Tuesday, January 28, 2020

Feet: The lengths people will go to?

In 1977 the Johns Hopkins psychologist John Money published the first modern case history of "apotemnophilia". The condition is referred to as a paraphilia of the stigmatic/eligibilic type in which sexuerotic arousal and facilitation or attainment of orgasm is dependent upon being an amputee, or an attraction to the idea of being an amputee. He distinguished apotemnophilia from "acrotomophilia", a sexual attraction to amputees. The apotemnophile's desire is to be an amputee, whereas the acrotomophile's desire is turned toward those who happen to be amputees for sexual pleasure. Apotemnophiles become fixated on carrying out a self-contrived amputation, or obtaining one in a hospital.

I suppose when you stop to think about it, people are strange (cue Jim Morrison and The Doors). The length some on us go, to be in fashion, is quite remarkable if the following report is to be believed. I said length but should have said short because I understand the latest trend in the US has found many ladies arriving at their friendly cosmetic surgeon to have their toes shortened. Yes, the little pinkies are amputated. For no medical reason but just to be able to fit more comfortably in the lean slick fashionable shoes enjoying a fashion vogue.

Now the idea is not new and it appears a prominent member of the Royal Family of yesteryear alledgedly had his little toes amputated to fit more comfortably into the trim brogues he made so popular.

Can we live without our little toes? Apparently so, indeed may amputees live perfectly fulfilling lives without any toes but this is not recommended, if it can be possibly avoided. Several years ago I did some preliminary research at the Bioengineering Unit at Strathclyde University in Scotland and was amazed to find out how much the toes contributed to foot function during walking.

The new trend for cosmetic foot surgery is global with toe lipo suction and shortening by surgically filleting in common practice. The small toes have three little bones which give two knuckles sometimes osteoarthritis fuses the knuckle joints and leaves a prominent “sticky out bit”. I am using technical terms now. Foot surgeons may remove this if it is the cause of extreme pain and or recurrent infection. Pain is usually the sole (excuse the terrible pun) criteria for orthopedic intervention. Conditions do apply and whilst elective cosmetic foot surgery would be frowned upon in orthodox circles times are-a-changing.


A somewhat bazaar footnote here is a very some percentage of people will derive sexual pleasure from having parts of their fingers and toes amputated. But not to leave you on that note I much prefer the story that supports the introduction of wide fitting shoes. In sixteenth century Spain the fashion for bear’s paw type shoes, a broad fitting shoe that measure 12 inches across the ball of the foot with individual compartments for each toe came about because the prince regent was born with polydactilism (six toes). Absence of antibiotics and a high mortality rate post surgery meant the prince was allowed to keep his extra toes and the shoe fashions were changed to accommodate. Way to go.

Reviewed 28/01/2020

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