Chapter III: Front Matter (3)

Another sad, but physiologically interesting, sight is the rolling walk of the drunkard. Here, again, the will is not deficient; but it is, partly, and by its own agency, dethroned. Enough of the will is left to set the machine going, not enough to guide it and control it well. Though the movements follow one another, for the most part, in proper sequence, they are uncertain and ill-directed. The balancing power is partly lost. The feet are dragged hither and thither, and thrown about, by the swerving weight of the body; and they follow one another upon the ground at uncertain intervals, and in any but a straight line. You watch a man in this state staggering from side to side, and wonder how he keeps his legs at all. Soon the foot catches against some slight obstacle or against the other leg, or fails to come quickly enough into the required place, and the man rolls over. The supple manner in which his unstrung limbs give under the weight, perhaps, saves him, to some extent, from the shock; but you must not imagine that drunkards have any charm against injury. A large proportion of the accidents admitted into our Hospitals are the result of drunkenness.

_Distinctive Features of the Human Foot._

I have already made a few comparisons between the human foot and that of certain of the lower animals. It will be interesting to add some others.

There are several animals, as the Monkey, the Bear, and some Reptiles, in which the foot resembles the human foot in many particulars. It has, for instance, the same number of toes as the human foot, and the same, or nearly the same, number of bones, and the latter disposed in much the same manner. Certain peculiarities, however, distinguish the human foot. These all have reference to the power which man, and man alone, possesses of standing firmly upright, and of walking steadily, upon the two feet.

The following are the most important of these distinctive features.

_First._ The several parts are fitted and bound together in a compact firm manner, so as to combine strength and elasticity in the highest degree. In this respect the human foot contrasts very remarkably with the sprawling foot of the Seal or Lizard (figs. 2 and 3, p. 11). The result is obtained, partly, by the great size of the tarsal bones, in proportion to the other components of the foot, and, partly, by the formation of the “Plantar Arch,” which is higher and stronger in man than in any of the lower animals.

_Secondly._ The TOES are short and small in relation to the other parts of the foot. In many animals, the Monkey for instance (fig. 44, p. 89), the toes form the greater part of the foot; and, in some, the bones of the instep are reduced in number as well as in size: the reason being that, in such animals, the toes are required to perform a variety of offices--burrowing in the ground, scratching, holding on to the branches of trees, catching and tearing prey, &c.--for which their services are not needed by man.

It may here be noticed that one of the great points of dissimilarity between the foot and the hand consists in the difference which the length of the digits bears to the other components in the two members. They form nearly _half_ the length of the hand, but not more than a _tenth_ of that of the foot. Clearly, therefore, they constitute a far less important segment of the lower limb than they do of the upper, and are intended to perform much less important functions in it. In the hand the fingers and thumb may be said to constitute the essential part; whereas the toes do little more than help the foot to adapt itself to inequalities of the ground and so to obtain a firmer holding. In civilized countries, accordingly, where we walk, chiefly, upon even paths and paved streets, very little evil results from the loss of the services of the toes which is incurred by covering over the foot to protect it against the hardness of the roads.

We often hear the toes spoken of as ill-treated members, which are not allowed fair play because the art of man keeps them in a state of inertness and deprives them of their natural functions. Anatomy, too, gives some countenance to the idea, inasmuch as it shews that the muscles which minister to the toes are as numerous as those which are concerned in moving the fingers; and we occasionally see persons, who, having been born without hands, or having lost them, contrive to write and paint and do other unusual offices with their toes. Watch the movements in an infant’s foot as yet unshod. They are considerably more free than in your own; especially you will observe that there is a power of separating the great toe from the others and approximating it to them which you have, probably, altogether lost. The small size, however, of the toes, and the comparative fixedness of the inner, or great toe, prove, that they were never intended for anything like the same variety of purposes as the fingers, and shew that, under the most favourable circumstances, the _pes_ could never be _altera manus_, as some would persuade us that it is. Certainly it was never intended to be an organ of prehension. Hence, although in practice, boot-makers may excite our wrath and deserve our condemnation, I don’t think that, in principle, they are so much to be complained of.

The _third_ striking peculiarity of the human foot is the size of the inner or GREAT TOE and the firm manner in which its metatarsal bone is joined to the other bones, so as to render it a main pillar of support to the foot. These features of the great toe have reference to the share of the weight of the body which is borne by the inner side of the foot, more particularly during the last stage of the step, when the body is propelled forwards over the other foot. Hence it is sometimes called the “hallux,” from a Greek word (ἅλ-λομαι) signifying to bound or spring. The _mobility_ of the _thumb_, enabling it to be opposed so easily to each of the other fingers, is a characteristic of the human _hand_; and the _solidity_ of the _great toe_ is equally, or even more, characteristic of the human _foot_. The great toe should be continued, from the instep, straight along the inner edge of the _foot_, or inclined a little _in_wards; often, as before mentioned, its phalanges become inclined _out_wards so as to interfere with the other toes[5].

[5] In ancient times warriors were wont to cut off the _great toes_
as well as the _thumbs_ of their captives to disable them for further
service (Judges i. 6, 7).

