4. Squinting is a very marked deformity when it is of a severe character. Sometimes it is very slight in early childhood, and passes off in a year or two. It will be encouraged by a bright light placed at the side of the child's cot, and the nursery light should always be out of the direct visual line of the child, in order not to affect the eyesight. The condition is due to a weakness of one of the muscles of the eyeball, and in some cases suitable glasses will correct squinting. Some cases are only cured by an operation, which should always be tried in bad cases, as squinting is a very undesirable deformity.
5. Birthmarks, or naevi, come under the heading of deformities of the face, which are in most cases curable. A naevus is a small blood tumour, which requires either surgical operative treatment or the application of radium. Electrolysis will dispose of some small naevi, and where this treatment is obtainable, naevi, even to the extent of large port-wine stains, can be cured without surgical interference. Although these skin tumours do not affect the general health, they are certainly deformities, and they should be removed in early years whenever possible.
6. Warts and hairy moles, also, if they are unsightly, should be dealt with, as most of them can very easily be cured by a surgeon.
7. Deformities of the feet are extremely common, and produce more ill-effects upon the general health than people realise. If the feet are deformed the walking is impeded, and the health poise of the body is affected, which causes shifting of the vital organs and pressure upon them. Many deformities of the feet are due to improper footgear. Badly shaped socks or stockings, and unhygienic boots or shoes, will push the big toe outwards and press upon all the other toes in turn. The mischief is generally done in early childhood, and it is the duty of every mother to see that her children's footgear is perfectly fitting, that it does not cause cramming of the toes or feet, if she wishes to avoid deformities. The inner side of the shoe should be straight. Sufficient room should be allowed in the boot for all the five toes to lie in a natural position, and the heels should be low and broad, and placed under the natural heel of the foot. Dancing in heelless slippers is one of the best exercises for the feet.
When a child suffers from weak ankles or flat feet, the sooner the matter is attended to the better. Proper exercises done regularly and carefully will strengthen the ankles and the ligaments of the feet. When these muscles and ligaments are weak the arch of the foot is flattened. If the condition is allowed to persist, an ugly, permanent deformity may follow, and, what is just as bad, the child suffers from fatigue to the brain and body, which any weakness in the feet produces. Any adult person who has flat foot knows how very tired she becomes after walking or standing, and more than one hospital nurse has had to give up her work because she is unfit for the standing and walking which ward work necessitates. If the deformity in these cases had been attended to in childhood, the trouble would never have persisted in later years.
What are the best exercises for flat foot, cramming, and distortion of the big toe?
(a) Tiptoe exercises with the bare feet night and morning.
(b) Walking up an inclined plank with bare feet, and walking down backwards.
Whilst these exercises are being done the toe can be gently pressed into position every night, after placing a pad of cotton-wool between the big toe and the next. The child should be allowed to go about with bare feet whenever the weather permits.
8. For weak ankles and flat feet, the tiptoe exercises and plank exercises can also be utilised, whilst massage and extension movements should be practised night and morning on the child. Grip the ankle with one hand, and lightly gather the toes into the other hand, and bend the foot inwards. Whilst the foot is in this position it is possible to work it in a semicircle gently. Another exercise consists in first bending the foot upwards as far as possible, and then downwards. Massage should be applied with the tips of the fingers, and should be in a circular fashion round the instep, sole of the foot, and the ankle.
Other exercises for weak ankles and flat feet are:
(a) Walk on the toes all round a room, and then upwards and downwards on an inclined plane, which may consist simply of a plank resting on a footstool.
(b) Hop round the room on each foot alternately.
To cure an ' intoed " foot, sharply bend the foot outwards, then inwards until the inner borders of the feet are touching
(c) Practise trotting exercises briskly, raising the heel off the ground.
(d) Stand on one leg, and rotate the other foot at the ankle.
9. Club foot is a more serious defect of the lower extremity, which may be corrected by manipulation and massage of the muscles, and by suitable foot instruments, which have to be carefully adjusted. Club foot is a turning of the foot inwards or outwards, or a marked drawing up of the heel. It is a fairly common deformity, and should be attended to as early as possible. In severe cases surgical interference is necessary.
Many of the minor deformities of the feet could be prevented if children were provided with hygienic sandals instead of distorting boots, which very soon weaken the muscles. Children ought to be taught foot culture far more than they are at present; in fact, the subject is quite neglected in most nurseries. After the morning bath a child should be told to move his feet briskly up and down in cold water, and then rub them dry with a rough towel until they are in a glow. This brings a rich supply of blood to the feet, which helps to nourish and invigorate the muscles. Then let the child do some of the foot exercises described above. Sunlight and fresh air are good for the feet, and that is why, so long as the soles are protected by sandals, children should be encouraged to expose the feet as much as possible to light and air.
10. The intoed foot is perhaps the most common deformity of the foot with which we require to deal. If you notice that your child walks with one foot or both feet turned inwards, make up your mind to train it into proper line. Make the child practise the tiptoe as well as the trotting and hopping exercises already mentioned, in addition to the following special directions for the condition.
Let the child stand with the heels and inner sides of the foot touching, then let him sharply turn the feet outwards. Bring them back to the former position, and repeat ten times. If it is practised several times a day, the child will gradually be able to turn the feet right back until they are almost in a line, with the two heels touching. Also make him practise walking up and down the room, pointing the toes, and turning them well outwards. If one foot is more markedly deformed than the other, special attention should be given to that foot. Skipping exercises are so good for all deformities of the feet and legs that a special article, with photographs, will be devoted to this subject. Step-dancing also should be taught children whenever there is any weakness of the feet and ankles. This sort of foot culture makes a wonderful difference to the poise, or balance, of the body, to the whole health and vitality, and even to the state of the brain. Fatigue is in many cases caused by abnormalities of the feet, and fatigue is a very great strain on the nervous system.
Deformities of the chest, shoulders, back, and hips will be considered in another article. To be continued.