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Friday, June 18, 2021

Is there a difference between bunions and hallux valgus?


( bunions image via pinterest)


The etymology of bunion probably comes from the Old French word "bugne, "meaning "a swelling caused by a blow."


( Bunion Surgery image via John Hopkins Medicine )


A bunion describes an inflamed advantageous bursa or fluid filled sac (like a balloon) which appears over the base of the big toe. The bursa may lie dormant or become inflamed (bursitis ) due to overlying shearing stress usually from shoes. Medial displacement of the first metatarsal head is a common symptom of triplane subluxation of the first metatarsal phalangeal joint commonly seen in hallux-abducto-dorsi-valgus (HADV). For convenience the term HADV is often shortened to Hallux Valgus (HV) or Hallux Abducto Valgus (HAV). This can and does lead to confusion. Bunions and HV often present clinically together but not all cases of HV will have a overlying bursitis.


(Video Courtesy: marcbarry1000 by Youtube Channel )


A common error is to confuse bunions with the unsightly exostosis (bony bump) at the base of the great toe caused by joint misalignment at the first metatarsal phalangeal joint.


(bunion and hallux valgus Image via wikipedia )

There are several reasons why Hallux-abducto-dorsi-valgus is caused but the consensus is instability at the rearfoot during late stance phase of gait causes hypermobility to move distally to the metatarso-phlangeal joints and causing them to subluxate. As a result the hallux (great toe) abducts (moves away from the midline of the body) on the transverse plane; everts (rotates along the long axis) on the frontal plane; and dorsiflexes on the sagital plane. The displaced hallux may overly (or underly) the second toe partially dislocating the digit, and causing a secondary hammer toe. This triplane deformity disarticulates the metartarsal phalangeal joint compromising its dual plane function, causing the metatarsal head to drift towards the mid line of the body. Osteoarthrosis (degenerative arthritis) may further compromise the interitiy of the joint and osteoarthrosis (degenerative arthritis) ensue. Prolonged external skin shearing over the bony prominence may excite a busitis. According a national survey by the American Academy of Orthopaedic Surgeons more than half of American women have measurable bunions (a lateral deviation of the hallux ≥ 20 degrees) but not are painful. They report nine out of 10 bunion cases affect women.


( Baby feet image via Vocal )


No one has ever been born with bunions or hallux-abductio-dorsi- valgus (HADV) but many people have a genetic pre-disposition . Bunions and HADV, affect women more than men and the former condition may be exacerbated by ill-fitting shoes, but this is rarely the primary cause. Discomfort from bunions include swollen, tender, big toe joints and joint pain, and stiffness. Lack of function may accompany HAV and can be alleviated by conservative means, such as stretching (traction), but conditions do apply. People living with developing bunions can also try a variety of conservative treatments, including wearing wider-toed shoes and foot orthoses to help restore proper balance in the foot. Should persistent pain continue then more drastic measures are required.


(toe traction image via Aliexpress)


The surgical removal of a bursitis is a comparatively simple process with good outcome. A bunionectomy however, usually includes elective surgery for hallux-abducto-dorsi-valgus. There are many procedures and in the vast majority of cases (approx. 85%) very successful outcomes . However, as with all surgical procedures there is always a risk of complications including post operative infection, long healing times, delayed return to work as well as imperfect post-surgical results. These concerns should always be fully discussed with the surgeon before informed consent is give to proceed.


( Bunions before and after surgery image via Bunion Institute )


Depending on the type and severity, and the age and activity level of the person, there are several operating procedures including micro-surgery commonly carried out. By far the most preferred method involves reconstruction of the large bone (metatarsal) which supports the big toe. This has two main attractions; it keeps the metatarso-phalangeal joint intact as well as allowing the big toe joint to appear straight. Sometimes a wedge of bone may be removed or an area may be fused to keep it in position. Pins may be inserted and surrounding ligaments, tendons and nerves often must be realigned with the bones. In some cases, a walking cast may be required. Full recovery may take a year albeit this is the exception rather than the rule. Sadly, even with a perfect job, reoccurrence of the deviation of the toe does arise and although, for the majority, this does not involve irritating symptoms, surgery is not always a cure.


(Four generations of feet Image via pinterest )


According to the Framingham Foot study into Hallux Abducto-Dosi- Valgus reseachers found genes more than shoes were likely to be the cause of the most common foot deformity. This is the first study to examine heretibility of foot disorders in white men and women of European descent, and 1,370 subjects were involved. Both men and women took part (mean age of 66 years and 57% were female) and the frequency of foot problems, including bunions as well as hammer and claw toes was recorded. Using estimated heritability software to perform genetic analyses of familial data (pedigree structures) they were able to estimate association. Hallux abducto-valgus and lesser toe deformity were found to be highly heritable depending on age and sex. The researchers suggested certain foot shapes, as determined by genetics, were predisposed to developing bunions. Previous studies have shown up to 60% of older adults have foot disorders which may limit mobility and reduce their quality of life. Despite its prevalence and sequestra there is little understanding of the genetics involved in the development of hallux abducto-valgus .The role of ill fitting footwear may exacerbate shear and friction across the skin surface and hence increase heat damaging the skin cell reproction resulting bursae formation and or callus and corns.

The American Academy of Orthopaedic Surgeons recommend people with prominent bumnions should wear good fitting shoes and avoid seems. Protective pads may also be used to help cushion the painful area. When persistent pain and difficulty walking follow it may be appropriate to undergo surgery. Bunion surgery realigns bone, ligaments, tendons, and nerves, bringing the big toe back to its normal position. Following bunion surgery, a long recovery is common and may include persistent swelling and stiffness.

Footnote
The purspose of this post is for information only and not intended to be actual medical advice. In the event you are concerned with bunions and or hallux -abducto-valgus please consult your own foot physician or general practitoner for advice .