Though, in many animals the number of the toes is the same as in man, this is not the case in all; and we may trace a gradual and progressive diminution of the number, in the following order.

40. Hippopotamus.

41. Rhinoceros.

42. Ox.

43. Horse.]

I have said (page 10) that the inner toe is incomplete in all animals, forasmuch as, in none, does it possess the same complement of bones as do the other toes. You will not be surprised to find, therefore, that it is the first to be missing. The ELEPHANT goes upon _five_ toes; but if you look closely you will perceive that the inner toe (fig. 39, I.) has not attained even its usual incomplete number of bones. It is short of one; and the inner wedge-bone, which looks like a metacarpal bone, is prolonged, downwards, to supply the place, and to give sufficient length to the toe. The same thing may be seen in some other animals, and it is interesting as shewing the first indication of departure from what may be called the standard number of the phalanges. In the HIPPOPOTAMUS (fig. 40) we have an additional stage of imperfection in this same toe; for here there is only one small bone to remind us of the existence of the toe (it is the same in the Rhinoceros, I.); all the rest have failed to be developed; and the animal, consequently, goes upon _four_ toes. Next the failure appears on the _out_er side of the foot, and affects the little toe. Thus, the RHINOCEROS (fig. 41) goes upon _three_ toes--namely, Nos. II. III. and IV.--and there is scarcely a trace either of the first toe or of the fifth. In Ruminating animals, as the OX (fig. 42), the second toe is wanting, as well as the first and the fifth; so that the foot rests upon _two_ toes (Nos. III. and IV.); and in the HORSE (fig. 43), as we have already seen, only _one_ toe--the middle one (No. III.)--is developed sufficiently to reach the ground.

Whatever pretensions to Humanity the MONKEY may make--and they are sufficiently striking to render some persons very uncomfortable on the score of relationship--he is certainly far removed from us in the construction of the foot (fig. 44); and the good people to whom I have alluded may derive consolation from the reflection that, in this respect at least, there is very little indication of cousinship. Indeed we ought not to speak of his _foot_ at all; for the part which corresponds with the human foot does not even deserve that name. It is so much more like a hand, that the term four-handed, or _quadrumanous_, is by naturalists applied to this class of animals. There is scarcely any plantar arch; the animal bears, chiefly, upon the outer edge of the foot; the digits are long and strong; and the inner one, instead of being parallel with the others, diverges from them so as to constitute a true _thumb_ instead of a great toe. All these points are very suitable for enabling the animal to cling to branches of trees, and for other prehensile purposes; but they unfit him for the upright posture, and render it impossible for him to walk steadily upon his lower limbs.

In the great ape called the GORILLA, which is found in the south-western part of Africa, and of which many specimens have now been sent to this Country, the _hind-hand_ is of great size and strength, as may be seen in the accompanying drawing made from a stuffed specimen in the British Museum. The lower part of the leg is also very thick, owing to the size of the muscles which move the great toe and the other digits, and which enable them to give a most powerful grasp. So strong and savage is the creature that all efforts to capture one alive, when full-grown, have, hitherto, failed. He is said to give evidence of his strength of hand and of his amiable propensities in the following way. He swings by his fore-hands from the trees, and, letting himself down quietly by them, watches an opportunity of seizing by the neck, with his huge hind-hand, some unwary Negro who may be passing by, draws him up, and holds him with vice-like grasp, till his struggles have ceased, and then drops him a strangled corpse to the ground.

Most of the characters above mentioned as distinctive of the human foot--such as its compactness and strength, the height of the plantar arch, the shortness of the toes--are, like the size of the calf, most marked in the higher members of the human family, in those, that is to say, who are gifted with the highest intelligence. Thus the formation of the foot is found to have a correspondence with the formation of the head, and may, like it, be, to a certain extent, taken, as I have before remarked, to be an index of intellectual, as well as of physical, capacity. The relation between the intellectual power and the physical conformation of man, which is here exemplified, and which is maintained throughout the frame, is a subject of extreme interest, and is one which has not attracted the attention of anatomists and ethnologists so much as it deserves.

To what secondary causes this harmonious adaptation of body to mind may be due, we cannot clearly tell; but we can see in it a provision for giving physical ascendancy to superior intellect. And it is most gratifying to be able to derive, as we may do, from this as well as from the observation of the past and the present, the assurance that the cultivation of the mind, provided its moral tone be preserved and proper sanitary precautions be taken, is not likely to be attended with any deterioration of the body. On the contrary, we have good reason to believe that the present civilized nations of the earth, with their higher mental culture, are inferior to none of their predecessors in the qualities of the body; surely soldiers never maintained a hand-to-hand struggle better than the victors at Inkermann; and we know that the civilized nations are physically superior to most of the uncivilized. We have good ground, therefore, to hope that the extension of education and commerce will be productive, on the whole, of an improvement of the physical condition of the species.

