Popular Science Monthly/Volume 25/July 1884/Glasgow's Bandy-Legged Children
By GEORGE HAY, M. D.
LAST summer the writer crossed the Atlantic and visited his native country, Scotland. His parents, now well advanced in years, were living in Glasgow, and he found himself at home. On the first Sunday after his arrival he took an extensive walk through the city, and, of course, observed the people, young and old, male and female. He noticed very few good-looking men or women in Glasgow. The men are, for the most part, short and squat, while the women are undersized, and anything but handsome. The people of both sexes physically differ entirely from the men and women of Edinburgh, who, as a rule, are straight and strong, well-featured and intelligent, and excellent examples of manly and womanly beauty. The principal industry of Glasgow—the building of iron and steel ships—demands a great deal of unskilled or rather of low-grade labor, and the ranks of the laborers are recruited from Ireland. Thousands of Irishmen are employed in this work, and earn very high wages—from twelve to fourteen pounds sterling in two weeks. The average riveter is a mere animal, given to eating, and drinking, and debauchery, and, as a consequence, despite his high wages, he is continually on the ragged edge of poverty, misery, and destitution. Of course, there are some exceptions to this general rule, and they soon become independent.
If, choosing some fine day when children are apt to be on the streets, we take a walk of a single mile in any direction in the city, we are sure to notice from fifty to one hundred children, between the ages of two and thirteen years, whose legs are deformed and distorted in ways which are remarkable, and to degrees which are really hideous. One would think that the whole juvenile population was suffering from rachitis or from osteomalacia. The lines in the annexed figures, in pairs, indicating the general contour of the leg and foot, will convey some notion of the deformities, of which hundreds of living examples may be seen on the streets of Glasgow. The short, straight lines, at the bottom of each pair, indicate the feet. It is generally the bones of the lower limb from the knee downward, the tibiæ and the fibulæ, which are bent in the manner indicated in the drawings, in which care has been taken to avoid exaggeration.In addition to those here illustrated, examples may be seen of forward or backward, regular or irregular curvature, single or double curvature of one leg, with an outward or inward, regular or irregular, single or double curvature of the other leg. In short, the legs of Glasgow children may be seen twisted and distorted in every imaginable direction. Some of these deformities are painful to look upon, though
from a professional point of view extremely interesting. The causes assigned by the people of Glasgow for the prevalent deformity are various, but none of them seem to account for it.
Let us consider the professional opinion first. Many of the physicians in Glasgow account for the rachitis, or osteomalacia, by laying the blame upon the water which is supplied to the city. The water comes from Loch Katrine, the lake made famous by Sir Walter Scott in "The Lady of the Lake," and is very pure and soft, containing, if the writer remembers rightly, only about half a grain of solid matter in the gallon, which solid matter consists mainly of silicic acid and a little humus in solution. It is particularly free from the lime salts which go to the formation of bone; but, even though that is the case, such an attempt at explanation displays an astonishing amount of physiological ignorance on the part of those who make it. A half-ounce of bread, more or less, additional in the diet, would make up for all the difference between a soft and a hard water. The professional opinion may, therefore, be rejected as not pertinent.
Another explanation was suggested to the writer by the Professor of Physiology in the University of Glasgow, who thought the curvature of the bones of the children was due to the abandonment of oatmeal as an article of diet by people whose ancestors were accustomed to its use, and to the substitution of wheat-bread. This seemed to be a very plausible opinion. But it can be objected that, in many places where oatmeal is hardly ever used, rachitis and osteomalacia are comparatively rare. For example, in the United States oatmeal has been comparatively little known as a food, and yet very few rachitic children are to be seen. Similarly in Edinburgh, so far as the writer could observe, oatmeal is much less used than formerly, and yet the diseases in question are not evidently on the increase; and in England, in many places where oatmeal is only considered fit food for horses, no cases of rachitis or of osteomalacia were observed. Furthermore, the ash of wheat yields more phosphoric acid than that of oats—the former contains 49·81 per cent and the latter only 43·84 per cent of that substance. It is true, however, that the ash of oats contains more lime than the ash of wheat; but then wheat contains quite enough of lime to build up bone-tissue—hence the fact that certain people do not build up sufficient bone-tissue, no matter what their diet may be, is proof that the diseases are due to a tendency in the individuals to waste, and not to assimilate these very phosphates which wheat-flour contains in abundance. This explanation, also, must therefore be dismissed as insufficient.
