accidents as rare as possible it is necessary to have a solid machine, to keep it in good condition, to inspect it before each trip, not to assume an immoderate pace, and in spite of the fashion, always to carry a brake if one is not an adept.

Dr. Petit's remarks about the wheel causing death may be true in very advanced cardiac cases, such as those of asystole, for example; but palpitations, dilatation of the chambers of the heart, hypertrophy with or without lesion of the valves, cannot be produced by an exercise of this kind, if it is taken in moderation. Likewise, the attacks of angina pectoris and of hysteria, of which Dr. Petit speaks, are never observed in trips which are neither too long or too rapid. On the contrary, exercise in general is useful in heart affections, and exercise on the wheel suits such better than any other kind. The treatment of cardiac subjects by absolute. repose is but very little practiced nowadays. In Sweden, gymnastics and massage are applied; in Germany, the system of Oertel, by the "cure de terrains," finds more and more advocates. This system consists in a regulated diet, and above all in walks, gradually increased in length, over routes more and more undulating, commencing very gently, so as to tone up the heart muscle, progressively, and allow it to perform an increased labor which is required of it. Furthermore, at at Maheim, the Drs. Schott recommend highly gymnastic exercises and baths in the treatment of heart cases. The therapeutics of movement then is the present mode of treatment, and there is no exercise more gentle and more easy to regulate than that taken on the wheel. It is less fatiguing than walking on the smoothest ground, and puts in play the whole of the muscles, even those most deeply situated; it accomplishes a veritable stirring up of the internal organs and, facilitating the passage of the blood in the vessels, lessens the work of the heart at the same time that it is toning it up.

On 400 subjects examined by Dr. Blagevitsch (of St. Petersburg), he determined that only good results on the

circulation had followed a moderate use of the wheel.

Such is also the testimony of Dr. Richardson, who states the constant and immediate result of the exercise to be an acceleration of the heart's movements, which stimulates organic interchange, and explains the great resistance to fatigue and loss of sleep, which welltrained cyclists exhibit.

On the other side, Dr. Richardson has never seen any immediate bad results, such as acute cardiac exhaustion, breathlessness, vertigo or angina pectoris. He even knows, curiously enough, a cyclist who climbs hills with ease on his wheel, but is unable to mount a ladder without experiencing dyspnea and palpitation. The moderate use of the wheel, he then advises, when the heart's action is feeble or when that organ presents signs of fatty degeneration. Dr. Richardson's colleagues approve of these observations and show themselves less timorous than the French physicians.

Dr. Sansom, for example, pronounces the conclusions of the French Academy on the subject of cycling as "ridiculous," and Dr. Little considers the sport an excellent therapeutic measure in certain heart affections such as dilatation, mitral lesions, etc. Dr. Washington Isaac knows a physician who has an advanced aortic trouble, which has given rise to no subjective symptoms in spite of outings on the wheel, and which the former only discovered by chance, in trying a new binaural stethoscope. This practitioner has not abandoned wheeling and does not experience any unfavorable result therefrom. So, from the advice of physicians who have personally taken up the subject, bicycling, far from being injurious, has always a favorable influence on heart affections, when it is judiciously practiced-be it well understood.

The state of the arteries requires more prudence, perhaps, than that of the heart. The use of the wheel should be forbidden to those whose arteries are too friable, and especially if there is any particularly weak point, as in the case of aneurism.

Varicose veins have also been con

sidered a contra-indication to bicycling, as is also the case quite recently in the use of massage and hydrotherapy. But a healthier conception of things has set in, and we have been obliged to bow to facts. Bicycling, better than any other proceeding, facilitates the flow of blood in the veins, empties the vessels, and by effecting greater tonicity of the muscles and of all the tissues, tends to restore the veins to their normal caliber.

Wheeling has been still further charged, when abused, with favoring congestion of organs (liver). It cannot be denied that toxic phenomena are caused, due to an accumulation of the products of cell disintegration, under the influence of prolonged exercise. Mr. Tessier's researches have shown that the activity of the disintegration is manifested by the existence of an albuminuria which is very appreciable in twothirds of the subjects who have exceeded their strength, and by a very sensible increase in the excretion of urea. Dr. Robin has made the same remark in the case of one of his patients: the quantity of albumen doubled during the periods of exercise on the wheel.

Only one conclusion may be drawn from these facts, viz. that subjects whose liver and kidneys are not sound ought carefully to avoid excess on the wheel, as well as all other kinds of excess. Perhaps albuminurics ought to renounce this exercise; still, new observations are necessary to definitely establish this clinical point.

