THE Human Body is one of the most worthy objects of man’s study. It is the noblest as well as the crowning work of creation. In it material organization is carried to the greatest perfection. It surpasses, therefore, all other physical objects in exquisiteness of construction and in interest. How comes it, then, that most persons are so ignorant respecting it? Men, well informed in other matters, are usually altogether uninformed with regard to this. In every other branch of science we find amateur students pursuing the subject with zeal and success. Geology, Chemistry, Botany, Zoology, and even Comparative Anatomy have each their votaries; but Human Anatomy attracts no one. Why is this? Partly, I think, because opportunities for acquiring such information as is suitable and interesting are not so many as they ought to be.

It must be confessed, also, that we teachers of Anatomy are somewhat to blame. We are too prone, in our Lectures and Examinations, to dwell upon bare details, without enlivening those details with the many bright features of interest with which they are naturally invested; and we fail, therefore, to render it so attractive a science as it might be. The example of those able and animated teachers, John and Charles Bell, who laboured with some success to disperse the clouds that have ever overhung the horizon of anatomy, has been too much forgotten; and the flame which they kindled has almost died out under the chilling apathy of their successors. Truly glad should I be to see a change in this. I cannot but think that if the teachers of Anatomy took higher and more philosophical views of their science there would be no lack of interest on the part of the students. The interest so excited would soon spread beyond the limits of the profession; and there would thus be opened up to the public some of the products of that rich vein of knowledge and of that abundant material for thought which lie buried in the human frame.

I therefore willingly accede to your request for a Lecture upon some part of the anatomy of the human body, relying upon the intrinsic interest of the subject to make amends for my own deficiencies in expounding it; and I select the Human Foot, because a few of the more important points of its construction can be explained without much difficulty, because it affords a good illustration of some of the principles of animal mechanism, and because its form constitutes one of the great characteristics whereby man is distinguished from the lower animals. As an instrument of support and of locomotion it excels the foot of any other animal. It evinces its excellence by enabling man to stand upright in a way that no other animal can do; and so efficiently does the foot accomplish this and perform the task of carrying the body, that the hand is set at liberty to minister to the will. Thus is the foot instrumental in giving us an advantage over other animals, and in enabling us to provide the means of defence; and, thus, it aids us to carry out those wondrous works which are second only to the marvellous results of creative power.

We are accustomed to regard the hand as the great agent by which all this is attained, and we are apt to forget how much it is indebted to the foot. We do not reflect that, if the foot of man presented no distinguishing peculiarity, the hand, like the corresponding part in other animals, would be compelled to share with it the task of carrying the body, and could, therefore, not be devoted to the various offices which it is now free to perform. Little right has the hand to say to the foot, “I have no need of thee.”

The principle of “division of labour.”

In this concentration of locomotive power in the foot we have an illustration of what is called the “principle of division of labour,” a principle with which all civilized communities are familiar, and to which we are much indebted for the present advanced state of the arts and sciences; but which we may be said to have borrowed from the economy of nature. We find ever-increasing manifestations of it as we ascend in the animal series, from the lower and more simple to the higher and more complicated forms. Indeed, just as each step in civilization is attended with a further development of this principle, so is each division of the animal kingdom distinguished from those below it by the more distinct assignation of particular functions to particular organs, and by the consequent improvement of the mode in which the functions are performed. While, in proportion as the several organs acquire more distinct speciality in their work, so do they become, more and more, dependent upon one another, and, more and more, subjected to the control of central government, which is represented by the brain.

For instance, some of the lower animals, as the fresh-water Polyp, present nearly a uniform structure throughout their whole substance; and every part of them consequently performs the same function. There is not one organ for digestion, another for circulation, a third for respiration, and so on; but all these functions are performed by the same structure, and are performed, therefore, in a rude and imperfect manner. Any portion of the creature possesses all the requisites for its own nutrition, and is, so, independent of the remainder, and can live alone. Hence, the polyp may be divided into a number of pieces, each of which goes on living. Gradually, as we ascend from these lowly beings to the higher classes of animals, we find organs and functions more and more distinct from another; a Stomach is provided for the work of digestion, a Heart for circulation, Lungs for respiration. Each of these organs is essential to the existence of the others and of every part of the body; and they are all maintained in harmonious co-operation by the presiding influence of the nervous system.

