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STUDIES IN HISTORYAND PHILOSOPHY OF SCIENCE

VOLUME 39

General Editor:

STEPHEN GAUKROGER, University of Sydney

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RACHEL ANKENY, University of AdelaidePETER ANSTEY, University of Otago, New Zealand

STEVEN FRENCH, University of LeedsOFER GAL, University of Sydney

NICHOLAS RASMUSSEN, University of New South WalesJOHN SCHUSTER, University of NSW/University of Sydney

KOEN VERMEIR, Centre National de la Recherche Scientifique, ParisRICHARD YEO, Griffith University

More information about this series at http://www.springer.com/series/5671

Roy J. Shephard

An Illustrated Historyof Health and Fitness,from Pre-History to ourPost-Modern World

Roy J. ShephardUniversity of TorontoBrackendale, British ColumbiaCanada

ISSN 0929-6425ISBN 978-3-319-11670-9 ISBN 978-3-319-11671-6 (eBook)DOI 10.1007/978-3-319-11671-6Springer Cham Heidelberg New York Dordrecht London

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Preface

What need is there for a systematic history of health and fitness? Certainly, our

libraries already contain many excellent books that chronicle the disciplinary

history of physical education, athletics and sport, both in North America and in

other parts of the globe. A quick survey reveals at least 14 major texts that discuss

the emergence of Physical Education as a respected academic discipline

(Schwendener 1942; Leonard 1947; Dixon 1960; Weston 1962; Khan 1964;

Hackensmith 1966; Zeigler 1975; Lee 1983; Swanson and Spears. 1996; Welch

2004; Lal and Narang 2006; Zeigler 2006; Tiwatri et al. 2008). Moreover, at least

one of these books is devoted to the appearance of specific physical education

programmes for women (Verbrugge 2012).

There is similarly a plethora of texts about the development of athletics as a

whole and the emergence of individual sports, particularly in regard to key events

in North America over the past 200 years (Michener 1981; Guttmann et al. 1990;

Pope 1997; Rader 1999; Gorn and Goldstein 2004; Gems 2006; Gems et al. 2008;

Park and Vertinsky 2011). In a longer-term perspective, Peter McIntosh has written

several valuable treatises on the social context of sport over the centuries (McIntosh

1970, 1971, 1993). Max and Nancy Howell have looked specifically at the devel-

opment of sports and games in the Canadian context (Howell and Howell 1969),

and Bruce Kidd has explored the sometimes murky waters of the politics of sport

(Kidd 1996).

However, only a few previous authors (Green 1988; Berryman and Parks 1992;

Leavitt and Numbers 1997) have examined interactions between personal fitness

and population health. This hiatus in the literature became apparent to me in 2011

CE, when I agreed to write a series of journal-style historical articles for the

recently founded Health and Fitness Journal of Canada (Shephard 2011, 2012a,

b, c, d, 2013a, b, c, d). My research for this initiative convinced me that the world

archives contained an untapped wealth of fascinating information. The time seemed

ripe to collate this material, and to prepare a definitive illustrated history of health

v

and fitness from the earliest human records to the sophistication of our Post-Modern

Era. I was thus very pleased when Springer Verlag also recognized this gap in our

historical, scientific and medical knowledge, and agreed to work with me in

preparing the present volume.

Although the history of health and fitness is a sadly neglected topic, it seems of

ever-growing importance from the viewpoints of health economics and social

policy. One of the striking paradoxes of our twenty-first century is that although

most nations are devoting an ever-growing fraction of their gross national products

to the support of state-financed and/or private medical services, at the same time

they face a challenging epidemic of obesity and related chronic disease. The current

medical crisis is in part a consequence of population aging, but a second major

cause is that most of the present generation do not engage in that daily volume of

physical activity to which they have adapted constitutionally over the centuries. In

industry, physical labour has been replaced by an ever-expanding demand

for sedentary, computer-oriented employment. In the home, power-operated equip-

ment has been substituted for manually-operated domestic tools. And as we travel

around our communities, an urban sprawl provides little opportunity for walking or

cycling, but requires an ever-increasing period of passive commuting, mainly by

private car.

The remedy seems simple enough – to bring the population of our world’scities back in line with the lifestyle required by their genetic make-up, through a

general increase in their daily physical activity and a resulting enhancement

of personal fitness. The many and extensive health benefits of engaging in

regular exercise were documented during the latter part of the twentieth century,

beginning with the efforts of pioneers such as Jeremy Morris (1910–2009 CE) and

Ralph Paffenbarger (1922–2007 CE), and continuing with our own Fitness

Research Unit at the University of Toronto. Such concepts gained greater prom-

inence and credence through a series of international consensus conferences

held in Toronto from 1988 to 2001 CE (Bouchard et al., 1990, 1994; Kesaniemi

et al. 2001), and through the emergence in 2008 CE, under the auspices of the

American College of Sports Medicine, of a new scientific grouping entitled the

“Exercise Is Medicine Global Initiative.” This movement has two primary goals:

• “To make physical activity and exercise a standard part of a global disease preventionand treatment medical paradigm”

• “For physical activity to be considered by all health care providers as a vital sign inevery patient visit, and that patients are effectively counseled and referred as to theirphysical activity and health needs, thus leading to overall improvement in the public’shealth and long-term reduction in health care cost”

These recent endeavours have brought into global prominence not only the

positive interplay between an individual’s health and his or her level of habitual

activity, but also the need for a well-coordinated and comprehensive community

action plan to encourage the required changes of personal lifestyle.

