its shape, the heads of the femora are removed farther from the center of gravity, and at the same time become rotated forward by the widening of the pelvis, and especially of the outlet of the pelvis. The effect of these changes is to bring the knees closer together, and to produce the weak-kneed condition and the awkward running gait peculiar to women. This condition of the limbs is well seen in pictures and statues of the nude figure, and it is often exaggerated by the artist or sculptor, probably to give a more distinct idea of a woman's helplessness or modesty. The knee-cap in women looks straight forward, while in men it is turned a little outward; and in women the knees touch, or even overlap each other, while in men they are quite free. In running, a woman has to move the knees round each other, and to throw the feet out in a succession of small semicircles, which accounts for the peculiarity in her gait. This gait is not found in young girls before the onset of puberty, and is useful as a diagnostic sign of pelvic evolution long before the ordinary signs appear.
Although this weak-kneed condition is quite normal, it is a fruitful source of deformity in growing girls. A little additional strain will convert it into knock-knee, and, by throwing the weight of the body on the inner ankle, it will quickly break down the arch of the foot and produce flat-foot or complete eversion of one or both feet. It is here, indeed, that nearly all the mischief lies, for according to my experience ninety per cent of the cases of lateral curvature of the spine in girls are associated with flat-foot. This deformity is exceedingly common among women, and a French savant recently quoted it as a proof of the physical inferiority of woman to man. To a slight extent flatfoot may exist in all women, as the position of the lower limbs after puberty would seem to produce it, and it may be Nature's plan to promote what anthropologists call marriage by capture; but to a large extent, and in its worst forms, flat-foot is the result of civilization. Indeed, both the highly arched instep and the everted foot are peculiar to civilized peoples, and are absent from the lower races, especially those who go barefoot, and both conditions owe their existence to the wasting of the muscles which flex the toes and foot by the constant use of tight-fitting shoes. In India, where the native workman makes use of his toes with almost the same facility as his fingers, the instep is obliterated by the fleshy bellies of the abductor of the great toe and the short flexor of the toes, which stretch across the arch from their attachment to the heel-bone. The wasting of these muscles is of little importance to us who have no need to use our toes in detail; but it is far otherwise with the deep flexors of the foot and toes which are attached to the leg-bones, and whose tendons pass under the ankle joint and arch of the foot and form their chief support. It is, indeed, from the wasting or inaction of the deep flexor muscles, coupled with the turning out of the toes which fashion has imposed upon us, that the ankle and arch of the foot give way under the changed position