Or, trace one of the functions in illustration of the same principle. Take the function of Locomotion, which has an especial relation to our present subject. In the Leech and the Worm the whole length of the body is occupied in the work, one part as much as another; and still, it is but a crawl. In the Fish the whole body is buoyed up by the water; it is flattened from side to side, and is all, from the head to the tail, concerned in the lateral stroke by which the animal is driven along; the side fins, which are the representatives of limbs, doing little beyond serving to guide and balance. In the other Vertebrates the work of locomotion is so far concentrated as to be assigned, almost entirely, to the limbs. All four limbs are in most of them devoted to it; while the bones and muscles of the trunk are only indirectly concerned in it. In Man, however, two limbs only are assigned to this important office. In him, therefore, the concentration of locomotive power, in other words the principle of division of labour, is carried out to the greatest extent—a disposition which affords one of the many proofs that the construction of his body combines with the faculties of his mind to place him at the head of the animal kingdom.

In making comparisons of different animals with one another, and in speaking of the relative perfection of their several organs, we must not forget that every organ of every animal is perfect as regards the purpose for which it was made. But some animals are said to occupy a higher position than others, or to be superior to others, because their mechanism is more complex, and they are, thereby, enabled to perform a greater variety of functions. And, in the animal kingdom, in proportion as each function rises into prominence, and becomes well and distinctly performed, so is a special organ assigned to it, and that organ becomes more and more highly elaborated.

You will not misunderstand me, then, when I say that concentration of function and perfection of structure usually go together. And, forasmuch as in the lower limbs of man there is a greater concentration of locomotive function than in any other part of any other animal, you will expect to find, in them, a greater perfection of locomotive mechanism—that is to say, a more complete combination of strength with variety, rapidity, and extent of movement—than is elsewhere to be met with.

This consideration will ensure attention while I give a brief account of the anatomy of man’s lower limb, more particularly of the foot.

Structure of the Lower Limbs.

The weight of the trunk is transmitted to the knee (see fig. 4, p. 15) by a single bone—the thigh-bone. This is the longest bone in the body, measuring, on the average, nearly eighteen inches. Above, it is jointed with the haunch-bone of the pelvis at the hip-joint. From the knee two bones descend to the ankle. Of these one is much the larger, and bears the chief of the weight. The other serves to give attachment to muscles, and to strengthen the ankle-joint. It runs down on the outer side of the ankle, forming there what is called the “outer ankle;” and a process of the larger bone runs down, in like manner, on the inner side, and forms the “inner ankle.” The front and inner side of the larger bone are close under the skin. This part is called the “shin,” being so named perhaps from the word “chine” or edge, because the leg presents an edge along the front, to facilitate its cleaving a way through the air, water, grass, or underwood. The shin itself is not particularly tender; but the skin is a good deal exposed here, and, as it lies so near the hard bone, it is easily injured; and, when “broken,” it is often difficult to heal.

In some very tall persons, and particularly in those who are so tall as to be called Giants, I have found the leg or shank bones, that is, the bones between the knee and the ankle, very long, disproportionately long to the rest of the skeleton. They are so in the skeleton of the Irish Giant, O’Byrne, which is preserved in the Museum of the College of Surgeons, in another Irish Giant in the Museum of Trinity College, Dublin, and in some other specimens which I have had an opportunity of measuring. In the name “Long Shanks” given to Edward I., the word “shanks” probably included the thigh as well as the leg, just as we are in the habit of applying the word “leg” to the whole of the lower limb.

Bones of the Foot.

There are 26 bones in the Foot. The hinder 7—called tarsal bones—are short and thick; they form the hinder part of the instep. In front of them lie 5 metatarsal bones, one passing, forwards, from the fore part of the tarsus to each toe. Behind, these are close together, and are connected with the tarsus. As they run forwards they diverge a little from one another; and their anterior ends rest upon the ground, and form the “balls” of the toes. They constitute the fore part of the instep. The remaining 14 bones are the toes. They are arranged in rows, like soldiers in a phalanx, three deep, and are hence called phalanges.