More Reading
Hannan M. T. Hannan, Menz H B, Jordan J.M et al 2013 Hallux Valgus and Lesser Toe Deformities are Highly Heritable in Adult Men and Women: the Framingham Foot Study Arthritis Care Res (Hoboken). 65(9): 1515–1521.
DISEASES & CONDITIONS: What to do about bunions Harvard Health Publishing 2020.

Reviewed 19/06/2021

Wednesday, June 16, 2021

Bunions are in the genes



According a national survey by the American Academy of Orthopaedic Surgeons more than half of American women sufferbunions (lateral deviation of the hallux ≥ 20 degrees). They report nine out of 10 bunion cases affect women. The common sexist misconception to prevail has been bunions were caused by constrictive footwear and hence more prone to affect females. The Framingham Foot study is a new study into Hallux Abducto-Valgus (that’s bunions to lay peeps), has found genes more than shoes are likely to be the cause of the most common foot deformity. This is the first study to examine heretibility of foot disorders in white men and women of European descent, and 1,370 subjects were involved. Both men and women took part (mean age of 66 years and 57% were female) and the frequency of foot problems, including bunions as well as hammer and claw toes was recorded. Using estimated heritability software to perform genetic analyses of familial data (pedigree structures) they were able to estimate association. Hallux abducto-valgus and lesser toe deformity were found to be highly heritable depending on age and sex. The researchers suggested certain foot shapes, as determined by genetics, were predisposed to developing bunions. Previous studies have shown up to 60% of older adults have foot disorders which may limit mobility and reduce their quality of life. Despite its prevalence and sequestra there is little understanding of the genetics involved in the development of hallux abducto-valgus .The role of ill fitting footwear may exacerbate shear and friction across the skin surface and hence increase heat damaging the skin cell reproction resulting bursae formation and or callus and corns. The American Academy of Orthopaedic Surgeons recommend people with prominent bumnions should wear good fitting shoes and avoid seems. Protective pads may also be used to help cushion the painful area. When persistent pain and difficulty walking follow it may be appropriate to undergo surgery. Bunion surgery realigns bone, ligaments, tendons, and nerves, bringing the big toe back to its normal position. Following bunion surgery, a long recovery is common and may include persistent swelling and stiffness.

A potted history of the Fool



( Maxfield Parrish Prints Image via Art.com)


In the medieval and Renaissance eras, jesters (gestour, or jestour, originally from Anglo-Norman (French) meaning storyteller or minstrel) were ‘itinerant fairground fools’ who entertained and informed, court jesters amused members of the household of a nobleman or a monarch. They entertained with a wide variety of skills: principal among them were song, music, and storytelling, but many also employed acrobatics, juggling, telling jokes, such as puns, stereotypes, and imitation, and magic tricks. Much of the entertainment was performed in a comic style and many jesters made contemporary jokes in word or song about people or events well known to their audiences. They enjoyed special privileges and court jesters could speak freely to their master, even when they were unpleasant and malicious.


(Court Jester Image via pinterest)


Traditionally jesters wore colourful costumes composed of a cap with flaps and sometimes decorated with a cockscomb, a brightly coloured jerkin adorned with bells, and a jester’s sceptre. Their clothes allowed them sui generis (legal protection) pass permitting them to wander freely over the court without fear of punishment. Their role was more than pure amusement; they were the original “truth tellers,” whose job was to mock typical human vices of vanity, venality, snobbery, petulance, laziness, carpetbaggery, and fatuity. In Europe, the court jester would be called fool, buffoon, clown, jongleur, jogleor, joculator, stultor, scurra, fou, histrio, morion, among many other names. He was an essential fixture of the royal courts and master castles.Throughout history, the best jesters would acquire legendary reputations, becoming celebrated for their sharp tongues and quick wit. All courtiers feared the jester’s attention.


( Decoração Image via pinterest )


The licenced fool came from a range of backgrounds, from nonconformist university dropouts to excommunicated monks. Typically, court jesters were outsiders, shunned by society for one reason or another. This alienation only sharpened their insight into human nature. The fool could say anything about anyone, including the king. Jesters and their masters often developed a strong bond and became very protective of each other. Complimenting the fool was seen as complimenting the master. The jester also kept the master in check, giving him an honest assessment of his decisions, character, and actions. It was generally accepted the sharp tongue of the court jester and stinging wit helped purge bad blood.


( The Court Jester Image via pinterest)


Sometimes court jesters were disabled some were kyphotic or hunchbacked others might be small people (dwarfism). Their marginalised position is thought to have offered unparalleled detachment from life’s passions and a key insight into the human condition. The vast majority were intelligent and quick wit, but there is evidence some were developmentally challenged, and their antics considered a great source of entertainment. Thee was a general belief madness allowed a deeper truth to be spoken.


(Stańczyk (1480–1560) Image via pinterest )


During the Rennaisance, jesters were common places in royal courts across Europe. The most revered was the Polish jester, Stańczyk (1480–1560). Unlike jesters of other European courts, Stańczyk was considered to have been much more than a mere entertainer. He served three Polish kings: Alexander I Jagiellon (1461 -1506), Sigmund the Old (1467 - 1548) , and Sigmund Augustus (1520 – 1572 ), and was considered the most politically astute man of his era. He used satire to criticize and warn his contemporaries and his witty jokes often pertained to current political or court matters. Contemporary writers and historians praised Stańczyk for fighting hypocrisy in the name of truth. In Polish literature, Stańczyk was often perceived as the symbolic conscience of the nation. Many believe the popularity and recognition Stańczyk enjoyed in sixteenth century Cracow , helped establish the function of the court jester in other European courts.


( Leon Wyczółkowski Image via pinterest )


Syphilis was long thought to be a disease introduced to Europe in the 15th century (carried back by Christopher Columbus’s crew). Recent discoveries of human remains in Hull, England, have revealed syphilitic pitting and the bones have these have been carbon dated to the 11th century. Syphilis causes widespread damage to the nerves of the brain and in the terminal stages results in personality changes, mood changes, hyperactive reflexes, abnormal mental function including hallucinations and delusions, decreased intellectual functioning, and speech changes. This is known as General Paralysis of the Insane and typically begins about 15-20 years after the original syphilis infection.