Sir James Emerson Tennent says that the Veddahs, or aboriginal inhabitants of Ceylon, use the foot in drawing the bow. They sit down, place the toe against it, and draw the string with the hand; and some of the American Indians appear to have used both feet in the same way. These Veddahs furnish a good illustration of the low physical condition which is usually associated with absence of mental culture. They are described as in a singularly degraded state. “They have scarcely any language, no knowledge of God, nor of a future state, no temples, no idols, no altars, prayers, or charms; and, in short, no instinct of worship, except it be some addiction to ceremonies, analogous to devil worship, to avert storms, lightning, and sickness. All presented the same characteristics of wretchedness and dejection--projecting mouths, prominent teeth, flattened noses, stunted stature, and other evidences of the physical depravity which is the usual consequence of hunger and ignorance. The children were unsightly objects, entirely naked, with misshapen joints, huge heads, and protuberant stomachs. The women were the most repulsive specimens of humanity I have ever seen in any country.”

_The Proportions of the Limbs._

A few years ago I took the measurements of numerous skeletons which I found in the museums in France, Germany, and England, and made the following table to shew the proportions of the several parts.

The length of the foot and hand is in all somewhat greater than it should be, in consequence of the bones composing them being usually less closely articulated in the artificial skeleton than they are in nature.

From this it appears that the limbs of MAN differ from those of the APE, chiefly, in the proportionate length of the thigh and arm, and in the shortness of the foot and hand. And it will be seen that, in both these particulars, the NEGRO differs from the EUROPEAN and exhibits some approximation to the APE.

I found, also (the tables shewing this are given in my work on the Human Skeleton), that these characteristic proportions of the European are brought out only during growth; for that in the early periods of infancy the foot and hand are, relatively, very long, and the thigh is actually shorter than either the leg or the foot, and the arm is shorter than either the forearm or the

MEASUREMENTS OF SKELETONS (IN INCHES).

+----------+---+------------+------+-------+-----+-----+-----+-----+-----+-----+-------------+
| | H | | |C S| H | R | H | F | T | F | Pelvis. |
| | e | Middle |Spine,|i f k| u | a | a | e | i | o +------+------+
| | i | point | |r e o u| m | d | n | m | b | o | | |
| | g | of |length|c r f l| e | i | d | u | i | t |Trans.|Ant.- |
| | h | spine. | of. |u e l| r | u | . | r | a | . | dia- |post. |
| | t | | |m n .| u | s | | . | . | |meter.|dia- |
| | . | | |- c | s | . | | | | | |meter.|
| | | | | e | . | | | | | | | |
+----------+---+------------+------+-------+-----+-----+-----+-----+-----+-----+------+------+
|European | | | | | | | | | | | | |
|(average |65 | Symphysis | 22.2 | 20.5 |12.7 | 9.2 | 7.3 |17.88|14.4 |10.6 | 5.2 | 4.3 |
| of 25) | | pubis. | | | | | | | | | | |
| | | | | | | | | | | | | |
|Negro | |{ 1 inch }| | | | | | | | | | |
|(average |62 |{ below }| 19.3 | 19.8 |12.1 | 9.4 | 7.7 |17 |14.4 |11.11| 4.6 | 4.1 |
| of 25) | |{Symphysis.}| | | | | | | | | | |
| | | | | | | | | | | | | |
|Bosjesman | | | | | | | | | | | | |
|(average |54 | Symphysis. | 17 | 19.6 |10.8 | 8.3 | 6 |15 |12.9 | 7.5 | 4.4 | 3.5 |
| of 3) | | | | | | | | | | | | |
| | | | | | | | | | | | | |
|Idiot | | | | | | | | | | | | |
|(in Berlin|57 | | 19.5 | 13.5 |12 | 8.8 | 7 |16 |12.5 | 8.5 | 5 | 3.8 |
| Museum) | | | | | | | | | | | | |
| | | | | | | | | | | | | |
|Chimpanzee| |{ 3 inches }| | | | | | | | | | |
|(average |50 |{ above }| 17 | |12.2 |11 | 9 |12.4 |10 |10.5 | 4 | 5.5 |
| of 4) | |{Symphysis.}| | | | | | | | | | |
| | | | | | | | | | | | | |
|Orang | |{ 3-1/2 }| | | | | | | | | | |
|(average |44 |{ inches }| 18 | |14 |14 |10 |10.6 | 9.2 |12 | 3.8 | 4.5 |
| of 2) | |{ above }| | | | | | | | | | |
| | |{Symphysis.}| | | | | | | | | | |
| | | | | | | | | | | | | |
|Gorilla | |{ 4 inches }| | | | | | | | | | |
|(average |58 |{ above }| 21 | |16.6 |12.9 | 9 |13.9 |11.3 |12 | 5.7 | 7.3 |
| of 3) | |{Symphysis.}| | | | | | | | | | |
+----------+---+------------+------+-------+-----+-----+-----+-----+-----+-----+------+------+

hand; and it is only, gradually, during the advance to manhood, that the proper proportions are attained. So that the transient or immature condition of the human frame shews certain resemblances to the permanent Negro type and to that of the quadrumanous animals; and these resemblances become obliterated during further growth.