You observe that, although each of the other toes has 3 bones, the great toe has only 2. In this respect, therefore, it is an imperfect, or, rather, an incomplete member. The deficiency does not depend upon a want of length in the great toe; for this is usually as long as the second toe; in some persons it is a good deal longer; and it is always distinctly longer than the outer two toes. The reason for there being only two phalanges instead of three probably is because the great toe is required to be stronger than any of the others; and an additional bone would have tended to weaken it. I have, elsewhere‍1, given reasons for thinking that it is the middle phalanx which is absent in the great toe.

It is a curious and interesting fact, affording a remarkable illustration of the close adherence to a uniform plan which has been observed in the construction of the various animals, that, in no instance, does this toe contain more than two bones. Even in those creatures, as the Seal (fig. 2), in which it attains to greater length than any of the other sprawling digits, it contains the same number of bones as in man, its extraordinary length being attained by an elongation of the two bones, not by the addition of a third. And in those animals, as certain Lizards (fig. 3), where the number of bones in the other toes is increased to 4 or even 5, the number in the first, or inner, toe is still no more than two. The same rule applies to the fore limb; the number of bones in the inner digit, which, in man and monkeys, is called the “thumb,” is in no case more than two. In some animals, as will be mentioned again, there is only one bone in this digit, and in some the digit is wanting altogether; but in none does it contain more than two bones.

This reminds me of a still more remarkable instance of adherence to a particular number of bones. In the mammalian group of animals the neck, with only one or two exceptions, contains seven bones, neither more nor less. Whether it be the long neck of the Giraffe, or the short neck of the Mouse, the Bat, or the Porpoise, each consists, like the neck in Man, of seven bones. For what reason a particular number should be thus rigidly observed, it is not easy to say.

Of the seven tarsal bones the uppermost (fig. 1) is called the astragalus, from a supposed resemblance to a die. It is the middle bone of the instep. Above, it is jointed with the leg-bones; behind, it is connected with, and rests upon, the heel-bone, which is the largest bone in the foot. The bone which lies immediately in front of the astragalus, and supports it in this direction, is called the scaphoid, or boat-like, bone. In front of it are three wedge-bones, each of which is connected with one of the metatarsal bones of the inner three toes. On the outer side of the wedge-bones, connected with the metatarsals of the two small toes, and locked in between them and the heel-bone, is the cuboid bone.

I must confine my remarks chiefly to the human foot. Still the anatomy of man derives so much interest from being studied in connexion with that of the lower animals, and is so much more instructive when this is done, that I cannot forbear diverging, here and there, to make a few comparisons. Let me, for a moment, draw your attention to a similarity, in general construction, which exists between the lower limbs of man, and the hinder limbs of other animals. And the comparison may be extended to the fore limbs; for however diverse may be the appearance and the mode of action of the limbs in different animals, whether they be terminated by hands or by feet, whether they move upon the ground or ply in air or water, whether they be attached to the head, as are the front fins in many fishes, or, as is more common, be situated at the fore and hinder parts of the trunk, the same plan is traceable in all.

Great, indeed, is the variety of detail in nature. It is everywhere observable. No two things, however near their resemblance, are precisely alike. Yet, as I have before said, there is a remarkable adherence to unity of plan. One star differs from another star in glory, yet all appear fashioned in the same manner, and subject to the same laws. There are almost infinite varieties in the vertebrate kingdom. Each animal exhibits its own peculiarities; yet they are all formed in the same manner, and are developed upon one fundamental pattern, diverging from it in different ways according to the requirements of each. Again, though the several parts of the same animal differ from one another; yet in the skeleton the same bones which exist in one part may, as a general rule, be traced in other parts and in other animals. The bones which make up the pelvis in man are repeated in his shoulder, and, even, in his skull; and they may be recognised in the pelvis, in the shoulder, and in the skull, of all other vertebrate animals, with few exceptions. They undergo, it is true, great varieties in shape and size; but they can be shown to be the same, or, in the language of anatomists, to be “homologous.” It is highly interesting to the anatomist to trace the same bone through the different parts of the same animal, and through the various animals of the vertebrate series, and to observe the modifications which it undergoes in order to adapt it to the multiform mechanism of the several classes, to observe it sometimes dwindling, or even vanishing, and then, it may be, reappearing under some new conditions.