( Henry VIII and "Will" Sommers Image via Wikimedia Commons )


According to Willeford (1969), one reason given for the longevity of court jesters was when the king was a syphilitic semi-imbecile, a jester even more grotesque may have served as a useful stage prop, disarming criticism by making the king look more nearly normal by comparison and thus making the make-believe of kingship possible.


(Is Hamlet a hero or a villain? Image via brainstudy.info )


During Elizabethan Era (1558 –1603), William Shakespeare (1564 – 1616), frequently made reference to jesters in his plays.

“Alas, Poor Yorick! I knew him, Horatio: a fellow of infinite jest, of most excellent fancy.”

In Twelfth Night, Feste was described as "wise enough to play the fool" and spoke in improvised rhymes and sophisticated riddles, ensuring the true meaning of his words remained obscure and beyond the understanding of common folk.


(Thomas Killigrew (1612 –1683) Image via pinterest )


After the Restoration, Charles II (1630 -1685 ) did not reinstate the tradition of the court jester, but he did greatly patronize the theatre and enjoyed the wit of Thomas Killigrew (1612 –1683). Samuel Pepys described him in his famous diary as "The King's fool and jester, with the power to mock and revile even the most prominent without penalty" (1668). Killigrew played a key role in the revival of English drama and in 1673, was appointed Master of the Revels.


( Punch and Judy Image via Southport Visiter )


By the 18th century, court jesters had died out except in Russia, Spain and Germany. In France the tradition of the court jester ended with the French Revolution. In France and Italy, the commedia dell'arte, featured travelling groups of jesters performed plays and a version of this passed into British folk tradition in the form of Punch and Judy puppetry.

Willeford W 1969 The fool and his scepter: a study in clowns and jesters and their audience Northwestern University Press.

Reviewed 1/06/2021

Tuesday, June 15, 2021

Shoes and sex in the Middle Ages



(Poulaines Image via JungleKey.fr )


“If ever a shoe style represented a symbol of social status then the long toed shoe of the Middle Ages remains unsurpassed. The fashion lasted for four centuries, unbroken.”

Introduction


(14th century poulaines Image via pinterest)


Footwear throughout history has supplied a social ritual, the knowledge of which indicated, breeding and status. The wealthy classes of the Middle Ages indulged their superiority by wearing sumptuous clothing and shoes became symbols, serving to indicate standards of conduct as well as emotional states. During the High Middle Ages fashion took a bizarre turn and the glitterati of European courts wore poulaines or, very long toed shoes. As the centuries passed, men’s footwear grew longer and longer until they were 24” longer than the feet they protected. Normal walking was impossible and young dandies stiffened their peaks with moss and grass ensuring the true purpose of the shoe dildos was obvious. Despite the fashion’s longevity no rational explanation has ever been proffered to explain the phenomenon. In the spirit of zeitgeist, the author attempts to now fill that void. The fashion began at the same time the first Crusaders were returning from the Holy Lands (The First Crusade, 1095–99).

Chivalry


( Sufi whirling Image via pinterest )


As European society emerged from the Dark Ages, high culture prevailed in the Empire of Islam which extended from India to Spain. When the two cultures clashed Knights were surprisingly impressed by the sophistication of the mystic culture of the Sufis. For centuries the Sufis developed a mystical path of love where the sensual and the spiritual came bonded in an ecstatic way. It was never clear whether the poet was praising a human beloved or the divine beloved or one shining through the other. Modern scholars acknowledge the influence of Islam formed the basis for European Chivalry and Courtly Love. The conventions of courtly love taught young men to sublimate their desires and channel their energies into socially useful behaviour. To do otherwise might have threatened social stability especially at a time when feudal lords and knights were engaged in the Crusades. For people to break these taboos only reinforces the strength and drive for sexual pleasure which transcend any moral precept.

Courtly Love


( Courtly Love Image via pinterest )


Courtly love flourished in the early 12th century during the cultural renaissance that followed the first Crusades. It involved the passionate devotion of lover and loved one. The relationship was always illicit i.e. the woman was the wife of another, often a lord or patron and its consummation was virtually impossible. The high minded ideas about romance spread when troubadours sang openly of love’s joys and heartbreaks in daringly personalised terms, extolling the ennobling effects of the lover’s’ selfless devotion. The troubadours (the term is derived from the Arabic word 'tare', meaning musical enchantment) promoted a love yearned for, and at times rewarded by, the solace of every delight of the beloved except physical possession by intercourse. Courts of Love were held to publicise the rules of love and the ladies who presided at the courts taught society about the new way to live and love.

Domnei & Donnoi


( 8 ideas of art inspiration Image via pinterest )


Most arranged marriages between aristocrats were for political reasons but convention upheld two "intimate ceremonies" as a form of courtship. Domnei (woman worship) was a custom where the would-be suitor gazed on the partly or fully undressed lady; and Donnoi where the couple lay naked together sometimes separated only by a pillow. The test for the young lovers was to prove their depth of love by avoiding intercourse. This was sensual, carnal and openly encouraged the delights of kissing and embracing. The sight of a beloved’s nudity and the touching of her body provoked desire. Under these circumstances it would be no stretch of the imagination to work out what gainful employ a 24" long extension on the foot might be put towards. Indeed, at a public banquet an average sized adult male with two 24 " long extensions on his feet could keep three women perfectly happy under the table, leaving his hands free to enjoy a health repast.

