TRAUMATISMS BROUGHT ABOUT BY ANIMAL AGENCIES 155 



mortal wounds, though they seldom were able to get away with 

 their victim because of the numerous people at the ghat. 



The patient is brought to the hospital suffering from the effects 

 of shock and haemorrhage, with a limb either snapped off or partially 

 torn off, or with larger or smaller lacerated wounds, in which the 

 bone may or may not be exposed and grooved by the sharks' teeth, 

 and with blood dripping from the ragged surfaces of the wound. 

 Usually the patient is in a state of extreme prostration, covered with 

 a cold sweat, and having a hardly perceptible pulse. 



More rarely there are only a few triangular or irregular lacerated 

 wounds, showing that the shark did not obtain a proper hold of the 

 victim. 



The great danger is death, either immediately or in a few hours, 

 from shock or haemorrhage. If this is avoided, the wounds appear 

 to heal readily if the patient is otherwise in fair health, but of course 

 amputation is often necessary. 



Man. — The bites inflicted by the Kru men on the West Coast of Africa in 

 quarrels are, or were, of not uncommon occurrence, and it was also fairly- 

 common to meet with injuries on the knuckles caused by scratches from 

 their teeth. 



These wounds were usually considered to be serious, for, although the teeth 

 of the African appear to be in excellent condition of repair and cleanliness, 

 still the slightest scratch may lead to ex;ceedingly severe inflammations, as 

 the present writers well know. The most careful antiseptic treatment must 

 be applied at once. 



TRAUMATISMS DUE TO PHYSICAL AGENCIES. 



Foot-binding. — The bandaging of the feet of young female children 

 began in the imperial harem of the T'ang Dynasty in China some 

 1,400 years after Confucius, the idea probably being to reproduce 

 as nearly as possible a club-foot. As a matter of fact, the result of 

 pressure of the short, heavy bandage commonly used, neatly and 

 tightly applied to the growing feet of young girls aged three to four 

 years, is to produce a very small foot in the condition of a pes cavus, 

 with the outer three toes in a varoid and the inner two toes in a 

 valgoid position. 



On examining one of these feet it is noted that it is very short, 

 and that the plantar surface has a deep groove dividing this aspect 

 of the foot into posterior and anterior portions. The posterior 

 portion contains the os calcis, which, when examined radioscopically, 

 presents a very different appearance from and position to that in a 

 normal foot. 



Notwithstanding objections to the contrary, we are of the opinion 

 that the person walks upon the posterior aspect of the os calcis, 

 and we further draw attention to the great alteration in the lines 

 of pressure and stress, as compared with those in a normal os calcis. 

 The anterior portion consists of the four small toes bent under the 

 foot, so that the dorsal aspect is placed ventrally, while toes them- 

 selves are much atrophied. By radiographs it is seen that the heads 

 of the metatarsals are approximated towards the os calcis. The 



