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The Bicycle in the Treatment of 
Nervous Diseases. 
BY 
M. HAMMOND, M.D., 
NEW YORK. 
REPRINTED FROM 
THE JOURNAL OF NERVOUS AND MENTAL DISEASE, 
January, 1892. 306 to 310 West 59TH Street, 
N ew York, February 10, 1892. 
Dear Sir: 
The use of the Bicycle as a means of prevent- 
ing various forms of disease, especially such as are of 
mental or nervous origin, has received considerable 
attention from physicians. 
We believe, however, its value is not generally 
appreciated by the profession, and that you may person- 
ally judge of its qualities, we would he glad to have you 
visit our warerooms, examine our varied assortment 
of wheels, paying special attention to the improved 
Bidwell (Thomas) Pneumatic l ire, make such inquiries 
as you may desire, and particularly look into our 
method of, and facilities for, giving instruction in riding. 
We shall also he most happy to extend to any 
physician, at any time before April 1st, the facilities 
of our riding hall and the services of our instructors, 
without charge, that he may familiarize himself with this 
form of out-of-door exercise and recreation. Lessons 
are half an hour in length, are given by appointment, 
and five are usually required. 
We will he pleased to have you avail yourself of 
this invitation. 
Respectfully yours, 
Geo. R. Bidwell Cycle Co. 
TELEPHONE 
H64-38TH STREET THE BICYCLE IN THE TREATMENT OF 
NERVOUS DISEASES. 
By GR/EME M. HAMMOND, M.D., New York. 
THE value of systematic exercise in the treatment of 
many diseases is certainly not fully appreciated by 
the average physician, nor could it be fully expected 
to be otherwise, since it is notorious that physicians, as a 
class, take little or no active and regular exercise. Walk- 
ing, and as little of that as will suffice in making his daily 
round of visits, is the only form of exercise which the busy 
physician imagines he can spare the time for; while such 
indoor exercise as is afforded by boxing, fencing, and the 
gymnasium, and out-of-door exercise, such as bicycle rid- 
ing, horseback exercise and skating are practically un- 
known to him, and their therapeutic value is not grasped by 
his mind at all. Under such conditions it can be readily 
comprehended that the advice relating to exercise which 
the majority of physicians give to their patients is valueless. 
They are giving an opinion on a subject concerning which 
they are densely ignorant. Very recently a practitioner of 
this city, whose professional position is enviable, advised 
one of my patients, who was suffering from fatty degenera- 
tion of the heart, to spend most of her time lying down and 
to take as little exercise as possible. The advice was bad. 
Fatty degeneration of the heart like fatty degeneration 
of the biceps can be cured by appropriate exercise. Many 
physicians know this, but how many of them can conscien- 
tiously admit that they are competent to direct the phys- 
ical training of a patient suffering from a feeble heart. 
The subject of the therapeutics of exercise is so vast that 
it is practically impossible to cover the ground in a paper 
of ordinary length. I therefore propose to consider only 
one of the formsof exercise, namely, bicycling, and that only 
in its relation to the treatment of some forms of nervous 
disease. Exercise when prescribed for nervous affections should 
preferably be taken out-of-doors. It must also be combined 
with pleasure, and should be prescribed not only with the 
view of strengthening the muscles, but also for its effect 
upon the mind. The effect upon the mind is often of greater 
importance than the effect upon the body. The feeding of 
the mind on self and the continual mental introspection 
which is so common in neurasthenia, hysteria and hypo- 
chondria should be combated by prescribing an exercise 
which necessitates the pleasurable concentration of the mind 
on what is being done, something which demands a certain 
amount of skill for its successful accomplishment, and which 
must therefore divert the thoughts from morbid channels, 
stimulate the mental faculties in a normal direction and en- 
gender a feeling of brain-rest and mental refreshment. 
