Popular Science Monthly/Volume 24/March 1884/Fashion and Deformity in the Feet
By ADA H. KEPLEY.
"A WELL-FORMED foot," says Chapman in "The American Drawing-Book," "is rarely to be met with in our day, from the lamentable distortion it is doomed to endure by the fashion of our shoes and boots. Instead of being allowed the same freedom as the fingers to exercise the purposes for which Nature intended them, the toes are cramped together, and are of little more value than if they were all in one; their joints enlarged, stiffened, and distorted, forced and packed together, often overlapping one another in sad confusion, and wantonly placed beyond the power of service. As for the little-toe and its neighbor, in a shoe-deformed foot, they are usually thrust out of the way altogether, as if considered supernumerary and useless, while all the work is thrown upon the great-toe, although that too is scarcely allowed working-room in its prison-house of leather. It is, therefore, hopeless to look for a foot that has grown under the restraints of leather, for perfection of form; and hence the feet of children, although less marked in their external anatomical development, present the best models for the study and exercise of the pupil in drawing." Camper, who wrote, in the seventeenth century, "On the Best Form of Shoe," says that his treatise originated in a jest made with his pupils, who "did not believe I should dare to make public a work on such a subject," which indicates the small estimate that was put upon the foot as an organ of the body. He begins by deploring the perversity which wholly neglects the human feet, while forcing the greatest attention to the feet of "horses, mules, oxen, and other animals of burden," and declares that from the earliest infancy the foot-coverings worn serve but to deform them, and make walking painful, and sometimes impossible; and he lays the blame on the ignorance of shoe-makers.
James Dowie, a practical and scientific Scotch shoemaker, in his excellent little book, makes the same statements as the artist; and the great Dutch surgeon, whose treatise he had translated into the English language, also laments that the subject of the feet is so neglected by those who are competent to instruct us about them. Lord Palmerston said to Dowie that "shoemakers should all be treated like pirates, put to death without trial or mercy, as they had inflicted more suffering on mankind than any class he knew."
One can not treat of the deformities of the feet without considering the nature of their covering, the boots and shoes, for it is these which cramp, distort, and disable them; therefore in this article, after a brief account of the anatomy of the foot, our attention will be confined to its principal distortions and the causes which produce them.
The feet furnish a firm base for the body in standing, and, undeformed, make walking easy and healthful. They sustain alternately the whole of the body's weight, and, though comparatively small, are admirably fitted to carry it without jar or discomfort, if unhampered by their coverings. They are in the highest degree elastic, from the large number of bones, with many articulations, with their attachments, and the plentiful supply of muscles, blood-vessels, and nerves to keep them vigorous and well-nourished. This elasticity enables them to carry the body over smooth and rough surfaces, not only without injury, but to its greater health. In just so far as this elasticity and freedom of natural action are interfered with, is their health, and with it that of the body, lowered. Anatomists divide the skeleton of the foot into three portions, the tarsus, with seven bones, forming the heel and arch bones; the metatarsus, with five bones just forward of the tarsus; and the toes, which contain fourteen bones, two in the great-toe, three in each of the other toes; beneath the ball of the foot, as it is called, are two small bones, which lie under the articulation of the great-toe and the adjoining metatarsal bones, making twenty-eight bones in each foot (see Figs. 16, 17, 19).
The large articulating surface of the feet, and their numerous blood-vessels, muscles, nerves, etc., render it peculiarly susceptible to injuries. Their distance from the center of circulation, together with the variations of temperature they have to endure, make them extremely liable to contract disease.