Long Toed Shoes


(Curly Toed Shoes2 Image via pinterest)


The fashion for long toed shoes lasted four centuries and although it ebbed and waned in that time, the length of shoes got longer until the style was abruptly halted in the early 15th century. Through its zenith, shoe length was subject to papal condemnation as well as sumptuary laws which always restricted excesses to the less wealthy. Despite this the fashion remained even although it caused men to walk unnaturally and ungainly with a wide based, high stepping gait. A particular fad of the young nobles who attended the court of William Rufus was to wear shoes with long tapering points like scorpions’ tails. Orderic Vitalis was an English born monk who spent the whole of his religious life in the Norman Abbey of Evroul and recorded much of the social events of his time. He documented a fool in the court called Robert, who stuff the points of his shoes with flax so they could be curled back in the form of a ram’s horn. He was subsequently given the ribald nickname Cornadus, meaning ‘Horner” or Horny.

Symptoms of Tertiary Syphilis


(Video Courtesy: nabil ebraheim by Youtube Channel)


The same high stepping pattern of movement (ataxia) is seen in tabes dorsalis, a sequestrate of tertiary syphilis where spirochetes destroys the central nervous system. Syphilitic myelopathy is a disorder characterized by muscle weakness and abnormal sensations caused by untreated syphilis infections. Loss of proprioception causes coordination difficulties which contribute to problems of wide based walking. The same infection causes widespread damage to the nerves of the brain and results in personality changes, mood changes, hyperactive reflexes, abnormal mental function including hallucinations and delusions, decreased intellectual functioning, and speech changes. This is known as General Paralysis of the Insane and typically begins about 15-20 years after the original syphilis infection.

The Court Jester


( Bufon Image via Clown Evolution )


"When the king was a syphilitic semi-imbecile, a jester even more grotesque may have served as a useful stage prop, disarming criticism by making the king look more nearly normal by comparison and thus making the make-believe of kingship possible."

(Willeford, 1969 p156).

Syphilis was long thought to be a disease introduced to Europe in the 15th century (carried by Christopher Columbus’s crew). Hence historians have had no reason to seek evidence of its existence prior to this date. Recent discoveries of human remains in Hull, England, have revealed syphilitic pitting and the bones have these have been carbon dated to the 11th century. The presence of the pox and the knowledge of its transmission would give reason to influence sexual practises.


(Video Courtesy: Timeline - World History Documentaries by Youtube Channel)


Safe sex


( Lotus Slippers/Shoes Image via pinterest)


The urge to prevent pregnancy was actively and creatively pursued since Onan spilled his seed (Genesis). Pre modern peoples of Europe regulated family size and women in antiquity had significant control over their reproductive lives. From ancient times a foreign object placed in the uterus was thought to prevented pregnancy and in periods when marriage was delayed it has been assumed that masturbation was an outlet. Until the Middle Ages women practiced birth control with little interference from religious or civil authorities. In courtly love shoe shaped dildos may have been used as sex toys and/or a means of physical contraception used after intercourse. The long shoe style may also have provided protection from sexually transmitted disease and or masked the symptoms. In a similar manner in Oriental Society, sexualisation of the Lotus Foot may have been for the same reasons.

Foot sex


( Lotus Feet Image via pinterest )


The association between feet and sex is found no clearer than in the Orient. The origins of foot binding are clouded although aesthetic appreciation of the small foot was present in early Chinese literature. Documentation of the foot binding starts from the 10th Century. Maintaining the Lotus foot (3” long) ensured hypersensitivity of the foot arch and forced the child to walk with small steps. Deportment was important and thought to increase the labial folds and muscle tone of the pelvic floors. The vagina was tight for life and the soles of the feet became second vaginas. Pedal sex was contemporary in the ancient world.

But what global event would cause two diverse societies separated by thousands of miles and eons of culture to adopt such a curious preoccupation with feet and sex? It had to be disease.

Fact or fantasy


(Jester Image via pinterest)


Footnote
What has been recounted is conjecture, and in the absence of written evidence must remain so. Whether shoes became sex toys by necessity and sexualisation of the foot, a focus for safe sex, will never be clear. However, something strange did happened in the 11th century and this has influenced our sexual behaviours to date. As an anthropologist/sociologist who studies the foot in health and disease, I could not finish this presentation without a foot note. The end of the fashion for long toed shoes came abruptly in the early 15th century. One other outcome of neuro-syphilis is Charcot foot where trophic ulceration decimates the sole of the foot making walking in anything other than shoe boxes, impossible.


(Duckbill Shoes Image via pinterest)


From contemporary paintings, the only evidence available, the style was quickly replaced by shoes which were so broad across the ball if the foot as to boast of individual compartments for each toe. The podiatrist’s delight was called Bears Paws (or Duckbills). A similar approach can be observed today in post-surgical moon boots used to support and protect injured tissues. By the 16C a new class of courtiers had emerged and deportment took on social significance where appearance reflected moral attitudes.

Reviewed 15/06/2021

Sunday, June 13, 2021

A brief history of medieval feet, shoes and clerics



(Barefoot priests Image via pinterest)


Although priests occupied an important position in ancient societies they almost invariably performed their duties, barefoot. Many believe this was an outward and visible sign of their inner humility and purity. When clerics wore sandals they were simple and devoid of fashion and symbolism. The clerical sandal represented sartorial separation from worldly vanities.



The priests of Phoenicia and Syria, according to Herodian (c. 170 – c. 240), wore shoes made from linen. Persian priests wore well-made sandals put together by expert workman. The priests of Athens, then Rome wore shoes called phaecasium. These were usually made of thin white leather, light in weight and covered the whole of the foot. In Rome, these shoes became popular with effeminate and foppish men. It was the right of citizens (male) to wear sandals.


(The Calling of the Apostles Peter and Andrew Image via National Gallery of Art )


Feet represented an inner state and the action of deliberately going without shoes demonstrated self-exile or a spiritual poverty. It was also used as a warning to others and barefoot prophets acted out the fate of those destined as sinners (prisoners and slaves). With the rise of Christianity came the need to spread of the gospel and bare footedness represented one of three states: the lack of social status, humility, or reference to the Divine. This related to the New Testament where Jesus sent the disciples out two by two and barefoot. (Luke 10:1-16)

"I am sending you like lambs among wolves. Take neither purse nor pack, nor sandals."


