uc 490 JiLZl — T, p.Yim - . 1 (~ V-, -P r-. r- j- Sputhern Branch of the University of California Los Angeles Form L-1 This book is DUE on the last date stamped below 1923 gUL3 MAY 2 9 1925 ^^^ 1 9 1932 APR 2 193S JAN 2 2 ^9^^ SEP 2 APR 13 1951 i MAY 1 3 1 Form L 'J-5hi 7,"22 A MANUAL ON FOOT CARE AND SHOE FITTING MANN AND FOLSOM U. S. Marine with full equipment. Complete weight of equipment 87-90 lbs. A MANUAL ON FOOT CARE AND SHOE FITTING FOR OFFICERS OF THE U. S. NAVY AND U. S. MARINE CORPS BY W. L. MANN, Ph.B., A.m., M.D., LIEUTENANT-COMMANDER (M.C.) U. S. NAVY; POST SURGEON, MARINE BARRACKS. QUANTICO, VA. S. A. FOLSOM, M.D., LIEUTENANT (M.C.) U. S. NAVY; MEDICAL OFFICER IN CHARGE OF ORTHOPEDIC DIVISION, MEDICAL DEPARTMENT, MARINE BARRACKS, QUANTICO, VA. WITH 58 ILLUSTRATIONS PHILADELPHIA P. BLAKISTON'S SON & CO l(i\ Z WALNUT S TKHI: I 3^^ ^ Copyright, 1920, by P. Blakiston's Son & Co. Tll-E MAI-LK FRKSK YORK PA. ^f UC We, as officers of military organizations, "are concerned to prevent the loss of even that one man in marching, and this can only be achieved by infinite pains and attention to a host of details, each triviai, in itsrlf." — Lei.ean. PREFACE An opportunity has been taken to present some of the results of our experience on this Post for the consideration of the Hne officer. The numerous demands made upon the modern officer renders it difficult for him to devote the proper time to pO the important subject — Care of the Feet of His Marching , Command. . It is hoped that the preparation of this little publication will ser\'e as a guide, a source of reference, and at the same time ser\'e to create an interest in this subject, causing the reader to realize the relative importance of the same. Should ; this result be accomplished, it will jjrobably justify the " cxi:)enditure of the energy involved. There is little claim to originality, as the data have been ) compiled from a varictv of sources. I INTRODUCTION Mobility and motility of an organization has been and continues to be one of the prime requisites for military successes. Notwithstanding the extensive motorization of modern armies, the results of the recent war tends to demonstrate that pedestrial motion still remains a vital factor in bringing the units into tactical and strategical positions. CONTENTS Page Value of the Proper Foot Care . . i Orthopedic Organization 2 Orthopedic Surgeon ... 2 Foot Inspectors - Responsibility for Proper Fitting of Shoes 3 The March 3 Tendency to Procure a Smaller Shoe than Necess.\rv . . 6 Anatomy AND Physiology OF THE Foot 7 Developing the Feet of the Recruit .14 Anatomy of the Shoe ix Care of the Shoes 20 Badly Fitting Shoes 20 Shoe-fitting 2,^ Fitting and Care of Socks -?> Care of Socks 26 Military Foot Inspection 27 Technique of Treating Mincjk An. mem. s ok ihe Feet. -'8 Cleanliness of the Feet 29 Blisters and Aurasion^ 32 Foot Strain .^5 Hallux Valgus .V'^ Hallux Rigidus (Rigid Great Tol; . -!<> Hammer Toe 41 Deformity of the Little Toe. . . . 42 Ingrowing Nails \2 Sweaty Feet (Bkomidrosisj .1,^ Corns CHokny Thickenings of the Skin; -14 Conditions Affecting the Anterior Arch 47 Affections of the Heel 49 Pes Planus (Flat-foot) .si Pes Cavus (Hollow-foot). . ,s(j Pedographs (Foot Imprints; oo XU CONTENTS Pagk ■f SiioK Fiihnu 74 Comparison of Marine Corps and Civilian Lasts 74 Causes of Misfits 77 Consideration of the Ball Points in Fitting 78 Consideration of the Variation between the Left and Right Foot 79 Resco Marine Corps Shoe Fitting System 83 Procedure in Measuring the Foot 85 Verifying the Size and Fitting the Shoe 87 Measuring and Fitting at the Barracks (3000 Men and.Over).. . 93 The Fitting Quarters 93 General Procedure of Fitting 98 Measuring and Fitting Men at the Barracks or in the Field (500-3000 Men) loi The Fitting Quarters 101 Measuring and Fitting Men in the Field (500 Men or Less) . 107 Appendix in Old Army Order Covering the Subject of Foot Measuring and Shoe Fitting in New Army Orders 116 Text of Revised Regulations Applying to the Fit of Enlisted Men's Shoes • 116 Marine Corps Orders 122 Post Special Order No. 47 123 FOOT CARE AND SHOE FITTING VALUE OF THE PROPER FOOT CARE Mobility is the first requisite of the soldier and to insure this the infantry officer should devote as much attention to the care of the feet of the men of his unit as the cavalry officer devotes to the care of the feet of his horses. This, however, is not always the case. The European authorities allow, when unseasoned troops take the field, for lo per cent, of incapacitation through pre- ventable foot injuries. This is almost equal to the casualties following an engagement with the enemy. More emphatically expressed; should a "million citizens spring to arms over night," there is'every reason to expect 100,000 of them to be on the sick- list, because of foot disorders. According to Napoleon's dictum, "more battles are won by strength of leg than b}' force of anns." The military .successes of Stonewall Jackson have Ijecn attributed largely to the marching capacity of his command, which officer is quoted as saying that he had rather lose two men in battle than? one- man in marching. Another military leader believes that battles are won jiKjrc by "sweat tlian slaughter." Ac:f:ording lo Wellington "the most essential juirt of a soldier's ccjuiiniient is a good jxiir of 2 FOOT CARE AND SHOE FITTING shoes, and — , another good pair of shoes." Another military leader is quoted saying that ' ' getting there first with the most won battles." In the Franco-Prussian War, over thirty thousand German soldiers were incapacitated in the first few weeks on account of preventable injuries to the feet. "The army which marches best, other things being equal, is the successful army." (Munson.) ORTHOPEDIC ORGANIZATION (a) Orthopedic Surgeon. It has been the custom of this Post to designate one of the medical officers as orthopedic surgeon; who, in addition to his other duties, is responsible for formulating the neces- sary rules and regulations on foot care and shoe fitting. Two of the overseas regiments, leaving this Post, had a medical officer who had received some instruction on this subject, and acted in this capacity. In any organization, unit, or detachment, it appears advis- able to assign one medical officer to this duty, preferably one who is interested in this subject. (6) Foot Inspectors. From all reports, the foot inspectors have rendered very valuable assistance, during the recent w^ar. These men were of two classes. One class was composed of Marines, who had enlisted for this class of duty, which duty they performed under the supervision of the medical department. Another class were men of the hospital corps who had previous instruction or training along this line. There should be one inspector for each thousand men when they take the field. The orthopedic surgeon should be pre- pared to instruct and train such members of the hospital corps as may be deemed necessary for this work. THE MARCH 3 RESPONSIBILITY FOR PROPER FITTING OF SHOES This appears to be a case of divided responsibility, accord- ing to Marine Corps Orders No. 185, (4) and 1S5, (5) (Series 1 916), the responsibihty rests largely with the company commander. The situation is analogous to sanitation. The regulation requires the commanding officer to be responsible for the sani- tary condition of his station, yet requires the medical officers to take the initiative in making necessary recommendations. Although there is nothing explicit in the Regulations on this subject, it is well to assume that, on account of certain tech- nical matters involved, the medical de])artment should act in the advisory capacity', and take the initiative whenever the occasion arises. This is in accord with oin- ex])crit'nccs at this Post (Quantico, Va). THE MARCH Man^hin;^ i.s usually a military ncrcs.sii\- executed to bring troops into advantageous or strategic positions at or near the battle line. It is therefore necessary to take well-known pre- cautions in order that the men may arrive at their de.stination in the Ijcst physical condition and not comijlctely fatigued. The starting hour is, of course, determined by the existing necessities. Whenever possible, however, it should be in the early morning when the men arc fresh and active and the air is cool and stimulating. Unless unavoidable, strenuous march- ing during the heat of the ractiscd only when military necessity demands, because the depressing jjhysical effects usually outweight the advantage of strategic positions. Previous to the start a light meal of bread, cereals, milk, 4 FOOT CARE AND SHOE FITTING tea, or coffee should be allowed. Marching with empty stomachs is weakeninj^ and therefore detrimental. The length of the march for a division or a brigade under normal conditions should not exceed 12 or 15 miles daily. The length of a day's march, however, is not measured by miles, but according to the condition of the roads, the weather, the pace, the loads carried, etc. The rate of the march should not average more than 2^^ miles per hour, inclusive of stops; more than this will lead to fatigue and exhaustion. To average this, 120 30-inch steps a minute are required. The march should be at route order, in open ranks, half on, each side of the road. This decreases the heavy, devitalizing cloud of dust, foul odors, water vapor from perspiration, etc., which tends to hang over close-order ranks. The march should end with the same equal pace with which it started; the frequent "final spurt" should not be invoked as, at this stage, it is doubly depressing. The men should alternate between marching in step and at ease; singing and w^histling popular tunes is to be encouraged. This dis- tracts their minds- from their fatigued condition, and is probably the surest way of preventing early exhaustion. Straggling, either from poor discipline or fatigue, is always to be avoided, as it is depressing to the "morale" of the entire body of troops. In hot weather coats should be unbuttoned or removed on the march but replaced at halts. The position of the body should be inclined slightly forward, similar to the position in mounting a flight of stairs. This is especially to be advised if the soldier is carrying his full equipment. Marching rigidly erect necessitates the expending of greater muscular effort and therefore early fatigue. Smoking on the march has a depressing effect on the physical condition of the men, particularly upon the heart and lungs. It also had a tendency to cause the mouth to become dry, THE MARCH 5 creating excessive thirst. This practice should be strictly prohibited. Before the start only the average amount of water to a meal should be ingested and the water bottles filled with water, unsweetened tea. or coffee. Following this, the canteens shiould not be resorted to until 732 niiles have been covered. The contents should then take the men to the end of the 15- mile march. The bottle should again be refilled at the end of every subsequent mile. The average normal requirements are one quart of water at the end of ever\- 7 ' 2 miles. The experienced soldier will march nearly all day with only an occasional recourse to his water bottle, and then drink \'er\' sparingly. The young and unwise will drink excessively every few miles, and as a consequence becomes "water- logged," perspires freely, tires easily, and refills his bottle from every strange, perhaps heavily contaminated, stream along the wayside. Water bottles should not be filled at these streams until the quality of the water is a])i)rovcd by the medical officer. A fairly satisfactory method of allaying the thirst while on the march is to suck on a small pebble placed in the mouth, to excite the flow of saliva, at the same time breathing through the nose. A few words on flexion, or bent knee marching might not be out of place. This is a method advocated by dc Raoul and is patterned after the oriental couriers and footmen. In this type of marching the body is bent forward at the hips, and the legs are bent at the knees, in .such a manner that it gives the marching man the attitude of almost falling forward at each stej). The displacement of the center of gravity of the body forward serves automatically at each step to drag the weight of the body along. Unless this method is thoroughly understood, and is system- 6 FOOT CARE AND SHOE FITTING atically developed, any attempt to change the method of marching, which each soldier has developed as his peculiar, individual type, may not be productive of the best results. To Lieutenant S. A. Folsom, MC, U. S. Navy, is acknowledged credit of the preparation of the major portion of the following chapters. TENDENCY TO PROCURE A SMALLER SHOE THAN NECESSARY For some reason there appears to be a tendency inherent in the human race to procure a casing for the foot which is too small. As an extreme example, illustrative of this fact, it may be mentioned that the gro\\i:h of the foot of the Chinese gentle- woman is stunted froin infancy by tight coverings. This trait is again illustrated by the modern woman wearing a tight shoe, with a short vamp and a high heel, causing the foot to be extended, which gives it an appearance of brevit^^ The male members do not escape this tendency, not even in a military organization. An examination of several thousand men on this station reveals that about 80 per cent, were wearing shoes which were too short. The public is apparently awakening to this error, judging from the number of advertisements of the so-called orthopedic shoe, appearing in the current magazines, and are endeavoring to correct the same. However, the faults of a lifetime cannot be remedied in a day or a week but requires the wearing out of at least one pair of properly fitted shoes before satisfactory results may be expected. Conditions Afloat. While the material in this book may be considered of pri- mary importance to -the Marine Corps on expeditionary duty ANATOMY AND PHYSIOLOGY 7 yet there may be nixmerous occasions where these remarks are equally applicable to officers and men of the Na\'^'. In naval training stations and where members of the navy form landing parties, the necessity of properly shod feet is obvious. Aboard ship, in the period of the four hour watch, officers and men often cover rather long distances in walking to and fro on the hard decks. But on occasions like this the feet support only the weight of the body and there are no heavy impedi- ments to cause an exaggeration of any minor defects of the foot gear. This fa\'orablc condition is, however, partly offset by the fact that there is little resiliency to a steel or wooden deck as is apt to be present when a command is marching on land. All things considered, improperly litted shoes may not result in as large a percentage of foot injuries among those afloat as in an infantr}' organization, yet such defects may result in certain postural abnormalities which may produce certain well defined constitutional symptoms. ANATOMY AND PHYSIOLOGY OF THE FOOT The human loot, considered in its entirety, is indeed a very wonderful anatomic part of the individual. In the smallncss of its size and weight, out of all proportion U) the burden borne and carried, it constitutes a mobile, strong, flexible and efficient member of the organism designed to bear weight forwards, backwards, and sideways without mishap. Encased in a cloth covering, the sock, and in a protective leather cover- ing, the shoe, both concomitants of an advancing and exacting ' ivilization, this member, the most unintentionally neglected l^art of the body is fully expected to do its duty indefinitely without complaint. As with other mccliani.sms, mechanical 8 FOOT CARK AND SHOE FITTING or otherwise, so with this, ignorance cannot accomplish satis- factory results. 