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STUDIES IN HISTORYAND PHILOSOPHY OF SCIENCE
VOLUME 39
General Editor:
STEPHEN GAUKROGER, University of Sydney
Editorial Advisory Board:
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):
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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
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Health Fit J Can 5(3):19–49
Shephard RJ (2012d) The developing understanding of health and fitness. 5. The renaissance.
Health Fit J Can 5(4):3–29
Shephard RJ (2013a) The developing understanding of health and fitness. 6. The enlightenment.
Health Fit J Can 6(1):82–118
Shephard RJ (2013b) The developing understanding of health and fitness. 7. The Victorian era.
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Swanson RA, Spears BM (1996) History of sport and physical education in the United States,
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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
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Weston A (1962) The making of American physical education. Appleton, Century, Crofts,
New York, NY
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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
1.5.2 North American Indians . . . . . . . . . . . . . . . . . . . . . . 13
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
1.7.7 North American Indians . . . . . . . . . . . . . . . . . . . . . . 43
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
2.3.1 Historical Background . . . . . . . . . . . . . . . . . . . . . . . 83
2.3.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2.3.3 Sports and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 85
2.3.4 Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
2.3.5 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
2.3.6 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
2.4 Jewish Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
2.4.1 Historical Background . . . . . . . . . . . . . . . . . . . . . . . 96
2.4.2 Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
2.4.3 Sports and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 102
2.4.4 Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
2.4.5 Health and Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . 109
2.4.6 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
2.5 Indian Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
2.5.1 Historical Background . . . . . . . . . . . . . . . . . . . . . . . 111
2.5.2 Daily Life and Economy . . . . . . . . . . . . . . . . . . . . . . 112
2.5.3 Sports and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 115
2.5.4 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
2.5.5 Fitness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
2.6 Chinese Civilizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
2.6.1 Historical Background . . . . . . . . . . . . . . . . . . . . . . . 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
3.3.3 Sports and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 161
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
3.4.6 Sport and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 197
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
3.5.5 Sport and Recreation . . . . . . . . . . . . . . . . . . . . . . . . 223
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
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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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