(Saint Fulgentius Image via pinterest )


Fabius Claudius Gordianus Fulgentius (468 -533) a Carthaginian priest sometimes wore sandals but also went barefoot. Come the fall of the Roman Empire and the barbarian invasions, craftsmanship declined in Europe and the skill of sandal making was almost lost. During the Dark Ages shoes were crude protection with little emphasis given to fashion common people went barefoot or wore rough clogs but as time progressed and trade improved economics a renewed interest in clothing took place.


( Byzantine(AD330 - AD1453) Image via priest )


The advent of Roman Catholicism coincided with a new order of fashion which initially only emphasised the plane. A spirit of religious exaltation pervaded and faith was transformed into visual symbols. Sometime between the first and third centuries eroticism and religion became intertwined, thought to be due to acceptance of celebration of creation. Colour acquired a religious significance and the period started with the humble sandal but the closed shoe and slipper took centre stage from the fourth century AD onwards. After this time only loose women continued to wear sandals.


( Wellworn Image via pinterest )


The beginning Christianity coincided with a general departure of excess and decoration. Religious art depicted Jesus and the Apostles wearing simple soleae, with the Virgin Mary, female saints and women in general wearing the more cultivated calcei. Later the symbols of Christianity absorbed the oriental taste for luxury and fascination with form. Footwear became more elegant in appearance and incredible in colour. The classical idea of dress was to glorify and display the body whereas the new Christian belief was to cover up. Sandals were replaced with shoes which had no distinction between left and right and made walking more difficult.


(St Francis Image via pinterest )


Saint Francis , Santa Teresa , Saint John of the Cross , and many others took bare feet as a literal command of Jesus. Elphage, Archbishop of Canterbury during the reign of Aethelred (martyred in A.D. 1012) always got up at midnight, even in winter, went outdoors, and prayed for hours, barefoot, without his cloak. It is recorded that many Anglo-Saxon monks, mainly Benedictines, of Elphage's time went barefoot as a lifelong penance.


( St Columba Image via pinterest )


Saint Columba established a celebrated monastery of barefoot monks on the Inner Hebridean island of Iona. Saint Aidan did the same at Lindisfarne. Finally, preacher and translator John Wycliffe (c. 1320s – 1384) traveled barefoot in England until he was martyred. Some of the most celebrated Roman Catholic saints went barefoot. Among these are the founders of the Franciscans , Dominicans , Discalced Carmelites , Poor Clares and Jesuits .


(Barefoot Priests Image via pinterest)


Francis, perhaps the best-known barefoot Saint, inaugurated an order of barefoot priests and went barefoot himself in strict imitation of the life of Christ. He took Jesus' marching orders literally, sending out his ministers two by two and barefoot, beggars in the service of God. Near the end of his life, Francis went on a famous barefoot and bloody walk up to the sacred cave at Mount Alvernia. where he is said to have received the stigmata.


(St Claire Image via Wikipedia )


Saint Clare of Assisi , founder of the "Poor Clares", Franciscan, (also known as the "Barefoot Clares") went without shoes. Charlemagne (742-814 AD) promulgated "Sovereign's law" which required clerics wear sandals when celebrating mass. Many medieval priests and Franciscan monks wore wooden sandals as a sign of disregard for material luxury. During pilgrimage many went barefoot out of choice, or to do penance for their sins, whilst others wore sandals as a token gesture.


(Basan Image via pinterest )


Leather riding boots called Basan (Basĕn, Baseyn, Basan(n)e, Basyn, Bazan) briefly were popular with the clerg after the Norman invasion . Whilst many pilgrims continued to go barefoot, common people viewed flatfoot with considerable suspicion. To the superstitious shoes could hide flatfeet (mark of the devil) and many cultures upheld footwear housed the spirit of its owner.


(William II Image via pinterest )


According to Strutt and Planché (1842), in the reign of William II (1087-1100) shod clergy wore ocreae restratae which were pointed boots and these were criticized by contemporary writers until a Papal bull banned clerics from wearing them.


( Henry the First Image via pinterest )


The sumptuary laws of Henry the First (1100-1135), prevented clergy from wearing long toed shoes (poulaines). In the High Middle Ages shoes took on a bizarre turn, incorporating many indecent overtones.


( Henry III Image via pinterest)


Reported by Wright (1922) one priest found a pair of shoes and wore them in contravention of his vows. He dreamed of being robbed and the thieves tried to kill him. He pled for his life but the assassins refused to accept her was a cleric because he wore shoes. Later when he awoke he throw his shoes out of the window and was never troubled with bad dreams again. It was in the reign of Henry III (1207-1272) barefooted friars were introduced in England.


( St Paul of the Cross Image via pinterest )


Hermit priest, Paolo Francesco Danei (St. Paul of the Cross) founded the Barefoot Clerics of the Cross (Passionists ) in the 17th century.


(Papal slippers Image via pinterest )


Today the ceremonial shoes of higher clergy in most Christian Faiths remains superb quality footwear whereas by contrast working clergy wear conservative footwear (usually back Oxford shoes).

Reference
Strutt J and Planché J A 1842 A Complete View of the Dress and Habits of the People of England H. G. Bohn University of Michigan
Wright T 1922 The romance of the shoe being the history of shoemaking London: Farncombe & Sons.

Reviewed 13/06/2021

Saturday, June 12, 2021

The history of poulaines (long toed shoes)



( Orderic Vitalis Image via The History Jar)


According to Grew and de Neergaard (2004 p.113), Orderic Vitalis the 11th century monk recorded much of the social events of his time,and attributed Fulk le Réchin (1043 - 1109), as the originator of the poulaine (pigaches or Pigage). Orderic Vitalis noted French aristocratto as "a man with many reprehensible, even scandalous, habits."