'calcaneus (OS CALCIS.) HEEL BONE^. STATIC PORTION OF THE FOOT. SEVEN BONES DYNAMIC PORTION OF THE FOOT. NINETEEN BONES SURFACE OF TALUS (ASTRAGALUS) FOR ARTICULATION WITH TIBIA (LOWER LEG BONE) CUBOID NAVICULAR (SCAPHOID) .THIRD ) , SECOND ^CUNEIFORMS FIRST J METATARSALS PHALANGES (TOES.) Fig. I. — Skeleton of right foot from above. [Cunningham.) Dotted line shows anterior arch formed by metatarsal bones. Concisely, the structure of the foot is composed of a nicely adjusted aggregation of twenty-six bones of various sizes and ANATOMY AM) PHYSIOI.CK'.Y Q shapes, each, however, designed to perform a certain definite lunction. Seven of these are of a very irregular shape and are located in the hind part of the structure fonning the heel and a portion of the so-called instep. The remaining nineteen, situ- ated in the forepart of the foot, form a portion of and radiate fan-like from the instep. These extend forward and to the luter and inner sides finally ending in, the toes. (See illus- iration No. i.) These different bones are held in the correct position by ligaments, tendons and muscles; the ligamentous support predominating in the posterior seven bones which form the static portion of the foot while muscular action pre- dominates in the anterior nineteen bones which fonn the dynamic portion. (See illustration No. i .) Over the dorsum ')r ujjper surface of the foot the muscles are few in number md lacking in development. However, on the plantar or lower surface filling in the arch beneath the instep there are five la\'ers of well-develojjed muscles which buttress the arch preventing descent of the latter when continued and excessive weight is borne. (See illustration No. 2.) The posterior seven bones, forming a compact mass and held h)y ligamentous attachments, move very slightly when a step is taken and serve to minimize the shock of impact and act as a recoil mechanism. On this mass — the static portion of the foot — in the shod man, all the weight of locomotion is first borne; first affecting the heel and center of the instcji. The anterior nineteen bones are controlled mainly by muscular action — the dynamic jjortion — and when in use bearing weight, move extensively. From the center of the instep the weight borne is shifted to the ball of the iooi which preads medially and laterally presenting an enlarged area to the walking medium. The toes also spread laterally, medially, and lengthen, gri])ping the surface. (Sec illustrations Nos. 3 and 4.) lO FOOT CARE AND SHOE FITTING y? a X •" •;^ -e> -^ CJ ^ O »b •-■ a o - t; r; 5 O H 11 ^^ CC o t£ 43 -a O d ?i SE ANATOMY AND PHYSIOLOGY II The longitudinal arch, on the inner side of the foot extends from the heel bone (Os Calcis) to the distal end of the first 1 i(.. <. Muscles con- Ik.. .|. J>ii). lu.i-. ..^ ..i Iik.I. Muscles trfilliriK lateral toe action. and tendons controllinK toe action. (C«m- I Cunningham.) niti/^ham.) metatarsal bone. (See illustration No. 2.) This is definitely fonncd by the inherent structural concavity of the bones held 12 roor (,AKF. AX]) SIIOK FITTIXC, among themselves by ligaments and supported from below by developed muscle layers. The anterior arch is formed by the distal ends of the meta- tarsal bones. (See illustration No. 5.) Themuscular develop- ment concerned in sustaining this arch is not so great as in the longitudinal. Fig. 5. — Cross section of feet showing metatarsal bones forming anterior arch. A shows formation of anterior arch by dit.tal ends of metatarsal bones. Xote convexity of instep, dotted line indicating integrity of arch and con- cavity formed on the plane C. B shows fallen anterior arch. Xote flat or convex instep, dotted line and absence of concavity on the plane C. A tripod is formed by the structure of the foot; the apex of which is the highest point of the heel bone (Os Calcis), the inner side of the ball of the foot at the base of the big toe (distal end of first metatarsal bone) and the outer side of the ball of the foot at the base of the little toe (distal end of the fifth metatarsal bone). (See illustration No. 6.) A comparison of the feet of the shod man and the bare footed savage is interesting and instructive. In the shod man the joints are not as flexible, the muscles are not as well developed and the toes in walking do not spread and grip; being limited by the shoe. Taking a step he strikes the heel ANATOMY AND PHYSHn.OGY 13 Pic;. 6. -Anterior view of feci and legs bhcjwinn inpod formation, correct foot posture and position of normal ankles. 14 FOOT CARE AND SHOE FITTING first, shifts the weight to the outer border of the foot, then full upon the ball while the toes as above explained, are limited in their motion. In that the shoes limit the bearing surface of his feet he "toes out" sometimes sHghtl}^ other times excessiveh', to preserve his equilibrium, thus throwing the weight borne backward on the inner border of the foot — on the arch — where it should not all be borne. (See illustration No. 9.) On the other hand, the savage has very flexible joints, well developed muscles under the arch as are also the muscles of the calf of the leg. In locomotion he has his feet parallel — the correct postiu-e — or "toes in" throwing the weight upon the ball of the foot, center of the instep and outer border of the foot. His toes unhampered by a covering spread widely, lengthen, grip the surface, and thrust vigorously backwards. He walks on soft, nonresistant earth which conforms itself to the irregularities of the foot forming an accurate impression which lessens the strain on the muscles and ligaments and minimizes the shock of impact. The reverse is true in the civilized individual who, his feet encased and limited in motion by a covering the bottom of which does not conform to the irregularities of the foot, walks the greater part of his life on macadamized roads or rock pavements where muscle strain and shock of impact is great. DEVELOPING THE FEET OF TH.E RECRUIT Upon the physiological development and muscular efficiency of the recruit's feet depends largely his future usefulness as a soldier. He is made or broken in the training camp. Com- parisons are helpful in explaining a delicate situation. Just as the professional weight lifter can not and does not develop his enormous muscles in a night or day, so it is with the foot DEVELOPING THE FEET 15 muscles of the new arrival in canip. The truth is, we have expected too much of the recruit and ha\'e done too little to I i' f'orrcct f'lol pnstiiri help him. The ^reat majority of men come from sedentary occupations in civilian life and enter upon an active pcdestrial i6 KOOT (AKK AXl) SIIOF. FITTING life, when they enter the vservice; and we must realize their short-comings and strive to develop these men correctly if iTood results are to be accomplished. The greater part of the w l^^^^^BRH '^^^^^^^^^^ipH^M^ It "*' r' ' *' ^^^K^ 1 >: *'^^^^^^^^H -A ^^ ^^3\1. -iit-^ Fig. 8. — Incorrect foot posture. " Toeing in." Pigeon toed. responsibility of developing this raw material depends primarily and essentially on the line officer, who, if he is to turn out the largest nimiber of fighting units, must know this subject and apply it in practice. That failure has often played a DEVELOPING THE FEET 17 great part is evidenced by the numerous examples of men disabled by foot trouble on the sick-list and awaiting surve>-. These men represent a loss of time and money to the govern- ment and are deadweights and incumbrances to the efficiency of the militarv machine. Pir;. 9. — Incorrect foot posture. Military position. "Toi-iriK out." When the recruit is first received in the service, careful and accurate measurements should be made of the feet, sock sizes estimated and shoes fitted. The work done in these for- mative periods must be graduated; that is, the distances marched or hiked and equipment borne nnist be gradualh- increased. 1 8 FOOT CARE AND SHOE FITTING This is done to develop the muscles of the feet, especially under the arch in the sole of the foot, and is left to the dis- cretion of the officer in charge, advised by the surgeon. At the end of about three months the feet should be re- measured, sock sizes re-estimated and shoes refitted. Why? Because the muscles of the feet have developed and the feet are thicker, broader and longer, so that the previous procedure does not suffice. After this second measurement and fitting, the same size shoe and sock ma^^ be worn as long as the indi- vidual is in the service; exceptional instances requiring a third measiu"ement and fitting which should be done if complaint is made. ANATOMY OF THE SHOE To know a shoe and to appreciate fully it's construction internally and externally one must necessarily know the names of the different parts. The parts of the shoe, externally from being forward are: the lifts of the heel, face of the heel, breast of the heel, waist or shank, sole, welt, vamp and upper. (See illustration lo.) The best way to study the internal construction of a shoe is by a cross-section. In a cross-section the following parts of the shoe are- to be seen; the sole, welt, thread holding the welt, upper and insole together (Goodyear Welt), drill lining and vamp of the upper. (See illustration ii.)- There are four standard types of internal shoe construction. They are the following: 1. Goodyear welt. 2. McKay sewed. 3 . Standard screw. 4. Pegged. ANATOMY OF THE SHOE 19 20 FOOr t'ARE AND SIIOK I'lTlKNG Of these four types the Goodyear Welt is the most widely used and universally adopted shoe. In maniifacturing the Good- \'ear Welt shoe the tacks in the lasting are all withdrawn and a machine with a curved needle sews the welt and upper to the insole without entering the shoe cavity. The heavy outsole is then stitched to the welt. (See illustration. y Fig. II. — Goodyear welt shoe. Cross section. Sole, welt, insole and fill A = Sole. B = Welt. C = Insole. exaggerated. D = Pill. E = Vamp. F = Drill lining. Thread (Goodyear welt feature). This type is superior in its construction to all others for the following reasons : 1. Smooth surface inside. 2. Most durable, efficient and comfortable shoe. 3. Outsole can easily be renewed. CARE OF THE SHOES Badly Fitting Shoes. Where the shoe is either too large, too small, or too old with wrinkled and broken drill lining there inevitably results CARE OF THE SHOES 21 friction, pressure and impact. These three factors are para- mount in the causation of callosities, corns, blisters, abrasions, tender and sore feet. So, in the examination of a shoe search- ing for the causative agent of foot disability, the fact that the shoe may be too large, too small, or too old, should be borne in mind. The part that the socks play will be discussed under that heading. Where the injuries above enumerated occur the shoe should be examined thoroughly for the points mentioned: 1. Top of toes — toe cap too low, leather stiff, improper construction ; 2. Ends of toes — shoe too short, loosely laced, improper construction ; 3. Outer sides of big and little toes — shoe too narrow across the instep. 4. Over the instep — tightly laced shoes, uneven wrinkled tongue; 5 . Along the outer and inner margins of the sole of the feet — faulty internal construction resulting in thick inner edge of insole or warping or curling of the latter. 6. On the sole of the feet — inequalities o( the inner sole caused by the warping of the leather or shifting of the fill (layer below the insole.) The shoes being the most imjjorlanl \)url of the soldier's equipment and the back bone of an infantry organization's efficiency; it is essential and imjjcrative that an elementary knowledge, at least, of their care be part of the officers knowl- edge. This knowledge should be imparted to the men at each and every (jpjjortunity where the occasion offers itself. To make the foot covering as water-proof as possible undir ordinary conditions the sole and welt should be thoroughly oiled with neatsfoot oil, bacon rind (salt removed by s«)aking) or in emergencies with machine oil of good quality as used in 22 rOOT CARE AND SHOE FITIIXG the lubrication of the rifle. Where constant exposure to water and cold is anticipated the upper as well should be thoroughly oiled by application of the oil and rubbing and kneading of the leather. Judgment, however, should be practised in oiling the uppers because too much oil is a detri- ment, in that it clogs the pores of the leather making the latter impermeable and preventing the moisture of the foot from evaporating. This condition of the shoe, then, is com- parable to rubber which is also impermeable. Where the shoes have become water soaked from continued wetting do not place them too near a fire as such quick drying causes stiffness and hardness of the leather with the j^roduction of corns, blisters, abrasions and similar affections. From the action of rapid drying, also, it should be noted that the leather decomposes and disintegrates quickly lessening the life of the shoe. Where haste is necessary pebbles ma}^ be heated and repeatedly placed in the shoe and agitated until a sufficient degree of dryness has been obtained. Hot cloths may be placed in the shoe or oats which absorb moisture readily. The shoes being dried by what ever method chosen, the}" should be thoroughly brushed and the leather kneeded with the fingers until supple. Wet shoes should never be exposed to the elements in freezing weather as the leather will become frozen. Should the shoes issued be lined with drill ducking this should be examined frequently to see if it is torn, wrinkled or lying smoothh^ in the shoe cavit}'. Dress shoes used for liberty should be kept brushed and polished constantly if long life is to be expected of the leather. As a preventive measure troops should be urged to examine the shoe cavity for protruding nails, wrinkles of leather or drill ducking and other inequalities of the surface. Broad laces should be used and laced stifficiently for the march to hold the heel in place and jirevent shifting of the foot forward in the SHOE-FITTING 21, shoe. The tongue of the shoe should be smooth, free of wrinkles and lie evenly under the laces. SHOE-FITTING Fitting and Care of Socks. The practical importance of correctly litting socks to the infantryman can hardly be justly estimated as no matter how- much care and judgment is exercised in fitting shoes all this work is for naught if the cloth foot covering is too large or too small. The inevitable conclusion is thus reached, that a sock too loose or tight in a correctly fitting shoe does as much damage and incapacitates the individual as much as a poorly fitting shoe. The way to the ideal system of fitting sock sizes to the corresponding shoe sizes is partially obstructed by obstacles which must be overcome if complete success is to be attained. Ii)ssentially, these obstacles to our i)rogress consist of various lifferences which exist in socks of the same weight, size and material; namely, flexibility and shrinkability. This is a]jplicaljle to both wo(jlen and cotton socks. Further, there is to be considered the multiple variations in the relative length, width and shape of the feet. Although it is readilx- conceivable that a sock of elastic material will be conformed : ') the shape of the foot, yet there is to be considered the fact that the difTerent materials after relocated washings will ni)i sometimes do this. An ideal material whose definite elasticity and shrinkability is predetermined accurately, and reservations made for variations, will do much toward establishing some fundamental plan for litting socks accurately. At the present time a general i)lan consisting of a "Sock Size Scale" which corres])onds to difTerent shoe sizes has been adopted to remedy as much as possible the existing evil of 24 FOOT CARE AND SHOE FITTING ill-fitting socks. This scale can be readily understood by reference to the plate in this Chapter. Shoe Size Corresponding Sock Size 5 5M 6 6}4\ loK 7 73^ 8 9 gVz} "K lO II 12 123^ \ 12H 13 14 !