I must, however, resist the temptation to wander into this attractive field. It will suffice to take an illustration by a comparison of the bones of the human lower limb with those of the hind limb of the Horse. This may be easily done by the aid of these drawings (figs. 4> and 5) in which the two limbs are placed side by side, and the corresponding bones are marked with the same letters. Notwithstanding the many points of difference the same plan will be recognised in each. There is in each the thigh(C), the leg(E), and the foot, with the tarsal and metatarsal(G) bones, and the phalanges(H, I, K). But in the Horse two of the digits (the marginal ones, that is, the great toe and the little toe) are wanting, two are rudimentary, and the remaining one, which corresponds with the middle toe of man, in length, size, and strength, more than makes amends for the deficiency of the others. The lowermost bone, or terminal phalanx, of this huge toe, called the coffin-bone(K), is encased in the hoof, which corresponds with the human nail, and is the only part of the foot that rests upon the ground.

In Man the whole weight of the body has to be borne upon two feet; often it is balanced upon one. The foot is, consequently, spread out; and all the bones, from the heel to the tips of the toes, are made to form the basis of support upon the ground. The Horse, on the contrary, having no hands, but four feet, does not require so great breadth in each foot; and the opportunity is taken to narrow the foot, and to lengthen it so as to give fleetness. The end is attained by suppressing some of the toes, by elongating one far beyond the others, and enduing it with such strength as to enable it to carry the requisite weight upon the tip of the last phalanx. The heel(F) is raised high above the ground and becomes the “hock.” To speak of a horse kicking with his heels is, therefore, about as correct as to say, that he breaks his knees. His knee, as you perceive by the position of the “knee-cap”(D), is high up in the hind limb, near his body, quite out of harm’s way in a fall. The fact is, that he kicks with his toes; and, when he falls, he cuts the skin over the part in his fore limbs, which corresponds with the back of our wrists.

In the upper segment, or thigh, the difference between the two limbs is seen to be, to a certain extent, the reverse of what it is below. That is to say, whereas, in the Horse, the toe is elongated and thickened, so as greatly to exceed the corresponding part of the human limb; in Man the thigh-bone is elongated, so as to be double the length of that of the horse; the thigh-bone in man is also placed more vertically, nearly in the plane of gravity of the trunk. The horse’s thigh-bone slants forwards and outwards, which gives the muscles great power by causing them to run more at right angles between their points of attachment; and this arrangement increases the strength of the animal in drawing weights, and facilitates springing. A man cannot spring without first bending the limbs a little; whereas a horse, or a goat, can spring, at once, from the position in which it is standing.

To revert to the anatomy of the Human Foot.

The Arch of the Foot.

The seven tarsal and the five metatarsal bones—that is, the twelve bones of the instep—are arranged and jointed together so as to form an arch from the point of the heel to the balls of the toes. This is called the “plantar arch,” from the Latin word planta, the sole of the foot. The astragalus forms the summit, or key-bone, of the arch. It receives the weight from the leg, and transmits it, through the hinder pillar of the arch, to the heel, and, through the front pillar of the arch, to the balls of the toes.

The drawing represents a section, from behind forwards, of the lower end of the leg-bone, and of the bones lying along the inner side of the plantar arch. Behind it extends through the heel-bone, and in front through the great toe. It exhibits the arrangement of the fibres and plates in the interior of the bones, and shows that the greater number of them, in each bone, follow the direction of the two pillars of the arch; that is to say, they descend from the summit of the arch where it supports the leg-bone, backwards and downwards, to the heel, and, forwards and downwards, to the balls of the toes. Their arrangement is, therefore, such as to give resisting strength to the bones in the directions in which it is most required.

You may think that the arch of the foot would have been a much simpler structure, as well as stronger, if it had been composed of one bone instead of several. But it must be remembered that it would, then, have been liable to be cracked and broken by the sudden and violent manner in which, during running and jumping, the weight of the body is thrown upon it. Moreover, the several bones, where they touch one another, are covered with a tolerably thick layer of highly elastic gristle or cartilage (represented by the clear line left in the drawing along the contiguous edges of the bones); and this provision, together with the slight movements which take place between these bones, gives an elasticity to the foot and to the step, and serves to break the jars and shocks which are caused by the sudden contact of the foot with the ground.