It seems as if the general injuries to the body resulting from diseased and crippled feet should be plain enough to attract attention, but such does not appear to be the case. No complete treatise on the feet has been produced. Physicians as a class seem to pay the subject but little attention. In the books in which the diseases and injuries of the feet are considered, the causes of disease, if stated, seem to be mentioned incidentally, and without proper notice of the connection between the diseases and the bad physiological conditions they induce. Physicians will prescribe for diseases caused largely by unsuitable clothing of the feet, without saying anything of the reform in the chaussure by means of which the disorder might be greatly mitigated, if not cured. A delicate woman was treated for months for a peculiar disease which made her a complete invalid, by an eminent specialist, who said nothing of the high-heeled, paper-soled, thin boots, the habitualFig. 2. wearing of which greatly aggravated her disorder. A paper showing the deleterious effects of such shoes on the health of women, read at a recent meeting of an association of doctors, seemed, according to the reports, to call out more objectors than it found friends. A competent woman physician excused herself for wearing such shoes because it was so hard to find hygienic shoes in stock, and added that, when physicians prescribed reforms in clothing, they had to be politic, to keep their patients; and when asked if she ever saw a woman who wore tight shoes, replied "No"; nor did she know any who wore tight corsets.
Walking is the exercise that, more than any other, brings every portion of the system into healthful activity. Many complaints would disappear under a thorough and careful course of pedestrianism; but who can walk if the feet are sore or diseased? General bad conditions arise from lack of exercise, which invigorates the muscles and oxygenizes the vital fluid. Dyspepsia is the usual attendant on such conditions, and may manifest itself either by general emaciation or by fatty degeneration.
The feet demand a covering which shall conform to their shape, allow them free play, and afford protection from injuries. Dowie scoffingly remarks, in his treatise, respecting shoes so cut at the toes as to represent the foot like that of a goose, with the great-toe in the middle. We are now in an era of "pencil-toed" shoes, so called, which recall Dowie's comparison. It is difficult to understand how shoemakers can be so careless of the shape of the feet and their needs as to cut shoes that in the toe are the very reverse of what toes demand; but it is more difficult to conceive how any one can endure the suffering they inflict. Dowie insists that tight-toed stockings are injurious to the feet, and recommends that they be woven with a separate covering for each toe, as gloves are made with fingers.
Fig. 1 is a foot copied from the antique, and shows "beauty of form and proportion, ease and elasticity of motion, as well as an admirable expression of adaptation and power for use throughout."
Fig. 2 shows the distorted foot of a Chinese woman, photographed from nature.
Fig. 3 represents the sole of a normal human foot. The dotted line shows how the foot is usually cramped in the shoe-sole. The heel of the foot is narrow, the anterior portion broad, the toes are nearly parallel to a line "C," drawn through the center of the sole from heel to toe. The line A B is drawn through the center of the instep, or great arch of the foot, and bisects the great-toe. It is this arch which mainly supports the weight of the body; the heel forms one of its
piers, the great-toe the other. One may easily see that when the great-toe is drawn from its line with the arch, as indicated by the dotted lines, the stability of the body is by so much destroyed; and when the heel is taken from its level with the bulk of the foot, by a high heel, yet more is the stability of the body destroyed. Erichson says: "Firmness of gait is caused by the foot resting on the heel behind and the ball in front, and principally by the foot resting on the broad line formed by the great-toe and the breadth of the fore part of the foot."
The dotted lines in Fig. 3 show the outlines of a quite liberal sole. It is easy to see how an ordinary foot would be cramped if confined within its limits.
Fig. 4 shows a very common shape of the foot, produced by cramping and crowding the toes. Many persons have only to look at their own feet to see fine specimens of this sort.
The diseases most common to the feet are corns, bunyons, calluses, enlarged and stiffened joints, stiff and wasted toes, overlapping and underlapping toes, in-growing nails, caries of the bone, exostosis of the toe-bones, onyxitis of the toes, flat-foot, club-foot, ulcers, malignant and fibrous tumors, dislocations, changes in the shape of the bones from pressure, and elephantiasis. All wounds, injuries, and diseases are extremely liable to take on erysipelatous and scrofulous conditions, which speedily endanger life through their inflammatory, gangrenous, or debilitating nature; fatty degeneration of the tissues may take place, and weakness of the joints and thickening of the ankles plague their owners.
