cent. 
It is regretted that tests were not made after the row- 
ing on ordinary days, since it is probable that even this 
may have caused an appreciable albuminuria and that 
the traces found in the twenty-four-hour specimens 
really represented a considerable amount of albumin 
passed in one urination after rowing, diluted with non- 
albuminous urine passed during the rest of the day. 
The renal conditions may he interpreted as an 
active hyperemia, becoming intense during the time- 
rows and races, and dependent in all probability on 
the increased arterial tension. Whether the hyper- 
emia ever leads to permanent changes in the kidneys 
is a matter for future investigation. 
The blood. Numerous estimates of the specific 
gravity of the blood were made by Hammerschlag’s 
method, with the intention of making blood counts 
and hemoglobin tests should any variation from the 
normal be observed. The method, however, was 
found to be tedious and unreliable, the results vary- 
ing according to the temperature. In several in- 
stances when the specific gravity was low 1.050 or 
thereabouts a blood count and hemoglobin test gave 
normal figures. The examinations made yielded no in- 
formation of importance and were therefore discon- 
tinued. 
The digestive system. One of the most trouble- 
some features in training of all kinds is the care of 
the digestive organs. Many a race has been lost be- 
cause of weak stomachs and because of prostration 
due to diarrhea. The crew squad this year offered 
no exception to this common tendency, for there were 
several cases of temporary attacks of indigestion and 
diarrhea. These troubles ought not to be attributed 
to the training but to improper diet and methods of 
eating. The food provided was all that could be de- 30 
sired in quality and in preparation. The chief criti- 
cisms suggested were in regard to the selection of food 
by the men themselves and to their common habit of 
eating too much and too fast faults not confined to 
crewmen but nevertheless unwise. The one aim of 
many of the men seemed to be to consume as much 
meat as they could get and in the shortest possible 
time. The amount of roast beef devoured at a single 
meal was astonishing, a man often disposing of five 
or six large slices. 
It has already been pointed out in discussing varia- 
tions in weight that the energy set free in muscular 
exercise is derived largely from the combustion of fat 
and carbohydrate material, while the proteid metabol- 
ism is directed chiefly to repairing waste. To use a 
rough illustration, if we regard the body as a machine, 
the proteid elements of the food go largely to replace 
the wear and tear of the machine itself, while the 
carbohydrates and fats furnish the fuel whose com- 
bustion liberates heat and energy and thus enables the 
machine to do work. Of course the body is not a 
machine and this comparison is not true except in a 
general way. During training the wear and tear of 
the body generally is much increased, and the proteid 
elements of the food must be increased accordingly, 
but it is an error to increase them so enormously as is 
frequently the case. The slight increase in the urea 
excretion indicates that much of the proteid material 
must pass through the digestive tract unassimilated. 
This throws a great deal of extra work upon the 
digestive organs, work which does no good to the 
body, but may, and undoubtedly often does, do harm 
in causing indigestion and diarrhea. 
The subject is deserving of study based on analyses 
of the food and of the excretions. A more accurate 
adjustment of food to needs and more time spent in 31 
mastication would unquestionably prevent that sensi- 
tiveness of the digestive organs which is one of the 
bugbears of the trainer. 
111. OVER-TRAINING. 
It was hoped that during this investigation data 
might be obtained bearing on the subject of over- 
training, but unfortunately (or fortunately, according 
to the point of view) there were no typical cases to 
study. The common symptoms are well known. 
They are, in brief, a loss of strength and endurance, 
so that a man previously strong becomes incapable of 
prolonged effort. This may be accompanied by a gen- 
eral nervous restlessness, by listlessness, by a loss of 
weight, by insomnia and by various digestive disturb- 
ances, such as anorexia and diarrhea. These symptoms 
should not be confounded with the temporary collapse 
which is occasionally seen after a severe exertion and 
which is more apt to be due to under-training than to 
over-training. The real condition at the bottom of over- 
training is still obscure, but in the light of this in- 
quiry certain possibilities are suggested as factors 
which may have to do with its causation. 