The present text examines the many facets of the health/fitness interaction in

an historical context, beginning with our knowledge of lifestyle in primitive

vi Preface

hunter-gatherer communities, where survival needs ensured an adequate level of

physical activity, and considering changes in both health and habitual physical

activity at each of the subsequent stages in the evolution of “civilization.” Attention

is directed to the likely health impacts of a growing understanding of Medicine

and Physiology. The progressive emergence of a middle-class is charted,

people with a surplus of both time and money, and the opportunity to choose

between the adoption of active or passive leisure pursuits. The processes of

urbanization and industrialization are considered, coupled with the growing need

for public health measures to augment the physical activity of the population.

At each stage in the course of history, the text explores the attitudes that prelates,

politicians, philosophers and teachers have adopted towards the health and fitness

of society. Finally, we chart and evaluate the emergence of professional and

governmental initiatives designed to increase involvement of the public in adequate

levels of active leisure through various school, worksite, recreational and sports

programmes.

The canvas for this text is broad, and I have personally learned a great deal

through my explorations of the successful and unsuccessful initiatives of by-gone

years. I hope that readers will have a similar experience, and that this detailed

survey of the past will provide them with new ideas for a problem that currently is

by no means resolved.

Brackendale, BC, Canada Roy J. Shephard

2014

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University of Illinois Press, Urbana, IL

Bouchard C, Shephard RJ, Stephens T et al (1990) Exercise, fitness & health. Human Kinetics,

Champaign, IL

Bouchard C, Shephard RJ, Stephens T (1994) Physical activity, fitness & health. Human Kinetics,

Champaign, IL

Dixon JG (1960) Landmarks in the history of physical education. Routledge & Kegan Paul,

London, UK

Gems G (2006) The athletic crusade: sport and American cultural imperialism. University of

Nebraska Press, Lincoln, NB

Gems G, Borish L, Pfister G (2008) Sports in American history – from colonization to globaliza-

tion. Human Kinetics, Champaign, IL

Gorn EJ, Goldstein W (2004) A brief history of American sports. University of Illinois Press,

Urbana, IL

Green H (1988) Fit For America: health, fitness, sport, and American Society. Johns Hopkins

University Press, Baltimore, MD

Guttmann A, Kyle DG, Stark GD (1990) Essays on sport history and sport mythology. Texas A&M

University Press, Austin, TX

Hackensmith CW (1966) History of physical education. Harper & Row, New York, NY

Preface vii

Howell N, Howell ML (1969) Sports and games in Canadian life: 1700 to the present. MacMillan,

Toronto, ON

Kesaniemi FA, Danforth E, Jensen MD et al (2001) Dose–response issues concerning physical

activity and health: an evidence based symposium. Med Sci Sports Exerc 33(Suppl 6):

S351–S358

Khan EA (1964) History of physical education. Scientific Book Company, Patna, India

Kidd B (1996) The struggle for Canadian sport. University of Toronto Press, Toronto, ON

Lal DC, Narang P (2006) History of physical education & sports. Sports Publication, New Delhi,

India

Leavitt JW, Numbers RL (1997) Sickness and health in America: Readings in the history of

medicine and public health, 3rd edn. University of Wisconsin Press, Madison, WI

Lee M (1983) A history of physical education and sports in the U.S.A. Wiley, New York, NY

Leonard FE (1947) A guide to the history of physical education. Lee & Febiger, Philadelphia, PA

McIntosh PC (1970) An historical view of sport and culture. In: Howell ML (ed) Ist Canadian

symposium on the history of sport and physical education. University of Alberta, Edmonton, AL

McIntosh PC (1971) Sport in society. C.A. Watts, London, UK

McIntosh PC (1993) The sociology of sport in the ancient world. In: Dunning E, Maguire JA,

Pearton RE (eds) The sports process: a comparative and developmental approach. Human

Kinetics, Champaign, IL, pp 19–38Michener JS (1981) Sports in America. Fawcett Crest, New York, NY

Park RJ, Vertinsky P (2011) Women, sport, society: Reaffirming Mary Wollstoncroft. Routledge,

New York, NY

Pope SW (1997) The new American sports history: recent approaches and perspectives.

University of Illinois Press, Champaign, IL

Rader BG (1999) American sports: from the age of folk games to the age of televised sports.

Prentice Hall, Upper Saddle River, NJ

Schwendener N (1942) A history of physical education in the United States. A.S. Barnes,

New York, NY

Shephard RJ (2011) The developing understanding of health and fitness. 1. Prehistory. Health Fit J

Can 4(4):3–19

Shephard RJ (2012a) The developing understanding of health and fitness. 2. Early city life.

