Showing posts with label DSM. Show all posts
Showing posts with label DSM. Show all posts

Thursday, October 2, 2025

Mnemonic

Mnemonic (pronounced ni-mon-ik)

(1) Something assisting or intended to assist the memory.

(2) Pertaining to mnemonics or to memory.

(3) In computing, truncated code thought easy to remember (eg STO for store).

1660–1670: From the New Latin mnemonicus from the Ancient Greek μνημονικός (mnēmonikós) (of memory) derived from μνήμων (mnmōn) (remembering, mindful) & μνσθαι (mnâsthai) (to remember); the ultimate root was the primitive Indo-European men (to think).  The meaning "aiding the memory", a back-formation from mnemonics dates from 1753, the noun meaning "mnemonic device" is from 1858.  The use in computer programming emerged in the early days of code and was a space-saving (eg del rather than delete) tool as well.  Mnemonical was the original form from the 1660s.  One of the charming ironies of mnemonic is it is one of those words so many can't quite remember how to spell.  It's thus in a sense "antimnemonic" and a contronym (also as auto-antonym, antagonym, or enantiodrome) which describes a word with two opposite or contradictory meanings, depending on context.  Mnemonic is a noun & adjective, mnemonician, mnemonicalist, mnemotechnist & mnemonicon are nouns, mnemonize & mnemonized are verbs, mnemonical & mnemotechnic are adjectives and mnemonically & mnemotechnically are adverbs; the noun plural is mnemonics.

Sans Forgetica

Sans Forgetica sample text.

Recently released, Sans Forgetica (which translates as "without forgetting") is a sans-serif font developed by RMIT University in Melbourne.  Back-slanted and with gaps in the character constructions, it’s designed explicitly to assist readers better to understand and retain in their memory what they’ve read.  Perhaps counter-intuitively for those outside the field, the shape is intended to reduce legibility, thereby (1) lengthening the tame taken to read the text and (2) adding complexity to learning and absorbing what’s been read.  Together, they create what in cognitive psychology and neuroscience is called "desirable difficulty", in this case forcing (RMIT might prefer "nudging") people to concentrate.

The first three paragraphs of Lindsay Lohan's Wikipedia page, rendered in Sans Forgetica.  Sans was from the Middle English saunz & sans, from the Old French sans, senz & sens, from the Latin sine (without) conflated with absēns (absent, remote).   Forgetica was an opportunistic coining, the construct being forget + -ica.  Forget was from the Middle English forgeten, forgiten, foryeten & forȝiten, from the Old English forġietan (to forget) (which was influenced by the Old Norse geta (to get; to guess), from the Proto-West Germanic fragetan (to give up, forget).  The -ica suffix was from the Latin -ica, the neuter plural of -icus (belonging to derived from; of or pertaining to; connected with).

From usually a young age, readers become skilled at scanning text, a process helped by most publishers seeking to render their works as legible as possible.  The theory of desirable difficulty is that omitting parts of the font requires the reader to pause and process information more slowly, thus provoking an additional cognitive processing which may enhance both understanding and retention.  While the application of the science to a font is novel, there’s nothing original about Sans Forgetica as a piece of typography, it being described as a hybrid of several existing schools and within the theory, on the basis of a small-group sample of students, it’s claimed to be a balance between legibility and difficulty.  According to the documents supplied by the developer, it’s not been tested as a device for advertisers to draw people to their text, the theory of that being people scan and dismiss (without retention) the great bulk of the large, static signage which is a feature of just about every urban environment.  With Sans Forgetica, because it can’t as quickly be scanned, people will tend longer to linger and so more carefully read the whole; a memorable event itself.

