Page:EB1911 - Volume 06.djvu/587

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568
CLUB-FOOT—CLUENTIUS HABITUS

as in England. The earliest clubs on the European continent were of a political nature. These in 1848 were repressed in Austria and Germany, and the modern clubs of Berlin and Vienna are mere replicas of their English prototypes. In France, where the term cercle is most usual, the first was Le Club Politique (1782), and during the Revolution such associations proved important political forces (see Jacobins, Feuillants, Cordeliers). Of the modern purely social clubs in Paris the most notable are The Jockey Club (1833) and the Cercle de la Rue Royale.

In the United States clubs were first established after the War of Independence. One of the first in date was the Hoboken Turtle Club (1797), which still survives. Of the modern clubs in New York the Union (1836) is the earliest, and other important ones are the Century (1847), Union League (1863), University (1865), Knickerbocker (1871), Lotus (1870), Manhattan (1865), and Metropolitan (1891). But club-life in American cities has grown to enormous proportions; the number of excellent clubs is now legion, and their hospitality has become proverbial. The chief clubs in each city are referred to in the topographical articles.

Walter Arnold, Life and Death of the Sublime Society of Beefsteaks (1871); John Aubrey, Letters of Eminent Persons (2 vols.); C. Marsh, Clubs of London, with Anecdotes of their Members, Sketches of Character and Conversation (2 vols., 1832); Notes and Queries, 3rd series, vols. 1, 9, 10; W. H. Pyne, Wine and Walnuts (2 vols., 1823); Admiral Smyth, Sketch of the Use and Progress of the Royal Society Club (1860); John Timbs, Club Life of London, with Anecdotes of Clubs, Coffee-Houses and Taverns (2 vols., 1866), and History of Clubs and Club Life (1872); Th. Walker, The Original, fifth edition, by W. A. Guy (1875); The Secret History of Clubs of all Descriptions by Ned Ward (1709); Complete and Humourous Account of all the Remarkable Clubs and Societies in the Cities of London and Westminster, by Ned Ward (7th edition, 1756); The London Clubs; their Anecdotes, History, Private Rules and Regulations (12mo, 1853); Rev. A. Hume, Learned Societies and Printing Clubs (1847); J. Strang, Glasgow and its Clubs (1857); A. F. Leach, Club Cases (1879); Col. G. J. Ivey, Clubs of the World (1880); J. Wertheimer, Law relating to Clubs (1885); L. Fagan, The Reform Club (1887); F. G. Waugh, Members of the Athenaeum Club (privately printed 1888).


CLUB-FOOT (talipes), the name given to deformities of the foot, some of which are congenital, others acquired—the latter being chiefly due to infantile paralysis. Talipes equinus is that form in which the heel does not touch the ground, the child resting on the toes. In talipes varus the foot is turned inwards and shortened, the inner edge of the foot is raised, and the child walks on the outer edge. These two conditions are often combined, the heel being drawn up and the foot twisted inward; the name given to the twofold deformity is talipes equino-varus. It is the most usual congenital form. In talipes calcaneus the toes are pointed upwards and the foot rests on the heel. This is always an acquired (paralytic) deformity.

The treatment of congenital club-foot, which is almost invariably varus or equino-varus, should be begun as soon as ever the abnormal condition of the foot is recognized. The nurse should be shown how to twist and coax the foot into the improved position, and should so hold it in her hand many times a day. And thus by daily, or, one might almost say, hourly manipulations, much good may be accomplished without distress to the infant. If after weeks or months of these measures insufficient progress has been made, the subcutaneous division of a tendon or two, or of some tendons and ligaments may be necessary, the foot being subsequently fixed up in the improved position in plaster of Paris. If these subcutaneous operations also prove disappointing, or if after their apparently successful employment the foot constantly relapses into the old position, a more radical procedure will be required. Of the many procedures which have been adopted there is, probably, none equal to that of free transverse incision introduced by the late Dr A. M. Phelps of New York. By this “open method” the surgeon sees exactly what structures are at fault and in need of division—skin, fasciae tendons, ligaments; everything, in short, which prevented the easy rectification of the deformity. After the operation, the foot is fixed, without any strain, in an over-corrected position, between plaster of Paris splints. By the adoption of this method the old instrument of torture known as “Scarpa’s shoe” has become obsolete, as have also some of those operations which effected improvement of the foot by the removal of portions of the bony arch. Phelps’s operation removes the deformity by increasing the length of the concave border of the foot rather than by shortening the convex borders as in cuneiform osteotomy; it is a levelling up, not a levelling down.