Health Fit J Can 5(1):27–46

Shephard RJ (2012b) The developing understanding of health and fitness. 3. The classical era.


Shephard RJ (2012c) The developing understanding of health and fitness. 4. The middle ages.


Shephard RJ (2012d) The developing understanding of health and fitness. 5. The renaissance.


Shephard RJ (2013a) The developing understanding of health and fitness. 6. The enlightenment.


Shephard RJ (2013b) The developing understanding of health and fitness. 7. The Victorian era.


Shephard RJ (2013c) The developing understanding of health and fitness. 8. The modern era.


Shephard RJ (2013d) The developing understanding of health and fitness. 9. The post-modern era.

Health Fit Can 6(4):3–85

Swanson RA, Spears BM (1996) History of sport and physical education in the United States,

4th edn. Wm. C. Brown, Dubuque, IO

Tiwatri SR, Rathor CL, Singh YK (2008) History of Physical Education. A.P.H. Publishing, New

Delhi, India

Verbrugge M (2012) Active bodies: a history of women’s physical education in twentieth-centuryAmerica. Oxford University Press, New York, NY

Welch PD (2004) History of American physical education and sport. C.C. Thomas, Springfield, IL

viii Preface

Weston A (1962) The making of American physical education. Appleton, Century, Crofts,

New York, NY

Zeigler E (1975) A history of physical education & sport in the United States and Canada:

(selected topics). Stipes, Champaign, IL

Zeigler E (2006) History and status of American physical education and educational sport.

Trafford Publishing, Bloomington, IN

Preface ix

Contents

1 Health and Fitness in Prehistory, Including Inferences

from the Current Lifestyle of Indigenous Populations . . . . . . . . . . 1

1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1.2 Early Hominoids and the Paleolithic Era . . . . . . . . . . . . . . . . 2

1.2.1 Early Humanoid History . . . . . . . . . . . . . . . . . . . . . . 2

1.2.2 Palaeolithic Habitat . . . . . . . . . . . . . . . . . . . . . . . . . 2

1.2.3 Emergence of Homo sapiens . . . . . . . . . . . . . . . . . . . 4

1.2.4 Recreation of the Palaeolithic Lifestyle . . . . . . . . . . . 5

1.3 The Mesolithic Era . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

1.3.1 Mesolithic Society . . . . . . . . . . . . . . . . . . . . . . . . . . 6

1.3.2 The Dorset Culture . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.3.3 The Thule People . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

1.4 Neolithic Societies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1.4.1 Characteristics of Neolithic Society . . . . . . . . . . . . . . 8

1.4.2 Middle East and South Asia . . . . . . . . . . . . . . . . . . . 9

1.4.3 Meso-America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.4.4 North American Indians . . . . . . . . . . . . . . . . . . . . . . 10

1.5 Oral Tradition and Historical Records of Habitual Physical

Activity Levels in Pre-history . . . . . . . . . . . . . . . . . . . . . . . . 11