The accounts of travellers indicate that some other nations present great varieties in the proportion which the length of the foot and hand bears to the height. Bushmen and Hottentots are very diminutive, commonly under 5 feet in height; and their hands and feet are remarkably small and delicate, in which respect they differ from Negroes. Mr Bartram observes with regard to the Cherokees or Muscogulges--a tribe of North American Indians--that the women are, perhaps, the smallest race of women yet known, almost all under 5 ft.; and their hands and feet are not larger than those of Europeans of 9 or 10 years of age. He tells us, also, what is very strange, that the men of this same tribe are of gigantic stature, “a full size larger than Europeans,” many of them above, and a few under, 6 ft.; but he says nothing of the size of their hands and feet. The hands and feet of the Patagonians are said to be very small. This may be contrary to what we might expect; but it accords with what I found to be the case in the skeletons of some Giants which I measured; for in all of them the feet and the hands were disproportionately short. It would seem, therefore, that, whether the stature of the individual be diminutive or gigantic, the foot and the hand, in either case, are, usually, less than their proper relative length. A greater number of accurate data are, however, necessary to enable us to generalise correctly upon this and other points of a like nature, or to decide what truth there is in the common remark, that a long foot in a child indicates a tall man.

In former times the parts of the human body were used as measures; and it was not uncommon to illustrate the tables of measures by drawings of the human body, with descriptions of the foot, palm, &c. One of the tables of the 16th century, derived in great part from the Romans and the Greeks, is founded upon the notion, which is not very far from the truth, that in the well proportioned man, the breadth of the palm is a 24th part of the whole stature, and the length of the foot a 6th part, and the length of the cubit--from the elbow to the end of the fingers--a 4th. The measures, however, varied at different times and in different countries, even though the names were the same. The latter have, in several instances, remained, though the definite measure which they now indicate is different from what it was, and differs from that of the part of the body from which the name was taken. Thus, our present foot measure (twelve inches) is considerably more than the length of the human foot.

_The Skin of the Sole._

The SKIN of the sole is soft and yet very tough and strong. It underlies a thick pad of fat, which separates it from the bones and the plantar ligament. The fat is interwoven with fibres passing, through it, from the tissue of the skin to the bones and ligaments. It is, in this way, rendered very firm, though it retains much of the soft quality of fat; and it forms an admirable cushion for receiving the weight of the body and defending from injurious pressure both the skin and the other parts of the foot. The fibres just mentioned bind the skin to the superjacent bones and ligaments, and hold it firmly to them, so as to prevent its being displaced from them in the movements of the foot upon the ground.

The accompanying woodcut shows that these connecting fibres are most numerous where there is the greatest pressure, viz. beneath the heel and the balls of the toes. It shows, too, that they take the direction at each of those parts which is most calculated to prevent displacement. Thus, at the heel their direction is chiefly from the heel-bone, backwards, to the skin. When we place the heel upon the ground in walking, the weight of the body has a tendency to drive the heel-bone _for_wards from the skin; and the direction of the fibres, from the heel-bone, _back_wards, just resists this tendency and holds the skin and the bone firmly together. On the contrary, when we withdraw the foot from the ground the pressure is in the opposite direction, and has a tendency to drive the metatarsal bones _back_wards from the skin. The course of the fibres is, consequently, changed. They, many of them at least, run _for_wards from the bones and prevent the displacement that would be likely to occur. This direction is also very marked, and for the same reason, at the end of the great toe. A bundle of fibres radiates from the projecting process, or tubercle, which is conspicuous upon the under surface of the bone near its end; and the greater number of them run _for_wards, through the pulp of the toe, to the skin, and maintain the connection of the skin with the bone when the latter is pressed _back_wards in withdrawing the foot from the ground.

The skin of the sole has a peculiar sensitiveness, which enables it to take quick cognisance of contact with the ground or of any injurious substances lying upon the ground. The sensitiveness in the foot is rather increased by its being so much covered up. We are aroused to a consciousness of this sensitiveness when the soles are tickled, or when any one treads on our toes, especially if there happen to be a corn there. We know also how sensitive the feet are to cold, and how liable we are to catch cold from wet feet. This sensitiveness renders washing the feet a refreshing luxury, especially in hot climates or when we are fatigued. It is a luxury much indulged in by Eastern nations; “Mephibosheth had neither dressed his feet nor trimmed his beard from the day the king departed, until he came again in peace;” and among the Jews in our Saviour’s time (Luke vii. 38), when guests were made very welcome, their sandals were unloosed, and their feet washed and carefully wiped, and, if the person were of high rank, anointed.

The integument of the foot varies in different animals, according to the nature of the ground upon which they tread and other circumstances. Thus the Elephant, the Hippopotamus, and the Rhinoceros, living in jungles and in marshy districts, have a more or less soft covering of skin. Oxen and Horses gallop about upon dry ground; and their feet are soled with thick hoofs of horn. The Dog has tough pads of skin with thick cuticle upon his feet; and the feet of the Feline tribe are muffled with fur so as to enable them to approach their prey with a noiseless tread. Man’s foot is, by nature, like the rest of the surface of his body, comparatively unprotected; but as the foot, by its efficiency, emancipates the hand from the drudgery of carrying, so does the latter make some return for this relief by providing artificial coverings which enable the foot to tread upon various surfaces, and protect it against the inclemencies of the seasons.