• 13 14M. 15 [ 13M Acutely realizing the present situation, and endeavoring to obtain some definite information as to the degree of varia- tion in socks of the same weight, size and material after re- peated washings a series of experiments were conducted at this Post (Quantico, Virginia). Standard Marine Corps socks (size 11) of Heavy Woolen, Light Woolen and Black Cotton were used. These experiments were made to determine : I. The amount of shrinkage in cotton and woolen socks; SHOE-FITTING 25 2 . The amount of flexibility lost in cotton and woolen socks ; 3. The effect of temperature on the amount of shrinkaj^e and loss of flexibility in cotton and woolen socks. The material of the socks used was as follows : 1. Heavy woolen. Yam. Gray worsted, made from not less than pure ^i blood wool ; 2. Light woolen. Yam. White. Commercially known as merino, composed of 50 per cent, wool and 50 per cent, cotton. 3. Cotton. Yarn. Black. Uniform quality of yarn, best "peeler" or equally long staple cotton free from impurities and full combed. Tests were as follows : Heavy woolen, light woolen and cotton socks each washed three times at same temperature. Three temperatures were used 212, 200, and 75 degrees Fahrenheit respectively. Ivory soap was used. The greatest amount of shrinkability and lost elasticity was found in the Heavy Woolen Sock. After the first wash- ing at 212 degrees Fahrenheit and immersion for fifteen min- utes, shrinkage of one inch in height, one inch in width and one and and one-half inches in length were noted. Second and third washings at 212 degrees Fahrenheit caused a further shrinkage one inch in height, half inch in width and half inch in length. Total shrinkage after three washings at 2 1 2 degrees Fahrenheit as follows: Height (from heel to top of sock leg) 2 inches Width 1.5 inches Length . 2 inches Total loss of elasticity noted as follows: Height (from heel to top of sock leg) 3 inches Width 2 inches Length. . j.5 inches 26 FOOT CAKE AND SHOE FITTING Washings and immersions in lcmi)craturcs of 200 and 75 degrees Fahrcnlieit caused very little shrinkage and loss of elasticity. Boiling seems to play a great part in the produc- tion of shrinkage and lost elasticity. In the light woolen socks after three washings each in the different temperatures as given above there was a total shrink- age noted as follows : Height (from heel to top of sock leg) 0.5 inches Width I inch Length 1.2 inches Total loss of elasticity noted as follows: Height (from heel to top of sock leg) 1 inch Width 1.5 inches Length 2.3 inches The total amount of shrinkage and lost elasticity in the cotton cocks after three- washings and immersions at each temperature was very inconsiderable and not worthy of note. CARE OF SOCKS When being fitted for shoes the individual should wear the light woolen sock which is preferable for general use about the barracks and on the march. In cold weather when a heavy woolen sock is to be worn larger shoes are necessary to pre- vent foot disability. Socks that are too small cramp the toes and produce a result identically the same as pointed narrow shoes. On the other hand large socks take up needed foot space in the shoe; and forming wrinkles produces painful blisters and abrasions. On the march every man should carry at least three extra pairs of socks. They are a necessity ; and being light in weight can be easily carried. Manifestly, they are a most important MILITARY FOOT INSPFXTION 27 part i)i the equi^jmeiit. No socks which have been danicd or socks with holes should be used on the march. Imnicdialcl>- after washing the feet the socks should be washed, dried and stretched before using again. Where facilities for washing are not at- hand they can be dried, kneeded and stretched. Changing of socks from one foot to another is advisable where time is available. MILITARY FOOT INSPECTION The recent great conflict, despite the abundant means of mechanical con\-eyances, has demonstrated that the days of marching are not over; and has shown vividly and most impressively the extreme prevalence of minor foot ailments occurring not only on the march, disabling and incapacitating many otherwise useful men, but also in the barracks resulting from drill and extended guard duty. These disabled men, often numerous, most assuredly must not all be sent to the Medical Officer who would be overcome by the weight of numl:)ers and unable to gi\-e each man adequate and individual attention. Again, he would be prevented from accomj^lishing other important work connected with the organization. The Medical Officer should supervise the work of ])revcnti()n and remedying of foot ailments; only attending j^ersonally to tlio severe cases. To these he can give his undivided attention procuring quicker and better results and thus lessening mate- rially the total number of sick days. The urgent need of toda\- is men trained in the remedying of minf)r foul ailments and apportioned to diff'crent organizations according to the strength of the latter. Those interested in this .subject have proposed that selected enlisted men, but i)rcf«rably hospital corpsmen, with some i>revious medical experience be traine States marine corps. /I i!ic Uniti-i! CLEANLINESS OF THE FEET The first essential in the proper care of the feet, as of the body, is rigid attention to cleanline.ss. Where this is neglected there accumulates an excessive amount of perspiration, fatty material, dirt and skin scales which tmdcr the action of bacteria 30 FOOT CARE AND SHOE FITTING decompose causing a very ollensive odor and the skin to disintegrate. The individual then suffers from abrasions, bhsters, tender, sweaty and flaccid feet. To maintain a standard of cleanliness and relative freedom from foot trouble and disability, inspections should be made. In the barracks this inspection should be made at least every fortnight. The company commander, accompanied by the sergeant who takes notes if necessary, passes through the barrack houses inspecting each man as he stands in his bare feet at the foot of his bunk. This can be accomplished in a very short time if the method is systematized. Some will maintain that this is repugnant and beneath the dignity of an officer. But the same is true of many other things in military life. vSurely if cavalry officers take scrupulous care of the hoofs of their horses, infantry officers can do the same with the feet of their men. One is just as important as the other. In the field, inspections are even more imperative. The feet should be inspected before and after every march so that all minor and trivial injuries can be attended to promptly and prevented from becoming serious disabling affections which cripple the efficiency of a command. Daily foot baths of cool or tepid water with just enough soap to cleanse should be taken. Do not soak the feet as this softens the skin. If hovisehold ammonia is procurable a few drops. of that in a basin is advisable. Cool or cold water is to be used because it not only hardens the skin and eases the sensation of burning after a march but also increases the tone of the foot. By tone is meant a stimulation whereb}^ the muscles are held in a state or condition of continuous contrac- tion ready to respond quickly to the slightest call. After a cold bath we all feel much better and anxious to do. This condition in modern terminology is called "pep." So let us CLEANLINESS OF THE FEET U a\' tliut cold water gives " pep " to a tired foot. Alter \v;isliin^' "1" course the feet should be thorouj^hly dried. In the field the feet should be washed and the socks changed before and after every hike. Water is usually present in the form of springs, wells or streams. By scraping a hole in the ground over which is spread a poncho, a suitable basin is readily made into which water may he poured from a canteen. 1 I'. I ; I'mik hn hasiii .'is iiscil in i lu- fl Where water is scarce just a few sjjoonfuls pcnnx'd on a towel, handkerchief or paper and ai)plied between the toes suffices. In extreme cases saliva on a handkerchief can be used to advantage. Both in the past anrl at j)resent the nails according to an unassailal>le custom have been cut "round." The corners should not be trimmed ofT as this encourages a nail to grow into the flesh resulting in an ingrown nail. Nails should he cut 32 FOOT CARE AND SHOE FITTING Straight across about every two weeks. Nails deformed b\ overgrowth, such as unusually thick nails and clubbed nails, can be remedied by soaking in hot water and paring do^^^l with a knife or rubbing down, with sand-paper. The material under the nails shoiild be removed with an orange stick, not with the point of scissors and the like. Correct way. Incorrect waj'. Fig. 14. — Trimming of toe nails. BLISTERS AND ABRASIONS The most common causes of blistering are: friction, pres- sure or impact. Accessory causes are ill-fitting shoes and socks, overriding toes, hammer toes, poorly constructed un- even cheap shoes, heat, moisture and uncleanliness. They are most often found in those whose foot skin is tender and soft, e.g., among newly recruited troops and those not accus- tomed to long hiking. The points usually affected are: the outer surface of the little toe, upper surface of the toes, surface and back of heel, upper surface of foot under the shoe-laces, ball of the foot and over the Tendo achillis (the large tendon attached to the upper surface of the heel bone). The forma- tion of blisters is a protective process. Irritation of the outer or false, and inner or true skins being continuous, there arises an inflammation of both, during which, the inner skin exudes BLISTERS AND ABRASIONS 33 an inflammatory fluid and raises the outer thus forming a blister. Treatment is directed primarily toward the cause. Inspect and remedy defects in the shoes or socks, such as nails, fallen toe cap, ill-fitting insoles, worn lining, tight lacing, uneven stitching as over the Tendo achillis posteriorly and badly worn, darned, small or dirty socks. Apply to blister tincture of iodine 3,^ per cent, or grain alcohol. Immerse needle in alcohol or heat in flame and puncture at the base, allowing fluid to escape and covering (outer skin) to collapse on the inner or true skin thus protecting the latter and minimizing infection (invasion of microbes). The blister (outer or false skin) should, therefore, not be torn or removed. Dry the skin with gauze or aljsorlient cotton and cover the blister with adhesive plaster which should be firmly pressed down so that the raised outer skin or epidermis will be forced into position. The adhesive may be made to stick well by heating it with a match or apj^lying ether if the latter is to be had. Should it be impossible to procure adhesive plaster, then sterile vaseline, boric acid ointment or zinc oxide oifil- ment may be ai^jjlied with benefit. If these last-named articles are at a premium, the regulation foot-i)owder may be dusted on the part and a few turns of a gauze bandage made. All the dressings being comjWcted, a moderate amount of the foot-powder should be dusted on them and in the shoe. The powder prevents the edges of the adhesive from adhering to the sock and lessens friction in the shoe cavity. Too nnuh powder is just as bad as none at all as a large quantity tends to cake and form uneven surfaces. Search should l)e made for all areas which are red and tender with no formation of blisters. Adhesive jjlaslcr should be jjlaced over these. Heel blisters occupy such a i)rominent i)lace in the category of transient foot ills that they shouhl be given careful attention. 3 34 FOOT CARE AND SHOE FITTING Usually caused by bad socks or poorly constructed ill-fittin.u shoes allowing the heel to slip, they form by far the great majority of blisters. The structural defects of the shoe are usually such as (a) heel too narrow or broad (b) shoe too long (c) shoe too broad across the instep with high heels (d) incorrect posterior curve of shoe not conforming to heel and tendon and (e) improper lacing. In the individual with a long, narrow foot and narrow heel, or the one with a broad foot and narrow heel, much benefit can be derived by placing a felt pad varying in thickness, corresponding to the tongue of the shoe in size and posterior to it. The greater part of these blisters will be avoided bj^ a proper measurement and fitting where the heel is regarded with more care. The figure-of-eight marching strap, originally devised and used by the French, will prevent the heel from slipping up and down, on the march in the great majority of cases. Abrasions are nothing more or less than blisters with the raised outer skin or epidermis removed exposing the rose red derma or inner skin. They are very painful due to the fact that the sensitive nerve endings in the derma or inner skin are vmprotected and exposed to changes of temperature and injur- ies. In the blister, on the other hand, these nerve endings are protected by the raised epidermis and accumulated inflam- matory fluid. The causes of 2lbrasions correspond to the causes of blisters. The treatment is primarily corrective. The cause should be sought for and remedied. Protective treatment includes the applying of alcohol (grain) or iodine 33^ per cent, to the area then zinc oxide adhesive plaster. In lieu of the adhesive plaster zinc oxide or boric acid ointment may be applied plus a few turns of a gauze bandage. In the prevention of blisters and abrasions there are three factors which determine the functional integrity of the foot: FOOT STRAIN 35 1 . Proper measuring of feet and fitting shoes. 