1.5.1 Inuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12


1.5.3 The Kalahari Bush People . . . . . . . . . . . . . . . . . . . . . 16

1.5.4 The Tarahumara Indians . . . . . . . . . . . . . . . . . . . . . . 17

1.5.5 Meso-America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

1.5.6 Other Pre-historic Societies . . . . . . . . . . . . . . . . . . . . 25

1.6 Acculturating Influences and Objective Data on Physical

Activity and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

1.6.1 Early Explorers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

1.6.2 Traders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

xi

1.6.3 Christian Missionaries . . . . . . . . . . . . . . . . . . . . . . . 29

1.6.4 Residential Schools . . . . . . . . . . . . . . . . . . . . . . . . . 30

1.6.5 Military and Industrial Intrusions . . . . . . . . . . . . . . . 31

1.6.6 Specific Impact of Acculturation Upon Igloolik . . . . . 32

1.7 Empirical Data on Habitual Physical Activity and Energy

Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

1.7.1 Issues of Methodology . . . . . . . . . . . . . . . . . . . . . . . 37

1.7.2 The Influence of “Rest Days” . . . . . . . . . . . . . . . . . . 39

1.7.3 Igloolik Inuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

1.7.4 Alaskan Inuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

1.7.5 Siberian Circumpolar Populations . . . . . . . . . . . . . . . 41

1.7.6 Sami Lapps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42


1.7.8 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

1.8 Empirical Data on Fitness Levels of Prehistoric Societies . . . . 45

1.8.1 Body Mass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

1.8.2 Body Fat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

1.8.3 Aerobic Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

1.8.4 Muscular Strength . . . . . . . . . . . . . . . . . . . . . . . . . . 50

1.8.5 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

1.9 Health of Pre-historic Societies . . . . . . . . . . . . . . . . . . . . . . . 51

1.9.1 Early Health Status of Pre-historic Societies . . . . . . . 51

1.9.2 More Recent Health Status of Indigenous

Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

1.9.3 Infectious Disease and Suicide . . . . . . . . . . . . . . . . . 56

1.9.4 Metabolic Risk Factors, Diabetes and Chronic

Cardiovascular Disease . . . . . . . . . . . . . . . . . . . . . . . 58

1.9.5 Changing Patterns of Nutrition . . . . . . . . . . . . . . . . . 60

1.10 Attitudes to Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . 61

1.11 Preventive Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

1.11.1 Traditional Arctic Games . . . . . . . . . . . . . . . . . . . . . 62

1.11.2 “White” Sports and Athletic Competitions . . . . . . . . . 63

1.11.3 Community Recreational Facilities . . . . . . . . . . . . . . 63

1.11.4 Overall Assessment . . . . . . . . . . . . . . . . . . . . . . . . . 64

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

2 Examples of Early City Life from Ancient Assyria, Babylon,Egypt, Israel, India and China: Health as a Gift of the Gods . . . . 73

2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

2.2 Sumerian, Babylonian and Assyrian Civilizations . . . . . . . . . . 75

2.2.1 Historical Background . . . . . . . . . . . . . . . . . . . . . . . 75

2.2.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

2.2.3 Sports and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 76

2.2.4 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

2.2.5 Fitness and the Optimization of Health . . . . . . . . . . . 81

xii Contents

2.3 Egyptian Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83


2.3.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83


2.3.4 Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

2.3.5 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

2.3.6 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

2.4 Jewish Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96


2.4.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98


2.4.4 Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

2.4.5 Health and Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . 109

2.4.6 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

2.5 Indian Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111


2.5.2 Daily Life and Economy . . . . . . . . . . . . . . . . . . . . . . 112


2.5.4 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119

2.5.5 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124

2.6 Chinese Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126


2.6.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

2.6.3 Sport and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 131

2.6.4 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

2.6.5 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

3 Legacies of the Classical Era: Minoa, Greece and Rome;A Recognition of Material Causes of Poor Health and Fitness . . . 155

3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

3.2 Historical Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

3.3 Minoan Civilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

3.3.1 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

3.3.2 Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . 159


3.4 Greek Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

3.4.1 Social Strata and Economy . . . . . . . . . . . . . . . . . . . . 164

3.4.2 Greek Understanding of Physiology and Medicine . . . 169

3.4.3 Physical Education . . . . . . . . . . . . . . . . . . . . . . . . . . 186

3.4.4 Therapeutic Exercise . . . . . . . . . . . . . . . . . . . . . . . . 190

3.4.5 Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . 194


3.4.7 Sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206

Contents xiii

3.5 Roman Civilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

3.5.1 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

3.5.2 Medicine and Physiology . . . . . . . . . . . . . . . . . . . . . 214

3.5.3 Health and Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . 218

3.5.4 Fitness and Training . . . . . . . . . . . . . . . . . . . . . . . . . 219


References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230

4 The Middle-Ages: Monasteries, Medical Schools

and the Dawn of State Health Care . . . . . . . . . . . . . . . . . . . . . . . . 241