Corns consist of hardened flesh that becomes thorn-like in its shape and density, and a dismal source of pain. "A corn," says a writer, "is really a wicked demon, incarnated in a piece of callous skin. Its mission is to distress and agonize humanity and increase its wickedness." Gross says, "A bunyon is a corn on a large scale," and he and other writers agree that it is caused by a diversion of the great-toe from its line with the arch of the foot. When the toe is thus diverted, it forms an angle on the foot, which the shoe irritates and makes callous; inflammation sets in, and suppuration frequently ensues, that, in extreme cases, may make necessary amputation of the foot or feet.
Fig. 5 represents the foot of a young woman who wore high-heeled, narrow-soled shoes, which must also have been too short.
Figures 6 and 7 represent forms of bunyon complicated with under-and over-lapping toes. Fig. 8 shows a deformity of the foot resulting from inflammation of the metatarsal, phalangeal, or great-toe joint.
Fig. 9 shows an apparatus for the cure of bunyons. Its object is to draw the great-toe back into line with the great arch of the foot.
Erichson says, bunyon is caused by improperly cut shoes, and adds that to cure it the foot should be put in a shoe cut straight from heel to toe at the inner line of the sole. The toes are naturally quite flexible. Cases are well known of men and women who, being devoid of hands or Angers, have learned to use the feet and toes instead. Miss Biffin, of London, became expert as a portrait-painter; anotherFig. 7. woman used scissors to cut out all sorts of figures from paper; and men have been fully as capable with their toes. The Chinese and Hindoos are said to be able to pick up the most delicate objects with their toes. Yet in most feet the toes are wholly incapable of independent motion, while in many feet they are entirely stiff, and are distressing objects to look at.
In-growing nails are caused by shoes which are too short, and are a source of exquisite torture. This disease may degenerate into a worse condition called onyxitis (see Fig. 10), when it discharges a fetid humor, and may render a resort to the surgeon's knife a necessity. Caries of the bone may follow wounds, bruises, contusions, bunyons, corns, and calluses of the feet; and bunyons, corns, and calluses, as well as wounds, bruises, and contusions, may take on erysipelatous, scrofulous, ulcerous, or tumorous conditions. Exostosis of the bones (Fig. 11) is an abnormal growth which requires the saw, knife, and gouge of the surgeon for its extirpation. The toes are especially liable to this disease.
Fig. 12 is a specimen of splay or flat foot. It is caused by a breaking down of the arch of the foot, whereby locomotion becomes painful and sometimes impossible. Impairment of the general health accompanies it; in its worst forms a partial displacement of the bones occurs, the toes turn up, and the sole grows convex, while the ankle is very likely to thicken and lose strength by fatty degeneration. It is most common among youth. Some writers attribute it to "vicious eversions of the foot in attempts at polite walking"; by others it is attributed to overwork. It is most common among the children of the wealthy classes. Old people are subject to it from a breaking down of the tissues with age. For its cure local means must be used, and special attention be given to the general health.
A disease called elephantiasis, sometimes necessitating amputation of the whole limb, may result from injuries to the foot. A case of this sort is found in the books, where a dislocation of the foot, caused by drawing off a boot, induced the disease.
It is now time to consider defects in shoes, by which most of these diseases may be provoked or aggravated.
Dowie, who was a practical as well as theoretical shoemaker, and so full of enthusiasm that he studied the foot under skillful anatomists, and sent all his journeymen to a course of lectures on the feet, enumerates as the principal evils, that shoes are worn too short; that they are cut too narrow at the toes and in the sole; that the soles do not conform to the shape of the inner curve of the foot, nor to the line of the great arch or instep and the great-toe; that at the waist, or middle, the sole is too stiff and unyielding; that the toe is vertically too shallow, or "wedge-toed," as lie calls it; that the heel is too high; that the sole turns up too much at the toes. He and Camper agree on these points. The evils attending shoes too short will be more readily perceived when it is understood that the foot is lengthened in walking, and more in running and jumping.