Dr. Robin has determined in two cases subject to attacks of uric and oxalic acid gravel, that a notable diminution in the production of uric acid. coincided with the days when these patients used the wheel, at the same time that the total amount of nitrogen increased.

According to some authors, cystitis and urethritis have been produced (Dr. Millée). Personally we have never observed it, and we do not believe the wheel capable, by itself, of causing it, unless the machine and the saddle are particularly ill-conditioned. Lastly, hernia is among the accusations. Outside of the fact that no one has ever

cited a case of the kind, it is sufficient to see the position of the rider on his machine, legs being semi-flexed, to decide that the danger is imaginary. A much more delicate question concerns the use of the wheel by women. Dr. Petit has charged it with all the evils possible to the genital organs. Two or three doctors, of the same opinion, believe that it can excite in women a local stimulation and irritation, as was formerly laid to the sewing machine's ac

count.

But these ideas were in circulation twenty-five years ago. Today, and especially since the practice of gynecological massage has extended, it is very important to recognize the fact that the immobility to which some systematically condemn women who suffer from affections of the uterus or its appendages, should be abandoned, and that appropriate movements are of service in a great number of cases. Now bicycling, wisely practiced, much resembles massage of the uterus, and can be recommended under the same conditions. In conclusion, experience has proven that it was without danger, and nearly all doctors who themselves ride recommend it to the ladies of their family.

In order to give a more precise opinion, Dr. Hogg addressed an enquiry to a large number of physicians, French and foreign, mostly gynecologists, and capable of expressing an opinion of decided value and weight. The great majority of them reported favorably on bicycle. exercise for women, provided it be regulated, taken outside of the menstrual periods, and that there be no contra-indications on the part of the genital organs. They considered it not only inoffensive but decidedly beneficial to the general health, and advised it in the treatment of certain maladies such as neurasthenia, hysteria, anemia, chlorosis, amenorrhea, dysmenorrhea. The local congestive action of cycling should forbid its use to women during their menses, and when there existed a habitual or accidental congestive state of the ovarian organs. More recently yet, Mme. Dr. Gaches-Sarraute has given to the Society of Public Medicine her approval of the

wheel for her sex. She herself has been a rider for some years and her judgment has necessarily great weight. Her opin ion is that all acute inflammations of the genital organs, with pain and fever, should proscribe wheeling as it does all other exercise. Chronic, painless lesions without fever are quite a different matter. For example, metritis with hypertrophied uterus does not constitute a contra-indication, nor salpingitis, nor old salpingo-ovaritis. In case of chronic peri-uterine inflammation the bicycle can act as a substitute for Swedish massage. Women being seated in the exercise, the uterine displacements are not aggravated. The bicycle, then, offers an exercise which is not injurious, as a general thing; and, says our confrère, if there exist disadvantages, they are more frequent in the case of men than of

women.

A last reproach which the detractors. of the wheel have presented, apropos of women, is that it exposes her to miscarriages or abortions; but this charge falls of itself before the statement of Dr. White in the American Therapist, who finds that the beneficial effect of cycling is especially manifested in the development of the perineal muscles, and that thus, at the moment of labor, the period of dilatation is passed more regularly. He has observed with three women who rode the wheel up to the sixth month of their pregnancy, that labor was facilitated by this fact; two of these women were primiparae, and were delivered without difficulty and without rupture.

In short, all the objections made to women on the wheel disappear, and we see even a woman physician and rider declare that it presents less inconveniences for woman than for man.

The old of both sexes should abstain from this kind of exercise, as well as from all other, when they have diseased or degenerated organs which expose them to accidents of various kinds. But if these elderly folk have good general health they can pursue it without fear. Richardson cites a case of an octogenarian who practiced moderate exercise on the wheel for a long time with advantage, and who recently made, in

one day, fifty miles. We do not advise like prowess to gentlemen of eighty years, but this shows at least that they can, without timidity, take to the wheel. Fear has been expressed of causing inflammation of the prostate in old men. We think, however, that with a good saddle those who have a simple hypertrophy of the gland have nothing to apprehend from the bicycle, which rather exerts a massage of that region capable up to a certain point of improving the gland.