4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241

4.1.1 “Dark” or “Middle” Ages? . . . . . . . . . . . . . . . . . . . . 241

4.1.2 Life After Collapse of the Roman Empire . . . . . . . . . 243

4.1.3 Reconversion to Christianity . . . . . . . . . . . . . . . . . . . 244

4.1.4 The Golden Age of Charlemagne . . . . . . . . . . . . . . . 245

4.1.5 Life in the Byzantine Empire . . . . . . . . . . . . . . . . . . 246

4.1.6 Life in the Arab World . . . . . . . . . . . . . . . . . . . . . . . 247

4.1.7 Renewal in Western Europe . . . . . . . . . . . . . . . . . . . 248

4.2 Medical Beliefs and Practice . . . . . . . . . . . . . . . . . . . . . . . . . 248

4.2.1 European Medicine in the Early Middle-Ages . . . . . . 249

4.2.2 Islamic Attitudes to Medicine . . . . . . . . . . . . . . . . . . 261

4.2.3 Medicine in Western Europe During

the Later Middle-Ages . . . . . . . . . . . . . . . . . . . . . . . 265

4.3 Growth of Scientific Knowledge in Europe . . . . . . . . . . . . . . . 271

4.3.1 Libraries, Learning and Faith . . . . . . . . . . . . . . . . . . 271

4.3.2 Technical Innovations . . . . . . . . . . . . . . . . . . . . . . . . 272

4.3.3 Health Care and the Poor . . . . . . . . . . . . . . . . . . . . . 273

4.3.4 Early Medical Texts . . . . . . . . . . . . . . . . . . . . . . . . . 274

4.3.5 Views on Physiology . . . . . . . . . . . . . . . . . . . . . . . . 276

4.4 Growth of Scientific Knowledge in the Arab World . . . . . . . . 276

4.4.1 Averroes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

4.4.2 al-Razi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

4.4.3 Seth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

4.4.4 Ibn Sina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

4.4.5 Ibn al-Nafis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281

4.4.6 Maimonides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282

4.5 Development of Medical Schools . . . . . . . . . . . . . . . . . . . . . . 283

4.5.1 Salerno . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

4.5.2 Montpellier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285

4.5.3 Paris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286

4.5.4 Bologna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287

4.5.5 Padua . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288

xiv Contents

4.6 The Spectrum of Health Care Personnel

in the Western World During the Middle-Ages . . . . . . . . . . . . 289

4.6.1 Qualified Physicians . . . . . . . . . . . . . . . . . . . . . . . . . 289

4.6.2 Barber/Surgeons . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295

4.6.3 Apothecaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297

4.6.4 Wise Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299

4.6.5 Opposition from the Church . . . . . . . . . . . . . . . . . . . 300

4.6.6 Clerics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301

4.6.7 Female Heads of Households . . . . . . . . . . . . . . . . . . 303

4.6.8 Role of Other Well-Educated Lay-People . . . . . . . . . 305

4.7 Public Health and Preventive Medicine . . . . . . . . . . . . . . . . . 305

4.7.1 The Islamic World . . . . . . . . . . . . . . . . . . . . . . . . . . 306

4.7.2 Northern and Western Europe . . . . . . . . . . . . . . . . . . 307

4.8 Physical Activity and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . 313

4.8.1 Lifestyle of the Nobility . . . . . . . . . . . . . . . . . . . . . . 314

4.8.2 Lifestyle of the Middle-Class and Agricultural

Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314

4.8.3 Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315

4.8.4 Attitude of Physicians Towards Exercise . . . . . . . . . . 316

4.8.5 Attitudes of the Church Towards Fitness . . . . . . . . . . 316

4.8.6 Attitudes of the Arab World Towards Physical

Activity and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . 317

4.9 Sport and Recreation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318

4.9.1 Equestrian Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . 318

4.9.2 Tournaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321

4.9.3 Jousting and Tilting . . . . . . . . . . . . . . . . . . . . . . . . . 322

4.9.4 Tennis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324

4.9.5 Bowling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325

4.9.6 Kolf . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326

4.9.7 Cricket . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327

4.9.8 Pall Mall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329

4.9.9 Football (Soccer) . . . . . . . . . . . . . . . . . . . . . . . . . . . 329

4.9.10 Archery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331

4.9.11 Other Types of Sport . . . . . . . . . . . . . . . . . . . . . . . . 331

4.9.12 Other Forms of Physical Activity . . . . . . . . . . . . . . . 334

4.9.13 Sedentary Pursuits . . . . . . . . . . . . . . . . . . . . . . . . . . 334

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337

5 The Renaissance: The Dawn of Scientific Enquiry into

Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

5.2 Contributions of Renaissance Scholarship

to Medicine and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352

5.2.1 Building a More Accurate Picture

of Human Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . 352

Contents xv

5.2.2 Circulatory System . . . . . . . . . . . . . . . . . . . . . . . . . . 355

5.2.3 Respiration and Gas Exchange . . . . . . . . . . . . . . . . . 368

5.2.4 Muscle Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377

5.3 Development of Schools of Health Science

and the Regulation of Medical Qualifications . . . . . . . . . . . . . 382

5.3.1 Academic Recognition . . . . . . . . . . . . . . . . . . . . . . . 383

5.3.2 Pattern of Instruction . . . . . . . . . . . . . . . . . . . . . . . . 384

5.3.3 Oxford and Cambridge . . . . . . . . . . . . . . . . . . . . . . . 384

5.3.4 Pisa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385

5.3.5 Pavia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386

5.3.6 Leiden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386

5.3.7 London . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386

5.3.8 Scotland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

5.3.9 Montpellier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

5.3.10 Bologna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

5.3.11 Paris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

5.4 Public Health and Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . 392