_On Shoes._

A few words on the subject of SHOES. No one will dispute the correctness of the principle that the shoe should be made to fit the foot; yet it is not a little remarkable that this principle is so often departed from in practice, and that the usual plan is to make the foot adapt itself to the shoe. That is, the shape of the shoe is determined according to the fancy of the maker or the dictates of fashion, and the foot is expected to mould itself accordingly. This is particularly the case with the fore part of the shoe, into which the toes, or most compliant parts of the foot, are squeezed. Thus, the shape of the sole of a sound foot is about that represented in fig. 47; the great toe is seen to be free from the others, and the line of its axis, prolonged backwards, traverses the centre of the heel. Compare this with the outline of the sole of a shoe as usually made; and the violence that is done to nature is at once perceived. The shoe is made quite symmetrical, or is curved a little in the part between the heel and the sole--in the “waist” as it is called--when the shoes are to be worn on the left and right foot respectively; and the toes, instead of being allowed to spread out a little, are pressed together, and made to converge to a point in the line of the middle toe, as seen in fig. 48.

The line of the great toe is thus quite altered, and the other toes are tightly wedged together (figs. 49 and 50); or, not being able to find room side by side, they overlap one another and form unsightly projections beneath the upper leather of the shoe. No wonder that “corns” and “bunions” and “in-growing toe-nails” are the frequent result of this treatment, and that so many persons are compelled to walk in a cautious, feeling manner, and to watch the ground narrowly, lest their cramped and tender toes come into contact with a stone or other projecting body.

How greatly to be lamented it is that the foot should be thus maltreated and distorted, and that walking should be made so painful, and that the shoe, which is intended to befriend and protect the foot, and which, if well fitted, would support it and preserve its shape, and make some amends to it for the rough hard roads upon which it is compelled to tread, should be thus perverted into a means of galling it and impairing its functions.

This subject has been treated of in a simple and concise manner by Dr Meyer, Professor of Anatomy at Zurich, in a small pamphlet, which has been translated into English by Mr Craig, and entitled, “_Why the Shoe pinches_[6].” I hope it may be read by boot-makers, and may lead to some improvement in their art. Dr Meyer very properly remarks that one of the main points to be attended to is, to allow the great toe to have its normal position; and this can be done by making the inner edge of the sole incline _in_wards, from the balls of the toes, instead of _out_wards. The accompanying drawing (fig. 51) gives the outline of a shoe designed under his superintendence, and shows the difference between it and the usual shape, the latter being indicated by the dotted outline. In fig. 52 the shoe is pointed, the pointing being effected from the outer side. I have often laboured, but laboured in vain, to impress the same point, and hope the more systematic attempt of Professor Meyer may lead to better results.

[6] _Why the Shoe pinches_, a contribution to Applied Anatomy by
Hermann Meyer, M.D. Professor of Anatomy in the University of Zurich,
translated from the German by John Stirling Craig, L.R.C.P.E.,
L.R.C.S.E., price sixpence.

The preceding four figures and the two following are taken from this
pamphlet with Mr Craig’s permission.

With regard to the _heel-piece_, I have already said that it should not be high because it makes the step less steady and secure, and at the same time shortens it, and impairs the action of the calf-muscle. A high heel-piece, moreover, renders the position of the foot upon the ground oblique, placing the fore part at a lower level than the heel; thus the weight is thrown too much in the direction of the toes, and they are driven forwards and cramped against the upper leather of the shoe. The high-heel of a boot, therefore, tends to aggravate the evils which are caused by the insufficient and ill-adjusted space which is allowed to the toes.

* * * * *

This account of the foot has necessarily been very superficial and imperfect. There are many points in its anatomy to which I have not even alluded; but, if I have succeeded in giving you some idea of the general plan of its construction, and in stimulating you to further enquiry respecting the mechanism of the Human Frame, my purpose will have been served. Still more will it have been so, if you carry away with you some sense both of the Pride and of the Humility which the review of such a structure is calculated to excite--of pride, not selfish pride, but pride resulting from a consciousness of the nobility of your physical nature, a pride which will make you spurn what is bad and degrading, and will help you to aspire to what is elevated and good. The impressions resulting from a comparison of this one fragment of Nature’s work with our own most laboured achievements must quell any other pride; and the very admiration with which we contemplate the structure of our body impels us to walk humbly with our God, whose gift that body is.

THE HUMAN HAND.

The great characteristic of the Hand, as distinguished from the Foot, is the mobility of the first digit, or thumb. Accordingly when this digit stands out apart from the others, and can be moved independently of them, so as to be more or less completely opposed to them, in the upper or Mammalian Class of animals, at least, we call the member a Hand. When this digit is absent, or is fixed in the same manner as the others, which is the case in each of the four limbs of Quadrupeds, we call the member a Foot. In Monkeys, or in most of them, the thumb is present and is separate and moveable in each of the four limbs; and these animals are, therefore, called “quadrumanous” or “four-handed.” Man, having the moveable thumb upon each of the two upper limbs only, is “bimanous” or “two-handed.” By this peculiarity, perhaps more definitely than by any other, he is distinguished in structure from all the rest of the animal series; and naturalists have, accordingly, given the epithet “Bimanous” to the class in which he is placed, and in which he stands alone.

