Dancing as part of the regular treatment of those convalescing from heart disease was prescribed two years ago by Dr. Frederic Brush, Medical Director of the Burke Foundation, the great institution for the care and treatment of convalescents at White Plains, to which many patients from New York City hospitals and other institutions are sent. The result of this treatment as shown by its effect upon thousands of patients has been amazing, and doubtless will elicit a gasp of astonishment from the uninitiated layman as well as from the physician of the older school. Dr. Brush says, however, that there have not been any bad results, but on the contrary the exercise has been of great benefit. Modern dancing (ball, contra and folk types) is a valuable form of physical exercise in the reconstructive-convalescent stages of heart disease, he declares. It affords a high degree of needed mental therapy, and advances the patient notably toward social restoration. Experience indicates its safety. It gives an added and readily available test of the cardiac reserve and of progress. The physician tells about his experience with dancing as a therapeutic agent in Hospital Social Service. It is of assured advantages, says the physician, to have the exercises pleasurably anticipated and enjoyed; and particularly valuable to have them simulate or merge into everyday physical and social activities. Good results of a road hike or short golf or coasting, versus to-and-fro grade walking or of soccer (a kick-about game) as compared with prescribed medicine-ball tossing are soon apparent in practice. Formal Formal gymnastics aid by inspiring courage and further exercise, in getting hold of the mild slacker or neurasthenic, and serve well in bad weather times; but in six years' observation of some 3,000 heart convalescents, says Dr. Brush, no regime has given such all-round satisfaction, safety and success as did the old farm regime where a total of nearly 500 cardiacs, boys and young men, were given essential freedom in play and work over the place (under reasonable regulation of rest). Dancing may be called an inherent activity-of all girls, of * Courtesy of the New York Times women up to fifty, and of most young and middle-aged men, says the physician; older persons are persistently happy in watching it; it is the most joyous of all play-exercises, and both physically and socially a stimulant, Convalescents with but a moderate degree of cardiac reserve may begin cautiously to dance, then go on to a considerable indulgence, with safety and benefit, he asserts. The heart patients early led the way in this. Women were found to be dancing in their cottages and boys exhibited various "jig stunts." The practice was checked, then carefully observed, encouraged and organized; and soon two or three formal dances per week were given, open to patients of all diagnoses and ages. For two seasons past a dancing class for cardiacs under eighteen years has been conducted, under medical and nurse watchfulness, the instruction being given principally by stronger patients of this group. Class attendance is compulsory as soon as the heart strength is considered adequate. The weaker and more diffident are gradually inducted. Many cardiacs have given special dances in entertainments. This highly diversional exercise is not stressed, but is included in the direction, "to begin to walk, coast, golf, dance, as soon as you feel able." Resident physicians' orders are occasionally given for more or less or none of these various exercises. How Patients For six months the dancing is out of doors. The spectators, too, are strongly affected for good, Dr. Brush asserts. One hardly recognizes these patients at such functions; they show color, animation, strength, good posture; pains and neurotic depressions have actually disappearedand are the less likely to return. "I can dance again!" is a valued expression by patients. There have been about twenty collapses or partial faints among all the thousands of dancers (30,000 patients cared for). About half of these were in cardiacs and found to be mainly hysterical or neurotic. Some heart patients have complained of increased pain, the day after, but no instance of decompensating has followed. (Decompensation means failure of the heart to increase in power sufficiently to overcome valvular disease.) The pulse rate rises moderately. Many patients express a feeling of benefit from the exercise. The prohibition with which most patients come is largely the outcome of two misconceptions-that dancing is necessarily and always a strenuous and exhausting exercise, and that one set of rules may apply to all heart disease. As a fact, says the physician, short-period dancing as thus practiced (a shuffling, with little weight lifting) is one of the milder exertions. The hour is often interspersed with other entertainment, and there is much sitting out of the numbers. Furthermore, cardiacs present all degrees of exercise ability and should not sweepingly be deprived of one of life's best diversions, says the physician, and what is for the majority a valuable reconstructive activity. "I have made considerable inquiry," says Dr. Brush, "among physicians of the broadest experience and have not learned of one instance of sudden death of a cardiac upon the dancing floor nor of heart failure being thought attributable to dancing (novelistic ‘heartbreak' is understood as excluded). Instances might be brought out, of course; yet this negative is significant in view of the recorded. acute heart failures during various other recreations and exercisings. I have, for example, personally known of decompensations from