The degree of elongation depends upon the shape of the foot. Long, slim, high-arched feet elongate most; short, fleshy feet least. In the first case the elongation varies from one fourth of an inch to one inch. It takes place forward and back, and the shoe should be long enough to allow for it. It is produced by the flattening of the
arch of the foot, when the weight of the body falls upon it; just as a carriage-spring elongates under pressure. The shoe which is just long enough when the foot is at rest, becomes too short when the elongation takes place, and the toes rise, as shown by the dotted lines in Fig. 13, preventing them from forming the firm pier which the anterior portion of the arch of the foot should have to rest upon, diminishing the elasticity of the organs, impairing their muscular force, and inducing the formation of corns through the rubbing of the toes against the leather. The weight of the body also crowds the toes up, and, turning the great-toe out of place, unfits it for its useful function. In-growing nails are caused by short shoes. An old poet says
"The shoe too short, the foot will wring";
and an old English couplet sums up the height of aggravating misery in these lines:
"Here's to our friends; as for our foes,
We wish them short shoes, and corns on their toes."
Narrow-toed shoes aggravate the abnormal position of the great-toe, and cramp the other toes closely together, stopping all their free and healthful motion.
Narrow soles cramp the whole foot; calluses, corns, stiff and inelastic joints, and wasted muscles follow. The distress endured by a fleshy foot in a narrow shoe must be felt to be appreciated. If shoes are not cut "rights and lefts," they do not conform to the shape of the foot, and keep it in a continuous strain, exercising also a tendency to break down the supporting arch. The foot, thrown out of position, falls too far to one side or the other, and we have "running down at the heels," and vicious inversions of the foot in walking.
Tight shoes impede the circulation, deprive the feet of the warmth they need, and ultimately cause waste of the tissues. A friend of the writer, a strong, vigorous man, in splendid health, nearly lost his life from congestion induced by an hour's wearing of a pair of tight boots. Of shoes too stiff at the waist or middle, Dowie says, "Rigidity of this portion of the foot-covering is particularly destructive of the muscles of the foot and leg, for it interferes almost entirely with the free play of the whole foot."
"Wedge-toed" shoes call for some preliminary remark. If one examines the ends of the fingers, it will be seen that they have a fleshy protuberance; the toes have this in common with the fingers, and its office in both is to make a soft, cushion-like protection for the bones. A wedge-toed shoe, such as is seen in Fig. 14, forces the toes immovably into a close envelope that crowds this cushion away from the bones, and wastes it to such an extent that the bones, lacking its protection, become diseased often to a degree requiring surgical treatment. The dotted lines in Fig. 14 indicate how the evil might beFig. 11.—Exostosis of the Bone.mitigated by giving a fullness in the upper leather. Take a round and narrow wedge-toed shoe, and let it be short as one may generally see them, worn, and you have an instrument of torture that is little short of the famous iron boot of the past ages.
"Box-toes" possessed the virtues of giving Fig. ll. Exostosis or the room for the extension of the foot, and saved their wearers from the torments of "wedge-toes," but they had other defects, and are now almost out of use.
High heels augment all the injuries and miseries we have enumerated. The foot on heels is in the position it occupies in going down-hill, or down the roof of a house, a most insecure and unstable one. The weight of the body is thus thrown forward, the center of gravity is shifted, and the weight becomes unequally distributed among the different parts of the foot, and the forward portion has to do the bulk of the work. The inevitable detriment such a condition entails upon the health of the foot and of the body does not need to be enlarged upon. Additional inconveniences resulting from it arise from the liability of the body to fall from its unstable poise, and the propensity of the narrowly pointed heels to catch in every little crack or opening, and trip up the wearer. Of these evils the awkward, tottering gait produced by high-heeled shoes is visible evidence.
The center of gravity of the body falls directly on the angle produced by the lines A and B in Fig. 15, which shows the foot at rest in its normal position on a level surface; the line A falls inside the outline of the foot, whereby the harmonious relations of each portion of the foot are indicated. Figs. 13 and 16 represent the foot as in position upon high heels, 13 being rather exaggerated, but 16 little higher than the average heel. A glance will show that just as the heel is elevated, the line A is thrown outside of the outline of the foot, disturbing the relation of its parts, throwing the weight of the body unequally upon it, and thereby seriously interfering with its functions.
Fig. 12.—Splay or Flat Foot.