(Fulk le Réchin Image via Find a grave)


According to Rossi (1976), Fulk le Réchin suffered painful bunions and ingrown toenails and commissioned his cordwainer to craft him a designer pair of shoes to accommodate these deformities. The clever shoemaker came up with triangular shaped shoes with a triangular extension beyond the toes (the peak). The French Count of Anjou had his peaks stuffed with flax so they could be curled back similar to a ram’s horn. Orderic Vitalis described them as scorpions tails, Fulk le Réchin was subsequently given the ribald nickname Cornadus, meaning ‘Horner” or horned one and strutted about the court, usually in a bad temper and quarrelsome manner.


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Now whether this is fact or fiction, no one really knows but something very strange did happened in the 11th century and across parts of Europe, the length of men’s shoes got longer and longer until they were 24 inches beyond the foot (i.e. three times the length of an adult foot (Nunn, 2000 p.18). The fashion for poulaines, continued almost unabated for the next three hundred years. The first literary reference to poulianes appears in the Eulogium Historiarum (crica. late 14c) and dated to circa 1361. Other sources cite 1382. No clear explanation has ever been proffered to explain this strange phenomenon. Nor the reasons why lomg toed shoes disappeared so quickly.


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After a courtier of William II, (1056 -1100) stiffened his long toed shoes with moss and grass and bent them into the shape of a ram’s horn (Grew F and de Neergaard M 2004 p.113) long toes shoes grew in popularity among young courtiers across Europe. Mocked at first the attraction to do deplorable things with poulaines made them irresistable. Gothic peaked shoes for men enjoyed greater popularity in affluent European countries from the 12th century. Peaks were either ankle shoes with a drawstring fastening wound around the leg, or slip-on shoes. Made in one piece these were fashioned individually by a cordwainer and many were highly decorated. A major part their continued popularity was due to the creation of a bourgeois class and according to Goubitz (2007 p.76 ) medieval shoes were custom made outwith the pocket of the lower classes, long toed shoes were restricted to those who could afford them. Some children’s poulaines have been found with modest peaks compared to adult sizes (Grew and de Neergaard 2004 p.29).




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By the 14 century, long toed shoes had become the vogue for male courtiers in Kraków, then the capital of Poland. France was the centre for fashion and when souliers à la poulaine, (shoes in the Polish fashion) started to be worn they were called Poulaines and in England they were called Crackowes (Yarwood , 1978).


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By 1340 in Poland, “crakows” or “poulaines,” had become a symbol of wealth and grandeur. Usually made from leather or occasionally embroidered textiles, velvets, and silks. Pikes (as they were called) were often hand-painted or etched with intricate patterns. Absurdly expensive and almost impossible to walk in, poulaines visibly represented a life of leisure and luxury, free of extraneous effort or the tyranny of practicality (McDowell 1997 p.31).


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Crown heads were the fashion doyens of the time and inter marriage between countries (or courts) the main reason for change of costume. One fashion was superimposed upon another with a trickle down to ensure courtiers and courtesans were kept à la mode. This languid fashion exchange meant costume took many years to change. The longevity (no pun intended) of fashionable long toed shoes was probably related to this slow, protracted passage of culture across towns and countries, in the absence of any widely distributed media in Medieval times.


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Richard II (1367 - 1400) married Anne (1366 – 1394) daughter of the King of Bohemia, Charles IV (1316 –1378), and Holy Roman Emperor in 1382. At the time Charles IV was the most powerful monarch in Europe, and ruled half of Europe's population and territory. Anne of Bohemia became Queen of England as the first wife of King Richard II. The marriage was initially unpopular in England but Anne soon won many English people over with her personality. The court of Charles VI, was based in Prague, and had become the height of Gothic style, her arrival caused, new influences on English art and costume. The arrival of long toed shoes in England is thought to have followed. This did not go without criticism however, and an English poem from 1388 complained that men were unable to kneel in prayer because their peaks were too long. Soon after in 1394, an anonymous 'monk of Evesham' recorded

"With this queen there came from Bohemia into England those accursed vices (English Cracowys or Pykys) half a yard in length,…”


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Poulaines came to a tip called, a lipipe or learup. (point of leather). The fashion for long toed shoes became an obsession for men in the Middle Ages and according to Rossi (1976 p. 105) young bucks quickly exploited the phallic possibilities and soon the extensions became longer and longer. Medieval cordwainers stiffened the extentions to keep them erect with soft organic material, like moss, hair, or wool (Grew and de Neergaard 2004 p.88) . To prevent the tip from curling when wet, sometimes a whalebone was used as a stiffener. The phallic extensions flapped with lifelike mobility with each step. The longer the toe the more masculine the wearer and sometimes small hawke bells (folly bells) was sown to the tip to gain attention and indicate an interest in sexual frolic, (Rossi 1976 p. 105). The fashion prevailed for over 300 years and soon the size of men's shoes got longer and longer until they were 24 inches longer than the foot. Some authorities believe, ‘Cock of the walk.’ may have had its origins with the poulaine.


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Cited by Rossi (1976 p.106), the church tried to discourage men from wearing them by saying poulaines prevented praying when kneeling. In 1215, Cardinal Curson (c. 1160 – 1219) forbade the wearing of poulaines by university professors at the University of Paris. Later across Europe, the fashion continued to be berated by clergymen from the pulpit with some decreeing them a Satan’s curse responsible for The Black Plague (1347 - 1351), as God’s displeasure at the wearing of the profane poulaine. In 1368, long toed shoes were banned in Paris and in the 14 century Pope Urban V (1310 – 1370), became a particularly strong critic and openly condemned them. The Council of Lavaur prohibited clerics and their servants from wearing poulaines.