Such results can be obtained by the proper use of the 
bicycle. The facility with which almost any one can learn 
to use it, the exercise of skill required in guiding and con- 
trolling its course, the exhilaration which comes from rapid 
motion, the continual change of the panorama of the land- 
scape, and the exercise of almost every muscle of the body 
make it an apparatus which not only develops the body, 
but is far more potent in stimulating a healthy cerebral ac- 
tivity and in arousing the mind from a lethargic condition 
than any medicinal remedy known to me. 
Far different is the result obtained from the use of appa- 
ratus which physicians often advise patients to purchase and 
to use at home. After an individual reaches the age of 
twenty-five his exercise should be combined with pleasure. 
That factor of mental exhilaration must be present, or else the 
exercise simply consists of physical motions which soon 
become stupid and wearisome to the performer. The use of 
dumb-bells, Indian-clubs and home exercises of all forms 
soon becomes drudgery. The patient works at them faith- 
fully for a few days with gradually increasing dislike. The 
exercise finally becomes repellent to him, and he ceases to 
perform it. This is the history of fully ninety per cent, of all 
the people, both well and sick, who with the most earnest 
intentions begin to exercise at home. The bicycle has 
2 
GR.EME M. HAMMOND BICYCLE IN TREATMENT OE NERVOUS DISEASES. 
3 
therefore two uses as a therapeutic agent, one as a developer 
of paretic muscles, the other as a mental stimulant. In the 
former case the paralyzed individual is willing and anxious 
to use it, because while he is exercising his muscles he is at 
the same time enjoying himself. 
I have prescribed the systematic use of the bicycle in 
sixteen different instances. Three of these were cases of 
paralysis due to anterior polio-myelitis; one was a case of 
paralysis resulting from multiple-neuritis, and one was a case 
of hysterical paralysis with slight contracture. Six were 
cases of neurasthenia. The twelfth case was one of sexual 
perversion, and the thirteenth case was one of abnormally 
developed sexual appetite. 
The cases of paralysis from anterior polio-myelitis can 
best be considered together.. In this group the object was 
simply to obtain stimulation and development of muscles 
which had degenerated both from disease and from disuse. 
It may be argued that in such cases any form of exercise, 
the performance of which calls into play the affected mus- 
cles, would be equally as efficacious as the bicycle. This 
would perhaps be true if the patient would invariably 
exercise under the supervision of an instructor who would 
see that the exercise was faithfully carried out, because peo- 
ple will not voluntarily go through stupid and uninteresting 
muscular movements day after day unless they are com- 
pelled to. This, however, is not the case with the bicycle. 
Those who learn to ride it learn at the same time to like it. 
They exercise voluntarily and enjoy it. After the art of 
riding is mastered the patient can exercise by himself with- 
out any supervision. Horseback riding, while it is an excel- 
lent form of exercise, cannot be indulged in by any one 
whose limbs are paralyzed to any marked extent. In cases 
I. and II., only the right leg was affected; in case III., both 
legs were paralyzed. In all three cases the disease seemed 
only to have affected those cells supplying the extensor 
muscles of the foot and toes. The muscles of the thighs 
were much weaker than they should have been, were 
smaller than normal, and were soft and flabby. This con- 
dition I attributed solely to disuse, as the electrical reac- 4 
ORAL ME M. HAMMOND. 
tions, though diminished quantitatively, were qualitatively 
normal. Case I. was a girl of twelve years of age, whose 
right leg had been paralyzed for five years; case II. was a 
lad fourteen years of age who also suffered from paralysis 
of the right leg which dated from his seventh year; case III. 
was a lady who is now about thirty years old. Both legs 
had been paralyzed since she was six months old. In the 
latter case the tendons of both gastrocnemii had to be cut 
to overcome a well marked talipes equinus of several years’ 
duration. In all of these cases walking was performed 
with great difficulty owing to the atrophy and paral- 
ysis of the thigh muscles. Mounting the stairs was im- 
possible in one case and accomplished with great effort 
in the other two cases for the same reasons. None of 
them could support the weight of the body in a stand- 
ing position if the knees were ever so slightly bent. 
