Prior to 1969, marathon runners were advised against drinking or eating during competition (i) since it was believed that espe

Prior to 1969, marathon runners were advised against drinking or eating during competition (1) since it was believed that, especially fluid ingestion would impair performance, not least by causing unpleasant gastrointestinal symptoms including the “stitch”. At that time, marathon runners and marathon races were quite different from their modern descendants. In particular, there were few competitive marathon runners; most were well trained, usually completing marathon races in less than 3-31⁄2 hours. As a result, most marathon races were small, with fields of a few hundred runners at most. Races usually closed after 31⁄2 hours and little if any, medical care was provided, presumably because there was little need. Indeed the first reports detailing the nature of the medical care provided at specific marathon races were published only in the 1980's (2).