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According to Boucher (1988 p.198), in 1367 poulaines were forbidden by an ordinance in Montauban France and a year later 1368, Charles V (1338 – 1380) of France issued an edict banning the making of wearing poulaines in Paris.

Nulle persone Cordewaner ou Cobeler .. face.. ascuns soler galoges ou husend oveqe ascun pike ou poleine qe passera la longuer ou mesure de deux poutz.


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In 1368, King Charles IV (1316 –1378) the King of Bohemia, decreed no commoner could wear poulaines and further banned his secretaries and notaries from wearing them or face a fine of ten (10) florins. He considered the long toed shoes and affront to good manners and disrespectful to God. Unabated eventually governments issued decrees to limit the length of poulaines to six inches for commoners, but permitting the length up to 24” for the nobility and aristocracy. The restriction in length of shoes was at first to discriminate "the haves" from "the have nots", then to quell the reappearance of the worship of the phallus.


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Once the style seeped down to commoners during the reign of Edward III (1312 –1377) of England, the first national sumptuary legislation went on record. Statutes were passed in the Parliaments of 1336, 1337 and 1363. These are available in the Statutes of the Realm. According to Bland (1976) one act included the following:

"no knight under the estate of a lord, esquire or gentleman, nor any other person, shall wear any shoes or boots having spikes or points which exceed the length of two inches, under the forfeiture of forty pence."

Nobility were allowed 24" (61cm) pointed shoes; gentlemen could wear 12" (31 cm) extensions and merchants 6.5" (16 cm).




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Towards the end of Richard II (1367 - 1400) reign extravagance in dress and manner of living rapidly increased. Richard was a bad example to his subjects and was known as "the greatest fob ever, to occupy the throne'. His excesses were legendary and his nobles and merchants were keen to follow his lead by spending large sums of money on their dress and the popularity of poulaines continued. To held standardise the measurement of shoes, shoemakers used three barley corn placed end to end (i.e. one inch). They determined 39 barley corns or 13 inches was the length of the longest foot. Smaller sizes were graded down in increments of one third of an inch. (Yue and Yue p.29)


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Long toed shoes symbolised the approaching readiness of young males to assume sexual and reproductive roles (Rossi 1997 p.108). Churchmen did not miss the overt phallic connotations and several Papal bulls (public decrees) were issued to prevent lower classes from wearing them, These protests were dismissed as the idealised aspect of medieval love disintegrated into the adulterous aspects of high gothic, courtly love. Poulaines or beaks were thought to be used as sex toys. By the late 14th century wooden or cork overshoes (pattens) fastened to the foot with leather cross straps became vogue and were worn indoors and outdoors. These kept the integrity of the poulaine supporting the extended toe as well as keeping the fine materials from damage (Nunn 2000 p.18). By middle of the 15th century in England, longer poulaines were back in fashion and pattens were almost ubiquitous (Grew F and de Neergaard M 2004 p.119).


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According to Boucher (1988) the zenith for poulaines was between 1460 -1470. Disgusted at the overt indecency in 1463, King Edward IV (1442 –1483) of England, decreed wearing long toed shoes in public as obscene, and more sumptuary laws were passed to limit a variety of racy fashions with the length of shoes restricted to two inches beyond the foot for everyone.

“No person under the state of lord, including knights, esquires, and gentlemen, to wear any gown, jacket, or coat which does not cover the genitals and buttocks. Also not to wear any shoes or boots with pikes longer than two inches."

In 1465, all cordwainers and cobblers within the City of London and surrounds, were prohibited from making shoes with pikes more than two inches long. According to Grew F and de Neergaard M (2004 p.31) there was also archaeological evidence from excavations of poulaines being deliberately cut in length. In 1470, French shoemakers were prohibited by law from making long toed shoes, and by 1475, the poulaine had vanished.


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Mounted knight’s riding into battle were particularly vulnerable to foot assaults from dismounted soldiers and wore sabatons (or sollerets) on their feet as part of their armour. Typically, sabatons were similar in style to poulaines and ended in a tapered point well past the actual toes of the wearer's foot. They were made of riveted iron plates called lames and consisted of a toe cap, four articulated lames, a foot plate and ankle plate, and a hinged heel cap, joined with buckled straps. These plates generally covered only the top of the foot. Sabatons were the first piece of armour to be put on and only used on horseback and pointy metal footwear would severely hinder movement and mobility on the ground, particularly under wet or muddy conditions, so the long points were detachable from the sabatons.


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Shoe fashion did change and by all accounts pretty rapidly by the end of the 15th century. Several theories have been postulated as to the swift demise of the poulaines but none attribute it to Sumptuary Law alone. Rossi (1997) and others suggested the inability to run in battle when the toes of the armour were so long citing Leopold III, Duke of Austria at the battle of Battle of Sempach (1386). Piles of shoe-tips found after the battle suggest otherwise. Certainly by the 16th century toe peaks could be removed easily in the case of a dismount. A surviving pair of sabatons belonging to Emperor Maximilian (1459 –1519) have extremely long poulaines, but the catches can be seen over the area of the big toe.


( Sabaton Image via wikipedia )


Another theory was when the heir to the Spanish thrown was born with polydactylism (extra toes). The risks of post operative infection and death following surgery were too great and much easier to change the fashion to broad toed shoes. In the absence of a modern media however, credible as these reasons may appear today, it is unlikely to explain the quick transition from long toed shoes to broad shoes (Bear’ Paws). An altogether more credible explanation would be the presence widespread disease which affected the feet, necessitating their prtection.