In the first and second cases the muscles of the left leg 
were undeveloped and much weaker than they should have 
been, though the muscles were not affected by disease. I 
prescribed the use of the bicycle in these cases three times 
a week, only allowing them to ride for a few minutes 
at a time. When muscular tissue is degenerated either from 
disease or disuse its cultivation must be carefully conducted 
at first. Over-use of a degenerated muscle only advances 
the process of degeneration, both of the muscular tissue 
itself and of the spinal motor cells which supply the mus- 
cles used; while on the other hand, intelligent use of the 
muscles is conducive to healthy stimulation and subsequent 
development. The development of muscular tissue is a 
slow process even in a healthy person. It is particularly 
slow where the muscles are degenerated. As the strength of 
the limbs gradually increased, I permitted the patient to 
ride for a longer time. 
Cases I. and II. have now been riding for over a year. 
For the past six months they have ridden daily out-of-doors 
when the weather was not too inclement. The effect on 
the muscles of the legs is well marked. The thigh muscles 
which were simply paralyzed from disuse and were formerly 
soft and flabby are now firm, fairly hard, and are fully as BICYCLE IN TREATMENT OF NERVOUS DISEASES. 
5 
strong as those of the average person. Both the patients 
can mount the stairs easily, can support their weight with 
the knees bent, and can walk very much better than they 
formerly could. In regard to the paralyzed muscles the 
improvement is not so marked. Electricity has frequently 
been used ©n these muscles, hence what improvement has 
been obtained in them cannot be said to be due entirely to 
the bicycle, though, unquestionably, it has been of material 
aid. The muscles are stronger, and there is more mental 
control over them than there was a year ago. I am confi- 
dent that one or two more years of cultivation will show 
even more decided improvement. 
Case III. was only able to continue her bicycle instruc- 
tion for a few months, but even in that time her limbs were 
perceptibly strengthened. When she takes it up again I 
feel confident, judging from the other cases, that the devel- 
opment of her muscles will be proportionate to the time she 
devotes to the use of her bicycle. 
CASE IV. Multiple neuritis.—The patient, a man thirty- 
two years of age, was first seen by me in December, 1890. 
He was a typical example of the disease, which was un- 
doubtedly of alcoholic origin. Both legs and both arms 
were almost completely paralyzed; the flexors of the fingers 
and toes were capable of some slight motion; the muscles 
of both arms and legs were atrophied; the nerves were hard 
and tender; and there was a great deal of spontaneous pain 
in both legs. There was a loss of tactile sense and pain 
sense, the patient not feeling the prick of a pin or a cut with 
a knife; but severe pains were experienced if passive move- 
ments of the extremities were made. The electrical reac- 
tion of degeneration were well marked. Under appropriate 
treatment the neuritis gradually subsided, leaving the mus- 
cles greatly weakened and atrophied. Soon after the power 
of standing and walking was regained and a fair amount 
of strength had returned to the arms, I sent him to Bid- 
well’s Bicycle School. For the first few days he rode 
three times for periods of five minutes each, with five min- 
utes’ rest between each ride. At first he had not sufficient 
strength to propel the bicycle and could only move it with 6 
the teacher’s assistance; but the improvement in the muscu- 
lar strength was rapid, and as the strength increased the 
time devoted to riding was lengthened and the period of 
rests reduced, so that in twelve days he could ride for half 
an hour uninterruptedly. From this time on his improve- 
ment was even more rapid, and in ten days more his strength 
seemed to have reached its normal condition. 
Exercise in any form should not be prescribed in cases 
of neuritis until all evidence of inflammation of the nerves 
has subsided and the period of regeneration has set in. 
Electrization of the muscles is, in my opinion, greatly infe- 
rior to bicycle riding as a muscular stimulant and developer. 