This last is a very important point; and we find numerous contrivances in different parts of the body to protect the brain and other delicate organs from jars. So efficient are these contrivances, and so exact is the adaptation of the mechanism of the limbs and the trunk to the texture of the internal organs, that, while these are in a healthy state, we are able to run, to jump, and to leap from a considerable height, without inconvenience. But, if the organs be inflamed, or if the nervous system be over sensitive, as in common headache, the provisions, which are calculated for the normal state, are insufficient; ordinary movements are then painful, and to jump is intolerable.

The muscles play a very essential part in this work. First, they place the limbs in the most favourable position. Thus, when we alight upon the ground, from a height, we always contrive to do so with the knees and hips a little bent, so that the limbs readily yield at the joints, and act as springs to break the jar. Elderly persons commonly keep the limbs bent, even when walking quietly along. They do this because they need all the benefit which position will afford to make amends for the loss of elasticity consequent on the thinning and drying of the cartilages, and other changes that take place in the body with advancing years. Secondly, the muscles brace the limbs and joints in the position in which they have placed them. We experience the effect of the want of this salutary influence when we kick against an unseen object, or fall suddenly, or receive any blow or shock for which we are unprepared. How disagreeable, to say the least, it is to make the step for an additional stair when we have arrived at the top of a staircase, or, still worse, to meet with an unseen stair when we think that we have got to the bottom.

You perceive from the drawing (fig. 6) that there is a great difference between the two pillars of the plantar arch. The hinder pillar is comparatively short, and narrow, and descends suddenly, almost in a vertical direction, from the ankle, to the ground; and it is composed of only one bone—the heel-bone—which is jointed directly with the astragalus: whereas the fore pillar is longer and broader, is composed of several bones jointed together, and slopes much more gradually to the ground. There is, therefore, far less elasticity in the hinder part of the foot than in the fore part. Hence, when we descend from a height upon the ground, we always alight upon the balls of the toes, and thus gain the advantage which the several bones and joints afford in breaking the shock. If, after going up stairs this evening, you take the trouble to come down again, you will find that you alight upon each stair on the balls of the toes and experience no inconvenience, however quickly the descent is made. But, if you change the mode of proceeding, and descend upon the heels, the feeling will be by no means agreeable; and the various organs of the body, being disturbed from their accustomed repose, will raise such remonstrances against your infringement upon nature’s ways, that you will scarcely be able to continue the experiment. Proportionately more distressing is the sensation caused by jumping from a chair upon the heels. Indeed, this is not done altogether without risk; and the trial of it is scarcely to be recommended to persons who have attained to that sober period of life at which we are willing to concede that, in some things, nature is wiser than ourselves. Only a short time since I saw a gentleman, who, in jumping down some steps into a back yard, accidentally came upon his heels, and jarred one hip so severely that he was confined to his sofa for several days in consequence.

But, you may say, “in walking we do place the heel upon the ground first and experience no inconvenience.” True, because the force with which the foot descends in walking is very slight; and the weight is directed upon the heel, obliquely, in such a manner as to bring the toes very quickly to the ground, and really to throw nearly the whole force in that direction. Moreover, you may observe that when we walk, the weight of the body is partly sustained by the fore part of the one foot till the whole of the other foot is on the ground. I will, however, revert to the disposition of the feet in walking and running presently.

The arch of the foot has to bear great weight and at great disadvantage; and there is very little in the shape of the bones to maintain its integrity. Indeed, they all fall asunder when the other structures are removed, the key-bone dropping through of its own weight. And the same thing may be remarked throughout the skeleton. Wherever two or more bones move upon one another, their surfaces are so constructed that they do not hold together without some assistance from the soft parts. There are joints in the body which we call “hinge-joints,” and others which we call “ball-and-socket joints;” but in none of them is there such a holding and locking of one part in the other as you have in the hinge and the ball-and-socket of the mechanic. In every case the bones are held together, not by their own shape, but by ligaments and muscles. Consequently, any one of the bones may be dislocated from those next it without breakage; and when the muscles and ligaments are cut through, or have been destroyed by maceration, all the bones, between which any movement was possible during life, separate from one another.

