In 1896, the journal of the american medical association published a cautionary article by dr. william c. krauss of buffalo, new york, that reported the curious case of a 37-year-old man with "acute dilation of the heart." it seems the patient, james h. c., regularly cycled the half mile to and from his job on the railroad, but on one occasion, he took a four-mile, 25-minute ride with his friends that left him severely distressed. at the end of it, his heart was pounding, he had a severe pain on the left side of his chest, and he was completely out of breath. james heeded his friends' advice and rode home immediately, covering the distance a bit more slowly. but his symptoms worsened overnight, and his heart was still racing at 130 beats per minute when krauss saw him two months later. the doctor's diagnosis was short and to the point: "over-bicycling."