The most recent revision (DSM-5-TR (2022)) to the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) followed DSM-5 (2013) in refining the somewhat vague section on amnesia in both the DSM-IV (1994) & DSM-IV-TR (2000) where appeared the terms “Psychogenic amnesia” & “dissociative amnesia”, the core element of which was: “one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.”  That really reflected the popular understanding and there was no clear definition of sub-types in the diagnostic criteria although in the text (not always in criteria) there was mention of localized, selective or generalized forms.  In the fifth edition, the disorder was called Dissociative Amnesia (psychogenic amnesia seems to have been replaced) and it was listed in the dissociative disorders section.  The definition still includes an “inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting” so the popular understanding remains acknowledged but sub-types are now listed: localized (for specific event(s)), selective (some parts of the event), or generalized (identity and life history) amnesia.  Consistent with the structural revisions elsewhere in the fifth edition, the exclusion criteria was made more explicit (ie the memory loss should not be due to substances, medication, a neurological condition or better accounted for by another mental disorder) although clinician remain aware of overlap.  Significantly the DSM-5 did clarify that amnesia is retrograde (loss of pre-existing memories), especially of autobiographical kind and emphasised the memory loss is “beyond what is expected from normal forgetting. Because in such matters, there will be so much variation between patients, it remains one of those conditions with fuzzy boundaries and the symptoms presented must be assessed on a case-by-case basis.

Amnesia (memory loss) is much studied and although associated with the aging process, traumatic events (brain injury or psychological impacts) and certain neurological conditions, there have been some celebrated cases of recovery without medical intervention.  One celebrated case was that of Rudolf Hess (1894–1987; Nazi Deputy Führer 1933-1941) who in 1941 (on the eve of Germany invading the USSR) flew himself to Scotland in a bizarre and unauthorized attempt to negotiate a peace deal with those in the UK he though would be "reasonable men".    His "offer" was rejected and he was locked up (including two weeks in the Tower of London), later to be sent as a defendant before the IMT (International Military Tribunal) in the first Nuremberg Trial (1945-1946).  There, so convincing were his symptoms of amnesia and other mental states the judges requested submissions from defence and prosecution counsel on the matter of his fitness to stand trial.  The prosecutors assured the bench Hess would be able to both understand and cope with the proceedings and that an imperfect memory was merely a hindrance to his defence rather than an insuperable obstacle.  This was of course a predictable argument and the judges acceded to the defence’s request for a thorough medical investigation although they declined the suggestion Swiss doctors be consulted, assembling instead a team from medical staff on hand (three Soviet, three American, three British and one French), all from the nations running the trial.  The physicians presented four national papers which broadly were in agreement: Hess was sane (as legally defined) but was suffering from hysterical amnesia, induced by his need to escape from uncomfortable realities, something they found was often typical of “those with Hess’s unstable personality”.  All concluded the amnesia was temporary and would vary in intensity, the US doctors suggesting it may even disappear were any threat of punishment removed.

Caricature of Rudolf Hess at the first Nuremberg Trial by New Zealand-born UK cartoonist David Low (1891-1963).

The author Rebecca West (1892–1983) covered the trial as a journalist and wrote some vivid thumbnail sketches, noting of Hess: “Hess was noticeable because he was so plainly mad: so plainly mad that it seemed shameful that he should be tried.  His skin was ashen and he had that odd faculty, peculiar to lunatics, of falling into strained positions which no normal person could maintain for more than a few minutes, and staying fixed in contortion for hours. He had the classless air characteristic of asylum inmates; evidently his distracted personality had torn up all clues to his past.  He looked as if his mind had no surface, as if every part of it had been blasted away except the depth where the nightmares live.”  Whether or not Hess was "mad" (as such folk were described in 1946) can be debated but to many at the time, he certainly looked a madman.

Predictably unconvinced, Hess’s counsel at a hearing on 30 November 1945 told the bench a defendant could hardly stage an adequate defence if unable to remember names or incidents vital to his case, adding that on the basis of discussions with his client, even if he understood the words, Hess was incapable of grasping the significance of the charges against him.  Nor would a trial in absentia be fair because it would constituent a “grave injustice” were a defendant not present to give evidence or challenge the testimony of witnesses.  He concluded by requesting proceedings against him should be suspended and resumed only if his condition significantly improved.  To that, the British countered with a lengthy lecture on the distinctions in English law between amnesia & insanity and seconded the Soviet view that participation in the trial (and thus the need to make a defence) might well cure his condition.  Essentially, the British argued if he could follow the proceedings, he was fit to stand trial.  The US team noted Hess had at times claimed to be suffering amnesia while in captivity in England between 1941-1945 and on other occasions admitted the condition was simulated.  In the slang of the English criminal bar: “He had a bit of previous”.  The Americans also expressed annoyance at him having repeatedly refused any of the treatment prescribed by the Allied doctors, concluding: “He is in the volunteer class with his amnesia”.  The lawyers having finished, the IMT asked Hess if he wished to speak on the matter.  Without delay, he rose in the dock and walked to the microphone where he addressed the court in a clear and calm voice, his statement coherent, unambiguous and, most historians have concluded, clearly premeditated: “Henceforth my memory will again respond to the outside world.  The reasons for simulating loss of memory were of a tactical nature.  Only my ability to concentrate is, in fact, somewhat reduced.  But my capacity to follow the trial, to defend myself, to put questions to witnesses, or to answer questions myself is not affected thereby.  I also simulated loss of memory in consultations with my officially appointed defence counsel. He has therefore represented in good faith.