The hand is the executive or essential part of the upper limb. Without it the limb would be almost useless. The whole limb is, therefore, so made as to give play and strength to the hand; and, in ever so brief a description of the hand, it is necessary, even more than in the case of the foot, to give some idea of the manner in which the other parts of the limb are constructed, and to dwell a little upon such points as have relation to its movements.

The general plan of construction of the upper limb will readily be understood by means of the drawings (figs. 53 and 58, p. 122). It resembles very much that of the lower limb (see fig. 4, page 15). The one bone of the upper arm--the _humerus_--resembles the one bone of the thigh, and is jointed, above, with the shoulder-blade, which, with the collar-bone, corresponds with the pelvis. Below, it is connected with the two bones of the fore-arm--the _radius_ and _ulna_; and these correspond with the two bones of the leg. In the wrist there are eight bones, called _carpal_ bones, arranged in two rows. These are connected with five _metacarpal_ bones; and these, like the metatarsals of the foot, are jointed with the _phalanges_. Of the latter there are three in each finger; but in the thumb, as in the great toe (page 10), there are only two.

The diagram shows how the bones of the hand are arranged in three divisions. Thus, the upper row of carpal bones (3, 4, 5) consists, practically, of three bones; the fourth (6), which is much smaller than the others, being rather an appendage to one of them than a distinct constituent of the wrist. (According to this view, the number of the wrist-bones corresponds exactly with that of the tarsal bones of the foot, viz. 7). The _outer_ of these three carpal bones (3) bears the thumb[7] and the fore-finger (I. and II.), and constitutes, with them, the outer division of the hand; the inner one (5) bears the ring-finger and the little finger (IV. and V.), and constitutes the _inner_ division of the hand; and the middle one (4) bears the middle finger (III.), and is the _middle_ division of the hand. The diagram shows, too, that the two outer bones (3 and 4), with the two outer divisions of the hand, are connected with the radius; whereas the inner bone (5) only, with the inner division of the hand, is connected with the ulna. Strictly speaking, even this bone is not directly connected with the ulna, but is separated from it, as will be shown presently, by a thick ligament.

[7] In deference to custom we call the palm the _front_ of the hand;
and, therefore, we speak of the thumb as the _out_er and the little
finger as the _in_ner digit: though it would better accord with the
ordinary position of the part, with its correspondence with the foot
and with comparative anatomy, to reverse these terms.

You frequently hear ignorant persons (and the greater number of persons are lamentably ignorant of the structure of their own body) speaking of the _small bones_ of the shoulder, or the _small bones_ of the elbow. You may think this a matter of no importance, and that it does not concern you and people generally to have any knowledge of human anatomy. But I will tell you what is very often happening, and will leave you to judge whether such complete ignorance on this subject is not attended with some practical disadvantage. A man meets with an injury, falls and hurts his shoulder. The immediate effects of the injury subside; but he does not quickly recover the use of the part; he still cannot raise his elbow, or put his hand upon his head, or put it behind him. Soon he begins to think that something more is wrong than has been suspected; and the notion creeps over his mind, and gradually takes possession of it, that some small bone is displaced. Not content with the assurances of his medical man, he resorts to a quack, called a “bone-setter.” The latter, taking advantage of the popular fallacy, gratifies the patient with the information that his fears are correct, affirms that “a small bone is out,” and proceeds forthwith to employ the requisite forcible measures for putting the said “small bone” in. I need not say with what result. Every year, in this civilized country, many persons are maimed for life by these attempts to put imaginary small bones in. I beg you, therefore, particularly to observe that _there is no small bone_ either at the shoulder or at the elbow. The only small bones are at the wrist; and these are so well fitted to one another, and so firmly bound together, that nothing short of a crushing force suffices to displace them. This remark respecting the small bones of the wrist is true of nearly all the small bones in other parts of the body. So that, in fact, small bones are very rarely dislocated; and when you hear it asserted that a small bone is out, you may pretty confidently conclude that the speaker does not know what he is talking about.

I have said that the upper limbs resemble the lower in their general construction. There are, however, some important differences; and one of the chief of these is the greater variety and freedom of the movements in the upper limbs. _Strength_, for the purpose of carrying the body, is the object in the lower limbs. _Mobility_ is the requisite in the upper limbs. Of this one example has already been given in the instance of the thumb as compared with the great toe.

_Movements at the Shoulder._

An equally striking example is afforded by the shoulder. In the first place, the “Shoulder-blade” itself can be moved in several directions--upwards, downwards, backwards and forwards;--whereas the “Pelvis,” i. e. the part which bears to the lower limb the same relation that the shoulder-blade does to the upper-limb, is immoveably fixed.