Talipes valgus is very rare as a congenital defect, but is common enough as a result of infantile paralysis and as such is apt to be combined with the calcanean variety. “Flat-foot” is sometimes spoken of as spurious talipes valgus; it is due to the bony arches of the foot being called upon to support a weight beyond their power. The giving way of the arches may be due to weakness of the muscles, tendons or ligaments—probably of all three. It is often met with in feeble and flabby children, and in nurses, waiters, policemen and others whose feet grow tired from much standing. Exercises on tip-toe, especially with a skipping rope, massage, rest and tonic treatment will give relief, and shoes or boots may be supplied with the heel and sole thickened along the inner borders so that the weight may be received along the strong outer border of the foot. When the flat-footed individual stands it should be upon the outer borders of his feet, or better still, when convenient, on tip-toe, as this posture strengthens those muscles of the leg which run into the sole of the foot and hold up the bony arches. In certain extreme cases the surgeon wrenches the splay feet into an inverted position and fixes them in plaster of Paris, taking off the casing every day for the purpose of massage and exercises.

Flat-foot is often associated with knock-knee in children and young adults who are the subject of rickets.

Morton’s Disease.—In some cases of flat-foot the life of the individual is made miserable by neuralgia at the root of the toes, which comes on after much standing or walking, the distress being so great that, almost regardless of propriety, he is compelled to take off his boot. The condition is known as Morton’s disease or metatarsalgia. The pain is due to the nerves of the toes (which come from the sole of the foot) being pressed upon by the rounded ends of the long bones of the foot near the web of the toes. It does not generally yield to palliative measures (though rest of the foot and a change to broad-toed, easy boots may be helpful), and the only effectual remedy is resection of the head of one of the metatarsal bones, after which relief is complete and permanent.

For paralytic club-foot, in which distressing corns have been developed over the unnatural prominences upon which the sufferer has been accustomed to walk, the adoption of the most promising conservative measures are usually disappointing, and relief and happiness may be obtainable only after the performance of Syme’s amputation through the ankle-joint.


CLUE, or Clew (O. Eng. cluwe), originally a ball of thread or wool, the thread of life, which, according to the fable, the Fates spin for every man. The ordinary figurative meaning, a piece of evidence leading to discovery, or a sign pointing to the right track, is derived from the story of Theseus, who was guided through the labyrinth by the ball of thread held by Ariadne.


CLUENTIUS HABITUS, AULUS, of Larinum in Samnium, the hero of a Roman cause célèbre. In 74 B.C. he accused his stepfather Statius Albius Oppianicus of an attempt to poison him; had it been successful, the property of Cluentius would have fallen to his mother Sassia. Oppianicus and two others were condemned, and some years later Oppianicus died in exile. But the verdict was looked upon with suspicion, and it was known for a fact that one of the jurymen had received a large sum of money for distribution amongst his colleagues. The result was the degradation of Cluentius himself and several of the jurymen. In 66, Sassia induced her stepson Oppianicus to charge Cluentius with having caused the elder Oppianicus to be poisoned while in exile. On this occasion the defence was undertaken by Cicero in the extant speech Pro Cluentio. In the end Cluentius was acquitted. Cicero afterwards boasted openly that he had thrown dust in the eyes of the jury (Quintilian, Instit. ii. 17. 21, who quotes this speech more than any other). His efforts are chiefly devoted to proving that the condemnation