He then sat down in what was described as a “stunned courtroom”.  It was at that point the trial’s most sensational moment and after taking a few seconds to digest things, the assembled press pack in their dozens rushed outside to file the story (the US military newspaper Stars and Stripes ran the punchy headline “Hess Nuts. Fake Story Fake”).  Immediately, the president of the IMT adjourned the session and the judges went into private session to decide whether Hess should be tried.  From their subsequent interviews and writings it appears they were not much influenced by Hess’s unexpected statement but were impressed by the similarity of the conclusions offered by the doctors, the chief US prosecutor saying such “unanimity of medical opinion” was, in his experience: “historically unique”.  All eight judges agreed Hess was fit to stand trial and, after being convicted on two counts ((1) conspiracy to wage aggressive war and (2) waging aggressive war), he was handed a life sentence and would remain incarcerated until in 1987 he committed suicide after some 46 years behind bars, the last two decades of which were served as the sole inmate (guarded buy dozens of soldiers on rotation from France, the UK, US and USSR) of Berlin’s sprawling Spandau Prison, a huge facility designed to accommodate hundreds.

Low’s take on the official German line explaining Hess deserting the German government as “madness”.  This cartoon does represent what was then the prevailing public perception of the typical behaviour expected of those in “lunatic asylums”.  Depicted (left to right) are:

Hermann Göring (1893–1946; leading Nazi 1922-1945, Hitler's designated successor & Reichsmarschall 1940-1945): Committed suicide by by crushing between his teeth an ampule of a potassium cyanide (KCN), smuggled into his cell in circumstances never confirmed, shortly before he was to be hanged after being convicted on all four counts ((1) Conspiracy to wage aggressive war; (2) Waging aggressive war; (3) War crimes and (4) crimes against humanity.

Adolf Hitler (1889-1945; Führer (leader) and German head of government 1933-1945 & head of state 1934-1945): With his wife Eva (née Braun; 1912–1945) of a few hours, committed suicide (he by gunshot and KCN, she by KCN alone) with the tanks of the Red Army only a couple of blocks from the Berlin Führerbunker.

Dr Robert Ley (1890–1945; head of the Deutsche Arbeitsfront (German Labour Front) 1933-1945): Committed suicide by hanging (by means of suffocation) himself in his cell in Nuremberg prior to the trial after having for some years made a reasonable attempt to drink himself to death.  He died with his underpants stuffed in his mouth.

Joachim von Ribbentrop (1893–1946; Nazi foreign minister 1938-1945): Hanged at Nuremberg after being convicted on all four counts.

Dr Joseph Goebbels: With his wife (Magda Goebbels (née Ritschel; 1901-1945), committed suicide (by gunshot) in the courtyard above the Führerbunker, shortly after they’d murdered their six young children.

Heinrich Himmler (1900–1945; Reichsführer SS 1929-1945): Captured by the British while attempting to escape disguised as a soldier, he committed suicide using an ampule of KCN concealed in his mouth.

