In Treacherous Shoal, Frederick Demarest is afflicted with clubfoot. It is a congenital deformity of the foot in which the tendons that connect the foot to the leg are too short, causing the foot to twist inward. A person with untreated clubfoot might be forced to walk on the side of their foot, or in a severe case, on the top of the foot. It can occur in one or both feet.

Hippocrates described a method for treating clubfoot by gently manipulating the infant bones into the correct position, then binding the foot to maintain the correct. Supportive shoes would maintain the new shape as the child grew.

This technique was forgotten in the Middle Ages, but gradually rediscovered by later practicioners. In the mid-18th century, Dr. William Cheseldon (1688-1752), working at St. Thomas’s hospital in London, successfully treated clubfoot by a similar method. I have imagined that Frederick’s foot is treated by an acolyte of Cheseldon there in London, although there is no evidence that his method was continued by others. It was reintroduced in the 19th century, and continues to be the primary method of treatment throughout the world, restoring eliminating pain and restoring ease of movement to countless sufferers.

Treatment of clubfoot is less successful if undertaken when the individual, as in Frederick’s case, is older. And so Frederick continues to struggle with pain and awkward movement, although faithfully continuing to wear the unfashionable boots needed to maintain the gains he has made. Many people in past centuries, including Napoleon’s chief diplomat, Talleyrand, suffered from clubfoot, and managed to lead productive and successful lives.