2. Proper corresponding sock — size. 3. (a) Feet inured to hiking or (b) prepared for such. The proper measuring of the feet and accurate fitting shoes together with the correct corresponding sock-size will be dis- cussed in full later. That feet inured to hiking will escape much injury is self evident. At this point, however, should be mentioned the appH cation of formaldehyde Sol. 10 per cent, on alternate days for six applications to the soles of the feet and especially points exposed to pressure. This serves to harden the skin and lessens the chance of inflammation. Adhesive jjlaster may be placed over suspicioned pressure points before the miarch to escape the formation of blisters together with the same weight socks the shoes were fitted with. FOOT STRAIN Because of the inherent facility of the layman to attribute any and every foot ill to flat-foot or a tendency thereto, many of the uninitiated and inexperienced, influenced by the jjopular trend of belief, readily diagnose this conditicm ius such. That such a step has a very decided and marked effect on the neurotic individual, and gives many persons the golden opportunity to malinger, is self evident. To begin with, the reader should thoroughly understand that this affection is f)ftcn associated with a visibly normal foot or foot j)Osture where theligamentshave not " given " or stretched; or with a visibly abnonnal foot or foot ])osture where the ligaments have "given." In short, the condition may be functional f)r organic. Whenever there appears a local, reddened, jjainful swelling in ruldition I0 other s\-mjitoms infection should be susjjccled. This cfjndilion usually occurs ni the case of the raw rele to adjustment, should be discarded or the shoe stretcher used in satisfactory shoes to remove friction and pressure. It requires almost constant attenticm to bring relief from corns if their entire removal is not contemplated. The feet are soaked in warm water for a period of fifteen minutes and the corn i)ared down every week or so, care Ijcing taken not to be overzealous in cutting deep and drawing Ijlood. When this is done measures must be taken immediately to check any infection because infections of the feet are very serious. Apply to the area from which the blood is (jozing Tr. Iodine 3^ per cent., then alcohol and cover with adhesive or apply directly the salicylic acid-collodion. The paring of corns is a tem- porary, not a pennanent mea.sure, and is not recommended. To .soften the homy tissue so that the whole corn will in a 46 FOOT CARE AND SHOE FITTING short Lime come out ami 1)C cured ])C!nnanenll\' uothinjj; is better than the followinj; combinatiou. SaHcyHc acid Grains xv 25 grains Flexible collodion Oz. i 1 ounce This is supplied by the medical department and is often supe- rior to any patented remedy on the market. The claims of manufacturers of corn remedies to remove a corn in a night are false and the opportunity is here taken to inform officers of the service that such is so. The solution above given is in- flammable and should not be near lighted matches, cigarettes, etc. The bottle should be kept tightly corked as evaporation is rapid when the contents are exposed to the air. The method of removing corns is as follows : (a) Wash the foot thoroughly. (6) Immerse in hot water about 15 minutes. When with- drawn note that the color of the corn is white and is soft to the touch. (c) Dry the foot thoroughly. (d) Apply the sa'icylic-collodion to the corn and about one- eighth of an inch around. Allow to dry. Apply another layer. Application is made with a glass rod or wooden applicator. (e) Apply adhesive plaster. This should be done on an average every day for four treat- ments. Sometimes even four treatments do not suffice and applications must be continued. Where the upper layer of the corn is particularly hard a thin slice may be pared off so that the salicylic acid-collodion can effect the tissue. At the end of the course of treatment it will be found that the com has a dead white appearance. With the end of tissue forceps or the back of the blade of a knife slide it under the loose dead skin at the margin of the corn and proceed around CONDITIONS APFECTING THE AXTF.RIOR ARCH 47 the com. Take care while prying the corn loose from the tissue not to cut the roots of prolongations which extend down- ward into the flesh because if these are severed the corn will recur. The whole treatment is directed toward removing the whole corn en masse with its roots and not piece-meal. Bleed- ing should not be caused when the corn is pulled out completely down to the derma or true skin (the quick) . The treatment described is best done while the men are in barracks; and should a march be taken immediately or soon after the sensitive areas, formerly occupied by corns, may be covered with adhesive. As callouses and corns are similar the treatment directed to remedying the former is the same as the latter. Lastly, attention should be given to the fact that the cause, ill-fitting shoes, must be removed or the condition will recur. CONDITIONS AFFECTING THE ANTERIOR ARCH (Conditions Affecting the Ball of the I'oot) As a consequence of the anterior arch's falling or flattening there arc two very important conditions which attract our attention. They are namely, callous fomiations im the sole of the foot over the heads (^f the metatarsal bones (ball of the foot), accompanied either with or without i)ain and metatar- salgia (pain in the fourth metatarsal joint). These conditions although not as prevalent as flat-foot still are of such a dis- abling character that their description should be given. T . Callous Formations on the Hall of the Foot over the Metatar- sal Heads with or without Pain.—Whi^n the distal ends ()f the metatarsal bones which form the anterior arch fall, they press downward ujjon the underlying muscles, tendons, fat and skin. Nature, to jjrotect the skin and to f(jrm a sui:)])orting ])tu\, causes callous to be formed which may cau.se exquisite jiain 48 FOOT CA"RE AND SHOE FITTING upon pressure similar to the familiar acute pain of the "stone bruise." The callous is fonned most frequently over the head of the second metatarsal bone. In severe claw-feet, where the toes are contracted presenting high prominences on their upper surface, callosities may be present over the heads of all the metatarsal bones and give rise to great pain and disability. 2. Metaiarsalgia {Morton's Disease). — In this condition there is severe neuralgic pain, sharp or burning in character, often of paroxysmal occurrence beginning on either side of the distal (far) end of the fourth metatarsal bone and passing up the foot and often up the leg. The cause is badly fitting shoes which cause the arch to fall; the metatarsal bones to be dis- placed and pinching of the nerves between the heads of the third and fourth and fifth metatarsal bones. The transverse arch formed by the distal ends of the metatarsal bones is flattened and the foot broadened; there may or may not be flat-foot (See illustration No. 5). The pain usually comes on when walking is attempted and is often so severe as to cause the patient to immediately remove the shoe and rub the foot. Treatment. The cause of both conditions being essentially the same, and since they are often associated, their treatment is practically identical. Relief may be had by mechanically supporting the depressed arch. Where the pain is acute, and temporary relief is imperative, resort may be had to adhesive straps applied transversely back of metatarsal heads (ball of foot) over properly shaped gauze or felt pads. Supports as used in civil life are incompatible to the a tivity of military Hfe. The best appliance, in military life is a cleat of leather one-fourth of an inch thick and one inch wide fastened to the sole of the shoe just back of the metatarsal heads. (Ball of foot) . AFFECTIONS OF THE HEEL 49 AFFECTIONS OF THE HEEL The affections of the heel in order oi their importance are: 1. Tenosynovitis (inflammation of the heel tendon and sheath). 2. Bursitis (inflammation of the little sac lying over the heel tendon). 3 . Periostitis (inflammation of the covering of the heel bone at the point of attachment of the heel tendon) 4 . Exostoses (outgrowths of bone commonly due to a previous infection of gonorrhea). The cause of these conditions is usually mechanical; being due to badly fitting .shoes or leggins causing friction and pres- sure In tenosynovitis, which by the \va\' is very common in foot roops, there is swelling and tenderness along the tendon associated with a grating .sound which may be elicited if the hand is placed on the tendon involved and the foot moved U]) and down. Where bursitis exists there are tenderness, swell- ing and signs of fluid; in periostitis there is u.sually not much swelling but extrene tenderness is found at the attachment of the heel tendon into the heel bone and may involve the surrounding bone. Exostoses may or may not be felt. Diag- nosis u.sually made by Ar-ray, chronicity and ])reA'i"iw liwtnrv- of gonorrhea. Treatment. Remove jirimariiy the excessive pressure or fric- tion by new .shoes or leggins or adjustment or the same. Strap pads of felt or cotton to the leg just above toe point involved when the tendon is affected and just IdcIow when the bursa or tendon attachment is involved. Alternately immersing the foot in hot and cold water — ' ' contrast baths ' ' — often does good. Strapping adhesive tape two to three layers thick transversely across the tendon is of benefit in tenosynovitis. The heel tnny 50 FOOT CARE AND SHOE FITTING be raised, to relieve the strain, one half to one-quarter of an inch. In acute cases where the pain is exquisite and walking impossible, rest is imperative; which, combined with hot compresses and massage of the neighboring parts, avoiding Fig. i6. — Normal feet (shoe wearing). Note position of ankles (inner sides), convexity of instep over anterior arch. Slight hallux valgus (out- ward deviation of both big toes). the irritated area itself, is of benefit. Symptoms are some- times slow in disappearing but patience must be practised and care taken if a recurrence is to be avoided. Cases associ- ated with infection are very stubborn and should be referred to the surgeon. PES PLANUS 51 PES PLANUS (Flat-foot) In discussing a subject more or less well known to the public consen-ation should be practised if undue emphasis and incor- rect impressions are to be avoided. It cannot truly be said that this subject does not deser\'e emphasis and impression — it does. However, on the other hand, one should not be led to believe by the flamboyant statements of those interested for financial reasons that this condition is common to the degree that one-half of our manhood is thus affected. Such statements and insidious advertising are made for a purpose. The impression I wish to make here is that every little ache and pain in the arch of the foot or leg is not a forerunner of this condition. Such s>Tnptoms may mean nothing but a tired foot; a condition of foot strain or bruised foot. A diagnosis of this condition cannot be made by the s}Tn])toms presented. An accurate diagnosis requires more than symptoms and a casual inspection of the foot. It has been found by extensive use at this camp (Quantico, Va.) that the method described by Dr. Edward A. Rich of Washington, D. C. has been rnosl efficient in diagnosis and altering shoes to fit abnormal feet. He has rightly said, "The diagnosis of the static foot defects has always been made largely by guess. Diagitostic aids have not been commonly sought or encouraged. Manx- surgeons, uninterested in foot subjects, have jum])ed at con- clusions from mere inspection, with the usual result that treatments ai)])lied have been misfits. To diagnose and classify the foot defects without gra]jhic aids is exactly on a par with the attempt at diagnosis and classification of the chest de- rangements witliout a stelhosffipc." (Sec subject of Pcdography). 52 FOOT CARE AND SHOE FITTING The principal causes are: I . Inherently weak and ill-developed muscles of the lower leg and sole of the foot. These muscles being subjected to the sudden bearing of excessive weight and work, or weight and Pig. 17. — Medial view of normal foot. Note concavitj^ of longitudinal arch. work excessive for that particular individual, fail to support the homy arch and allow the latter to fall. 2. Ill-fitting, ill-constructed shoes causing incorrect foot posture-toes turned out. The first cause has been discussed PES PLANUS 53 in Chapter 2. The second cause may be explained as fol- lows: Where the feet are parallel in standing or locomotion the line of ^Yeight bearing rtnis through the center of the knee Km;. i8 — Medial view of abnormal foot. (Pes planus or flat foot.) Note at X the depression of the lonRiludinal an-h. cap, middle of the leg, and to the cunlcr of the loiigiludinal arch. When the toes are turned out this line of weight bearing is shifted inward on the inner ])ortion of the longitudinal arch whicli tnav or mav not b(^ able; to bear the Iturdcn. If not, 54 FOOT CARE AXD SHOE FITTING Fi<;. 19. — -Posterior view of feet practically normal. Left ankle shows sliglit inversion (turning in). Right ankle normal. PES PLANUS ^v") the inevitable happens — the muscles fail to buttress the bony arch and the latter fails with stretching of the lij^amentous attachments. Obiectivelv, in cases of Pes Planus inversion (turnini,^ in) I'll,, jt,. ruaicriur view of abiiuiiiial fed. .\ulc Uic inv(.r:,iun ituriniiK in) of the ankles. A ca.sc of pes plaints (Hat-font). of the ankles may l)e nrtiiicd. ll.n\«.\ii, ihis may bo ab.scnt or even occur in the ojipositc condition Pes Cavus or Hollow Foot. This inversion of the ankles should not be taken as a criterion in diaj^nosinj.; the condition of Flat-foot. The arches' appearance lus the bare feet with the full weight uijon 5() FOOT CARE AND SHOE FITTING them are placed in a plane surface offer no means of discovering the true height of the bonjT- arch. The symptoms of flat-foot are varied and numerous. Ho\\- ever, the predominant one is pain in the feet. This may be located indefinitely in the arches of the feet, heels or second- arily in the calves of the legs, knees or hips. The pain is iisually absent during rest and is experienced only when use of the feet is attempted. Treatment. 1. Complete rest for a few days. 2. Alternately immersing the feet in hot and cold water. 3. Correct walking posture; the feet parallel in standing: and walking. 4. Feet measured and shoes fitted. 5. Foot exercises. 6. Strapping of the feet Avhich should be done or supervised by the Medical Officer. 7. Shoe alterations to shift the misplaced weight where ii naturally belongs. 8. Arch supports should not be worn for this condition as they tend to decrease the muscular power of the soles of the feet. PES CAVUS (Hollow-foot) It is important that this condition, heretofore conspicuously ' absent from Foot Manuals in general, be discussed and brought to the attention of officers because of its extreme disabling character when made manifest. In the past the subject of Pes planus (Flat-foot) has, in my opinion, been stressed en- tirely too much both by manufacturers of foot supports for PES CAVUS ,1/ pecuniary reasons and by military men because of carelessness or inadequate means of examination. By this I do not mean to say' that Pes Planus (Flat-foot) is not common, it is common; Ji. Lulcral view of nurnial fuut. Nulc cuiivcxily ut ai'cu iiuitkid x denoting the integrity of the anterior arih. but still other conditions exist and we should watch for them with an unbiased frame of mind. Pes Cavus (Hollow-foot), is just the opposite and is a condition where the longitudinal arch is hifjher than nonnal. It has been noted so frociuently S8 FOOT (ARE AND SHOE FITTING in foot examinations where a prcx^ious diagnosis of llat-foot by inspection had been made, that it is hereby brought to the attention of officers as an entity. This condition of Pes Cavns, more common than has been Pig. 22. — Lateral view of abnormal foot (fiat-foot). Note at x the flattening denoting the fall of the anterior arch usually associated with pes cavus. formerly thought, is characterized by a longitudinal arch higher than normal, poor muscular development of the soles of the feet and an inherent tendency on the part of the indi- vidual to shift the greater part of the weight to the outer PES CAVtrs 50 borders aiid balls of the feet. Where the arch has assumed a great height and the muscular development is poor the weight is not borne by the outer borders of the feet but is in turn shifted entirely to the balls of the feet (anterior arches). These latter, being unable to support the weight, fall. Asso- ciated with extreme degrees of Pes Cavus and fallen anterior arches is the condition of inversion (prominence of inner side of the ankle). For facility of description and measurement for treatment Pes Cavus has been divided into three degrees of height; one, two and three. (See foot imprints.) The causes of Pes Cavus are usually ill-fitting shoes which, cramping and binding, restrict functional activity. The assumption of great burden and excessive hiking also play a part in making a condition worse the tendency of which has existed since birth due to inherent organic and functional muscular deficiencies. Again, incorrect foot posture with the toes turned in has a part in the causation of the condition. The most common causes from ill-fitting shoes are: 1. Shoes too short. 