Reprinted from the University Medical Magazine (Edited under 
THE AUSPICES OF THE ALUMNI AND FACULTY OF MEDICINE OF 
the University of Pennsylvania) through the 
Courtesy of the Publishers. Nov., 1892. 
THE BICYCLE 
IN ITS 
RELATION TO THE PHYSICIAN. 
By SENECA EGBERT, A.M., M.D., 
Lecturer on Hygiene, Drexel Institute, Philadelphia. 
Compliments of 
ALBERT A. POPE, 
Boston. Reprinted from the University Medical Magazine (Edited under 
THE AUSPICES OF THE ALUMNI AND FACULTY OF MEDICINE OF 
the University of Pennsylvania) through the 
Courtesy of the Publishers. Nov., 1892. 
THE BICYCLE 
IN ITS 
RELATION TO THE PHYSICIAN. 
By SENECA A.M., M.D., 
Lecturer on Hygiene, Drexel Institute, Philadelphia. 
Compliments of 
ALBERT A. POPE, 
Boston. THE BICYCLE 
IN ITS RELATION TO THE PHYSICIAN. 
By Seneca Egbert, A.M., M.D., 
Lecturer on Hygiene, Drexel Institute, Philadelphia. 
The above title may seem incongruous to some, and doubt- 
less there are many who have never given much thought to 
the relations existing between the medical man and the now 
popular wheel. The fact that the latter is so extensively 
used, not only as a means of recreation, but also by many for 
the purpose of more rapid progression, and in the transaction 
of their daily business,'must give it some influence, for good 
or evil, upon the general health of the riders, and as such our 
profession is bound to take cognizance of it. Though still, 
in the eyes of some, a mere fad, perhaps even a nuisance, it 
is remarkable to what an extent the use of the wheel has 
reached. It is said that in this city there are upwards of 
twenty thousand wheelmen and wheelwomen, and that there 
are almost one hundred establishments in this country alone 
busily engaged in the manufacture of the machines in ques- 
tion is evidence that the business is one of extreme propor- 
tions. Moreover, the effect that the League of American 
Wheelmen, a body with over thirty thousand very active 
members, is exerting upon the improvement of the roads 
throughout the country shows that they have considerable 
power and influence. And it is with a full recollection of 
Burdette's recent remarks upon prophesies and prophets that 
I venture to assert that this extensive use of the bicycle is not 
a passing craze, that it has not reached its limit, and that it 
has come to stay, the use becoming more universal as both 
the wheel itself and our streets and highways are improved, 4 
The Bicycle and the Physician. 
and as wrong notions and prejudices are eradicated from the 
popular mind. 
Consequently, it is with the feeling that cycling is to have 
an increasing influence on public health, one way or the other, 
that, after a practical experience of several months, the writer 
ventures to note the various relations between the doctor and 
the silent steed. I say after a, practical experience, because 
I have found that that decidedly modifies certain notions and 
theories that I, along with others unused to the riding, formerly 
had. And, though it is hard not to speak with enthusiasm of 
that which is really a delight, I shall try to put down the facts 
exactly as they are. 
In the first place, as an exercise cycling is superior to 
most, if not all others, at our command. It takes one into 
the out-door air, is entirely under control, can be made as 
gentle or as vigorous as one desires ; is active and not pas- 
sive; takes the rider out of himself and the thoughts and 
cares of his daily work; develops his will, his attention, 
courage and independence, and makes pleasant what is other- 
wise often most irksome; moreover, the exercise is well and 
equally distributed over almost the whole body, and, as 
Parkes says, when all the muscles are exercised, no muscle is 
likely to be over-exercised. This general muscular exercise 
also has its direct effect upon the other and vital organs of 
the body, the heart, lungs and digestive organs especially; 
and the improvement in general health and digestion, after a 
few weeks' riding, is by no means illusory or fleeting. We 
all know that the trouble with many of our patients is purely 
functional, and that their maladies have been brought on by 
lack of pure air, too little exercise, and too much mental 
worry over their work or business. For these the bicycle 
furnishes an agreeable remedy. 
Take a case of nervous or anemic dyspepsia, of hepatic or 
intestinal torpor; the increase in the flow of the blood cur- 
rent, the gentle vibration and the additional elimination of 
waste matters through lungs and skin, all results of a ride on 
the wheel, are just what we desire for the cure of our patient. 
Or with one of a tuberculous diathesis, or with incipient The Bicycle and the Physician. 