Not only is this so, but in no instance are the movements of joints limited simply by the shape of the bones—that is to say, they are never brought to a stop by a part of one bone coming into contact with the edge of another. Such a contact would have caused a sudden check; and this would have been attended with more or less jar and with some danger of chipping and breaking the articular edges. The range of movement of a joint is always regulated by the ligaments or the muscles, not, directly, by the bones; and the restraint thus imposed upon the movements is brought to bear, not suddenly, but gradually; somewhat like the effect of the “break” upon a railway-train; while the cartilages between the bones may be compared with the “buffers” between the carriages.

It is chiefly by means of strong Ligaments, or sinewy bands, passing from bone to bone, that the shape of the plantar arch is maintained and the movements of the bones upon one another are regulated and limited. These ligaments are numerous; but I will mention only two.

One, the Plantar Ligament (A, fig. 7), of great strength, passes from the under surface of the heel-bone, near its extremity, forwards, to the ends of the metatarsal bones; in other words, it extends between the lowest points of the two pillars of the arch, girding, or holding, them in their places, and preventing their being thrust asunder when pressure is made upon the key-bone (D); just as the “tie-beam” of a roof resists the tendency to outward yielding of the sides when weight is laid upon the summit. The ligament, however, has an advantage which no tie-beam can ever possess; inasmuch as a quantity of muscular fibres are attached along the hinder part of its upper surface. These instantly respond to any demand that is made upon them, being thrown into contraction directly the foot touches the ground; and the force of their contraction is proportionate to the degree of pressure which is made upon the foot. Thus they add a living, self-acting, self-regulating power to the passive resistance of the ligament. In addition to its office of binding the bones in their places, the ligament serves the further purpose of protecting from pressure the tender structures—the blood-vessels, nerves and muscles—that lie above it, in the hollow of the foot, under the shelter of the plantar arch.

Another very strong ligament (B in the wood-cut) passes from the under and fore part of the heel-bone (F) to the under part of the scaphoid bone (E). It underlies and supports the round head of the astragalus, and has to bear a great deal of the weight which is transmitted to that bone from the leg. It does not derive the same assistance from a close connexion with muscular fibres as the ligament just described; but it possesses a quality, which that and most other ligaments do not have, viz. elasticity. This is very important, for it allows the head of the key-bone (D) to descend a little, when pressure is made upon it, and forces it up again when the pressure is removed, and so gives very material assistance to the other provisions for preventing jars and for giving ease and elasticity to the step.

A glance at the drawing will show you that here is a weak point in the foot. The head of the key-bone receives great weight from the leg, but is comparatively unsupported; and there is a considerable strain upon this part when the heel is being raised in walking. Moreover, a good deal of movement takes place between the key-bone (D) and the scaphoid bone (E), more than between any other two bones of the instep; and freedom in the range of movement is generally attended with some sacrifice of strength. The strong elastic ligament comes in therefore with peculiar advantage at this point; and it is underlaid, and additional support is afforded exactly when it is most required, by the tendon (b in fig. 12) of a strong muscle, the especial office of which is to assist in raising the heel and bending the instep, and which runs, from the back of the leg, behind the inner ankle, to the scaphoid bone.

Weak Ankle and Flat-foot.

In spite, however, of the thick elastic ligament and the strong tendon just mentioned, the joint between the astragalus or key-bone and the scaphoid bone still remains a weak point. The head of the key-bone, from being insufficiently supported or from being overweighted, is very apt to descend a little below its proper level; the consequence of which is that the plantar arch is lowered and the foot is flattened; and the more the foot is flattened the weaker it necessarily is, because the position of the bones then becomes less and less favourable for bearing weight, and an increasing strain is thus incurred by the ligaments and muscles. Hence the foot and ankle feel weak; and the weakness is especially felt when the person endeavours to raise the heel, so as to mount upon the balls of the toes, in walking. For the performance of that movement with ease and steadiness a well-formed plantar arch is essential; and the person, whose feet are defective in the manner we are considering, can never walk with a bold, firm step. The movement in him may be better described as a shuffling from one foot on to the other, than as a walk. To this I will recur again when I come to speak more of walking. The defect, when slight in degree, is commonly called “weak-ankle;” when more decided it is called “flat-foot,” because the sole is then nearly, or quite, flat. The head of the key-bone, under such circumstances, may even bulge downwards and inwards, and form a prominence on the inner side of the sole, so as to give more or less convexity to the line on the inner side of the foot, which should be concave.