2. Shoes too narrow across the instep and ball of the foot. 3. Heels of shoes too high with (i) and (2). 4. Pointed-toe shoes (English) where the inner side of the .sole curves outward. 5. Poor muscular development since l)irlli with incorrect foot posture. The symj)toms are very fugacious and inconstant. Many complain of pain, which at times becomes intense when weight is borne, situated in the toes, ball of the foot and longitudinal arch. The pain does not tend to remain at one point but skips from place to place. Treatment: Where the soldier is disabled and incapacitated and this condition is suspected, teniporar}- relief may be ob- tained by placing a gauze or felt pad ^ inch in thickness under 6o FOOT CAKE AND SHOE EITTlNO the longitudinal arch and strappinj:;; it in place with adliesive tape. The thickness of the pad may be increased or decreased until relief is experienced. Alternately immersing the feet in hot and cold water-contrast baths — gives comfort. Where circumstances permit, however, all cases should be sent to the Medical Officer for diagnosis and treatment. PEDOGRAPHS (FOOT IMPRINTS) The method of diagnosing foot affections by a casual inspec- tion, walking or hopping test, or by palpating the foot has been discarded as obsolete and inefficient. By the pedograph method five prominent signs are taken into consideration. These signs are: 1. The pedograph picture; 2 . The contour line of the foot ; 3. The height of the scaphoid bone (the keystone of the longitudinal arch) ; 4. The muscular development of the soles of the feet, especially under the longitudinal arch; 5. The presences or absence of the juvenile fat pad. In taking the imprints the individual is seated and extending the leg the bare foot is painted with an iron solution. Formula of Iron Solution. Tr. Ferric chloride 45 c.c. Glycerine 5 c.c. Alcohol 50 c.c. Then hastily, the foot is placed on paper, porous in charac- ter, and the individual is told to place all the weight on the one foot. At this point the contour line is drawn by using a pencil held at right angles to the plane surface. This contour line demonstrates the amount of inversion of the ankle although PEDOGRAPHS 6l the muscular development of the soles ol' the feet should be watched as often a heavy bulging muscular la}-er w-ill produce the picture of inversion. The foot is then removed from the paper and the height of the scaphoid bone estimated. This is done by drawing a line from the posterior-inferior aspect of the inner malleolus to the first metatarsophalangeal joint on its plantar aspect. The scaphoid bone is usually felt one- half inch below this line which is known as the Feiss Line. The sole of the foot is then palpated and the muscular develop- ment noted as thin, moderate or thick. Presence of the fat pad is also sought for. All this cumulative data is then marked on the pedographic sheet together with the man's name, rank, organization, and diagnosis. A solution of tannic acid is now applied to the iron imi)rint of the foot which turns a jet black. The formtila of the tannic acid solution is: — • Tannic acid gm. x (by wt.) Alcohol 90 c.c. The base lines and au.xiliary lines are now drawn on the l^edograph for estimation of the disability if present. The first base line is drawn from a point posterior to the internal malleolus to the first metatarsophalangeal joint. The contour line extending beyond this shows the degree of inver- sion. The line of axis weight bearing is next drawn from the center of the heel to a ]K)int midway between the first and second toes. A line is next drawn at right angles to the line of axis weight bearing from a ])oint i)ostcrior to the heel. A line M is next drawn also at right angles to the line, of axis weight bearing, from the first metatarsophalangeal joint. Midway between the line M and is drawn the line of esti- mation, also at right angles to the line of axis weight bearing. The line of estimation is then checked. One check is i)lace(1 FOOT CARE AND SHOE FITTING Fig. 23. — Pedograph. Normal foot. PEDOGRAPHS (\^ Fici, 2.V/. — fcilo^;!'''!'!'- Normal fool. 64 FOOT CAKE AND SHOE FITTING Fig. 24. — ^Pedograph. Pes planus (flat-foot). 1°. PEDOGRAPHS 65 Fir.. 24rt. PcloKr.i ■ I:, 1,1, I tl .1 f..,i( I I 66 FOOT CAKE AND SHOE FITTlN"G ^rr^ fUo /^i^Vl-c^ Fig. 25. — Pedograph. Pes planus (^flat-foot). 2°. PEDOGRAPHS 67 /■^/Ua.*t.w> 3 <^fH Pto. 2^n. Pcut/ Fig. 27. — Pedograph. Pes cavus (hollow foot). 2°. PEDOGRAPHS ^^ .£>;% Vt<.. ZTn. I'c.l<().;r;iiili. I'cs f;iviis (IkiIIhw f..fit). i' 72 FOOT CARE AND SHOE riTTINd Fig. 28. — Pedograph. Pes cavus (hollow foot). 3°. PEDOGRAPHS 7.^ FlO. 28a.— P<(l<.;^r;ipli. I'c-. c.iviis (111. 111. w I. 74 FOOT CARE AND SHOK FIl "I IXC at the outer border of the imprint, the other check being placed at the junction of the Hne of estimation and the first base line, or if valgus exists, at the junction of the line of estimation and the contour line. Midway between the two check marks of the line of estimation is the point A^ which is normal. To the inner side of point A^ the line is divided into three parts repre- senting the degrees of Pes Planus, while to the outer side of the point A^ the line is divided into three parts representing the degrees of Pes Cavus. The above method, with the exception of some modifications, was originated and used by Dr. Edward A. Rice of Washington, D. C. SHOE-FITTING Comparison of Alarine Corps and Civilian Lasts The average individual, upon being measured and subse- quently fitted, almost invariably asserts that the shoe given him is too large and that in civilian life he wore such and such a size shoe without suffering any inconvenience. From this he deducts that he is the most competent judge of his own size. Furthermore, he declares that he can never wear the size fitted him and predicts with all earnestness the direst calamit>' that will befall him on the future march or drill. This man is a fair sample of those who, ignorant of their own size and of the difference m sizes between the Marine Corps Lasts and Civilian Lasts, endeavor to jam their feet into anything made of leather because of the prevailing style. This is a result of the hap- hazard pernicious system of demand for appearance which has ruined more feet than can be estimated. In this discussion many details of difference between the sizes of the Marine Corps and Civilian shoes could be enumer- ated. However, details are dry and uninteresting; and it is SHOE FITTING 75 the purpose of this Manual to ehminate such superfluous material where possible. Suffice it to say that a Marine Corps shoe size 7EE is far different from the correspondin>^ Fig. 2y. — Anterior view iarris(jii or dress shoe. civilian shoe size; and further tliat civilian shoes made by different manufacturers differ among themselves. These differences of size may be one of length or width. It is there- fore self apparent that, as the mihtary shot- is a shoe dislinc- 76 FOcrr CARE AND STloE IITTTXC live and physiologic, every man should be correctly measured and fitted when he first enters the service if he is to be efficient and render full value to the go\'ernment. The great majority of recruits received in the service for training are men who were formerly occupied in sedentary occui^ations; exercising but little or none at all and riding Fig. 30. — Lateral view of marine corps garrison or dress shoe. whenever possible on street cars, automobiles, bicycles and the like. This universal aversion to walking is not at all startling and exceptional but typical of the man of toda}' who surrounded by mechanical conveyances of all types, saves himself the effort and takes the path of least resistance. This type of man will usually have imdeveloped relatively weak feet. Now supply this individual w^ith shoes the sizes of which have been selected haphazardly and he will stand CAUSES OF MISFITS 77 an excellent chance of having feet which are ruined organically and functionally before he leaves the training camp or is sent back from the firing line. Then there is that other type of individual who has practi- cally earned his livelihood by constant use of the feet. This individual usually has well formed, well developed, strong feet. These feet one would call "good feet." Literally, throw shoes at this man, or rilldw him io ^olc't bi< ^h^c^ i^■(^u^ I'^iG. 31. — Sole of marine corps garrison or urcss shoo. the pile, and those good feet will not last long under the stress and strain of military life. It requires no mental effort to readily jpercei\'e that no matter whether a man enters the service with well or badly developed feet the end result is always the same if care is not taken tt) mertsure his feet and fit shoes correctly. Causes of Misfits. In the past when large numbers of men arrived suddenly at a concentration or training camp aiul ininicdjal c out fitting was 78 FOOT CARE AXD SHOE FITTING imperative, commissary otTiccrs and their assistants often allowed the recruit to specify the size shoe he wore and in some instances pennitted him to select his shoes from a pile. Such an uns^^stematic procedure necessarily resulted in a large number of men receiving ill-fitting shoes with subsequent foot disability. Fortunately for the efficiency of our armed forces such an antiquated, obsolete measure has been discarded. Consideration of the Ball Points in Fitting. Where the first metatarsal and fifth metatarsal bones join the higher and larger bones of the ankle proper or instep there are located points called the "ball-points." These points for the sake of convenience in description and according to size may be designated as the primary and secondary "ball-points." The primary or large "ball-point" is located on the inner side of the foot back of the big toe where a promi- nent protruding eminence is, seen. The secondary or small "ball-point" is located on the outer side of the foot back of the little toe where a protruding but less prominent point is SHOE FITTING 7() noted. In locomotion when a step is taken, and the heel raised it must be understood that both these joints move simultaneously. In fitting a well-constructed military shoe it must be made certain that these two points correspond with the "break" or the ' ' ball-points ' ' of the shoe sole and shoe upper in flexion of the foot. When ill-fitting has occurred these points may be anterior or posterior to the "break" with evil results. Also where the "ball-points" of the feet and shoes fail to coin- cide exactly there is a loss of gripping or propelling power directed backward to shove the weight borne forward. SHOE -FITTING Consideration of the Variation Between the Left and Right Foot The difference in the general characteristics of indix-idual men's feet and between different individuals is striking!)- ap})arent when measuring and fitting is ]:)ractiscd. The i)oints of difference are not merely width and length Ijut involve multiple minor parts which together form a proposition of which some cognizance should alwaj's be taken. In discussing the similarity of people's features we always say there is "something" about him or her that is familiar but cannot, definitely say. We cannot definitely say because our casual inspection is not complete enough. Corres])ondingly there is that "something" about the feet which collectively make a great difference and j^resents obstacles which must be over- come if accurate measuring and fitting is to be practised. These differences between the feet may be stated to consist essentially in the posture of the feet causing the ankle joint to be deviated inwards or outwards; the slope of the toes backwards from the great toe presenting, according to the 8o FOOT CARE AND SHOE FITTING Lateral vie^ Anterior view. Fig. 33. — Xewly designed dress shoe U. S. Marine Corps. SHOE FITTING 8 1 length of the toes either a pointed or square front; one may be thin, bony and devoid of extensive muscular development while the other may be fat, well padded in the heel, sole and around the joints and very much thicker through any given part than the other. Again the heights of the arches both anterior and longitudinal differ; and there may be a great difference in the distance from the back of the heel bone to the metatarsals in one individual's feet and the distance between the same points in another's. The distance mentioned — from the back of the heel bone to the metatarsals — is of great im- portance in fitting as it fixes the location of the primary and secondary ball-points. In investigations conducted in the Army Concentration Camps it was found that in 60 per cent, of the enlisted men's feet the left foot was larger than the right. In some cases this difference equalled two full sizes. Such findings as this suggest food for thought. However, even with this great variation in some cases there will not result any mistakes in fitting either foot too short, as the Resco Marine Corps Fitting vSystem requires that each foot shall l)e measured and the larger foot ser\"e as the index of size. The correctly fitted shoe must allow all ])arts of the foot to function unrestricted and unhampered by any impediments. The parts of the foot which are important to consider in regard to the degree of fimctionability when a shoe is fitted are the following : 1. The anterior and longitudinal arches. 2. Expansion of the foot sidcwise and lengthwi.se. ,^. The "Tripod" — the principal points of locomotion and weight bearing — must be considered and shoes fitted so that it is allowed to spread apart and afford the maximum bearing surface. (See Anatomy and Physiology of the Foot.) 82 FOOT CARE AND SHOE irniNG SHOE-FITTING When the present system was introduced abundant oppor- tunity was offered to study the psychology of the individual in regard to the shoe question. Upon a careful investigation at this camp (Quantico, Va.), concurring with similar investi- gations at different camps throughout the country the follow- ing characteristic points of the recruit were noted: 1. An inherent reluctance of the recruit to cooperate and to accept "something that was new" as conclusive evidence. 2. Personal vanity played a great part. Feet were often jammed in shoes one to one and a half sizes too small for them. 3 . Absolute ignorance of his own shoe size. 4. Ignorance of the fact that fitting must be practised with the point in view that the feet expand due to burdens borne and subsequent development from training. 5. Ignorance of the difference between the Marine Corps (MilitarjO Last and the Civilian Last. 6. Ignorance of the corresponding sock size. The system as used at present is not infallible. The detail of men engaged in the work must be previously trained; show an esprit of cooperation ; care for and note constantly the con- dition of the machine; work with speed but not unnecessary haste; work accurately and demonstrate good judgment. In measuring the feet and fitting large members of men the following deviations of shoes from the accepted standard were noted: 1. Shoes too short. 