Whether Hess was at any point insane (in the legal or medical sense) remains debated although, as is often the case, more interesting still is the speculation about just when the instability began.  Whether any credence can be attached to the official statement on the matter from the Nazi Party is doubtful but in the view of Reich Chancellery, his madness predated his flight to Scotland in 1941 (one of the strangest incidents of World War II (1939-1945)).  What the German press was told to publish was that Hess had become "deluded and deranged", his mental health affected by injuries sustained during World War I (1914-1918) and that he'd fallen under the influence of astrologers.  Just to make that sound convincing, the police conducted a crackdown (a well oiled technique in the Nazi state) on soothsayers and fortune-tellers.  Dr Joseph Goebbels (1897-1975; Nazi propaganda minister 1933-1945) wasn't consulted before the "madness" explanation was announced and he seems to have been the only senior figure in the regime to grasp the potential implications of revealing to the public that for some time the country's deputy leader had been mad.  Others though did make the connection.  When Hermann Göring tried to shift the blame to aircraft designer and manufacturer Willy Messerschmitt (1898–1978) because he'd provided Hess a twin-engined Bf 110 Zerstörer (destroyer (heavy fighter)) for his flight, the engineer responded by saying Göring was more culpable because he should have done something about having someone unstable serving as Deputy Führer.  Göring could only laugh and told Messerschmitt to go back to building warplanes and, as it turned out, the strange affair was but a "nine day wonder" for not only did the British make no attempt to use Hess's arrival on their soil for propaganda purposes (which astonished Goebbels) but other events would soon dominate the headlines.  The only place where the strange flight left a great impression was in the Kremlin where comrade Stalin (1878-1953; Soviet leader 1924-1953) for years mulled over who within the British establishment might have conspired with Hess to allow the UK to withdraw from the conflict, leaving Germany able to invade Russia without having to fight on two fronts.  Historians have concluded the reluctance by the British to use for propaganda the arrival of Hess was their concern comrade Stalin might suspect collusion. 

Arthur Sinodinos, b 1957; Liberal Party functionary and minister variously 2007-2019; Australian ambassador to the US 2019-2023, right ) presenting to Donald Trump (b 1946; US president 2017-2021 and since 2025, left) his credentials as Australia's ambassador to the US, the White House, Washington DC, February 2020.

Less dramatic but perhaps medically even more remarkable than the Hess affair was the recovery from amnesia by Arthur Sinodinos, a case which deserves to enter the annals of academic psychiatry & neurology (and debatably, those of the thespians).  In Australia, royal commissions are public investigations, established by but independent of government.  Not a court, royal commissions are created to enquire into matters of public importance and, within their terms of reference, have broad powers to conduct public & in camera hearings; they can call witnesses, compelling them (under oath) to provide testimony and they deliver recommendations to government about what should be done, consequent upon their findings.  These can include recommendations for legislative or administrative changes and the prosecution of institutions or individuals and they’re of great interest because they appear to be the only institution (at least theoretically) able to compel a politician to tell the truth.  Even that power is limited though because when appearing before royal commissions, politicians seem especially prone to suffering amnesia, an obviously distressing condition which compels them frequently to utter phrases like “I can’t remember”, “I don’t recall”, “not in my recollection” etc.  In the lore of the New South Wales (NSW) bar, Mr Sinodinous, while in 2014 being questioned by an enquiry, is believed to have set a record for the frequency with which the condition manifested.  Fortunately, the enquiry handed down no adverse findings against him and almost immediately, his memory appeared miraculously to recover, enabling the Australian Liberal Party government to appoint him ambassador to the US in 2019 so there's that.  The following transcript is wholly fake news:

Donald Trump: "What did you and Joe Biden talk about?"

Arthur Sinodinous: "I can't remember."

Donald Trump: "Not to worry, he won't remember either."

In the rich slang of the NSW bar, the condition once known as RCM (Royal Commission Memory) is now also referred to as “Sinodinos Syndrome”, on the model of “Marcinkus Syndrome” which describes the medical status of Roman Catholic priests who, being investigated for this, that or the other, although seemingly fit and healthy, are never able to be certified quite well enough to be interviewed by police or other authorities.  The condition is named after Archbishop Paul Marcinkus (1922–2006; President of the Institute for the Works of Religion (the “Vatican Bank’) 1971-1989).

Sunday, September 14, 2025

Pagophagia

Pagophagia (pronounced pag-off-faghia)

(1) The excessive and constant eating of ice, often as part of extreme dieting.

(2) A craving to eat ice, sometimes associated with iron-deficiency anemia.

Pre 900: A compound word, the construct being págo(s) + -phagia.  Págos is from the Byzantine Greek, the perfective stem of φαγον (éphagon) (I ate; I devoured), singular first-person aorist active indicative form (by suppletion) of σθίω (esthíō) (I eat; I devour).  Phagia is from the Ancient Greek πάγος- (phag-) (stiff mass; frost; ice) from pēnunai, (to stick, stiffen), from the primitive Indo-European root pag.  It was used also in a derogatory, figurative sense to describe a cold, unfriendly person (in the sense of one metaphorically cold like ice).  The nouns pagophile & pagophily and the adjective pagophilic reference species which prefer (ie are adapted to) ice as a habitat.  Pagophagia is a noun and pagophagic is a noun & adjective; the noun plural is pagophagics.