The first and most obvious one is the condition of 
the heart. We have seen that a great increase in 
size and strength is demanded of this organ and it 
may easily happen that it is called upon for more 
work than it is able to do and that instead of estab- 
lishing a compensatory hypertrophy it becomes dilated 
and weakened. A “ broken-winded ” athlete is proba- 
bly one with a dilated, flabby heart. 
The second possible factor is the condition of nutri- 
tion. This is more difficult of demonstration than the 
first. As already pointed out, the nutrition may be 
disturbed in two ways, either by an improper diet, in 
which the nutritive elements are not apportioned to 32 
the needs of the body, or by disturbed digestion, as a 
result of which the food taken into the body is not 
utilized. That both of these contingencies may occur 
has been sufficiently demonstrated. 
The third factor may be simple overwork. This is 
not so likely as the two preceding, for, when properly 
nourished, the capacity for work on the part of healthy 
young men is certainly much greater than that de- 
manded in training. The peculiarity of training work, 
however, is its concentration. It may be that the ex- 
cessive work accomplished in a brief space of time 
exhausts the muscles so that they do not recuperate 
before being called upon for a repetition of the work 
that there is, so to speak, an accumulation of fatigue, 
and that this constitutes over-training. 
The fourth factor which suggests itself is a nervous 
one, and this, while more intangible than the others, is 
unquestionably an important one. In the present 
state of our knowledge it can only be surmised, not 
proved. It is well known that there is a nervous fa- 
tigue entirely distinct from muscular fatigue and re- 
sulting from prolonged anxiety, from monotony of 
work apd from numerous other causes. It may be 
that anxiety about a coming contest, together with 
the prolonged mental strain of mastering the techni- 
calities of such a difficult art as rowing or such a com- 
plicated game as football, may lead to a condition of 
nervous exhaustion, and that this nervous exhaustion 
contributes to over-training. 
No one of these factors will account for all cases of 
over-training and probably more than one cause must 
be admitted. At any rate it is safe to suggest certain 
points which should be borne in mind in laying out 
any course of training. They are, (1) not to throw 
too much work upon the muscles and especially upon 
the heart, until they are strengthened by preliminary 33 
work; (2) to watch the nutrition carefully, and (3) 
to avoid nervous fatigue by providing a certain va- 
riety of exercise, and by not confining the attention 
too closely to the approaching contest. 
Finally, this investigation has demonstrated that 
the physiological effects of training, on the heart and 
kidneys in particular, may approach unpleasantly near 
to pathological conditions, and that there should be 
some competent supervision to insure that the safe 
limits, when those are determined, shall not be passed.  THE BOSTON 
Medicaland Surgical Journal. 
A FIRST-CLASS WEEKLY MEDICAL NEWSPAPER. PUBLISHED EVERY THURSDAY. 
Two Volumes yearly beginning with the first Nos. in January and July. But 
Subscriptions may begin at any time. 
This Journal has been published for more than sixty years as a weekly journal under its present title 
time, as the ability°andSde^erm^Pa? others t0 assure its patrons from time to 
active medical journalism of the day, without olf that waH the requirements or the most 
tance from the past. sacrmcing any ot that enviable reputation which is an iuheri- 
coaijutors;^1' 6dlt°rial of Dr. George B. Shattuck, assisted by a large staff of competent 
repS::«= illustmS^fe^ofnirease'SvaJuTfr bueresr6 f°r 
SubLrinMonaC°TdnloartloaS’ b°°kB f°r r6Vie'V> should be to the Editor. 
mon^yhorderfdraft.^r^^ist'ered^ette^06^6 tbS Under8*ned. to whom remittances should be sent by 
To Foreign ed M®sic.°’ ®5-°0 a year in advance. 
Ten consecutive numbers free by mail on receipt of $1.00.° ° ’ *l>s6 & yett aL‘dltlonal- Single numbers, 15c. 
Sample copies sent free on application. 
Published by DAMRELL & UPHAM, 
383 Washington St., Boston.