The representation of “flat-foot” here shown was drawn from the foot of a labouring man in this county. He said he believed the deformity was due to his having worn thick tight shoes when he was a growing boy. He is most likely right in his opinion; for tight or ill-fitting shoes, cramping the feet and preventing the proper growth of the bones and the free play of the muscles, are a common cause of this evil. This is so especially among the agricultural class, whose feet are, from an early period, enclosed in stiff unyielding leather cases that are enough to mar nature’s best efforts to construct a plantar arch.

The same drawing shows that flat-foot is not the only deformity for which “high-lows” are answerable. Besides the almost total want of calf, which is due to the wearer being obliged to hobble along, whole-footed, with short feeble steps, it will be seen that the great toe has not been allowed to assume its natural straight line, but has been squeezed athwart the other toes, so as to be almost at a right angle with the foot. No room at all is thus given for the second toe; it has been driven quite out of the field, and has been obliged to hide itself by bending down under the other toes. This is no uncommon state of things. Frequently it is attended with the formation of a painful bunion upon the prominent inner side of the ball of the great toe; and, in addition, there is sometimes a corn upon the first joint of the second toe, which is a source of so much inconvenience that I have known many sufferers glad to get relief by parting with the toe.

I wish I could hope that the days of high-lows are numbered, and could believe that in the next generation they will be ranged with the things of the past, and that our children may know these enemies to the form of the rustic foot, only as objects to be gazed upon with feelings of astonishment and pity, just as we regard the perukes and the stays of our ancestors. There are, however, some practical difficulties in the way of the fulfilment of this charitable wish.

There are two periods of life at which Flat-foot is most likely to be engendered. First, in infancy, if the child be put upon its feet too early, before the bones and ligaments are strong enough to bear the weight of the body. Therefore mothers should not indulge their anxiety to see their infants walk very early; the pride attendant on premature success is liable to be followed by regret at finding that the children never walk well. Parents and nurses should be content to let the children crawl and roll about upon the floor, and should not encourage them to stand upright, especially if they be rather heavy or weak children. Children are quite sure to acquire the faculty of walking as soon as they are well fit to exercise it.

The second period is at about fourteen. The body attains a considerable increase of weight at this time, in consequence of the quick growth that takes place. We often remark that lads and girls of this age shoot up apace; and their greater weight is not always attended with a proportionate acquisition of strength. They are apt to be rather weak and ungainly in their movements; and the weakness often shows itself in the foot, by a yielding of the plantar arch. Moreover, many boys and girls are, at this age, turned out into the world to earn a livelihood, and are obliged to be a good deal upon their feet, and perhaps, in addition, have to carry weights. Thus errand-boys, butchers’ and bakers’ boys, and young nursery-maids, are frequent sufferers in this way. The constrained positions in dancing, also, if enforced too much, or continued too long, so as to tire the feet, sometimes lead to the same result. On the other hand, moderate exercise of this kind is calculated to strengthen the foot and also the whole frame, and contributes much to improve the carriage.

This is not the place to enter into particulars of treatment. I will, therefore, merely remark that the common notion of supporting and strengthening the ankles by tight-laced boots is altogether a mistake, and must be ranked among the most influential of the causes which combine to spoil so many feet. It has its parallel in the idea of strengthening the waist by stays. The notion is, in both instances, fortified by the fact that those persons who have been accustomed to the pressure, either upon the ankle or the waist, feel a want of it when it is removed, and are uncomfortable without it. They forget, or are unconscious, that the feeling of the want has been engendered by the appliance, and that had they never resorted to the latter they would never have experienced the former; just as dram-drinking induces a recurrence to the stimulus by causing a sense of sinking when it is discontinued; and, for the same reason, the opium-eater can hardly exist without his drug.