Ice, diet and the DSM

Pagophagia (the excessive consumption of ice or iced drinks), is often regarded as a recent phenomenon and a novel manifestation of pica (a disorder characterized by craving and appetite for non-edible substances, such as ice, clay, chalk, dirt, or sand and named for the jay or magpie (pīca in Latin), based on the idea the birds will eat almost anything) but in texts from Classical Greece are warnings in the writings of both the physician Hippocrates (circa 460–circa 370 BC) and the polymath Aristotle (384–322 BC) concerning the dangers of the excessive intake of cold or iced water.  The cause of the death of Theophilus (Byzantine (Eastern Roman) Emperor 829-842) was officially dysentery but, based on the original texts of Byzantine historians and chroniclers of the era, modern researchers speculate the cause of death may have been related to Theophilus' pagophagia (snow eating), a long-time habit he indulged to relieve the symptoms of gastric inflammation.  In the medical literature, from the sixteenth century on, there are discussions and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of eating disorders, another range of conditions with a long history.

A noted feature of the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5 (2013)), was the more systematic approach taken to eating disorders, variable definitional criteria being defined for the range of behaviours within that general rubric.  What may have appeared strange was including the ice-eaters within the psychological disorder Pica which is characterized by the manifestation of appetite for non-nutritive substances including sharp objects (acuphagia), purified starch (amylophagia), burnt matches (cautopyreiophagia), dust (coniophagia), feces (coprophagia), sick (emetophagia), raw potatoes (geomelophagia), soil, clay or chalk (geophagia), glass (hyalophagia), stones (lithophagia), metal (metallophagia), musus (mucophagia), ice (pagophagia), lead (plumbophagia), hair, wool, and other fibres (trichophagia), urine (urophagia), blood (hematophagia (sometimes called vampirism)) and wood or derivates such as paper & cardboard (xylophagia).  DSM-5 also codified the criteria for behaviour to be classified pica.  They must (1) last beyond one (1) month beyond an age in infancy when eating such objects is not unusual, (2) not be culturally sanctioned practice and (3), in quantity or consequence, be of sufficient severity to demand clinical intervention.  Interestingly, when the text revision of DSM-5 (DSM-5-TR, 2022) was released, the sentence “individuals with atypical anorexia nervosa may experience many of the physiological complications associated with anorexia nervosa” was added to the description of the atypical anorexia nervosa example to clarify that the presence of physiological consequences during presentation does not mean that the diagnosis is the (typical) anorexia.  However, it must be remembered the DSM is a tool for the clinician and, while it can be a useful source document for the lay-reader, there are other publications better suited to those self-diagnosing or informally assessing others.  An individual for whom the only symptom of pica is abnormally high and persistent ice consumption doesn’t of necessity need to be subject to the treatment regime imposed on more undiscriminating consumers.

One of the reasons pagophagia is one of the more-researched and better-documented examples of pica is its strong association with iron deficiency anemia (the word in modern use unrelated to ischemia (local disturbance in blood circulation) which well into the twentieth century was sometimes a synonym), something which manifests especially in women as one of the consequences of the menstrual cycle.  The research has established there’s a high prevalence of pagophagia in patients with iron deficiency which tends to disappear once treated although the mechanism isn’t fully understood.  One theory is chewing ice temporarily increases alertness in those with iron-deficiency–related fatigue, possibly by improving cerebral blood flow or nerve conduction.  Pagophagia is thus unusual among the picas in that it’s a “red-flag symptom” in hematology whereas the others tend to be of interest to nutritionists and the psychiatric community.  The correlation is not absolute because not all pagophagics suffer an iron deficiency; for some it’s the pleasure or the crunch, the oral stimulation or merely a habit but if the craving is strong or compulsive, the usual recommendation is the use of supplements (ferritin, serum iron, transferrin saturation, hemoglobin).

One cube at a time.