Another opinion ascribes the deformity to the peculiar method of carrying their babies in vogue among the women of Glasgow. A large shawl or plaid is wrapped over one shoulder and around the waist of the mother, with one turn around the baby, which is additionally supported by sitting on the mother's arm. This is a very convenient way of carrying a baby—almost as convenient as that adopted by some savage tribes, whose papooses are borne in a basket slung over the mother's back. It is only employed when the mother is out on an errand; and, though the child's legs, of course, are somewhat constrained by the shawl, the actual time during which that is the case amounts to very little in the twenty-four hours, and is not long enough to produce the deformity. Moreover, not many miles away, at Saltcoats, on the Ayrshire coast, all the women carry their babies in precisely the same manner as in Glasgow, and yet not a single case of rachitis or osteomalacia is to be seen there. The people of Saltcoats, however, are Scotch. The same method of carrying babies is quite common over all the south and west of Scotland, yet nowhere else in the country, except in Glasgow, are so many horrible cases of rachitis or of osteomalacia to be seen.
Some persons, observing that many of the Glasgow mothers, whether married or unmarried, are workers in the mills—cotton, woolen, linen, and jute mills—are of the opinion that there is something in their employment that promotes bandy-leggedness. But, so far as I could observe, the children of such women were no more rickety than the children of women in other occupations. The mills in Great Britain are, so far as their hygienic condition is concerned, far better provided for than the mills of any other country in the world; they are looked after by the Government, and regularly visited by a competent and responsible inspector. Mill-workers have, nowadays, an easy, comfortable, and healthful occupation, and really there is nothing in mill-work to deform or injure either the women or their children.
Many lay the blame for the trouble upon the air. Glasgow air does not appear to be different from other air, and is certainly no worse than that of a dozen other manufacturing cities where no unusual bandy-leggedness exists. Consideration of this point may, then, be dismissed at once.
The writer believes that an adequate explanation for the affliction may be found in the habits of the Irish people. It is well known that all over the south and west of Ireland thousands of the peasantry live in mud cabins, which are for the most part several feet below the level of the surrounding soil, many of them destitute of windows, doors, and chimneys, the places of which are supplied by simple holes. The cabins are warmed by a peat-fire in the center of the burrow under the hole in the roof. The fuel is got from the adjacent bog, and its smoke would speedily blear and blind the eyes of any stranger who might venture to go inside. Such holes are continually damp, and are hot-beds (or rather cold beds) of rheumatism, rickets, osteomalacia, and various other diseases. There are generally half a dozen or more miserable children, huddled together for mutual warmth in the cold months, along with the parents, in addition to whom there is generally at least one full-grown pig, with perhaps a litter of young ones. The food of the family consists chiefly or entirely of potatoes, and it is seldom indeed, that any of the members see bread or meat, although occasionally a little fish, in the shape of eels from the adjacent "bog-holes," may find its way to their mouths.
According to Marshall ("Human and Comparative Physiology"), "potatoes are a weak food, one pound being only equivalent to about six ounces of bread, or four ounces and a half of lentils; they are not much more nutritious than the succulent vegetables." It follows that, in order to support the body at all, enormous quantities must be eaten. The stomach expands to accommodate the huge bulk of this inefficient food, the body becomes paunchy, and the limbs of children, enfeebled by rachitis, occasioned partly by the miserable food and partly by the unwholesome surroundings, bend under the weight of the trunk, and the deformity already described is the result. The writer remembers distinctly the time when large bands of Irishmen used to visit England and Scotland, during the autumn of each year, to be employed on the harvest-field as shearers or reapers. But, owing to the introduction of machinery, that occupation is gone. The harvest only employs men for a few weeks each year; but the building of iron ships is carried on all through the year: the shearers have become riveters, and have remained in Glasgow. The late Hugh Miller, describing those reapers, wrote thus: "Pot-bellied and bow-legged, and with scarcely a rag to cover them, these wretches walk abroad into the daylight of civilization, the annual apparition of Irish ugliness and Irish want." The vice of constitution, acquired in the miserable cabins of the wilds of Connaught, has become hereditary, and it is the now recognized principle of heredity which accounts for the deformed legs of the children of Glasgow. When the bones are bent at obtuse angles, the deformity is usually treated in the hospitals by fracture, i. e., the bones (both tibiæ and fibulæ) are broken at the angle, and the fracture is treated in the usual manner. This is done, however, after the bones have become hard and have assumed a permanent set.
It may be objected by American observers that the Irish in America exhibit none of these excruciating deformities. But it must be remembered that few but reasonably able-bodied Irish manage to get to America. Few others can get together the means to pay their passage; and any cripples or seriously deformed persons would be liable to be refused passage by the transportation companies, or rejected and sent back as paupers on arrival here. At this point, again, the law of heredity comes into play, for if the parents, and the children which they bring along with them, are not rachitic, the chances are that the children and children's children born in America, will not be rachitic either.