5.4.1 The Great Plague of London . . . . . . . . . . . . . . . . . . . 392

5.4.2 European Boards of Public Health . . . . . . . . . . . . . . . 394

5.4.3 Theories on the Source of Epidemics . . . . . . . . . . . . . 394

5.4.4 Introduction of Cotton Clothing . . . . . . . . . . . . . . . . 395

5.4.5 Appearance of the Toothbrush . . . . . . . . . . . . . . . . . 395

5.4.6 Control of Food Supply . . . . . . . . . . . . . . . . . . . . . . 396

5.4.7 Measures Adopted by Housewives . . . . . . . . . . . . . . 396

5.4.8 Assessment of Overall Population Health . . . . . . . . . 396

5.5 Attitudes of Kings and Scholars to Health and Fitness . . . . . . . 397

5.5.1 Henry VIII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397

5.5.2 Queen Elizabeth I . . . . . . . . . . . . . . . . . . . . . . . . . . . 398

5.5.3 James I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399

5.5.4 Charles I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401

5.5.5 The Puritan Commonwealth in Britain . . . . . . . . . . . . 402

5.5.6 Pilgrim Fathers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403

5.5.7 Luther . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404

5.5.8 Calvin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405

5.5.9 Knox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405

5.5.10 Rabelais . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406

5.5.11 Leonardo da Vinci . . . . . . . . . . . . . . . . . . . . . . . . . . 406

5.5.12 Michelangelo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407

5.6 Attitudes of Physicians Towards Physical

Activity and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408

5.6.1 Mendez . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408

5.6.2 Castiglione . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408

5.6.3 Mercuriale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409

xvi Contents

5.6.4 Pare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410

5.6.5 Joubert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411

5.6.6 Duchesne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411

5.6.7 Cagmatis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412

5.6.8 Cogan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412

5.7 Physical Activity and Educational Curricula . . . . . . . . . . . . . . 412

5.7.1 Petrarca (Petrarch) . . . . . . . . . . . . . . . . . . . . . . . . . . 413

5.7.2 da Feltre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414

5.7.3 Alberti . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415

5.7.4 Vegio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416

5.7.5 Richard Mulcaster . . . . . . . . . . . . . . . . . . . . . . . . . . 416

5.7.6 Burton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417

5.7.7 Montaigne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418

5.8 Health, Fitness and the Universities . . . . . . . . . . . . . . . . . . . . 419

5.8.1 Stubbes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419

5.8.2 Dalton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420

5.8.3 Policies on Sport at the Universities

of Cambridge and Oxford . . . . . . . . . . . . . . . . . . . . . 420

5.8.4 Sports Policies of European Universities . . . . . . . . . . 421

5.9 Changing Patterns of Sport and Habitual Physical

Activity During the Renaissance . . . . . . . . . . . . . . . . . . . . . . 422

5.9.1 Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422

5.9.2 Habitual Physical Activity . . . . . . . . . . . . . . . . . . . . 433

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437

6 The Enlightenment: The Impact of Reason and Religion

upon Health and Fitness in a Period of Urban Growth

and Industrialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447

6.1 Background to the Enlightenment . . . . . . . . . . . . . . . . . . . . . 447

6.2 Contributions of the Enlightenment to Science,

Medicine and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449

6.2.1 Development of Schools of Health Science . . . . . . . . 450

6.3 New Knowledge of the Circulation, Respiration

and Muscle Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 454

6.3.1 Circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 454

6.3.2 Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463

6.3.3 Muscle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474

6.4 Attitudes of Scholars, Church Leaders and Physicians

Towards Physical Activity and Health . . . . . . . . . . . . . . . . . . 480

6.4.1 Scholars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481

6.4.2 Church Leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493

6.4.3 Physicians and Proponents

of “Alternative Medicine” . . . . . . . . . . . . . . . . . . . . . 498

Contents xvii

6.5 Public Health and Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . 517

6.5.1 Provision of Clean Water . . . . . . . . . . . . . . . . . . . . . 518

6.5.2 Sewage and Garbage . . . . . . . . . . . . . . . . . . . . . . . . 519

6.5.3 Average Lifespan . . . . . . . . . . . . . . . . . . . . . . . . . . . 519

6.6 Physical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520

6.6.1 Enlightenment Schools . . . . . . . . . . . . . . . . . . . . . . . 521

6.6.2 Educational Philosophers . . . . . . . . . . . . . . . . . . . . . 523

6.7 Habitual Physical Activity and Fitness . . . . . . . . . . . . . . . . . . 527

6.7.1 Activity Patterns of Traditional Farmers . . . . . . . . . . 527

6.7.2 Development of Highways and Turnpikes . . . . . . . . . 529

6.7.3 The Advent of Water Power . . . . . . . . . . . . . . . . . . . 532

6.7.4 The Introduction of Steam Power . . . . . . . . . . . . . . . 534

6.7.5 Physical Fitness and Obesity . . . . . . . . . . . . . . . . . . . 534

6.8 Patterns of Sport and Recreation . . . . . . . . . . . . . . . . . . . . . . 537

6.8.1 Equine Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537

6.8.2 Water Sports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 538

6.8.3 Boxing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540

6.8.4 Lacrosse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541

6.8.5 Dancing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541

6.8.6 Strolling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541

6.8.7 Sedentary Recreation . . . . . . . . . . . . . . . . . . . . . . . . 543

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548

7 The Victorian Era: The Birth of Scientific Societies

and the Blossoming of Public Health . . . . . . . . . . . . . . . . . . . . . . . 559

