A bioarchaeological and biocultural investigation of Chinese footbinding at the Xuecun archaeological site, Henan Province, China.

From 2005-2006 the Institute of Cultural Relics and Archaeology, Henan Province, excavated the Xuecun cemetery as part of a salvage archaeology project associated with the South to North Water Diversion Project. This gave a unique opportunity to examine burials from the Ming-Qing Dynasties (1360-1911). Burials from this period are seldom excavated as the Chinese, do not want to disturb their direct ancestors. This is one of the first studies to examine the paleopathological consequences for footbinding in China. A total of 202 individuals were analyzed for evidence of bound feet: including the loss of musculature in the legs, alterations to muscle attachments, changes in the morphology of the tarsals, metatarsals, and phalanges, and signs of infection and trauma. Length and width measurements of tarsals, metatarsal, and phalanges were taken from all females with observable bones. T-test results confirmed a significant difference in tarsal and metatarsal length/width. The incidence of footbinding also increased through time from no evidence in the Han Dynasty, Tang Dynasty, Song Dynasty, and Jin Dynasty, to a dramatic increase in the late Ming Dynasty to Qing Dynasty.

Does cortical reorganisation explain the enduring popularity of foot-binding in medieval China?

In the past, it used to be taught that neural connections were essentially fixed and unchangeable from birth. However, in recent years it has become clear that, in fact, the brain possesses a tremendous degree of latent plasticity, and significant reorganisation can occur in response to changes in the body. This is clearly demonstrated by the phenomenon of phantom limbs--the vivid sensation of a limb still being present despite its amputation. After removal of a limb, the region of the somatosensory cortex that is deafferented is "taken over" by afferents that normally innervate the adjacent areas of cortex. This cross-activation between the different areas of the somatosensory cortex plays a large role in creating these phantom sensations. The same is also true of the motor cortex. After amputation of a limb, the deprived area of motor cortex does not remain nonfunctional but instead becomes active in the control of adjacent non-amputated muscle groups. It is notable that the genital area of the somatosensory cortex and the pelvic floor muscle area of the motor cortex are dislocated and in both cases lie adjacent to the foot area. Foot-binding of Chinese girls started around the 10th Century AD and for the next millennium was an extremely prevalent and popular custom. Mothers would tightly wrap their daughters' feet from about the age of six years, thus preventing the feet from maturing normally. The aim of the process was to create as small feet as possible, since this would greatly enhance a girl's matrimonial prospects. Historians of the period have noted that Chinese men viewed foot-binding as conducive to better sexual intercourse because they believed that women with bound feet had vaginas that were more highly muscled and sensitive. We hypothesise that since foot-binding kept a girl's feet small and atrophic, this resulted in underutilisation of the foot areas of her somatosensory and motor cortices. This resulted in cross-activation between the redundant foot cortex and the adjacent genital areas in her brain. Hence women with bound feet devoted a disproportionately large area of the sensory and motor cortices of their brains to their genitalia and pelvic floor musculature, which made them more sensitive and pleasurable lovers. This caused Chinese men to prefer their sexual partners to have bound feet, which resulted in the enduring popularity of foot-binding in China over the last millennium.

Paleopathological study of hallux valgus.

Hallux valgus is the abnormal lateral deviation of the great toe. The principal cause is biomechanical, specifically the habitual use of footwear which constricts the toes. In this study, descriptions of the anatomical changes of hallux valgus from published cadaveric and clinical studies were used to generate criteria for identifying the condition in ancient skeletal remains. The value of systematic scoring of hallux valgus in paleopathology is illustrated using two British skeletal series, one dating from the earlier and one from the later Medieval period. It was found that hallux valgus was restricted to later Medieval burials. This appears consistent with archaeological and historical evidence for a rise in popularity, during the late Medieval period (at least among the richer social classes), of narrow, pointed shoes which would have constricted the toes.

The "Braids Lady" of Arezzo: a case of rheumatoid arthritis in a 16th century mummy.

OBJECTIVE: To diagnose a probable case of rheumatoid arthritis in a mummified female body from the 16th century and to backdate the first clinical diagnosis, entering the diatribe regarding the ancientness of the disease. METHODS: Image techniques such as normal X-ray, X-ray by mammography, total body CT and high resolution CT were used. Microscopic examination by stereomicroscopy was performed. Samples of tissue were submitted to histology. These data and the review of past literary references, of artistic representations and of paleopathological cases provided an interesting contribution to reconstruct the history of the disease. RESULTS: The body of the "Braids Lady" showed all the "stigmata" of the disease. The left hand revealed large erosions of the metacarpophalangeal joints of both the third and the fourth fingers, volar metacarpophalangeal subluxation of both the third and the fourth fingers and lateral deviation of all the fingers. The carpus showed some minute and marginal erosions of the bones. The bases of the first phalanges were slightly flared. The toes showed partially overlapped fibular deflection. CT evidenced subluxations of the joints. The body showed no involvement of sacroiliac articulation. CONCLUSIONS: The "Braids Lady" was affected by rheumatoid arthritis. A large number of features typical of the disease were recorded. Differential diagnosis supported the findings. The death of the lady was established at the end of 16th century, namely 200 years before the first clinical diagnosis worked out by Landré Beauvais in the early 1800s.

The shod foot and its implications for American women.

Throughout history, members of human societies have gone barefoot, and those societies seemingly had a low incidence of foot deformities and pain. Only one study has addressed the problem of infection through injury to the bare foot; otherwise, the unshod foot seems to have had minimal problems. Initially shoes were made in the shape of the foot and were sandals. Over time, shoes became decorative items and symbols of status and vanity. As the shape of shoes changed, they became deforming forces on the foot and the source of pain. Recent studies by the Council on Women's Footwear of the American Orthopaedic Foot and Ankle Society have tried to document the problems caused by shoes on the feet of American women. Attempts should continue to educate women on appropriate shoes and proper fit.