ACQUIRED DEFORMITIES OF THE LOWER LIMBS.
The lower limbs are subject to deformities arising from dif ferent sets of causes, some of which act upon the osseous or bony, others on the muscular, others on the circulatory system. The deformities connected with the bones of the lower limbs include those which arise from rickets, as described at page 241; con traction of the limb from abscess in the hip joint; dropsy of the knee joint; bow-leg, out-knee, and knock-knee affections de scribed at page 244. Deformities of the muscles of the lower limbs include the varieties of talipes or club-foot, enlargement of the bursa of the patella, housemaid's-knee; bunion; and, rupture of muscular fascia; affections all explained in the chapter on the muscular system, pages 231-237.
These deformities are results of various mechanical influences telling upon the limbs, and combined, as a general fact, with con stitutional defects and weaknesses.
Acquired Deformities of the Feet.
Other forms of tight pressure upon the body are open to serious, if not to equal, objection. The wearing of shoes which compress and distort the feet is a singularly injurious custom. The pointed shoe or boot is the most signal instance of a mis chievous instrument designed for the torture of the foot. By this shoe the great toe is forced out of its proper line towards the other toes, giving a reverse curve, from what is natural, to the terminal part of the inner side of the foot, while all the other toes are compressed together towards the great toe, the whole pro ducing a wedge-like form of foot which is altogether apart from the natural. Such a foot has lost its expanse of tread; such a foot has lost its elastic resistance; such a foot has lost the strength of its arch, to a very considerable degree; such a foot, by the irregular and unusual pressure on certain points of its surface, has become hard at those points, and is easily affected with corns and bunions. Lastly, such a foot becomes badly nour ished, and the pressure exerted upon it interferes with its circu lation and nutrition. It ceases to be a member upon which the body can sustain itself with grace and with easiness of movement, even in early life; while in old age it becomes a foot which is ab solutely unsafe, and which causes much of that irregular hobbling tread which often renders so peculiar the gait of persons who have passed their meridian.
It very often happens, that these mistakes in regard to the boot and shoe are for a time increased by the plan of raising the heel and letting it rest on a block of a pointed shape, " the peg top." Anything more barbarous can scarcely be conceived. By this means the body, which should naturally be balanced on a most beautiful arch, is placed on an inclined plane, and is only prevented from falling forwards by the action of the muscles which counterbalance the mechanical error. But all this is at the expense of lost muscular effort along the whole line of the mus cular tracks, from the heels actually to the back of the head; a loss of force which is absolutely useless, and, as I have known in several cases, exhausting and painful. In addition to these evils arising from the pointed heeled boot, there are yet two more. In the first place, the elastic spring of the arch of the foot being broken, the vibration produced by its contact with the earth, at every step, causes a concussion which extends along the whole of the spinal column, and is sometimes very acutely felt. In the second place, the expanse of the foot being limited, the seizure of the earth by the foot is incomplete both in standing and in walk ing, so that it becomes a new art to learn how to stand erect or to walk with safety.
The mention of these deformities of the feet would hardly be complete without referring to that systematic deformity of the foot which is practised on the female population of China to this day, and which is brought about by bandaging or compressing the foot, in earliest life, so as to prevent growth. The foot of the Chinese woman, crippled by this process, is simply atrophied; it retains, generally, its original shape, but it is really still the foot of a little child.