There are those who believe and assert that an upright carriage of the body is assisted by high heels. A little thought and observation will convince the candid inquirer that this is a mistake. A shoemaker called my attention to the baggy trousers knees observable in connection with the wearing of high-heeled boots, and said, "Elevation of the heel thrusts the knee forward." The human body should stand erect from the heels upward, but the projection of the knee makes necessary a bending forward of the whole frame, to maintain an equilibrium. This is undoubtedly one cause of the ungraceful round shoulders and poked-forward head noticeable with so many women and girls.
The shoes of men, as a rule, are not so badly constructed and worn as the shoes of women and children. A larger proportion of men wear custom-made shoes, in which some effort is made to fit the foot. Businessmen generally have eschewed heels, except the lowest "lifts." Among soldiers and policemen, foot-soreness is a common complaint, and renders the man who has to endure it unfit for service. It is stated that, during the late East Indian wars, the native foot-soldiery, when ordered to "march," took off their regulation shoes and hung them on the ends of their muskets, while they went barefoot. Commanding officers reported great loss of men who could not keep up on account of foot-soreness, and were easily picked off by the enemy. A Highland regiment, when ordered to "charge" the foe, took off their shoes and charged barefoot, as they could do more effective work. The regulation shoes interfered with free muscular action. Dowie characterizes the shoe as a "Juggernaut of cruelty," saying it possesses wedge-toes, a rigid waist, high heels, and convex inner soles, and adds: "If a soldier be weak or lame in the feet, he can never apply with advantage the strength of his arm in charging the enemy, or in sustaining a charge, because the foot is that part of the mechanical system or leverage which rests upon the fulcrum, the ground, and, if you weaken the leverage at this important point, the strength of the whole system is reduced."
The opinions of Mr. Dowie on this subject coincide with those of eminent military men. The defects which he enumerated were common in the shoes of our own soldiery during the late war, and were followed with the same results.
It is very hard to find any woman who will confess that her shoes are too tight, too short, or too high-heeled. Her shoes are usually "miles too big," and hurt by their looseness. If women complain of lame backs or aching feet, they will be sure the shoes have no part in it; because women are really not aware how they have departed from nature in this regard. The perfect female foot is described by a physician as follows: "It should have great breadth and fullness of instep, a well-marked great-toe, a long second toe, a small little-toe." Woman needs a strong and firm footing, particularly because of her function of motherhood, and yet this perfect foot is the exact opposite of the ideal lady's foot of to-day; narrowness, shortness, and littleness are the qualities that go to make it up; and there are women, if we may believe what is said in the newspapers, who to secure a narrow foot are willing to have the little-toe ruined.
Strange as it is, the American women, while cramping the feet, deny it. The Chinese are more logical. They distort and cripple the feminine foot to a much greater degree, and then sing its praises. Its favorite name, the "golden lily," is well known.
Many of the peculiar ailments under which women pass their days in invalidism, unhappy and miserable themselves and making others unhappy, would vanish or be greatly mitigated if they would but apply common sense to the selection of their shoes. It is very hard to persuade them to reform their habits on this point, but I have never known any woman who had learned the new comfort to go back to the old habit.
No exercise is so healthful and delightful as walking, yet few women can endure it. For to walk in their ordinary shoes is one of the most exhausting labors women can attempt. There is no doubt that by a thorough and careful system of pedestrianism many women would become robust, though now half-invalids. I know of one who walked on an average two or three miles a day, and would spend an hour Fig. 14.—A Wedge-toed Shoe. or two cutting brush, saplings, and small trees, lopping off limbs, hauling brush to gullies and into heaps, and climbing fences. Her garments were warm and loose, her shoes "stogies," big, broad, and low-heeled. Health came as a reward. Another case is of a lady who is a commercial traveler in a large Western State. Her health broke with indoor confinement at school-teaching and book-keeping, and she was advised to try the road, which she did, as agent for a sash, door, and blind factory, and afterward for a paint, oil, and glass establishment. She never misses a day nor a train, dresses feet and body for comfort, is hearty and well, and earns a large salary.