The pro-ana community does recommend the eating of ice, not merely as a food substitute but because the body needs to burn energy both to melt the ice and subsequently restore the body to its correcting operating temperature.  With frozen water, this effect is greatest in negative calorie terms but the discount effect applies even to iced confections.  If a frozen confection is listed as containing a calorie content of 100 (25 grams of carbohydrate @ 4 calories per gram), this does not include the energy the body expends to melt the ice and the net consumption is actually around 72 calories.

All things in moderation: Lindsay Lohan enjoying ice-cream and (an allegedly virgin) iced mojito, Monaco 2015.

Pro-ana does NOT however approve of frozen confections, the preferred one litre of frozen water containing zero calories yet demanding of the body a burn of around 160 calories to process, the energy equivalent of running one mile (1.6 km).  The practical upper limit per day appears to be between 3-5 litres (.67 / .8-1.1 / 1.3 (US / Imperial) gallons) depending on the individual and it’s speculated a daily intake much over eight litres may approach toxicity, essentially because the localized symptoms would be similar to hypothermia and some organs fail optimally to work when body temperature drops too much.  Paradoxically, pro-ana also notes, ice shouldn’t be eaten when one is too hot.  After running, the body actually exerts energy through the active effort of dissipating excess heat and if one were to ingest large amounts of ice as one was cooling off, some of the heat generated would be neutralized by the coolness of the ice, minimizing some of the energy burning benefits.  There’s also the need to avoid dental damage; pro-ana recommending it be allowed to melt in the mouth or consumed as shaved ice.

Saturday, August 2, 2025

Podophilia

Podophilia (pronounced podd-ah-fil-ee-uh or pod-oh-fil=ee-uh)

A paraphilia describing the sexualized objectification of feet (and sometimes footwear), commonly called foot fetishism although the correct clinical description is now "foot partialism".

1980s: The construct was podo- + -philia.  Podo- (pertaining to a foot or a foot-like part) was from the Ancient Greek πούς (poús), from the primitive Indo-European pds.  It was cognate with the Mycenaean Greek po, the Latin pēs, the Sanskrit पद् (pad), the Old Armenian ոտն (otn) & հետ (het), the Gothic fōtus and the Old English fōt (from which Modern English gained foot).  The Greek poús was the ancient Greek and Byzantine unit of length originally based upon the length of a shod foot and the idea in Europe endured for centuries although until the seventeenth century there were little attempts at standardization, even within the one jurisdiction and although things were settled well before the twentieth century, in the legal sense it wasn't until 1959 that the US, Canada, New Zealand, South Africa, Australia and the UK signed the "International Yard and Pound Agreement" which codified avoirdupois weight and length then used in all those nations, a set (although largely supplanted by the metric system (except in the US)) which officially still defines both Imperial and US customary units.  The suffix –philia was from the From Ancient Greek φιλία (philía) (fraternal love), from φλέω (philéō) (to love), from the earlier Ionic Greek (where the meanings diverged somewhat over the years.  It was used to to form nouns meaning a fondness, liking or love of something and in pathology picked up the specific technical sense of abnormal liking or tendency such a paraphilia.  One with specific attraction to feet or footwear is a podophile and their predilections are described as podophilic.

Lindsay Lohan and her lawyer in court, Los Angeles, December 2011.

The English phrase “length of the chancellor's foot” is neither an allusion to lineal measurement nor an early example of political podophilia.  It is a critique of law and most associated with a passage by the English jurist and scholar John Selden (1584–1654) which appeared in his Table Talk (published posthumously in London in 1689), discussing the flexible, adaptable law of equity and how its administration differed from the rigid, precedent-bound courts of common law: “Equity is a roguish thing: for law we have a measure… equity is according to the conscience of him that is Chancellor, and as that is larger or narrower, so is equity. ’Tis all one as if they should make the standard for the measure we call a 'foot' a Chancellor’s foot; what an uncertain measure would this be! One Chancellor has a long foot, another a short foot, a third an indifferent foot.

In other words, in the Court of Chancellery, equity was administered by the Lord Chancellor at his discretion, the attraction being when the application of common law precedents were seen to create an obvious injustice, equity could intervene to provide a just result: justice based on fairness rather than strict legal rules.  However, implicit in that flexibility was the estimation of equity could vary from one Chancellor to next and thus the Court of Chancellery soon created its own contradictions, attracting critics who noted an outcome depended on the personal judgment of the Lord Chancellor who reached his decision on a “case-by-case” basis.