As regards children, we do not advocate bicycling for them. They enter into all games and sports with too much ardor, to this one especially, and rapidly go to excess. Moreover, their joints, heart and nervous system ought to develop slowly, progressively; and grave disorders may ensue if they fatigue themselves to excess. Arthritis, palpitations, the fever of overwork, menace them more than adults. It is wiser to interdict the wheel to children under thirteen or fourteen years of age. We only permit it to them where they are reasonable enough to use it with moderation and especially if they are accompanied by older persons capable of controlling them.

Another disadvantage which exists. for all bicyclists, but principally for children, whose tissues have not acquired all their firmness, is curving of the spinal column (cyphosis) which makes their head drop forwards, elevates the shoulders, and rounds the back. Children must observe a good position, the body well erect on the machine, under pain of becoming deformed. This deformity has not, it is true, much importance, for if it tends to diminish the capacity of the thorax, this capacity is indeed augmented by the exercise of wheeling and by the deep inspirations it requires. One can only reproach it with destroying the harmonious development and elegance of the body.

We do not share, however, the ideas of Legendre concerning the dangers from children's games of play, provided that these exercises are wisely graduated. But we cannot too much blame the conduct of parents who have wheels made for children (bicycles or tricycles) of six

years, of five years, and who do not fear to commence training an infant of twentytwo months, as that little baby of Nice, who made, each day, five-eighths of a mile in a tricycle.

ADVANTAGES.

Open air feature-exercises all the muscles, as shown by M. Marey at the Academy of Medicine. In climbing and descending hills different muscles are called into play, and the deepest-seated muscles of the trunk are used as well as those of the limbs.

Wheeling, then, apportions the muscular work better than any other exercise and in an absolutely symmetrical way. This is not the case in fencing, for example, where with right-handed persons, the right arm and leg become stronger, while the right shoulder droops and the spinal column curves from the same side. Likewise, in riding horseback, almost all the effort is localized in the adductor muscles of the thighs, and the custom of grasping the horse by pressure of the legs everts the knee and makes walking difficult and ungraceful when the horseman is on foot. On the contrary, the cyclist gains a great suppleness and elasticity in the legs, and although it has been so charged, he does not forget how to walk. The fact that the velocipedist does not have to support the weight of his body, as in walking, facilitates the cure of varicose dilatations of the veins. The increased tonicity of the muscles of the abdominal wall aids, in an effective way, dilatation of the stomach and intestine, prolapse of these organs, and the constipation which accompanies inertia of the digestive tract.

As for dyspepsias, they are also frequently benefited or even cured; in part, doubtless, by the mechanical action exerted on the stomach by its massage and partly by improved appetite and stimulation of all the organic functions.

Bicycling is therefore the best exercise wherewith to oppose diseases of impaired nutritive origin, rheumatism, gout, diabetes, passive congestion of internal organs and all infirmities affecting people of sedentary habits hem

orrhoids, varices, constipation, obesity, migraine, etc.

In nervous maladies, especially neurasthenia, it can render great service (Hammond, Journal of Nervous and Mental Diseases, January, 1892). However, we only advise it in light forms of neurasthenia, or when the strength is about being re-established: a very little exercise at first, gradually increased, carefully avoiding fatigue. Thus practiced, its influence on the physique and morale of the patient will be considerable.

Anemia and general debility have no more powerful enemy. Sad ideas and preoccupations disappear as if by magic, after a spin of several miles, and all observers agree that one feels calmer, more cheerful and gay, on returning from a bicycling trip, at the same time that the moral and physical hyperesthesia of the neuropathic is diminished.

Certain experts of this sport go so far as to make a moral agency of the wheel. Thanks to it, cafés and saloons have less attraction for young men, who replace the enervating stays in a tainted atmosphere, surrounded by the smell of tobacco and adulterated liquors, by long outings awheel, drinking in the pure and revivifying air. The rider seems freed from that chain which attaches us to earth, and experiences a sensation of lightness and infinite speed.

The vibrations, analogous to those of carriage riding, long since recommended to the depressed and hypochondriac, similar also to those oscillations of the** chair and head-piece planned by Charcot, for the treatment of various neuropathic states, react on the central nervous system, by a mechanism which is none the less certain if unexplained.

The wheel is becoming an agency for medical treatment, and ought to be so regarded. Cases of old arthritis, incomplete ankylosis, muscular atrophies or paralysis, may be considered in this connection.

RECOMMENDATIONS.

Have a solid, well kept wheel. Avoid fatigue, do not ride too soon after a full meal; ascend steepest hills on foot. Excess is revealed by loss of appetite and inability to sleep, from fatigue.