The feet not only look smaller, but really become so in tight, high-heeled shoes, in consequence of a reduction of the blood-supply. We are told of a Frenchman who invented an apparatus for reducing the size of the nose, and it consisted only of a spring which cut off the supply of blood to the organ. A paper was read at a recent health congress in Switzerland, calling attention to a French style of shoe, which, the author remarked, gave the foot a "hoof-like" appearance. This style is much worn here, and produces a clumping, ungraceful jolt in the gait, tending to induce destructive spinal vibrations.
Probably the worst and most lasting injuries to the foot are produced during childhood, when the bones and cartilages are tender, and the muscles are soft and most sensitive to strains. As a rule, children's shoes are too short and too tight, and no allowance is made in them for the growth which is all the time going on, or trying to go on, in the foot. Evidently an injury cramping the growth at this time can not be remedied; and if the children have any tendency to become bandy-legged or knock-kneed, badly shaped shoes, especially if they have high heels, will aggravate the evil and make it more lasting.
Fig. 15.—Proper Position of the Foot upon the Ground.
André, an old French writer, is quoted by Camper as saying that high-heeled boots produce curvature of the spine in children. The shifting of the body from foot to foot to get ease contributes to this effect in one direction, and the bending forward of the body to preserve equilibrium in another, while the soft condition of the bones and muscles is a helping influence to it.
It should be remembered, too, that children suffer most from in-growing nails caused by short shoes. Flat-foot, which is also most common among children and youth, is largely the result of convexity of the inner sole—a too common fault of children's shoes. In such shoes the center of gravity of the body is thrown out of its relations with the corresponding point in the foot, and eversions take place. The continuous strain between the foot and an improperly fitted shoe tends to produce dislocations of the bones and to weakening of the muscles. Doubtless much of the breaking down of girls at school may be traced to some such cause as this. Boys' shoes, on the other hand, generally have low heels and broad soles, and their wearers are relieved from the special suffering which too vain mothers allow to be inflicted on the feet of their daughters.
The evils to which women are subjected from the causes we have delineated do not stop with the sufferers who induce them upon themselves, but are transmitted to their children, an inheritance of acquired weakness and suffering.
Some specimens of the shoemaker's art are shown, to illustrate how far those artists are from adapting their work to what the feet require.
Fig. 17 is the sole of an old lady's shoe, custom-made, for the wearer, suffering from constant aching feet, wanted shoes cut for ease. The heel is correctly cut, but the soles are made convex, or not curved, as the dotted line indicates they should be, to the inner curve of the foot; the toes are narrowed, or rounded, turning the great-toe inward and cramping the rest, and they allow nothing whatever for the elongation of the foot, and would look like stuffed puddings when the feet were in them. They were cut of soft kid, but, except the low heel and the soft material, they had not a single merit. They were cut in exact contrariety to the shape of the feet, and did not bring about the relief that was sought for in them.
Fig. 18 is a sample of an improved cut of shoe for women and misses. These shoes are worn by a small minority at present. They
do not altogether escape the faults of other shoes; some are wedge-toed; in others the heel is too high; and oftentimes a fault in the sole wrenches or distorts the foot. The best grades of these shoes are too high in price for other than well-to-do people to enjoy them. Fig. 19 is a specimen of the best sort of shoe made for children, but, worn too short and too tight, it will become a means of harm to the tender foot of the child.
It is hard to understand how men and women can endure to wear the present style of pointed-toed shoes and boots. The "corn-crop" is one that never fails, and the prevalent fashion will certainly assure a yield of unusual abundance. The devotee who wore peas in his shoes for penance could make ample atonement for all his sins by simply dressing his feet according to the mode.
The whole subject is worthy of the profound study of the physician, the shoemaker, and the shoe-wearer, all of whom seem to have wickedly neglected it. If men and women, in this period of the revival of the antique, will study the natural and beautiful feet of that era, when the appreciation of physical beauty was most perfectly developed, we may hope for some not far-distant time when our demand will be for a normal healthy foot in a natural and comfortable covering, and not for a crippled and distorted, withered, ugly "club," bound in an instrument of torment.