golf, tennis and the innocuous ping-pong. "The psychoneurotic element is increasingly understood to be important in heart disease, and these patients are advanced in recuperation by the dance's emotional and physical 'setting-up,' the suggestion of normality, the stimulus of dressing and appearing well, and the feeling of rising again out of prohibitions and above social invalidism." Joseph Lee on Health Teaching* National Child Health Council 17th and D Streets, N. W. Washington, D. C. Gentlemen: My general feeling is that children ought to be taught the right habits, told that such and such a thing is important, and perhaps that it is important in order to keep well or to succeed in athletics, but mainly ought to be told that this is the way to do, with as little reference to their health as possible. I don't believe that children ought to be brought up as valetudinarians. The main and most important of all things about health is to do something worth while and forget yourself and your health. I have *In answer to a request for ways in which health habits could be taught through recreation known whole families whose physical condition was continuously and permanently depressed by constant attention upon it. It required a war to cure them and that probably not permanently. The health habits to be taught from the kindergarten to the sixth grade (up to the age of 12) should be as to food, sleep, bathing, care of the bowels, exercise, brushing their teeth, and clothes, especially not wearing their coats when it is too warm. As to wearing warm clothes until the main heat of the summer is over, especially underclothes, also as to getting one's feet wet, going out in the rain, falling into the water, and other wholesome pursuits-parents are still influenced by the feeling of sacrilege,-that the god will somehow swat you if you show impudence, too great confidence,-what the Greeks called hubris; that a cold in the head is a sort of judgment of heaven for having had the cheek to go out without your overcoat. The nature studies should be of the real interests and intentions of plants and animals, just as the latter are told in Thornton W. Burgess's stories, not as either of them are told in scientific books. I myself was permanently sterilized as to botany by a fool teacher who taught me that the pistil was composed of the germ, the style and the stigma, a piece of information which I have unfortunately remembered ever since. I think methods of fertilization, especially where the bee or some outside party take a hand, give a sense of the wonders of nature almost more than anything else. I used to sit up nights reading astronomy, and I think the relation of the sun, earth, moon and planets could be taught in about half an hour to most children if it was done in a sensible way. All boys are interested in mechanics except as taught in school. For children above the sixth grade, either in the elementary or the high school, I think there should be sex instruction, preferably by their parents. I don't know whether it is cver given in school to advantage. For teachers I think the best preparation for making the children. healthy as distinguished from teaching health is that the teacher should himself be thrilled with some particular subject and should. teach it so as to give the same feeling to the children. I believe that health is positive. Fearlessness, loyalty, an interest in games, and some sense of the poetry of life I believe are the main sources of health. Yours very truly, (Signed) JOSEPH LEE rules may apply to all heart disease. As a fact, says the physician, short-period dancing as thus practiced (a shuffling, with little weight lifting) is one of the milder exertions. The hour is often interspersed with other entertainment, and there is much sitting out of the numbers. Furthermore, cardiacs present all degrees of exercise ability and should not sweepingly be deprived of one of life's best diversions, says the physician, and what is for the majority a valuable reconstructive activity. "I have made considerable inquiry," says Dr. Brush, "among physicians of the broadest experience and have not learned of one instance of sudden death of a cardiac upon the dancing floor nor of heart failure being thought attributable to dancing (novelistic 'heartbreak' is understood as excluded). Instances might be brought out, of course; yet this negative is significant in view of the recorded. acute heart failures during various other recreations and exercisings. I have, for example, personally known of decompensations from golf, tennis and the innocuous ping-pong. "The psychoneurotic element is increasingly understood to be important in heart disease, and these patients are advanced in recuperation by the dance's emotional and physical 'setting-up,' the suggestion of normality, the stimulus of dressing and appearing well, and the feeling of rising again out of prohibitions and above social invalidism." Joseph Lee on Health Teaching* National Child Health Council 17th and D Streets, N. W. Washington, D. C. Gentlemen: My general feeling is that children ought to be taught the right habits, told that such and such a thing is important, and perhaps that it is important in order to keep well or to succeed in athletics, but mainly ought to be told that this is the way to do, with as little reference to their health as possible. I don't believe that children ought to be brought up as valetudinarians. The main and most important of all things about health is to do something worth while and forget yourself and your health. I have In answer to a request for ways in which health habits could be taught through recreation |