2. Shoes too narrow.' Although shoes were sometimes found too large either in width or length this class was decidedly in the minority. SHOE FITTING 83 SHOE-FITTING Resco ^Marine Corps Shoe-fitting System The two devices used in this shoe-fitting system count for simplicity of operation and facility in measuring and fitting large numbers of men in the least possible amount of time. One device — the foot measuring machine — follows roughly the I'll,. 34. — Resco marine corps foot measurinR device. conl(jur line of the bottom of the adult human foot but is larger. This machine is of cast metal and has the heel jKJsition elevated to a correct height for positioning thehuman heel when the foot is being measured for the Marine Corps Shoe. A composite of the angles of the inner-soles and lasts of all Marine Corps sizes in the Marine (^)rps size range dctcmiincs the angle at which the side wings arc set. The operation and adjustment of the small pointer on the width scale moved by 84 Four CAKE AND SHOE TITTING the spreading side wings has been thoroughly worked out. This machine essentially translates the foot length and width into the shoe size length and width. The second device — the shoe-fitting device — consists of a set of thin metal blades each possessing a metal knob one-half inch thick on one end. The lengths of these blades respect- FiG. 35. — -Resco marine corps shoe fitting devices. Sizes corresponding to shoe lengths indicated. ively corresponds with a shoe length which they verify after the foot has been measured in the foot measuring machine. A study of the illustrations accompanying this section will readily make clear the construction and operation of these devices. Although the great majority of shoe wearing people have not nonnal feet according to the classic standard certain reser\'ations are made and this measuring machine is con- structed for the great average of supposedly normal feet according to the standards of to-day. MEASURING THE FOOT 85 In attempting to measure markedly abnormal feet accuracy is sacrificed. For ever}' established last there is a type of machine, e.g., the Marine Corps, Navy and Army. PROCEDURE IN MEASURING THE FOOT The individual removes his old shoes, puis on his Marine Corps Pack, holds his rifle and mounting the measuring plat- form sets his stockinged foot onto the base of the machine making certain that the heel fits snugly against the curved block at the back. At this time the measurer notes carefully whether the center of the foot is in the center of the machine. To do this he imagines a line through the center of the foot from the heel to the toe and makes this line correspond with a like line in the bottom of the machine. The wings at the sides are then released and ]jermitlcd lu press tightly against the sides of the foot. The plunger on the front of the machine is then ]M-esscd Ijackwards until it touches the end of the foot. Thus the width and length indicators are ^et. However, this is not final. The person being measured is then requested U) balance on the foot being measured by resting the hand against an over- head support and told to raise the heel onc-fourlli to lialf an inch placing all the superimposed weight on the ball of the the foot. This ri.sing simulates locomotion; and since he is bearing all the weight he usually bears on the march the act will cause the same expansion of the foot length and sidewise. Upon this act of rising there is a resultant s])read of the foot; a pushing of the plunger forward; and he wings laterally indicating automatically the correct shoe length and width. The inflication f)f the shoe length is always positive. This is not so, however, with the shoe width. As the person raises the Jieel up and down the width indicator will sometimes be 86 FOOT CARE AND SHOE FITTING seen to waver back and forth. The measurer noting this takes the middle mark between the extensive points touched by the width indicator as the correct width. For instance if the pointer vacillates between width E and width F the correct width for the shoes would be a width EE. Wherever doubt is entertained as to the exact j^oints of width Pig. 36. — Foot being measured in Resco marine corps foot measuring device. and length is always best to select the greater length and nar- row width. vSo simple is the indication of the size that the interpretation is made quickly and accurately which counts for efficiency in measuring. In the U. S. Army Special Regulations No. 28 complete instructions for using the machine are given. They are as follows : (a) After taking the machine from its box, open it widely by moving the lever as far front as possible and pulling -out VERIFYING THE SIZE 87 the plunger as far as it will go. The machine is now ready for use. (6) Have the man put his foot in the machine and stand with all his weight. The heel should rest firmly against the heel block. It is important that the foot should rest in the exact center of the machine. (c) Release the lever which operates the width indicator, and push the plunger until the plate touches the toe. Do not touch the plunger again while the foot is in the machine. Make sure that the metal side pieces touch the toe joints. (d) Then let the man throw his entire weight on the ball of his foot, raising the heel slightly. (e) The width is automatically registered by the arrow as the arrow wavers, following the action of the heel up and down, take the average of the extremes. (Example. If the arrow wavers from width "6" use width "c") The correct size of the shoe is indicated by the pointer on the plunger on the right-hand scale. (/) Measure the other foot in the same manner and if there should be a difference select size to fit the longer foot and the narrower width. (g) Oil the slide under the device occasionally. Note. — Verify the length selected by testing with shoe-fit- ting device. SHOE-FITTING Verifying the Size and Fitting the Shoe In this final and most important act the fitting device is used to verify the size of shoe length as indicated by the foot measuring machine. Width is detcnnincd from the mea.surc- mcnts of the measuring machine and is not demonstrated by the fitting device. 88 FOOT CARE AND SHOE FITTING VERIFYING THE SIZE 89 The shoe-fitting devices, as previously described, are thin metal blades each one of which possesses a metal knob on one end; and corresponding to a shoe length, is so marked, for example, 7, 7}'^, 8 and so on. The device, corresponding to the shoe length as measured, is inserted into the shoe cavity; the knob end slipping into the toe cavity and pressing against the leather of the end of the shoe, while the other end of the device presses against the heel. The blade of the device being flexible readily conforms to the curvature of the arch and lies fiat and snugly on top of the insole. Both shoes being thus treated, they are laced firmly and snugly ; and walking is done back and forth on a level surface, up a flight of staris to a level platform and do\\Ti a elevated in- cline. This walking and stamping on plantigrade surfaces simulates the conditions of marching and serves as an index of the foot expansion in the service shoe bearing the super- imposed weight of the body and equipment. The foot thus being made to expand sidewise and lengthwise to its maximum a very clear idea is obtained of the shoe fit. The person being measured should be able to thus walk without the toes jamming against the knob to such an extent that discomfort and pain is experienced if the measurer has been accurate in his estimations. Merely touching the device is not considered. Actual discomfort must be produced be- fore the size of shoe is changed. From this it can be readily seen and appreciated that where discomfort is not produced by the toes jamming there is suflicient space allowed for toe action when the blade and knob are removed. Such is the purpose of the device. It has been found that cooperation of the person is essential and during the process of "trying out" the shoe by walking, standard questions are asked by the fitter who bears in mind 90 FOOT CARE AND SHOE FITTING Fig. 38. — Resco marine corps shoe fitting device and foot in the shoe cavity. (X-ray photograph.) VERIFYING THE SIZE 9 1 the important parts of the shoe which must fit correctly. Such questions are: "Do your toes touch the knob?" "If so is discomfort or pain experienced?" "Does your foot sHde forward in the shoe?" "Is the upper too loose?" "How does the shoe feel across the toes and instep?" This, in addition to the mechanical devices, is conducive to accurate and conclusive results as found by extensive practice on this station. (Quantico, Va.) If the length is correct, which it shall be if the procedure described is carried out, there shall not only be comfort but also the ball-points of the foot will be exactly opposite the ball-points of the shoe and thus the two will move synchro- nously in locomotion. The correct use of the shoe-fitting device has practically eliminated the old fault of short shoe sizes. However, mis- takes may be made if judgment is not practised. Especialh" .so, where the length is correct, but the heel of the foot abnor- mally narrow and therefore not gripped by the shoe, the foot slides forward in the shoe and presses against the knob. This condition will also ha])pen if the shoe is too wide. Width if not accurately determined by the mea.suring ma- chine must be done by hand. The person faces the fitter who gra.sps the leather back of the toe cap with the index-finger and thumb. A faint movement of the leather .should be detected by the gripping fingers if the width size is correct. Where a distinct ridge of leather is picked up, the inference is that the width is too large, and conversely, if no movement of the leather is detected the width is too .small. In estimating width much depends on the training of the fitter and his judg- ment. However, in addition to the above, the comfort of lite individual is considered and the question is asked whether the toes are pressed upon tightly or the shoe is too loose oxer this particular part. 92 FOOT CARE AND SHOE FITTING n ARMY x:5^=Sp^T>,». I I NAVY "^ ^M MARINE ■ COMMON TO ALL Fig. 39. — Outline of sole of composite last suggested by Mr E J Bliss Boston, Mass. THE FITTING QUARTERS 93 The Army Special Regulation No. 28 on the use of the shoe- fitting devices are as follows: (a) Select from the several meastuing devices in the set the one marked mth the size or half-size corresponding with the shoes to be tried on. (6) Insert the knob end of the device into the toe of the shoe, springing the other end of device down to the inner sole, against the counter. (c) The middle of the flat spring piece will lie flat with slight pressure of the foot. (d) If the soldier, with pack and rifle on his back, can without discomfort pace back and forth in shoes with device inserted, the shoes will be sufficiently long to allow — for foot- expansion when the device is withdrawn. Note. — The majority in every case pass satisfactory the above described test. SHOE-FITTING Measuring and Fitting Men at the Barracks (3000 Men and Over.) (a) The Fitting Quarters. The fitting quarters should be centrally situated or as near so as convenient in order that the least possible time will be taken by the men in passing to and from the building. The size of building recommended, and used with perfect satis- faction at this Post (Quantico, Va.) is the ordinary type of barrack building ninety-eight feet in length and nineten feet and four-sixteenths of an inch in width. This building is divided into three rooms, the waiting, measuring and fitting rooms, by partitions seven feet and four-sixteenths of an inch in height fitted with doors. These partitions extend width- wise at right angles to the long axis of the building. There is 94 FOOT CARE AND SHOE FITTING UJ cQ a Z aio t- oo ^EE 2 7KE 3 5HF 2 7>2EE 2 6B I 7MF 2 6C 2 8B 2 6D I 8C , 3 6E 3 8D 4 6EE I 8E 3 6F 2 8EE I 6}iB I 8F I eViC. 3 SViB I 6KD 3 8MC 3 63^E I 8HD 3 6>^EE I SHE 3 63.^F 2 8MEE I 7B I 8HF 2 7C 3 9B 2 7D 2 9C 2 7E 4 9D 3 FITTING PLATFORM 97 Pair 3 3 3 I 2 3 9E 9EE 9F 9>2B 9KC 9>^D 93'2E 2 9>^EE 2 9>2F 2 loB loC loD loE loEE loF I0>2B io>^C loj-aD iCaE Pair 0>^EE 2 o>^F iB iC iD lE lEE iF 13-26 O^C i>^D iKE i>2EE I3-2F 2B 2C 2D 2E The testing incline consists of a horizontal platform thirty- iwo by twenty-five inches equipped with legs thirty inches in height. The incline leading from one side of the platform p* ^ — i Fig. 4.}.— Fitting platform and test incline. to the floor is nine feet in length with wooden cleats on its upper surface at intervals of three inches. (Jn the opposite side of the platfomi are steps which arc twenty-five inches from the table to the floor. (See drawing.) 7 98 FOOT CARE AND SHOE FITTING SHOE -FITTING General Procedure of Fitting The company commander being responsible for the con- dition of the shoes and proper fitting of his command takes the initiative in arranging an engagement with the Medical Officer in charge of the measuring and fitting. Men who have just entered the service, those who have completed the train- ing and those who are in need of new footwear are sent to the fitting quarters. All the men upon arriving at the fitting quarters should have the pack and rifle, and be accompanied by the company commander or his representative. Entering the waiting room — the number determined by the recorder — everyone is ordered to remove the leggings and shoes. This done, men as needed are called by the orderly who stands at the door leading from the waiting room to the measuring room; and as each man passes the recorder a printed "Deformity and Recording Slip" is made out. The recorder writes the man's name, age, organization, date, time in service and record of present size of shoe. (See facsimile of slip.) The orderly closely observes the number of men in the measuring room and prevents overcrowding of the same by only calling a man from the waiting room when he sees one step from the measuring table to the fitting room. Entering the measuring room the table is mounted by the person to be measured and the slip handed to the measurer. Deformities are noted and recorded if it is a first meastirement ; and each foot being accurately measured, as before described, the measurements as made are noted on the slip under the heading of "Estimated Size of Shoe." The slip is returned to the man and he passes on into the fitting room. Here again a check is maintained to prevent overcrowding in the GENERAL PROCEDURE OF FITTING 99 3 o a. I •<; " £ac! lOO FOOT CARE AND SHOE FITTING person of the shoe overseer who allows only the number of men to enter the fitting room equal to the number that passes out. Entering the fitting room the slip is given to one of the stockmen who notes the "Estimated Size of Shoe" and pro- cures from the rack a corresponding size of shoes containing in the shoe cavities the Resco Marine Corps Shoe Fitting Devices. The slip is returned to the man by the stockman. The fitting platform is then mounted, and facing the fitter the slip is handed to the latter who notes the size svipplied and examines the width of the shoe. The company officer stands beside the fitter to see that all his men are fitted satisfactorily. Walking is then practised on the testing incline to reveal any deficiencies in length. If the test is satisfactory and the size correct the fitter retains the slip and records the size as the "Fitted Size." "The vSize of Sock" is recorded by reference to the Sock Scale. (See page 24.) The man is then told to remove the shoes, give them to one of the stockmen, place on his own and