The Movements of the Foot.

We come now to the Movements of the foot upon the leg; and rarely do we contemplate anything more calculated to excite our admiration. Consider their variety, the rapidity with which they take place, in order to effect the requisite succession of positions in walking and running, and to adapt the sole to the inequalities of the surface on which we tread; and remember the great weight which has to be sustained while these movements are going on: yet, how seldom is there a failure.

This combination of variety of movement with security is effected by the employment of three joints, each of which plays in a direction different from the others, while all act harmoniously together.

One of the three joints—strictly called the “ankle-joint”—is between the leg-bones and the foot-bones, that is, between the tibia and fibula, above, and the astragalus beneath. By means of it the foot may be bent or straightened upon the leg; in other words, the toes may be raised or depressed. In this movement the heel participates, being depressed when the toes are raised, and vice versâ. A second joint is between the astragalus and the heel-bone. It permits the foot to be rolled inwards or outwards upon an antero-posterior axis; so that the sole may be turned inwards, with its inner edge upwards, or may be turned down so as to be placed flat upon the ground. A third joint is between the first and second row of tarsal bones—that is, between the astragalus and the heel bone, behind, and the scaphoid and cuboid bones in front. It permits the degree of flexure of the tarsal or plantar arch to be increased or diminished.

Had the several movements which are requisite for easy walking all taken place in one joint, that joint must necessarily have been very insecure; indeed, it must have been a “ball-and-socket” joint, and we should have been poised upon our feet in the state of what is called “unstable equilibrium”—a state quite incompatible with security or strength, and which would have rendered the assistance of the upper limbs essential to either standing or walking.

An instance of a similar kind of mechanism to this of the joints between the foot and the leg is presented by the mode in which the head is secured upon the back-bone. We can nod the head upwards and downwards; we can turn it to either side in so free a manner that we are able to command with our eyes the whole circle in which we sit simply by the movements of the head; and we can incline the head to the right or to the left. Any of these movements may be made very quickly; and there is a separate joint or joints for each of them. Thus, the nodding movement takes place between the head and the first vertebra or uppermost bone of the spine; the turning of the head from side to side takes place between the first and second vertebræ, the head with the first vertebra rotating upon a pivot projected upwards from the second vertebra; and the inclination of the head from side to side takes place by movements of the second vertebra upon the third, of the third upon the fourth, and so on. The result is that, although the movements are thus varied, they are free as well as rapid. Yet the head is so well poised and so strongly fixed that the neck is able to bear it all day long without fatigue; and, as though the weight of the head, which is by no means inconsiderable, were not enough for the neck, we are in the habit of selecting this as the part upon which to carry burdens. One never feels so strongly impressed with the carrying capabilities of the neck and the ankle, as when following men and women in mountain districts toiling up and down the hills under great bundles of hay, baskets full of bitter beer, and various things intended to minister to the comfort and luxury of travellers and the inhabitants at the top. So effectual, indeed, are the provisions for security that, notwithstanding the freedom and variety of their movements, the joints of the foot with the leg, and of the head with the spine, are, in proportion to their size, the strongest in the body.

I have stated the movements that take place in the three joints of the foot with the leg in a simple manner, for the sake of avoiding confusion. In reality, however, they are not so simple, but very difficult to analyse and make out correctly. The difficulty is due, partly, to the close proximity of the joints to one another, which renders it no easy matter to distinguish the movements of one from those of the others, and, partly, to the fact that the movements in each joint are a little oblique.

In the latter respect the foot-joints resemble most of the others in the body; and it is this obliquity in the movements of the joints, added to the curves and twists in the shape of the bones, that constitutes one of the chief difficulties in investigating and clearly understanding the mechanism of the human frame. It has been said that “Nature abhors a vacuum:” it may with equal truth be said that she abhors a straight line. In the Human Skeleton, at any rate, all the bones are bent and twisted, some in two or three directions; and the surfaces by which any bone is jointed to the adjacent bones, are invariably oblique with regard to each other.