Secondly, the “Shoulder-joint” is so made as to permit a great variety and extensive range of movements to take place. We can move the arm forwards or backwards, as in throwing a ball, or, in sword exercise; we can raise it so that the limb points straight upwards; and we can swing it round in any direction. It is owing to the free movement in this joint that we are able to apply the hand to every part of the body, so as to remove sources of irritation. It is interesting to observe how other animals get on without hands, though they are much exposed to what we should consider great annoyance, as from flies, &c. The Cow, for instance, lashes its hide with its tail. The Cat licks itself with its tongue. The Sparrow dusts itself by the road-side. The Pig and the Donkey roll in the mud. And many of them, as the Horse and the Ox, have a thin muscle, called “panniculus carnosus,” spread out under the skin, which effects those sudden twitchings of the skin whereby they are enabled to jerk off anything that troubles them. In Man the hand answers better than all these methods combined; and it is necessary that it should do so, because his skin is more sensitive and less protected by natural covering than that of any other animal.

Chest and shoulders of man.]

For this freedom of movement of the arms, so important to the usefulness of the hand, we are much indebted to the “Collar-bones.” These bones, so called because they are placed at the lower part of the _collum_ or neck, extend, horizontally, from the upper edge of the breast-bone, to the processes of the blade-bones which overhang the shoulder-joint. Thus they hold the shoulders apart, and give width to the upper part of the chest. They also steady the shoulder-blades, and afford a _point d’appui_ to the muscles which effect the lateral movements of the arms,--for instance, to the muscles which tend to draw the arms together, as when we hold anything, between the hands, in front of us; and to those which separate the arms from one another, as when we stretch them out at right angles with the body.

Chest and shoulders of bird.]

Many animals--the ELEPHANT, the RHINOCEROS, the HORSE and the OX--have no collar-bones; and they are only able to swing their fore limbs to and fro. They cannot execute any lateral movements. They cannot throw the limbs out sideways, nor press their fore feet together, so as to hold anything between them. If the horse wants to seize or hold any substance he must do it with his mouth. The Elephant has a special provision for the purpose of prehension in his trunk, which enables him to provide himself with food by pulling down the branches of trees. The LION and the TIGER can press their fore paws together sufficiently to enable them to hold their prey, and fix it upon the ground, while they put the head down to it and pull at it and tear it with their teeth; and they are furnished with rudimentary, or half, collar-bones suspended in the flesh of the upper part of the chest; while the little SQUIRREL, which sits upon its hind legs, and holds up the nuts between its fore paws to be nibbled, has complete collar-bones. So has the flying BAT, the climbing SLOTH and the digging MOLE. In BIRDS the collar-bones (fig. 56, AA) are very large; and, for the purpose of giving them greater strength, they are united together in the middle line just above the breast-bone, forming what is commonly called the “merry-thought;” and, as this is not sufficiently strong to resist the force of the powerful muscles which flap the wings and sustain the animal in the air, there are, in addition, stout “side-bones,” called by anatomists “coracoid bones.” These (B) run, from the breast-bone (D), in the same direction as the collar-bones, one, on either side, to the shoulder-blades (C); and they afford even more efficient support to the shoulders than do the collar-bones. The coracoid bones are peculiar to oviparous animals, or nearly so. In some reptiles, as the CROCODILE, they quite supersede the collar-bones.

These few examples are enough to show that freedom of movement of the arms, especially of lateral movement, is closely associated with, and, indeed, is dependent upon the shoulder-blades being supported and steadied by bones, which extend from the breast-bone to the shoulder-blades, and fasten the one to the other.

But, even the powers and advantages conferred by nature have often some drawbacks; and this free play of the arm at the shoulder in man, of which we are speaking, and the provision for it afforded by the collar-bone, are no exceptions to the remark. It is necessary for so great a range of movement that the socket in the shoulder-blade should be shallow, and that the ligaments which connect the arm-bone with the blade-bone should be loose. Hence the shoulder-joint is weak as regards its ability to resist injury. The collar-bone also causes the shoulder to project so much that it is greatly exposed to injury and often bears the brunt of a fall. A man is thrown from a horse or is knocked down upon the ground, and, if anything prevents the hand being stretched out, the chances are that he falls upon the shoulder. True, the head is saved thereby; but the shoulder suffers. Hence the shoulder-joint is more often dislocated than any other; and no bone is more frequently broken than the collar-bone. Even in little children, in whom, notwithstanding their many tumbles, the other bones usually contrive to escape, the collar-bones are often broken; and in grown-up persons the shoulder is sometimes dislocated by the mere action of the muscles, as in swimming, or throwing, or lifting a weight above the head.

That you may understand the movements of the shoulder a little more fully, I will ask you to contrast the drawing (fig. 58), which shows the position of the blade-bone upon the chest in Man, with the drawing (fig. 57) of the corresponding parts of the Rhinoceros; and you will at once recognise several important differences, besides the presence of the collar-bone in the one and its absence in the other.