7.1 Background to the Victorian Era . . . . . . . . . . . . . . . . . . . . . . 559

7.2 Scientific Advances in the Victorian Era . . . . . . . . . . . . . . . . . 561

7.2.1 Scientific Societies . . . . . . . . . . . . . . . . . . . . . . . . . . 561

7.2.2 Positivism, Anti-positivism and Critical Theory . . . . . 565

7.2.3 New Knowledge of the Circulation . . . . . . . . . . . . . . 567

7.2.4 New Knowledge of Respiration . . . . . . . . . . . . . . . . . 578

7.2.5 Tissue Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . 583

7.2.6 Muscle Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . 588

7.2.7 Evolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 588

7.2.8 Microbiology and Epidemiology . . . . . . . . . . . . . . . . 594

7.3 Views of Victorian Scholars Concerning

Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 598

7.3.1 Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . 598

7.3.2 Theologians and Social Darwinists . . . . . . . . . . . . . . 610

7.3.3 Philosophers, Politicians

and Prominent Authors . . . . . . . . . . . . . . . . . . . . . . . 612

7.3.4 Statesmen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 622

7.3.5 The Voice of Women . . . . . . . . . . . . . . . . . . . . . . . . 626

xviii Contents

7.4 Physical Activity Trends in Victorian Society . . . . . . . . . . . . . 627

7.4.1 Industry and Agriculture . . . . . . . . . . . . . . . . . . . . . . 627

7.4.2 Domestic Activities . . . . . . . . . . . . . . . . . . . . . . . . . 628

7.4.3 Transportation Technology . . . . . . . . . . . . . . . . . . . . 629

7.5 Physical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 630

7.5.1 Germany . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 631

7.5.2 Denmark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 637

7.5.3 Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639

7.5.4 Czechoslovakia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 641

7.5.5 Switzerland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 642

7.5.6 France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 643

7.5.7 England . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 646

7.5.8 United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651

7.5.9 Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 657

7.6 Sports, Recreation and Entertainment . . . . . . . . . . . . . . . . . . . 661

7.6.1 Sports Organizations and Associations . . . . . . . . . . . . 661

7.6.2 Sports and Entertainment . . . . . . . . . . . . . . . . . . . . . 670

7.6.3 Sedentary Recreational Activities . . . . . . . . . . . . . . . 684

7.7 Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686

7.7.1 Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686

7.7.2 Physical Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . 695

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699

8 The Modern Era: Blossoming of the Olympic Movement

and the Conquest of Acute Disease . . . . . . . . . . . . . . . . . . . . . . . . 715

8.1 Background to the Modern Era . . . . . . . . . . . . . . . . . . . . . . . 715

8.2 Scientific Progress During the Modern Era . . . . . . . . . . . . . . . 716

8.2.1 New Knowledge of the Respiratory System . . . . . . . . 717

8.2.2 New Knowledge of the Cardiovascular System . . . . . 719

8.2.3 New Knowledge of Haematology and Exercise

Immunology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 727

8.2.4 Assessments of Physical Performance

and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 729

8.2.5 The Growing Interest in Body Build . . . . . . . . . . . . . 744

8.2.6 Integrative Physiology and Responses to Exercise

in Extreme Environments . . . . . . . . . . . . . . . . . . . . . 748

8.3 Politicians and Governmental Policies on Health

and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 757

8.3.1 Germany . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 757

8.3.2 Health and Fitness in Italy . . . . . . . . . . . . . . . . . . . . 762

8.3.3 Russia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 766

8.3.4 France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 768

8.3.5 Britain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 773

8.3.6 United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 781

8.3.7 Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785

Contents xix

8.4 Views of Authors and Philosophers

on Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792

8.4.1 Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792

8.4.2 Philosophers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 798

8.5 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802

8.5.1 Demographics and Birth Control . . . . . . . . . . . . . . . . 803

8.5.2 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 805

8.5.3 Acute Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . 807

8.5.4 Chronic Conditions . . . . . . . . . . . . . . . . . . . . . . . . . 810

8.5.5 Radio, Television and Health Education . . . . . . . . . . 818

8.5.6 Racism and Eugenics . . . . . . . . . . . . . . . . . . . . . . . . 819

8.5.7 Alternative Medicine . . . . . . . . . . . . . . . . . . . . . . . . 820

8.6 Physical Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 822

8.7 Trends of Fitness and Physical Education During

the Modern Era . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 823

8.7.1 Initiatives Addressed Mainly to Women . . . . . . . . . . 823

8.7.2 National Emphases in Fitness, Physical

Education and Sport . . . . . . . . . . . . . . . . . . . . . . . . . 829

8.8 Major Sport During the Modern Era . . . . . . . . . . . . . . . . . . . . 842

8.8.1 National and International Competitions . . . . . . . . . . 842

8.8.2 Opportunities for Female Participation . . . . . . . . . . . 844

8.8.3 Doping of Athletes and Its Control . . . . . . . . . . . . . . 853

8.9 Sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 858

8.9.1 Textbooks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 858

8.9.2 Professional Organizations . . . . . . . . . . . . . . . . . . . . 859

8.10 Sport and Leisure Activities . . . . . . . . . . . . . . . . . . . . . . . . . . 864

8.10.1 Paid Holidays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 865

8.10.2 Swimming Pools and Aquatic Events . . . . . . . . . . . . 867

8.10.3 Other Sports and Activities Coming

to Prominence in the Modern Era . . . . . . . . . . . . . . . 871

8.10.4 Outdoor Recreation . . . . . . . . . . . . . . . . . . . . . . . . . 875

8.10.5 Sedentary Activities . . . . . . . . . . . . . . . . . . . . . . . . . 878

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 881

9 The Post-Modern Era: Chronic Disease and the Onslaught

of a Sedentary Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 903

9.1 Background to the “Post-Modern” Era . . . . . . . . . . . . . . . . . . 903

9.2 The Impact of New Technology upon Our Understanding

of Health and Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 904

9.2.1 Developments in Respiratory Physiology

and Studies of Metabolism . . . . . . . . . . . . . . . . . . . . 905

9.2.2 Developments in Cardiology . . . . . . . . . . . . . . . . . . . 912

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9.2.3 Developments in Understanding

