308 ILLINOIS STATE ACADEMY OP SCIENCE 



is by far the most common deviation of the spine. It con- 

 stitutes about two-thirds of all spinal abnormalities 

 noted among high school graduates. The comparison 

 also shows that lordosis, or swayback, is more common 

 than kyphosis, or stooped shoulders. 



FLAT FEET 



While our records show that 35% of the high school 

 graduates examined have some abnormality of the feet, 

 it should be noted that only about 7% of the men and 10% 

 of the women have frank flat feet. Undoubtedly, our sta- 

 tistics include some instances of flat feet that are normal, 

 as it is characteristic of certain races to have flattened 

 arches. It should also be borne in mind that this large 

 per cent is more apparent than real, because it includes 

 a large number of cases of defects in standing and walk- 

 ing that are potential, and not actual signs of pes planus. 



We have attempted to discover and to treat flat feet 

 with reference to their predisposing causes by recogniz- 

 ing pes planus as weak feet before flattening of the long 

 arches has developed and the usual train of symptoms 

 are present. The body weight normally passes slightly 

 to the inside of the center of the knee, through a line pro- 

 longed from the crest of the tibia, through the ankle, over 

 the dorsum of the foot to the second toe. With the be- 

 ginning of eversion of the foot and the change of direc- 

 tion of the body weight, it is only a question of time be- 

 fore the symptoms and signs of flat foot become evident. 



The importance of muscle insufficiency, improper nu- 

 trition and communicable disease in the production of 

 flat foot are shown in the following table, taken from 

 the statistics of Ehrenfried: 



Children under twelve years of age examined 1,000 



Children with debility of the feet 440 



Congenital — club-foot 18 



Idiopathic — physical debility 95 



Secondary, due to some other condition 327 



A. Rickets 200 



B. Cases of unsuspected infantile paralysis 107 



No comment upon the occurrence of flat feet is complete 

 without emphasis upon the relation of the wearing of 

 ill-fitting shoes to pes planus. The necessity of education 

 directed toward the use of hygienic shoes, proper post- 