5 
phthisis, how much depends upon teaching him to breathe 
properly, i. e., fully and deeply, and to spend much of his time 
in the open air. This, the bicycle will do for him, perforce. 
Cases, also, of neurasthenia, melancholia, and other nervous 
troubles, will derive much benefit from our present hobby, 
for, in addition to the above hygienic elements, the wheelman 
must develop - whether he will or not-his will, his in- 
dependence and self-reliance, and the accurate control of all 
his muscles. Those of rheumatic tendencies, especially, will 
find that regular and systematic riding will do much to keep 
the disease in abeyance, and even to act as a cure. Someone 
has said that every muscle is a little heart, and, surely, no 
better means can be devised of eliminating deleterious waste 
matters from the whole system than the general and active 
use of all the muscles, voluntary and involuntary. In this 
connection permit me to quote the testimony of Dr. W. G. 
Stables, formerly a prominent medical officer in the Royal 
British Navy. He says: " My rheumatism used to come on 
periodically and last for six weeks at a time, during which I 
could hardly stand on the floor, nor sleep in bed without feet 
and legs elevated. Since I adopted cycling as an exercise, 
and thus found pleasant means to keep my skin in working 
order, I have never had a single twinge of rheumatism. 
Cycling has banished my pains and lightened my mind, and 
made me, physically and mentally, double the individual I 
was." Of course, this is only an isolated case, but dozens of 
other erstwhile sufferers could give similar favorable evidence. 
And it is just in these respects that the wheel is destined 
to be of great benefit to women. It gets them out of doors, 
gives them a form of exercise adapted to their needs, neither 
too violent nor too passive; one very pleasant withal that 
they may enjoy in company with others or alone, and one 
that does go to the root of their nervous troubles; for we are 
beginning to realize that these do not, for the most part, have 
their primal origin in woman's peculiar anatomy and physi- 
ology. Even the orthepsedist may employ the wheel with 
benefit in certain cases, as by proper adjustment of the parts 
more or less work may be given to the limbs and muscles of 6 
The Bicycle and the Physician. 
either side. Other conditions might be cited, did space per- 
mit, wherein we might look for decided benefit from the 
proper use of our machine, but these will, I think, be sufficient 
to indicate that we have in it one of the therapeutic means 
for which some of us have long been looking. I might here 
note that in a recent and extended article on " Physical 
Education/'1 Sir Frederick Treves speaks very highly of 
cycling as an exercise, and discusses at length its advantages 
and disadvantages. Unfortunately, he writes from the stand- 
point of one who has not had the personal experience, and I 
doubt whether that would really verify some of the things 
which he thinks are to be set down as objections to the 
exercise. 
Of course, 1 have been presupposing in all my previous 
remarks that the rider will have a wheel adapted to his or 
her weight and strength, properly adjusted in all its parts, 
but especially in the relationship between the saddle and 
handle bar and pedals, and, above all, that the rider takes 
pains to maintain a correct position and to do all he can to 
benefit his health and bodily development. In fact, I am 
confident that it is through neglect of some one of these 
important points that the evils attributed in justice to bicycle 
riding arise. There can be no question as to the erect posture 
being the correct one, and if this be maintained, cycling does 
"tend to develop the chest" by increasing the lung capacity, 
"and to exercise the muscles passing from the trunk to the 
upper limbs," Sir Frederick's opinion to the contrary not- 
withstanding. But if his "tall, lanky lad with a narrow 
chest and a stooping back," or any other person, persists in 
maintaining a posture resembling a half-opened jack-knife, 
the faults and evils resulting therefrom cannot fairly be 
attributed to the use of the wheel. It requires muscular 
effort to sit erect, on a bicycle or elsewhere, and that effort 
means, as everyone knows, the continued exercise of all the 
muscles of the back and neck. The arm muscles are brought 
strongly into play in hill climbing and whenever the speed is 
considerably increased, and the augmented depth and fre- 
1 Treatise on Hygiene, Stevenson and Murphy, 1892. The Bicycle and the Physician. 
7 
quency of respiration that even a minimum of exercise in- 
duces makes a new demand upon all the chest muscles and 
the diaphragm. 