In one case the growth of the muscular fibre is produced 
artificially, and is therefore slow and imperfect; in the other, 
the development follows the laws of nature and the muscles 
are exercised through the will power, the motor impulses 
being transmitted through the nerves as fast as their regen- 
eration makes transmission possible. 
Case V. Hysterical paralysis with slight contraction.— 
The patient, a young lady fifteen years of age, with a decid- 
edly neurotic family history, was suddenly taken with com- 
plete paralysis of the right leg while at school. The physi- 
cian who attended her at the time informed me there were 
no disorders of sensibility. When I first saw her, about 
three weeks after the onset of the paralysis, the limb was 
motionless, and slight contracture of the flexors of the leg 
was perceptible. There were no disorders of sensibility, 
nor was there any evidence of an organic lesion. I pre- 
scribed the use of the bicycle daily for half an hour at a 
time. At first it was necessary to strap the foot of the par- 
alyzed leg to the pedal of the bicycle in order to keep it in 
position. She was encouraged by the teacher, under my 
instruction, to continually make every mental effort to use 
the paralyzed limb, the sound leg being strong enough, 
with slight assistance from the teacher, to propel the ma- 
chine. Thus she was receiving passive exercise of the par- 
alyzed leg, together with alternating stretching and relaxa- 
tion of the contracted muscles, and at the same time was 
being urged to make volitional muscular efforts. The treat- 
GRsEME M. HAMMOND. BICYCLE IN TREATMENT OF NERVOUS DISEASES. 
7 
ment was successful. Muscular movements were made 
slowly at first and seemingly with great difficulty, but 
gradually the mind regained control of the muscles and a 
cure was established. I have recommended the steady use 
of the bicycle in this case with the idea that systematic out- 
of-door exercise will, by physical development, eradicate 
any tendency to a recurrence of the attack. 
Cases VI. to XI. inclusive, were cases of neurasthenia. 
Five of them were men, one was a woman. The usual 
symptoms which are so familiar to the neurologist, such as 
insomnia, vertigo, depression of spirits, fulness or pressure 
in the head, dyspepsia, constipation, irritability of temper, 
loss of energy, and the host of other minor symptoms which, 
when taken collectively, tend to make life a burden to their 
possessor, were present in these cases. In the majority of 
instances, anxiety, worry or trouble of some kind was re- 
sponsible for their condition. 
In an individual with a strong and vigorous body, and 
who is accustomed to take a great deal of out-door 
physical exercise, small annoyances, and even troubles 
and griefs of considerable magnitude, are borne with a 
mental courage and fortitude which ordinarily can be but 
feebly reproduced in those who are physically undevel- 
oped. There is a buoyancy of spirit in the strong 
and healthly which rises superior to the onslaught of 
troubles, while the individual of sedentary habits, or who 
never has felt the courage which goes hand-in-glove with 
health and strength succumbs sooner to the troubles which 
fall to the lot of nearly every man and woman. The devel- 
opment of the symptoms of nervous exhaustion follows as 
a matter of course. The plan of treatment for the relief of 
such cases is to strengthen the mind and the physical sys- 
tem at the same time. The direct cause of the disease can- 
not always be removed. Worry and trouble are things 
which cannot be relieved by a physician’s prescription. But 
the intelligent physician aims to so strengthen the mental 
vigor of his patient that his brain will regain the power to 
assert itself and perform its functions in a natural manner. 