pass out by the shoe overseer who takes especial care that no fitted shoes leave the fitting room intentionally or otherwise. The completed fitting slips are signed or stamped by the Medical Officer and sent to Company' office where the "Fitted Size" and "Size of Sock" are entered in the man's record service book by the company clerk. (Marine Corps Orders; Ntmiber 42 (Series 191 5) Dec. 20, 191 5 Paragraph 185 (4)) Thereafter all shoes issued to the individual must correspond with the size entered in the record service book. The slips are returned by the company office to the Medical Officer in charge of measuring and fitting for his files. Following this system at this Post working an enlisted personnel of eight men, an average of one hundred and twenty men an hour were accurately measured and fitted. MEASURING AND FITTING lOI SHOE-FITTING Measuring and Fitting Men at the Barracks or in the F'ield (500-3000 Men) Fitting Quarters. For measuring and fitting men totahng the above numbers half a barrack building the length of which is forty-nine feet or tents joined together so as to equal the amount of floor space included in the above will provide ample room for all purposes. It must be repeated again that a central location is imperative as the time element is very important. The division of the quarters into several rooms or of the tents into several compartments is not absolutely necessary just as long as the equipment is spaced correctly and the men engaged in the work are sufficiently acquainted with the routine to manage the men systematically as they pass through. The equipment necessarily must be of such a size that it will be adaptable to the floor area without undue overcrowding and consequent confusion. Mess benches, if in the barracks, or logs and similar material, if in the field, will suffice as seats for those who remove the shoes and leggins. The recorder's table should be of the same size as described in Chapter 18, or in the field the top of a barrel, smooth top of a stump box, etc., can be utilized. A measuring table twenty by five feet equipped with legs thirty inches high is recommended; the plans to be the same as described for the larger table in Chai)- ter 1 8 equipped with steps. In the field it has been found that an improvised bench, smooth topped large rock or stump with a sea box on top makes a fairly good fitting platform. (See illustration. Chapter 20) . Testing incline and fitting platfonn should have same dimensions as mentioned in Chapter 18 for work in the barracks. In the field the testing incline can be made by placing two boards or logs in position, the proximal I02 FOOT CARE AND SHOE FITTING ends resting on the sea box or its support and the distal ends on the ground. The rack required for fitting five hundred to three thousand men should contain approximately ninety- six pigeon holes, each pigeon hole being eight by six inches and twelve inches deep. Swinging doors fastened and held se- curely should be added. Shelves are optional depending on the amount of space. The sizes of shoes and numbers of individual pairs required would be approximately the following : Pair . I . I . I . I . 2 5C 5E. 5EE 5F 53-^C 5MEE 2 5HF 2 6B 6C 6D 6E 6EE 6F 6HB 6MC 6MD 6ME 6HEE eyiF 7B 2 7C 2 7D 2 7E 2 7EE 2 7F 2 7MB I 7HC 2 Pair 7HD 2 7HE 2 7HEE 2 7KF 2 8B I 8C 2 8D 2 BE 2 SEE 2 8F 2 8KB I 8MC 3 8KD 3 8KE 3 8HEE I 8KF 2 9B I 9C I 9D 2 9E 2 9EE 2 9P 2 93-^6 I 9KC I 9MD I 9KE 2 9KEE 2 FITTING QUARTERS 103 Pair 9>^F 2 loB I loC I loD 2 loE I loEE 2 loF I io>^A I loHB I loKD I loHE I lO^EE 2 loHF I iiB I Pair IlC IlD.... IlE iiEE... iiMB.. iiHC. iiHD.. ii^E .. iiHEE. iiKF.. 12B 12C...., 12D 12E Aboard ship the testing indine and measuring platform may be made by utiHzing a mess bench with one pair of legs let down in the first instance and a mess bench and sea box in the latter. Other equipment as specified may be made and arranged according to the discretion of the Medical Officer. Racks cannot be considered in the field. The best arrange- ment would be to procure the desired sizes and number of pairs of shoes from the Quartermaster; and placing a strip of adhesive plaster on the heel marking the size with ink arrange them in parallel rows on the ground according to size. The sizes and number of individual pairs will vary according to the number of men to be fitted. The list complied in this chapter is suitable for a starting j^oint. Fitting slips should be used in the Barracks and the same procedure carried out as described in Chapter 18. In the field it will be a rare occurrence if a man is measured and fitted for the first time so slij^s will not be so necessary. If required, however, slips of ordinary writing paper with measurements, etc., may be made out and sent to the company office for entry in the record service book. I04 FOOT CARE AND §IIOE FITTING 6 //y. / * 4 7 / / / / / / 'fl / / / / / / ~i / / / / d «^ / 1 / '1 / / 1 / 1 / 1 / / t A 1 A 1 / / 1 1 / 1 / -^ 1 1 1 1 1 / / 1 1 h / / / H -/ ~i ~l -/ / k -/ -/ -/ -/ s± -/ ^ V V -/ -1 -I ^4 -/ -/ V -1 "1 -/ 5 V -/ "/ -/ V "/ ../ «/ -/ V <> V w V -/ „/ -v ■"i* ^ V V "•/ ^/ V -/ / ir. V V -/ -/ V -/ S-* "A V / / / w r- y V V '■Z V ^/ V V V ~h -/ V vo V V -/ V -/ -/ ~riii (imss hcmii ami si'u bo.x). used in the Barracks. Being thus familiar with the system generally, he can devise many make'shift appliances, arrange his men correctly and do efficient work. In the field the greatest numl)cr of fittings will be second or io8 FOOT CARE AND SHOE FITTIXG Fig. 49. — Marine fully equipped on makeshift fitting platform. Medical officer is observing the fit. MAKESHIFT TEST INCLINE 109 third fittings, where the data for sizes will be taken from the record service book. It is evident, then, that the great bulk of the work will be devolved on thefitters and that the measurer will have little to do. It is therefore recommended that the fitting space, where comparative seclusion is essential, be ])laced under cover. The general plan of the measuring and fitting spaces will be similar to those used in the Barracks. A space of ground two hundred and twenty-five square feet should be pegged off with wooden pegs. In this space may be placed logs, 1-1., uKL'siiiiL LL'Ti iiicuiK,' ami liLliu^ plaUorin Im use 111 tin posed of a sea box, mess bench and two planks. boxes and similar material for tliosc who Iuin'o to remove the shoes and socks. Here also will sit the recorder with a bo.x upon which are placed the record service books of those who are to be measured for the first time. Regulation fitting slips or slips of writing paper may be used to record first measure- ments and fittings. Directly in front of the waiting space is a space equal in area which is also pegged off; this is the measuring si)ace. Here may be placed a makeshift measuring platform. (See illustration.) One pair of Resco Marine Corps Foot Measur- } no FOOT CARE AND SHOE FITTING ing Machines is sufficient for all purposes. There is one measurer. Directly in front of the measuring space is the fitting space equal in area to each of the other two and under cover of canvas. In this is placed the makeshift fitting platform and test incline. Only the common shoe sizes should be procured from the Quartermaster and each size plainly marked by adhesive tape and ink on the side of heel. The shoes may be arranged in parallel rows on benches or logs and replaced as quickly as they are returned. The personnel of the fitting space will consist of one stockman and one fitter. From this description it can be readily seen that the men will pass through the different spaces in exactly the same manner as in the barrack building. APPENDIX OLD ARMY ORDER COVERING THE SUBJECT OF FOOT-MEASURING AND SHOE-FITTING General Orders War Department, No. 26. Washington, August 16, 1912. I . With a veiw to increasing the marching capacity of troops, company commanders will personally measure the feet and fit the shoes of men of their commands and will be held responsi- ble that the instructions herein contained are strictly followed. All measurements prescribed herein will be taken with the soldier standing in bare feet and with a 40-pound burden on his back, bearing the entire weight upon the foot to be measured. Balance may be preserved by resting the hand on a fixed object. The measurements of the foot, which must be taken to make suitable preliminary selection of the shoe to try on. are (a), the length; (6) the circumference around the ball. To measure the length the soldier will stand with foot upon the foot measure, furnished by the Quartermaster's Depart- ment, fitted in a slot in a board, the heel of the soldier fitting snugly against the heel block. The movable block will then be pushed up until it touches the end of the great toe. The scale on the top of the mea.sure, which is graduated in sizes, will then be read, and the i;roper length of the shoe will be determined, approximately, by adding 2 to the reading of 111 112 FOOT (ARE AND SHOE FITTING the scale; thus, if the soldier's foot scales 63--^, a shoe not smaller than 83-^ should be tried on first. To take the ball measure, pass the foot tape, supplied by the Quartermaster's Department, around the foot at the prominent tubercle at the base of the great toe and the promi- nent tubercle at the base of the little toe. The tape should lie closely to the flesh, but should not be so tight as to compress it. Having taken the foregoing meas- urements, the shoe best suited to the foot will be determined by reference to Circular No. lo. Quartermaster General's Office, April 6, 191 2. For example, assume that the circum- ference of the ball is found to be 9^^ inches. In the table on page 28 of the aforesaid circular, under the heading " Marching shoes," it will be seen that for a foot requiring an 8}y^ shoe a ball measurement of 9^^ inches corresponds to a D width. The size of shoe to try on for actual fitting is, then, in this case 8HD. If the ball measurement found as above does not correspond exactly with any ball measurement given in the table, then the narrower of the two widths between which the measure- ment lies should be selected. Beginning with the size and width thus tentatively selected, shoes will be tried on until a satisfactory fit is secured. Correct fit in waist and instep will be determined experimentally. To determine the fact of fit the shoe will be laced snugly and the soldier with a 40-pound burden upon his back will again throw his entire weight on one foot. The officer will then press in the leather of the shoe in front of the toes to determine the existence of sufficient vacant space in that region to pre- vent toe injury. Under no circumstances should this vacant space in front of the great toe to be less than two-thirds inch ; nor should there be pressure on the top of the toes. The officer will then grasp with his hand the leather of the APPENDIX 113 shoe over the ball. As his fingers and thumb are brought slowly together over the leather, the shoe should feel snugly- filled without apparent tension, while the leather should lie smoothly under the hand. If the leather wrinkles under the grasp of the hand, the shoe is too ^vide and a narrower width is needed; if the leather seems tense and bulging and the hand tends to slip over easily, the shoe is too narrow and a greater width is necessary. It may be necessary to try on several pairs of shoes in this manner before an entirely satisfactory shoe is secured. A record of the proper size and width of shoes as determined above will be kept as provided in Circular No. 10, Quarter- master General's Office, April 6, 1912. Measurements will be taken and shoes will be fitted as prescribed at least once in each enlistment and the record will be changed from time to time if subsequent fittings render a change necessary. Sizes called for in requisitions will conform to the record; and the fact of fit of shoes issued on such requisitions will be personally verified in every instance by company commanders in the manner above prescribed. No shoes will be issued to, or worn by. enlisted men while on duty which are not fitted in accordance with this order. New shoes should be adapted to the contours of the feet as soon as possible. Shoe stretchers, with adjustable knobs, to take pres.sure off painful corns and bunions, are issued by the Quartermaster's Department. All shoes should be properly broken in before beginning a march, but if this is impracticable, then the following is suggested but not required. The soldier stands in his new shoes in about 2 3-^ inches of water for about five minutes until the leather is thoroughly pliable and moist; he should then walk for about an hour on 8 114 FOOT CARE AND SHOE FITTING level surface, letting the shoes dry on his feet, to the irregu- larities of which the leather is thus molded in the same way as it was previously molded over the shoe last. On taking the shoes off a very little neat's-foot oil should be rubbed into the leather to prevent its hardening and cracking. If it is desired to waterproof the shoes at any time, a con- siderable amount of neat's-foot of should be rubbed into the leather. Light woolen or heavy woolen socks will habitually be worn for marching; the socks will be large enough to permit of wrinkling. Darned socks, or socks with holes, will not be worn in marching. Company commanders, by frequent inspections throughout the year, will maintain the feet of their men in condition for proper marching. They will cause the proper trimming of nails, removal or paring of corns and callouses, relief of pain- ful bunions, treatment of ingrowing nails, and other defects, sending serious cases to the surgeon. Before a march is undertaken by foot troops company com- manders will personally inspect the bare feet of their men. While on the march they will personally see each day that their men wash their feet as soon as possible after reaching camp, prick and evacuate blisters, and cover such blisters or excoriations with zinc oxide plaster, supplied by the Medical Department, applied hot, dust the feet with the foot powder supplied by the Medical Department, and put on clean socks. Hereafter, an undue amount of foot injury and disability from shoes will be regarded as evidence of inefficiency on the part of the officers concerned and as causes for investigation. Post quartermasters will provide a place in the quarter- master's storehouse where shoes may be fitted for the purpose of determining or verifying the record required by General Orders, No. 48, War Department, 191 1. For the purpose of APPENDIX 115 fitting they will keep on hand at all times a complete series of each size and width of shoes furnished for issue. Shoes of this series will be put in stock and issued before they become unserviceable, and will be replaced by new shoes, keeping the series always complete. Company commanders will report in writing to the post commander every instance of failure to secure proper shoes for their commands or to obtain proper facilities for fitting the shoes as herein directed. Post com- manders will investigate the reasons for and be held respon- sible as far as lies in their power for the rectification of such deficiencies. A brief record of the number of such reports from company commanders and the reason for such deficiencies will be fur- nished to inspectors at each inspection of the post. Inspections conducted under the provisions of paragraph 913, Army Regulations, will embrace an inquiry into the man- ner in which this order has been complied with, and the report of inspections will include a statement of all instances