On the other hand, an improper position, especially the 
one so commonly seen, not only does tend to cramp the chest 
and to interfere with the proper oxygenation of the blood, 
but by compressing the iliac vessels it also interferes with 
the How of blood to and from the lower extremities, whose 
muscles are all being most actively exercised and, therefore, 
most in need of an unimpeded current at this time. Certainly, 
the gain of the few seconds per mile that this incorrect posi- 
tion is supposed to give cannot in any measure compensate 
in ordinary riding for the physical harm it must induce. I 
am aware that other objections have also been urged against 
the use of the bicycle, and it will not be out of place to refer 
to what may seem to be the graver of them. Undoubtedly, 
the excessive use of the bicycle or tricycle by very young 
children is not advisable. Bad habits of position and car- 
riage are only too readily acquired at this age, and there is 
danger of serious muscle strain and possibly nerve injury. 
Another fault is that parents too often purchase a machine 
too large for the child in order to save the expense of a new 
one the following year, the result being that both the weight 
and the power needed to propel it are in excess of the child's 
abilities. Moderate riding on a proper wheel need not, how- 
ever, be forbidden For older boys and girls there is probably 
not the same danger, though intelligent supervision is never 
harmful, and especially watchfulness for incipient harm is 
advisable with girls about the time of puberty. Even at this 
time the bicycle may do good by drawing a too studious or 
house-loving youth or maiden into the open air and active 
exercise, and the writer has in mind two cases, one fourteen, 
the other eighteen, where a decided increase in height, and 
especially in length of lower limb, can be fairly attributed, 
he thinks, to bicycle riding within the last year or two. 
As for injurious results from pressure on the perineum, 
these seem to exist more in the minds of non-riders than in 
the persons of the riders themselves, and there is but little 8 
The Bicycle and the Physician. 
if any evidence that such results occur. The bad position 
already condemned does bring undue pressure on the peri- 
neum and is an additional reason against it, but with a proper 
saddle and the erect position the weight really comes partly 
upon the feet and partly upon the tuberosities of the ischia, 
where it should. Treves says that cycling has caused no 
aggravation of the symptoms in numerous cases of hyper- 
trophied prostate in his experience, and that cases of chronic 
constipation with hemorrhoids and functional disorders are 
benefited by it. Nor is there any evidence that varicose 
veins are caused by it, though this or any other vigorous 
exercise on the feet may not be advisable in cases of long 
standing. I also do not believe that there is any danger of 
hernia being induced in any way, though I should not advise 
anyone suffering therefrom to do much riding. This, how- 
ever, more on the grounds of caution than from any actual 
knowledge of danger to such cases. The vibration and jar- 
ring was formerly an unpleasant feature of the exercise, but 
improved roadways, spring frames and especially pneumatic 
tires have all combined to reduce these to a minimum, and 
to make them unnoticeable except to the very sensitive. It 
is possible that with one of the older machines on bad roads 
a woman with certain uterine displacements might feel the 
worse for riding, but for the majority of women who ride 
today the increased tone and quickened circulation in the 
pelvic viscera, together with the improvement in general 
health, will more than compensate for any discomfort on this 
score., I know one fair rider who has never yet experienced 
any distress comparable with what she suffers from the jar- 
ring of our city street cars. 
Again, I am often asked whether the motion of bicycle 
riding is not the same as that of running a sewing machine, 
and whether the same evils may not arise from the former as 
from the latter. Not at all. Women, at least, sit erect on 
their wheels, and consequently the thigh never makes even 
a right angle with the trunk, and there is no stasis of blood 
in the lower limbs and genitalia. Moreover, the work itself 
makes her breathe in oceans of fresh air; and if she wears a The Bicycle and the Physician. 
9 
corset at all, it is a loose one that won't interfere with respira- 
tion. If she enjoys cycling at all, she cares more for comfort 
and health than she does for the fashions. As a contrast, the 
woman at the sewing-machine works indoors, probably in an 
ill-ventilated room, stoops over her work, contracting the 
chest and almost completely checking the flow of blood to 
and from the lower half of her body, while at the same time 
she is increasing the demand for it there, finally aggravating 
the whole trouble by the pressure of the lower edge of the 
corset against the abdomen, so that the customary conges- 
tions and displacements have good cause for their existence. 
One other objection has been advanced, and that is that the 
exercise of the lower limbs would so increase the size of the 
iliac and psoas muscles as to materially decrease the superior 
pelvic inlet; but these muscles are flexors of the thigh upon 
the trunk, and their action is almost wholly passive, since 
each limb is alternately flexed by the weight and power of 
the opposite one as it descends and gives the impulse to the 
wheel. Surely, there would have to be an abnormal develop- 
ment of all those other muscles that are so actively engaged 
before these two should so increase in bulk as to be an 
obstacle in future parturition; nor will anyone, on second 
thought, venture to assert that these two muscles of the 
whole body are not to be normally developed along with the 
others. Only a pelvis very narrow transversely could be an 
excuse for forbidding cycling on this ground. 