This can undoubtedly be accomplished by appropriate medic- 8 
GR.EME M. HAMMOND. 
inal treatment. But this is not all. Physical development 
leads to a certain form of mental development. With in- 
creasing strength comes greater courage, perseverance and 
tenacity of purpose, and when physical exercise can be com- 
bined with a pursuit which is not only pleasant, but which 
must necessarily engross the mind and thereby lead it away 
from morbid thoughts, and from that introspection which is 
usually so prominent a feature of neurasthenia,we havearem- 
edy which as an adjunct to appropriate medicinal treatment is 
an ally which is worthy of a great deal of consideration. In 
the bicycle we obtain a combination of physical and mental 
exercise which meets the requirements of the case more 
thoroughly than any other form of treatment. The six 
cases referred to in this paper always speak enthusiastic- 
ally of the benefit they received from the bicycle. They re- 
turned from their rides physically tired, but mentally re- 
freshed. Comparing these cases with other similar cases 
who did not use the bicycle, I am forced to admit that the 
recovery of the latter might have been materially accel- 
erated if the bicycle had been prescribed. Neurasthenics 
should begin to ride out of doors as soon as they have 
learned to manage their wheel well enough to retain their 
equilibrium without assistance. They should be encour- 
aged to ride for as long a time as they can without experi- 
encing great fatigue. Beginning with a moderate ride of a 
mile or two, the distance should be rapidly increased till 
from ten to twenty miles are covered in a morning or af- 
ternoon’s ride. If the companionship of other riders can 
be obtained, so much the better, provided they are not neu- 
rasthenics. The longer the ride and the more unfamiliar 
the scenery, the more the patient’s mind is diverted from 
self and the thought directed into more varied and health- 
ful channels. Patients with neurasthenia should therefore 
be instructed to take long rides at a moderate speed, and to 
vary the direction of their travels as much as possible. 
CASES XII. and XIII. both suffered from abnormal sex- 
ual appetites. Case XII. a young man, twenty-four years of 
age, had observed for the past year a gradually increasing 
desire for members of his own sex. He had been able to BICYCLE IN TREATMENT OE NERVOUS DISEASES. 
9 
control his appetite so far, but was fearful lest it should 
finally overcome him and lead him to perpetrate acts which 
were naturally abhorrent to him. Case XIII. was a man, 
thirty years of age, whose naturally vigorous sexual appe- 
tite had been fed by indulgence, till it seemed as if the 
gratification of his desires was his only object in life. 
I have observed during my twenty years experience 
among athletes, that physical fatigue is antagonistic to the 
sexual appetite, and that men who devote their lives to the 
cultivation of their physical strength are seldom, if ever, 
immoderate sexually, and during the periods of active train- 
ing are often abstemious simply from lack of desire. 
Energy, which, in others might be expended sexually, is in 
them consumed by hard physical work. It has, therefore, 
been my custom in those cases, in whom I have considered 
it advisable to diminish or to abolish the sexual appetite, 
to prescribe severe and fatiguing exercise in conjunction 
with suitable medicinal treatment. I have found nothing 
more serviceable than the bicycle to accomplish this 
object. It should be used daily, preferably in the after- 
noon, and the patient should be directed to ride long dis- 
tances at a rapid rate of speed, not carrying it to such an 
extent as to produce exhaustion, yet sufficiently so to in- 
duce well-marked fatigue. 
Both of these patients have repeatedly told me that a 
hard ride would invariably abolish all sexual desire, even if 
the appetite was at its strongest just before the ride was 
taken. Of course, medicinal treatment was administered 
in both instances; but there can be no doubt that their re- 
covery was hastened and facilitated by the hard physical 
labor they were subjected to by the use of the bicycle. 
These thirteen cases cited are not by any means the only 
ones in which the bicycle has been advantageously em- 
ployed, but they represent three different classes of disease, 
all of which were benefited by the bicycle, and yet in each 
class the manner of using it was different. What would 
have been considered the immoderate and injudicious use 
of a remedy in one class of cases, was only attended by 
good results in another. For the guidance of those who 10 
GRALME M. HAMMOND. 
