A Century of Cardiomythology: Exercise and the Heart c.1880–1980

The relationship between health and exercise involves risks as well as rewards. This article focuses on heart disease and the marathon to show how doctors have negotiated that relationship over a century. Three distinct changes in biomedical attitudes towards vigorous exercise are outlined. First, the mid-Victorian interpretation of pathological hypertrophy of the heart was overturned at the end of the nineteenth century. Secondly, hypertrophy was reinvented as a beneficial physiological adaptation in the 1940s and 1950s. Thirdly, these claims of distinctiveness were challenged by the leisure revolution. Sports doctors and cardiologists reinvented exercise as a drug that could only be safely used with the guidance of a medical professional. Medicalising sport reduced its risk and maximised its reward, both to the individual and the state.