London's Pulse: Medical Officer of Health reports 1848-1972

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Barking 1948

[Report of the Medical Officer of Health for Barking]

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Fortunately flat feet, if we mean the breaking down of the longitudinal arch,
is by no means so common as it is considered to be and indeed may be said to be
uncommon among children.
What children do is to turn their ankle over so that the arch, instead of being
upright, is tilted to one side. This can, and does, give the appearance of a flat foot
and this trouble is very real and quite common.
The main cause of this defect is lack of muscle tone and is particularly likely
to occur when children are growing fast or when they are run down after an illness.
It does not matter what the defect is—whether it is true flat foot or not—
we should try to do something about it.
At the very outset I want to say there is not very much that can be done for
"true" flat foot but for the other defect, which is so often called "flat foot" a
great deal can be done, and having regard to the fact that these are more numerous
we are very happy that we are able to do something for them.
Question:—What causes Bunions?
Answer:—This is a question which has been put to me with regard to school
children. When first I began to think out an answer I could not help wondering
what on earth bunions had to do with school children because, whilst we cannot
say no child has ever had a bunion, I certainly cannot remember one that did.
A bunion is an inflamed, swollen joint, between the great toe and the ball of
the foot; in some cases it is largely due to the fact that children have never worn
proper fitting shoes and by the time they reach adult life there is not much that
can be done about it.
The plain blunt fact is that in a significant proportion of people the great toe
should stick out, just in the same way as our thumbs stick out when we lay our
hands on the table in front of us.
Until shoe manufacturers recognise this simple fact and until children are
redeemed from the curse of wearing unnatural shoes so long will these children
(when they grow up) suffer from bunions, due to the fact that the great toe has
been forcibly moved to an unnatural position.
I have been told that Henry VIII wore shoes with bulging toes because he
had deformed toes and that his courtiers followed suit.
In these days I wish some child prodigy of the screen was, for this reason, or
that, constrained to wear shoes with plenty of room for the toes. These would, of
course, look strange to us at first, but if this could only happen we should find a
large number of mothers refusing to be anything but in the fashion, and this would
be of great benefit to our children.
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