Sometimes I think its helpful to explore the past of a particular field, if only (usually) to see how far things have come. But, as the famous adage goes, be careful what you ask for. Sometimes, you get a glimpse of how far things, have NOT gone.
Take this little gem. I found it in a book called Club Feet: Its Causes, Pathology, and Treatment, by William Adams, FRCS, London, 2nd Edition, 1873. If you get past the florid writing style, and some of the archaic terminologies, its a real window onto medical thinking regarding club feet, some of which persists to this day. I'll see you on the other side of the snippet below, wherein our hero talks on the psychological impact of club feet. Remember, this was before Freud.
So, we need to examine our habits of mind, is it? Byron aside, elsewhere in the chapter, Adams refers to those without having any corrective interventions (unchanged club feet) as having to go back to the farms, or remain in areas of "manufactury." And throughout the text, there are many references to the challenges faced by people with club feet back in the late 1800s. So at least by that token, there's been a wee bit of forward momentum.
But, and you knew there was going to be a "but" now, didn't you, when you examine some of the surgical practices, there is surprisingly little that has changed. He talks of tenotomies (achilles lengthening) and anterior tibialis transfer, as well as osseous (bone) realignment, much as is still done today. The thing that is not so surprising, to me at least, is they did no long-term follow-up back then, either.
I will be paying occasional visits to this book, with the aim of showing other aspects, most especially some of the shoe and brace approaches taken back then. For example, did you know that they used metal as part of their casting? It was used to hold the foot into a specific position while the plaster dried, because plaster in those days took quite some time to set. So the metal remained a part of the cast. Sounds downright comfy, don't it?
How about you out there? I'd love to hear your comments on this lovely little excerpt, and to hear as well about other sources of historic information on club feet, if you have any.
And remember, work to develop those highest qualities of your mind. You'll make philosopher yet!
What a fascinating post! I just received your comment on my blog post about Of Human Bondage and the myth of Hephaestus so naturally I can't help but imagine that the use of metal in setting casts relates to his role among the gods as blacksmith and craftsman. In response to your question, I would be honored if you provided a link to the post here.
ReplyDeleteMy understanding of surgery in the nineteenth century is that it was relegated to the level of craftsmen and laborers because no self-respecting doctor would messy his hands with blood and bones and viscera. Of course, I can't help but wonder if W. Somerset Maugham would have used this book as a reference when discussing b/l and developing the character of Philip Carey...