of failure on the part of com])any commanders to secure proper shoes for their commands and the cause of such failure. (1856626 R— A. G. O.) II — A new pattern shoe has been adopted for the service which, when the old stock shall have been exhausted, will supersede the different patterns now on hand in the Quarter- master's Department. Hereafter, until the old supply is exhausted, requisitions for shoes will be filled from stock on hand, irrespective of pattern or finish. (1856626 vS— A.G.O.) By order of the Secretary of War: Leonard Wood, Major General, Chief of Staff. Official : Geo. Andrews, Adjutant General. Il6 FOOT CARE AND SHOE FITTING NEW ARMY ORDERS SPECIAL REGULATIONS NO. 28 TEXT OF REVISED REGULATIONS APPLYING TO THE FIT OF ENLISTED MEN'S SHOES Changes No. 3. War Department, Washington, September 20, 19 18. Paragraph 14, Special Regulations No. 28, Sanitary Regula- tions and Control of Communicable Diseases, is changed, as follows : 14. (Changed by S. R. No. 28, C. No. 3, W. D., 19 18). Fitting of shoes and care of feet. — With the view of increasing the marching capacity of troops, company, troop, battery and Detachment commanders will personally satisfy themselves that the men of their commands have been properly measured and fitted with shoes and socks, and will be held responsible that the instructions herein contained as to care of feet are strictly followed, and that their men are required to wear shoes and socks properly fitted. Foot-measuring machines and shoe-fitting devices will be supplied by the Quartermaster Corps in such numbers as may be needed at each camp and garrison post in the United States, the Philippines, Panama Canal and Hawaiian Departments, for use in fitting shoes. The use of the measuring machines and the fitting devices is to be under the supervision of the unit supply officers and supply officers of depot brigades, to whose offices will be attached personnel properly instructed in meas- uring- and shoe-fitting devices will be kept by company, troop, battery, and detachment commanders. Directions for operating "Resco" foot-measuring machine: (a) After taking the machine from its box, open it wide by APPENDIX 117 loving the lever as far front as possible and pulling out the lunger as far as it will go. The machine is now ready for se. (b) Let the man put his foot in the machine and stand with 11 his weight. The heel should rest firmly against the heel ilock. It is important that the foot should rest in the exact center )f the machine. (c) Release lever which operates the width indicator, and msh the plunger until the plate touches the toe. Do not touch the plunger again while the foot is in the machine. Make sure that the metal side pieces touch the toe joiats. (d) Then let the man throw his entire weight on the ball of his foot, raising the heel slightly. (e) The width is automatically registered by the arrow. As the arrow wavers, following the action of the heel up and own, take the average of the extremes. (Example. If the arrow wavers from width "b" to width "d" use width " c") The correct size of the shoe is indicated by the pointer on the plunger on the right-hand scale. (f) Measure the other foot in the same manner and if there should be a difference select size to fit the longer foot and the I arrower width. (g) Oil the slide under the device occasionally. Note. — Verify the length selected by testing with shoe- fit ving device. a) Select from the several measuring devices in the set the one marked with the size or half-size corresponding with the shoes to be tried on. (6) Insert the knol) end of the device into the toe of the shoe, springing the other end of device down to the inner sole, against the counter. (c) The middle of the flat spring piece will lie flat with slight pressure of the foot. IlS FOOT CARE AND SIIOK FITTING (d) If the soldier, with pack and rifle on his back, can without discomfort pace back and forth in shoes with device inserted, the shoes will be sufficiently long to allow for foot- expansion when device is withdrawn. Note. — The shoes must in every case pass satisfactory the above described test. Shoes of the size indicated by measuring machine, fitted with the proper shoe-fitting device, will be laced snugly; and the soldier with a 40-pound burden on his back will throw his entire weight upon one foot. The officer or enlisted man will grasp with his hand the leather of the shoe over the ball. As his fingers and thumb are brought slowly together over the leather the shoe should feel snugly filled without apparent tension, while the leather should lie smoothly under the hand. If the leather wrinkles under the grasp of the hand the shoe is too wide and a narrower width is needed; if the leather seems tense and bulgy and the hand tends to slip over easily, the shoe is too narrow and a greater width is necessary. Usually it will be necessary to try on several pairs of shoes in this manner before an entirely satisfactory shoe is secured. No shoes will be issued or worn by enlisted men which are not fitted in accordance with this order. When foot measuring machines and shoe-fitting devices are not available, the procedure in determining the fact of fit of the shoes will be the same as contained in the preceding paragraph. The officer or enlisted man fitting the shoe will also press in the leather of the shoes in front of the toes to determine the existence of sufficient vacant space in that region to prevent toe injury. Under no circumstances shovild this vacant space in front of the great toe be less than two- thirds of an inch, or the width of a man's thumb, nor should there be pressure on top of the toes. Measurements will be taken and shoes will be fitted as soon APPENDIX 119 as practicable after the enlistment or induction of the soldier into the service, and the record will be changed from time to time if subsequent fittings render a change necessary. , Sizes called for in requisitions ^vill conform to the record, and the fact of fit shoes and socks issued on such requisition will be personally verified in every instance by a company, troop, battery, and detachment officer. New shoes should be adapted to the contours of the feet as soon as possible. Shoe stretchers, with adjustable knobs, to take pressure off painful corns and bunions, are issued by the Quartermaster Corps. All shoes and socks must be properly broken in before beginning to march. The following is suggested but not required. The soldier stands in his new shoes in about 2 3^ inches of water for about five minutes until the leather is thoroughly pliable and moist; he should then walk for about an hour on the level surface, letting the shoes dry on his feet, to the irregtdarities of which the leather is thus molded in the same way as it was previously molded over the shoe last. On taking the shoes off a very little neat 's-foot oil should be rubbed into the leather to prevent its hardening and cracking. If it is desired to waterproof the shoes at any time, a con- siderable amount of dubbin should be rubbed into the leather. Shoes issued to enlisted men will be regularly inspected by company, troop, battery, and detachment commanders to see that water-proofing substance is applied often, and that they are not injured by being placed too near heating apparatus. Heat ruins leather and causes wet leather to decompose rapidly. Light woolen or heavy woolen socks will habitually be worn for marching; the socks will be large enough to permit free movement of the toes, but not so loose as to permit of wrin- kling. Darned socks or socks with holes, will not be worn in I20 FOOT CARE AXU SHOE FITTING marcliing. (This is not to be construed, however, as prohibit- ing soldiers from wearing properly darned socks while on ordinar}'' duty, at drill, etc. If on marches two pairs of socks are worn, the outer pair may be darned socks.) Woolen socks will shrink about one size after being washed a few times. Proper fitting of socks must be secured under personal super- vision of a compan}'', troop or battery oflficer. Company, troop, battery, and detachment commanders, by frequent inspections and care throughout the year, will maintain the feet of their men in condition for proper marching. They will cause the proper trimm.ing of nails, removal or paring of corns and callouses, relief of painful bunions, treat- ment of ingrowing nails, and other defects, sending serious cases to the surgeon. Before a march is undertaken by foot troops, company, troop battery, and detachment commanders w-ill personally inspect the feet of their men in condition for proper marching. They will cause the proper trimming of nails, removal or paring of corns and callouses, relief of painful bunions, treatment of ingrowing nails, and other defects, sending serious cases to the surgeon. Before a march is undertaken by foot troops, company, troop, battery, and detachment commanders will personally inspect the bare feet of their men. While on the march they will personally see each day that their men wash their feet as soon as possible after reaching camp, prick and evacuate blisters, and cover such blisters or excoriations with zinc oxide plaster supplied by the medical department, applied hot, dust the feet with a foot powder supplied by the medical department, and put on clean sock. Hereafter, an undue amount of foot injury and disability from shoes will be regarded as evidence of inefficiency on the part of the officers concerned and as causes for investigation. APPENDIX 121 A place will be provided where officers may have shoes fitted for the purpose of determining or verifying the record. For the purpose of fitting unit supply officer they will draw from the camp quartermaster, on memorandtmi receipt, a try- on set consisting of a complete series of each size and width of shoes furnished for issue. Shoes of this series will be put in stock and issued before they become unserviceable, and will be replaced by new shoes, keeping the series always complete. Company, troop, battery, and detachment commanders will report in writing to the post or regimental commander every instance of failure to secure proper shoes for their command. Post or regimental commanders will investigate the reasons for and be held responsible as far as lies in their power for the rectification of such deficiencies. A brief record of the number of such reports from company, troop, battery and detachment commanders, and the reason for such deficiencies will be furnished to inspectors at each inspection of the post. Inspections conducted under the provisions of paragraph S89, Army Regulations, will embrace an inquiry into the man- ner in which this order has been compiled with, and the report of inspections will include a statement of all instances of failure on the part of company, troop, battery, and detach- ment commanders, to secure proper shoes for their commands and the cause of such failure. (S. R. No. 28, C. No. 3, Sept. 20, 191S.) By Order of the Secretary of War: Pkyton C. March, General, CliieJ of Staff. Official: P. C. Harris. Acting Adjutant ricneral. 122 FOOT CARE AND SHOE FITTING MARINE CORPS ORDERS (a) Marine Corps Orders No. 38 (Series 1915.) October 12, 1915, Par. 185. (b) Marine Corps Orders No. 42 (Series 1915), December 20, 1915, Paragraphs 185 and 190. (c) Marine Corps Orders No. 37 (Series 1916), November 4, 1916, Par. 258. Marine Corps orders No. 38 (Series 19 15), October 12, 191 5, Par. 185, amended to read as follows: "185. (i) Instructions for fitting of shoes. The man to be fitted shoiild sit on a chair in a natviral position with one leg crossed over the other, as shown in the illustration below. "2. It is recognized that in most cases a man's feet are not exactly the same size, one being a little larger than the other ; therefore, in measuring for shoes, the length of each foot will be measiu"ed with the standard size stick, furnished by the Quartennaster's Department. To determine the approximate size of shoe for the man to be fitted, two sizes will be added to the largest measurement shown on the stick; thus: If a man's larger foot measures five (5) on the size stick, add two (2) sizes to same, which will call for a number seven (7) shoe; if the foot measures six and one-half (63^), add two (2) sizes to same, which will call for a number eight and one-half (8M) shoe, and so forth. Beginning with the size thus selected, shoes will be tried on until a satisfactory fit is secured." Marine Corps Orders Headquarters, Number 42 (vSeries 1915). U. S. Marine Corps, Washington, December 20, 19 15. 190. (i) The individual cards for recording sizes of shoes are hereby dispensed with APPENDIX 123 (2) Paragraphs 185 (4) and 185 (5), Marine Corps Orders are revoked and the following substituted: 185. (4) After determining the con-ect length and width of shoe to fit a man's larger foot, entry of such size will be made in the man's service-record book and thereafter no other size shoe will be issued to him, unless it is proven by a refitting , that a dift'erent size is required, in which case his records will be changed accordingly. (5) Upon receipt of this order all men will be measured in order to ascertain the correct size of shoe they should wear and the necessary notations in their service-record books will be made. (AI.C.O. 42, 12-20-15.) George Barnett, Major General Commandant. Office of the Post Commander, Marine Barracks, Quantico, Va., January 28, 1919. Post Special Order No. 47. 1. Building No. 503 has recently been fitted U]^ and is now availal)le for the purpose of obtaining proper foot ineasurc- ments for all men of this command. Lieutenant S. A. Folsom, M. C. USN., at Dispensary No. 6, telephone No. 231 is in charge of this work. 2. It is the intention eventually to have every man of each organization at this post .scientifically measured so as to insure a perfect fitting shoe, and in order to accomplish this with as little delay and disorganization of the routine as possible, the following procedure will govern : (a) Whenever men of any organization desire shoes, the commanding officer of .such organization will communicate with Lieutenant Folsom to a.scertain the time that such measurements can be made. 124 FOor I'ARK AM) SHOE FITI'ING (6j These men will be required to wash their feel and put on clean socks, and, accompanied by their service record books, will then be marched in heavy marching order with rifles to building 503 and measured in the presence of a commissioned officer of the organization concerned, who will assist in making such measurements under the direction of the medical officer in charge, and will as soon as same have been completed make a permanent record in the service record books of the men concerned. (c) Thereafter, shoes of the recorded size only wall he issued, and in submitting clothing requisitions on which shoes appear, great care must be exercised by the officers preparing the requisitions and issuing the clothing, to see that this is strictl}' complied with. (d) In case a man complains that shoes issued in accord- ance, with such measurements do not fit properly and are not comfortable, a remeasurement will be taken by the officer in charge of the foot-measuring squad in building 503. By Order of Brigadier General Myers. S. M. Harrington, Major, Ass't A. & I., M. C, Post Adjutant. UNIVERSITY OF CALIFORNIA LIBRARY Los Angeles This book is DUE on the last date stamped below. REG'D LD-URL n*lov'ni975 NO^ 3 1976 NON-RENEWABLE DEC 14 1990 DUE 2 WKS FROM DATE RECEIVED 10m-7,'71 (P6348s8) — Z-53 uc SOUTHERN REGIONAL «-n Ka 001143 270 5 L 006 060 833 8 I