may consider it expedient to use the bicycle as a remedy, 
the following suggestions may be useful: 
It is best, in most cases, to have the patient taught pri- 
vately. Indeed, this is essential in cases of hysteria and 
neurasthenia, particularly when the subject happens to be 
a woman. The nervousness, agitation and fright, which 
pervade all nervous women and most nervous men at the 
bare possibility of taking their initial lessons before an au- 
dience, is in itself sufficient to neutralize any benefit which 
might be derived from the exercise; while on the other 
hand, if the lessons are taken with only the patient and the 
teacher in the room, the feeling of trepidation soon vanishes, 
and gives place to those of enjoyment and exhilaration. In 
such cases I would not even permit the intrusion of inti- 
mate friends or relatives; of course, if the case is one of 
simple paralysis these restrictions do not apply. The 
teacher should be a man of discrimination, who understands, 
that he is not only giving a bicycle lesson, but is also deal- 
ing with a case of sickness. Most of my patients were 
taught by a special teacher at Bidwell’s School, who, acting 
under my instructions, exercised both tact and patience 
with his teaching, and materially aided me by his encour- 
agement of fretful or despondent patients. It seems to me 
that all physicians who desire their neurasthenic or hyster- 
ical patients to take bicycle lessons, should carefully instruct 
the teacher in regard to his management of th.e case. Im- 
patience and irritability on the teacher’s part, often dis- 
courage patients who might have been greatly benefited 
by judicious management. 
As comfort is essential to pleasure and contentment, a 
bicycle should be selected which combines fine workman- 
ship and smoothly running parts, with the least amount of 
vibration, while traversing rough or uneven roads. A bicy- 
cle which works stiffly, or which “squeaks,” or where the 
saddle is uncomfortable are often matters, which though 
trivial to the healthy individual, are of the greatest annoy- 
ance to the sick. One of my patients, a hysterical man, was 
one day so annoyed by the continual “ squeak, squeak,” of 
his pedal every time it revolved, that he finally burst into BICYCLE IN TREATMENT OF NERVOUS DISEASES. 
11 
tears, dismounted, left his bicycle in the road and returned 
home in the cars, in a highly hysterical condition. 
At the present time the pneumatic tired machine is the 
most comfortable. Rough roads can be traversed on it 
with very little jar or vibration. It is particularly to be de- 
sired for women. The American, or Thomas tire, as it is 
called, is superior and more enduring than any tire that is 
imported. The weight of the bicycle is a matter of impor- 
tance, and should be carefully determined by the weight of 
the individual who intends riding it. A heavy person is 
liable to break a wheel which is too light for him; on the 
other hand, it is not advisable for a person, especially if he 
is not strong, burdening himself with more weight than is 
necessary. The selection of the weight of the wheel had 
best be left to Bidwell. 
In riding, the body should not be inclined forward, at 
least, only to a very slight degree. In racing, undoubtedly 
greater speed can be attained when the body is bent almost 
at right angles with the legs; but with the invalid in search 
of health the case is different. The attainment of great 
speed is not the point to be gained. He should sit in a nat- 
ural and easy position, with the chest out, and the head 
well up, so that respiration can be carried on to the best 
advantage. 
If physicians would study the bicycle as a remedy and 
prescribe it intelligently, they would often find it exerting 
a beneficial influence far in excess of their expectations. Bicycling as a Therapeutic. 
The attention of physicians is called to the value of bicycling in 
numerous forms of nervous disease. Many practitioners have found it 
an auxilliary of great usefulness in restoring nervous or delicate patients 
to a condition of health. 
Our facilities for giving instruction are excellent. Our riding hall is 
50x100 feet in size, and competent and careful teachers give personal 
attention to each pupil. All lessons are private. Physicians may have 
their patients taught under their personal supervision when desired. 
Ladies will find our methods most agreeable. 
A cordial invitation is extended to physicians to inspect our building. 
We are dealers in ALL LEADING MAKES OF BICYCLES, 
and manufacturers of 
THE TOURIST, 
THE CONQUEST, 
THE STUDENT. 
The two first named being wheels of the highest class and the latter 
a medium priced wheel, 
Our catalogue gives full information. 
GEORGE R. BIDWELL CYCLE CO, 
306-310 West 59th Street. NEW YORK.