Persons with organic heart disease should either not ride 
at all or do so with caution. Even those whose hearts are 
functionally weak should be careful, though the riding will, 
probably, benefit them by improving the general health and 
removing the cause of the disorder. Several deaths have 
occurred from heart failure, and there is, perhaps, a real 
danger that too great a strain may be thrown upon a faulty 
heart, especially by those unaware of their condition. Nor 
should patients with any other grave organic trouble attempt 
much hard or rapid riding, lest it be too heavy a tax upon 
the already weakened part. Finally, the same objections 
exist in this as in any other exercise against over-exertion, 10 
The Bicycle and the Physician. 
over-training, or other unwise action. Like everything else, 
the ownership of a bicycle, or the ability to ride it, does not 
guarantee the possession of brains by the subject. 
Having thus considered, at some length, the influence of 
the bicycle upon the health of those who ride, it will not be 
out of place to say a word or two about its use by the doctor 
himself. To many physicians, in the earlier years of their 
practice especially, the cost and maintenance of a horse and 
carriage is a serious burden and drain upon their financial 
resources. To these the bicycle is an efficient substitute for 
the more expensive outfit. It costs practically nothing for 
sustenance, room-rent, or repairs; it is always ready at a 
moment's notice, with no dependence on the pleasure of the 
stable-boy or driver, and it can be ridden almost anywhere 
that one can drive. As I have already hinted, pneumatic 
tires have almost wholly removed the terrors of rough pave- 
ments and bad roads; but these latter are rapidly being 
improved, thanks to the efforts of the wheelmen who are 
awakening public interest all over the country in the deplor- 
able condition of the highways. For night use in the city, 
where it is often impracticable or inadvisable for the doctor 
to use his horse, it especially recommends itself, and the 
saving of time by its use at any hour is not inconsiderable. 
As we know, a few moments in times of emergency may 
mean' a great deal to the patient. A recent case of the 
writer's comes to mind wherein the ten minutes that his 
wheel gained for him, in responding to the summons, meant 
the difference between life and death to the patient; so it 
seemed, at least, to the latter and his family. Contrary to 
the general opinion, it is easy to learn to ride, and there are 
few, indeed, that cannot master the whole problem in an 
hour. The additional knack of applying the power most 
effectually, and of moving with the greatest ease, will come 
within a day or so, while even sooner the balancing becomes 
automatic and requires no thought. The same effort that 
one employs in walking will carry him thrice or four times 
the distance on the wheel, and with far less fatigue, for the 
greater part of the weight is carried on the saddle, and not The Bicycle and the Physician. 
11 
by the thighs and legs, which are doing the bulk of the work. 
A speed of eight or ten miles an hour is easily maintained; 
in the city one makes better progress than in the street cars 
or average carriage, and for the country practitioner, in a 
community blessed with good roads, I am confident that he 
would find that, for the greater part of the year, the bicycle 
would save time for him in more ways than one. Lastly, 
the wheel affords an agreeable means of recreation and 
relaxation to the busy physician, which he can take at a 
moment's notice, or even in the actual pursuit of his duties, 
and it gives him that active exercise in the open air, with 
only a minimum of fatigue, which too many of us need and 
too few of us get. The only practical objection that I know 
to many physicians employing the bicycle is that it is not 
available in rainy weather; but, then, comparatively few of 
our days, from May to November, are of such a character. 
As to the exercise not being dignified, I believe that that 
depends altogether on the man who rides. It is well known 
that many physicians in Washington and Buffalo, two cities 
noted for their fine pavements, use the bicycle constantly in 
their practice without detriment to either their professional 
standing or dignity. 
In conclusion, let me say that, if a vein of enthusiasm does 
seem to run through the foregoing remarks, I have only tried 
to show what seems to me to be the true status of the 
steed " in its relations to our art and profession. 
Since writing the above, and with the advent of cold 
weather, there has been called to my attention the danger of 
incurring laryngitis by riders breathing through the open 
mouth. Care should be taken to keep the mouth closed and 
to breathe altogether through the nose, especially on cold 
days; and also after riding and becoming heated to avoid 
draughts and assume additional clothing till the body has 
cooled and become rested. S. E.