In the RHINOCEROS the chest is deep, from the back-bone to the breast-bone, and is flattened at the sides; and the depth of this part of the trunk is increased, slightly, by the breast-bone projecting, keel-like, underneath, and, much more, by the spines of the back-bone running up into a high ridge, above. The blade-bone and the arm-bone are applied against the flat side of the chest, and lie, lengthways, between the spine and the breast-bone, nearly parallel with the broad flat ribs. The blade-bone has no process overhanging the shoulder-joint, and, as before said, there is no collar-bone. The short thick arm-bone descends nearly in a line with the blade-bone, and has huge processes at its upper end for the attachment of muscles. The parts are designed to bear the great weight of the animal, and to carry its ponderous head and horn; but the only movement of which they admit is a sliding of the blade-bone and arm-bone, backwards and forwards, upon the side of the chest.

In animals of similar construction to the Rhinoceros, but of lighter frame, and of greater fleetness, the blade-bone is placed more obliquely, which gives freer and easier movement both to it and to the arm-bone. This, for instance, is the case with the well-bred horse, and if we want a quick-going horse, one that can lift his fore feet well, we should observe whether the shoulder-blade is oblique, and whether the spines of the back rise well above it. Such a horse is said to have “a good shoulder” and to be “well up.” He will carry a saddle well, and is not likely to trip.

In MAN the chest has proportionately less depth and length, and greater breadth, than in any other animal; the breast-bone is quite flat; and the spines of the back are sloped downwards, so that they do not project beyond the level of the ribs and the blade-bones. Hence he can lie easily either upon the stomach or the back--a privilege which is shared with him by very few of the lower animals. Scarcely any of them can lie upon the back, or even upon the stomach without the help of the fore limbs. The donkey enjoys rolling over and over upon a dusty road, but he cannot poise himself for a minute upon his back.

The sides of Man’s chest, moreover, are not _flat_, as in the Rhinoceros and Horse, but _rounded_, so that the blade-bones can revolve upon them to and fro, as well as slide upwards and downwards; and the long arms--comparatively long, that is, from the shoulder to the elbow--hang quite free of the chest and form sharp angles with the blade-bones.

The blade-bones are accommodated to the shape of the chest; for, instead of being elongated in a direction parallel with the ribs, they are prolonged downwards, along the sides of the chest, at right angles with the ribs. This prolongation of the lower part of the blade-bone is very important, inasmuch as it enables the muscles to hold the bone steady upon the wall of the chest, and so gives greater power to those muscles which pass from the blade-bone to the arm and act upon the shoulder-joint. Were it not for this provision the contraction of the muscles intended to raise the arm would quite fail to produce the desired effect, and instead of it would simply cause the shoulder-blade to revolve upon a transverse axis. That is to say, when we endeavoured to raise the arm our effort would merely have the effect of raising the hinder part of the shoulder-blade.

In each of these particulars--in the form of the chest, and in the shape and direction of the shoulder-blade--the Monkey is intermediate between Man and the inferior animals. The Monkey’s chest is broad and round, in proportion to its length, if we compare it with other animals; but this is less marked than in the human chest. And you perceive that the Monkey’s back-bones project, as they do in other animals, beyond the level of the ribs. The blade-bones are also like those of Man in being prolonged downwards, and in being carried, to a certain extent, across the ribs; but their lower angles do not run so far in this direction as they do in the human skeleton.

The movement of raising the arm, as in carrying the hand _outwards_, or pointing upwards, or putting the hand upon the head, is rather a difficult one, and requires the combined action of many muscles. It is, therefore, to be avoided by persons to whom muscular straining is likely to be injurious; and the power of effecting this movement is easily impaired by accident or disease. A long time often elapses even after a slight bruise of the shoulder, before the person recovers the power of putting the hand upon the head.

The exercise of raising the arms above the head is a good one for those in health, and is much, and wisely, recommended by the directors of gymnastics. It brings many muscles into play, not only those of the shoulder, but the muscles all round about the chest, viz. those which pass from the spine and ribs, as well as from the breast-bone, head, and pelvis, to the shoulder-blade and arm; and, thus, it tends to strengthen the spine and the chest, as well as the shoulders and arms. There is, perhaps, no exercise so good as this; and it is much to be regretted that the dress of young ladies, with its paraphernalia of stays and shoulder-straps, interferes so greatly with it. The frequency among them of “pigeon-breast” and “crooked spine” must, partly, be attributed to the confinement of the arms, caused by the mode of dress and the customs of life. One of the few opportunities afforded to the arms of availing themselves of this exercise is in the dressing-room during the process of brushing the hair. I would by all means, therefore, recommend young ladies to give sufficient time and attention to this part of the toilette, and not to delegate it to the lady’s maid. If, in addition, I suggest that it be commonly done with open window, I feel sure that I shall have a deservedly great authority among them--Miss Nightingale--on my side.

The movement at the ELBOW is, merely, that of bending and straightening, in a hinge-like manner; yet there is a slight obliquity in the direction in which it takes place, an obliquity resembling that in the movement at the knee (page 39).

_Pronation and Supination of the Hand._

In the FOREARM and HAND there is a movement with which we have nothing exactly corresponding in the leg. It is called “Pronation and Supination.” In _pronation_ we turn the palm _down_wards, as in picking up any substance from a table; in _supination_ we turn the palm _up_wards, as a boy does when he holds out his hand for a caning, or for the more agreeable purpose of having a shilling put into it.