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Modern scholars acknowledge, the Influence of Islam on European culture at this time, and believe it formed the basis for European Chivalry and Courtly Love. In the absence of feudal lords and Knights engaged in the Crusades young men of the court were taught to sublimate their desires whilst channelling their energies into socially useful behaviour. To do otherwise, might threatened social stability. European courtly love flourished in the early 12th century and high-minded ideals of true romance were spread throughout when troubadours sang openly of love’s joys and heartbreaks in daringly personalised terms, extolling the ennobling effects of the lover’s’ selfless devotion. Their songs promoted a love yearned for, and at times rewarded by, the solace of every delight of the beloved except physical possession by sexual union. The relationship was always illicit i.e. the woman was usually older, the spouse of another, often a lord or patron, and consummation was not possible. During this time contemporary romantic literature began to include strong reference to women's feet. Troubadours waxed eloquent about their attractiveness and the literate read about them in the few books of the time e.g. The Romance of the Rose (circa 1230). Attractive feet were white; narrow with high arches and long straight toes. Toe nails were worn long with large white moons on pink, pale nailbeds. All this interest in women's feet came at a time when long toed shoes were popular among male courtiers. Increased sexual focus on the female foot intensified during the thirteenth century.


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The conventions of courtly love allowed two "intimate ceremonies" of courtship. Woman worship (domnei) allowed the would-be suitor to gaze upon the partly or fully undressed partner and naked courting couples could lie side by side sometimes separated by only a pillow. Kissing and embracing were encouraged but the lovers proved their depth of love by avoiding sexual intercourse. These behaviours were highly sensual and carnal and at a time in history when married couples were parted or marriage was delayed, masturbation provided the perfect solution. By the same token, heavy petting provided a practical form of birth control especially when neither religious nor civil authorities interfered with women’s business. In Occidental Society, long toed shoes may have provided an ideal means of birth control and later provide protection from sexually transmitted disease. A historical corollary, if required, was foot binding in Oriental Society, at precisely the same time, the bound (Lotus) foot became incorporated into sexual practice. Young men stuffed their long-toed shoes with moss and grass to stiffen their poulaines and put them to a very practical use. Sometimes small hawk bells (folly bells) were sewn on the end of the shoe to audibly indicate, the wearer was interested in sexual frolic. Promiscuous sex among the privileged became prevalent in the Middle Ages.


(Video Courtesy: Timeline - World History Documentaries by Youtube Channel)


Previously, syphilis had long been thought to be a disease introduced to Europe in the 15th century (carried back by Christopher Columbus’s crew). However, new research suggest a form of treponemal disease spread by sexual contact, existed in Europe prior to 1492. The presence of syphilis, the knowledge of its transmission and no means of preventing transmission gave reason to influence Medieval sexual practices. The longevity of long toed shoes may have had much to do with promiscuity among the ruling classes both as a sex toy and means to prevent STDs. Wearing poulaines caused men to adopt a wide based, high stepping gait similar to the staccato movement of a puppet. This was considered style and slavishly copied by courtiers eager to gain the pleasure of the regent. A similar gait pattern is seen in tertiary syphilis.


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Another severe complication of end stage syphilis involves neuropathic pathology similar to Charcot foot . An extremely painful condition causing skin ulceration, infection and fragile bones. A varient on the Treponema pallidum bacterium causing syphilis may have come from North America and account for the Syphilis Epidemics which decimated both European and Oriental cultures. In any event the fashion for Poulaines came to an abrupt end across Europe and appears to have been replaced by Duck Bill shoes (very broad shoes) in the early 15th century.


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In the spirit of zeitgeist, Duck Bill shoes celebrated the Cult of the Virgin Mary, and with reference to the female genitalia, they incorporated delicate slashing of the fine leather uppers to conveniently accommodated even the most deformed foot. The style worn mainly by mean remained popular for almost a hundred years.

Footnote


( long points doubled back and secured with chains Image via Dreamstime.com )


Several sources including McDowell (1976 p.31) make reference to James I Scotland (1394 - 1437), wearing long points doubled back and secured just below the knee with silken laces, or chains of silver or gilt,. There is however, no archaeological or medieval iconographic evidence to support poulaines were ever tied to the leg.

Interesting Sites
Hunt K 2021 Skeletons reveal the cost of medieval fashion for pointy shoes CNN
Imbler S 2019 Why Were Medieval Europeans So Obsessed With Long, Pointy Shoes? Atlas Obscura

Bibliography
Armelagos G.J, Zuckerman M.K, and Harper K.N 2012 The Science behind Pre-Columbian Evidence of Syphilis in Europe: Research by Documentary Evol Anthropol. 2012 Mar; 21(2): 50–57.
Bossan M 2012 The Art of the Shoe Parkstone International
Gianni AJ, Colapietro G Slaby A Melemis SM Bowman RK 1998 Sexualization of the female foot as a response to sexually transmitted epidemics: a preliminary study Psychological Reports 83 491-498.
Peacock J 2005 Shoes: The complete sourebook Thames & Hudson
Rossi WA 2000 The complete footwear dictionary 2nd Edition Kreiger Publishing Malabar Florida
Vance P (Translater and Editor) 2000 Albert Racinet Illustrated history of European costume : Period Styles and Accessories Collins and Brown Limited

References
Boucher F 1988 A history of costume in the west Thames and Hudson London Bland A 1976 A history of ballet and dance in the western world London: Barrie & Jenkins
Goubitz O, van Driel-Murray C and Groenman-van Waateringe W 2007 Stepping through time:Archaeological footwear from prehistoric times until 1800 Stichting Promotie Archeologie
Grew F and de Neergaard M 2004 Shoes and pattens: Medieval finds from excavations in London:2 2nd Ed The Boydell Press Woodbridge
McDowell C 1997The man of fashion :Peacock males and perfect gentlemen Thames & Hudson London
Nunn J 2000 Fashion in costume 1200 - 2000 2nd ed New Amsterdam Booksa : Chicago
Rossi WA 1976 The sexlife of the foot and shoe Kreiger Publishing Malabar Florida
Yarwood D 1978 The encyclopaedia of world costume BT Batsford London
Yue C and Yue D 1997 Shoes: Their history in words and pictures Houghton Miffin Company Boston

Reviewed 12/06/2021