of Muscle Function . . . . . . . . . . . . . . . . . . . . . . . . . 920

9.2.4 Developments in the Determination

of Other Body Tissues . . . . . . . . . . . . . . . . . . . . . . . 923

9.2.5 Developments in Understanding

of the Immune Response to Exercise . . . . . . . . . . . . . 924

9.2.6 Genetics of Health and Fitness . . . . . . . . . . . . . . . . . 927

9.2.7 Adaptations to Exercise in Challenging

Environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 930

9.3 Attitudes of Governments and Political Leaders . . . . . . . . . . . 936

9.3.1 United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 936

9.3.2 Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 945

9.4 Health in the Post-Modern Era . . . . . . . . . . . . . . . . . . . . . . . . 952

9.4.1 Life Expectancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 953

9.4.2 Governmental Emphasis upon Preventive

Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 954

9.4.3 Professional Development of Health

and Fitness Personnel . . . . . . . . . . . . . . . . . . . . . . . . 956

9.4.4 Epidemiology, Chronic Disease and Physical

Inactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 960

9.4.5 Improvements in Occupational Health . . . . . . . . . . . . 963

9.4.6 Rehabilitation Programmes . . . . . . . . . . . . . . . . . . . . 967

9.4.7 Other Developments in Public Health . . . . . . . . . . . . 970

9.5 Fitness and Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 975

9.5.1 Factors Stimulating and Sustaining a Renewed

Interest in Physical Fitness . . . . . . . . . . . . . . . . . . . . 975

9.5.2 Testing and Screening Protocols . . . . . . . . . . . . . . . . 979

9.5.3 Population Surveys of Fitness and Physical

Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 983

9.5.4 New Training Techniques . . . . . . . . . . . . . . . . . . . . . 987

9.5.5 Enhancing Fitness by Work-Site Programmes . . . . . . 989

9.5.6 Fitness Requirements of Physically Demanding

Occupations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994

9.5.7 Fitness and Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . 996

9.5.8 Motivational Awards . . . . . . . . . . . . . . . . . . . . . . . . 997

9.5.9 Motivational Agencies . . . . . . . . . . . . . . . . . . . . . . . 998

9.5.10 Physical Demands of a Hunter-Gatherer Lifestyle . . . 1002

9.6 Physical Education Programmes . . . . . . . . . . . . . . . . . . . . . . 1003

9.6.1 Physiological Impact . . . . . . . . . . . . . . . . . . . . . . . . 1004

9.6.2 Academic Performance . . . . . . . . . . . . . . . . . . . . . . . 1005

9.6.3 Long-Term Impact of Enhanced Physical

Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1006

Contents xxi

9.7 Sport and Leisure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1006

9.7.1 Governmental Involvement . . . . . . . . . . . . . . . . . . . . 1007

9.7.2 Sports Participation . . . . . . . . . . . . . . . . . . . . . . . . . 1010

9.7.3 Professional Associations and Journals . . . . . . . . . . . 1010

9.7.4 Introduction of New Sports . . . . . . . . . . . . . . . . . . . . 1013

9.8 Olympic Games and Competitive Sport . . . . . . . . . . . . . . . . . 1024

9.8.1 Female Participation in Competitive Sport . . . . . . . . . 1025

9.8.2 Loss of Amateur Idealism . . . . . . . . . . . . . . . . . . . . . 1027

9.8.3 The Changing Nature of Athletic Competition . . . . . . 1028

9.8.4 Current Economic Costs and Benefits

of Olympic Competition . . . . . . . . . . . . . . . . . . . . . . 1038

9.8.5 Other Competitive Games . . . . . . . . . . . . . . . . . . . . . 1041

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1044

10 Future Directions in Health and Fitness . . . . . . . . . . . . . . . . . . . . 1065

10.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065

10.2 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065

10.2.1 Life Expectancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065

10.2.2 Changing Government Health Policies . . . . . . . . . . . 1067

10.2.3 New Health Challenges . . . . . . . . . . . . . . . . . . . . . . 1067

10.3 Fitness and Physical Activity . . . . . . . . . . . . . . . . . . . . . . . . . 1069

10.3.1 Loss of the Military Imperative . . . . . . . . . . . . . . . . . 1069

10.3.2 The Growing Influence of Robots

and Home Offices . . . . . . . . . . . . . . . . . . . . . . . . . . . 1070

10.3.3 Motivation to Regular Physical Activity . . . . . . . . . . 1070

10.3.4 Fitness Testing and Programme Safety . . . . . . . . . . . 1071

10.3.5 Occupational Fitness Requirements Beyond

65 Years of Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1072

10.4 Physical Education, Exercise Science

and Sport Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1073

10.5 Sport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1074

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1075

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