La Bicyclette: Chez les Hernieux
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Citation
A. Mignon. La Bicyclette: Chez les Hernieux. 1899. cyclearchive.com, https://cyclearchive.com/books/la-bicyclette-chez-les-hernieux-1899/
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Contents
- Author A. Mignon explains he was prompted by Dr. Lucas-Championnière's report to the Académie de Médecine on hernias healing through cycling, and describes canvassing fellow physicians and cyclists for confirming cases. He found few documented improvements beyond one instructive case supplied by Dr. Georges Petit, but many hernia sufferers cycling without ill effect, and states the thesis will focus on inguinal hernias.
- Surveys prior medical opinion on cycling and hernia risk, quoting Professor Berger's Traité de Chirurgie on effort during a fall as a cause, a British Medical Journal piece on saddle height and handlebar position, and The Lancet's Dr. Cresswell, Dr. H.-L. Cortis, Dr. Tissié, and Lord Bury and Hillier, most of whom found no case of cycling causing a hernia.
- Defines abdominal hernias after Paul Berger and classifies them as spontaneous/acquired versus traumatic, and as reducible, irreducible or strangulated per Samuel Cooper, distinguishing Astley Cooper's 'hernia of force' from 'hernia of weakness.' Discusses the role of obesity and fatty infiltration of the abdominal wall in hernia formation, drawing on Berger and Lucas-Championnière.
- Unpublished case of B..., an 18-year-old office clerk with a simple inguinal hernia (bubonocèle) the size of a small apple since age 12, inguinal ring 4-5cm. After two hours of daily cycling he has worn no truss for three years and the hernia no longer protrudes even when coughing.
- Unpublished case of H..., 34, a cyclist for ten years whose inguinal hernia (bubonocèle) first appeared at 18 while working as a baker's apprentice. Despite now cycling 10-12 hours a day as a newspaper delivery man, he reports the hernia reduces more easily than before.
- Unpublished case of M..., 40, a former high-wheeler racer with a simple inguinal hernia (bubonocèle) the size of a small hen's egg since age 25, first noticed after a racing fall. Its volume shrank while he cycled and the improvement held four years after he stopped riding, though he must wear a truss to walk.
- Unpublished case of an insurance-company employee over 56 with an irreducible double inguinal hernia (épiplocèle) present since birth, worn with a double truss and thigh straps. Eight years of amateur cycling produced no change in the hernias' size.
- Unpublished case of B..., 58, a man of independent means with an irreducible double inguinal hernia dating from age 6, surgically treated in Belgium at 28 with sixteen years' remission before recurrence. He rides a woman's-frame machine (to clear the horizontal tube) three hours each morning and two each evening without fatigue, though walking down the Champs-Élysées exhausts him.
- Communicated by Dr. Léon Petit: C..., 28, a well-known sprinter turned endurance racer with a large lifelong double oschéocèle, rode a fatiguing 24-hour road race unbandaged and won, the hernia feeling lighter afterward. Years later, having switched from cycling to motorcycles and cars, he again needs a truss and notices his condition worse without pedalling.
- Reprinted from the Bulletin de l'hôpital civil français de Tunis, communicated by Dr. Loir, director of the Institut Pasteur de Tunis: a 36-year-old professional man's oschéocèle worsened from 1893 despite trusses. Switching in 1898 to a low, women's-frame bicycle stopped the hernia descending, the abdominal fat disappeared, and by autumn the visceral impulse could no longer be felt on coughing even unbandaged.
- Summarised from the Bulletin de l'hôpital civil français de Tunis, reported by Dr. Schoull: a patient's small hernia (pointe de hernie) worsened with recurrent bronchitis and coughing fits. Daily moderate 30-40km rides from spring 1896 brought complete relief within three months, holding through 1897 before a further winter bronchitis caused mild recurrence.
- Unpublished, communicated by Dr. Georges Petit of the Hôpital d'Ormesson: A..., 35, a track-and-road cyclist, developed a left inguinal hernia (bubonocèle) after a coughing fit during influenza in 1890 but kept racing and seemingly recovered. The hernia only reappeared, with new obesity and a slight varicocèle, after he gave up cycling for motorcycling eight months before examination.
- Explains cycling's general physiological benefits (deeper breathing, a stronger heart, better nutrient oxidation per Albert Robin, symmetrical muscle use per Professor Gariel) and argues it beats riding, fencing, apparatus gymnastics and walking for hernia sufferers because the seated position removes the vertical jolt and heel-strike that aggravate a hernia. Also credits cycling's fat-reducing effect, citing Guillemet, and its promotion of intestinal evacuation, citing Jennings, Regnault and Bianchi.
- Argues cycling suits almost all hernia sufferers regardless of age, hernia size or irreducibility, citing patients aged 40, 56 and 58 from the Observations. The only real caveat is localized pain, which need only pause cycling temporarily, and a stationary 'Home Trainer' is recommended for weaker patients before they progress to the road.
- Sets out practical rules: avoid falls, high speed and steep gradients; prefer a low saddle set well back from the pedals, per Lucas-Championnière's advice to the Académie de Médecine, rather than the fashionable upright racing position; dismount gently rather than jumping from the pedal, per Professor Gariel; avoid cobbled roads; and use a well-made suspensory support rather than a truss for oschéocèle or irreducible hernias.
- States five conclusions: cycling is a physical exercise wrongly proscribed for hernia sufferers; no case was found where cycling caused, increased or aggravated a hernia; sufferers who cycle gain general health benefits and occasionally a reduction in the hernia itself; these benefits require following the stated training rules; and cycling is the exercise of choice for hernia sufferers. Approved by Dean Brouardel, President Gariel and Vice-Rector Gréard.