In the 1860s, descriptions of boys who grew progressively weaker, lost the ability to walk, and died at an early age became more prominent in medical journals. In the following decade,  French neurologist Guillaume Duchenne gave a comprehensive account of the most common and severe form of the disease, which now carries his name—Duchenne MD. It soon became evident that the disease had more than one form.  The other major forms are Becker, limb-girdle, congenital, facioscapulohumeral, myotonic, oculopharyngeal, distal, and EDMD.  Duchenne and Becker muscular dystrophies, being caused by a mutation of a gene located on the X chromosome, predominantly affect males, although females can sometimes have severe symptoms, as well. Most types of MD are multisystem disorders with manifestations in body systems including the heart, gastrointestinal system, nervous system, endocrine glands, eyes, and brain. 
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Muscular Christianity spread to other countries in the 19th century. It was well entrenched in Australian society by 1860, though not always with much recognition of the religious element.  In the United States it appeared first in private schools and then in the YMCA and in the preaching of evangelists such as Dwight L. Moody .  (The addition of athletics to the YMCA led to, among other things, the invention of basketball and volleyball .) Parodied by Sinclair Lewis in Elmer Gantry (though he had praised the Oberlin College YMCA for its "positive earnest muscular Christianity") and out of step with theologians such as Reinhold Niebuhr , its influence declined in American mainline Protestantism . Nonetheless, it was felt in such evangelical organizations as the Fellowship of Christian Athletes , Athletes in Action , and the Promise Keepers .