The Lord Chancellor with feet in flippers: Lord Hailsham of St Marylebone (Quintin Hogg, 1907-2001; Lord Chancellor 1970-1974 & 1979-1987).  Hailsham was a Tory (Conservative) but the photograph was taken by the Labour Party politician Lord Healey (Dennis Healey, 1917–2015).

The rationale was both clear and commendable but lawyers trained in the courts of common law liked the certainty and predictability of adherence to precedence; their fees were dependent on them winning their clients’ cases, not seeking an abstraction like “justice”.  Thus the phrase became legal shorthand for judicial arbitrariness in which outcomes depended on personal discretion rather than objective standards.  The equity lawyers were of course sensitive to the criticism and what evolved in the Court of Chancellery was its own set of “rules” although these came to be called “equitable maxims” and were principles & concepts which can be thought of as a kind of “proto-fuzzy law” in that they existed to ensure justice and fairness would be delivered but in a consistent manner.  The phrase however survives as a critique of subjective decision-making by authorities or inconsistencies in governance or law.

Often focused on toe cleavage, many self-described foot fetishists provide curated content.

Although the psychiatric community has since the mid-twentieth century devoted some time to discussing, re-defining and pondering what is apparently the 1800-odd year history of foot fetishism, a glance at the literature does suggest it’s been thought usually an interesting quirk in the human condition rather than a condition, much less a mental disorder.  Before the American Psychiatric Association (APA) in 1987 published the revised third edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-III-R), fetishism was usually described as a persistent preferential sexual arousal in association with non-living objects or an over-inclusive focus on (typically non-sexualized) body parts (most famously feet) and body secretions.  With the DSM-III-R, the concept of partialism (an exclusive focus on part of the body) was separated from the historic category of fetishism and appended to the “Paraphilia Not Otherwise Specified” category.  Although one of the dustier corners of psychiatry, the field had always fascinated some and in the years since the DSM-III-R was published, a literature did emerge, most critics maintaining partialism and fetishism are related, can be co-associated, and are non-exclusive domains of sexual behavior.  There was a technical basis for this position because introduced in DSM-IV (1994) was a (since further elaborated) codification of the secondary clinical significance criterion for designating a psychiatric disorder, one the implications of which was that it appeared to suggest a diagnostic distinction between partialism and fetishism was no longer clinically meaningful or necessary.  The recommendation was that the prime diagnostic criterion for fetishism be modified to reflect the reintegration of partialism and that a fetishistic focus on non-sexual body parts be a specifier of Fetishism.

Lohanic footage: Lindsay Lohan’s feet, the right plantar flexing (left), the left dorsiflexing (right).  Wikifeet's expert critics rate Ms Lohan's feet at 4½ stars (beautiful feet); her page has 3653 images.

Fetish was from the Latin facere (to make) which begat factitious (made by art), from which the Portuguese feitico was derived (fetiche in the French), from which English gained fetish.  A fetish in this context was defined as "a thing irrationally revered; an object in which power or force was concentrated".  In English, use of fetish to indicate an object of desire in the sense of “someone who is aroused due to a body part, or an object belonging to a person who is the object of desire” dates from 1897 (although the condition is mentioned in thirteenth century medical documents), an era during which the language of modern psychiatry was being assembled.  However, the earliest known literary evidence of podophilia lies in dozens of brooding, obsessive love letters from the second century AD of uncertain authorship and addressed to both male and female youths.  That there are those to whom an object or body part has the power to captivate and enthral has presumably been part of the human condition from the start.

Suspected podophiles, parked outside shoe shop.

From the beginnings of modern psychiatry, such a focus was not in itself considered a disorder, unless accompanied by distress or impairment although it was noted by many that if even a nominally “harmless” fetish became an obsession, it certainly could impair healthy sexuality.  In DSM-5 (2013), the diagnosis was assigned to individuals who experience sexual arousal from objects or a specific part of the body which is not typically regarded as erotic and presumably any body part or object can be a fetish, the most frequently mentioned including underwear, shoes, stockings, gloves, hair and latex.   Fetishists may use the desired article for sexual gratification in the absence of a partner although it’s recorded this may involve nothing more than touching smelling the item and the condition appears to manifest almost exclusively in men, the literature suggesting a quarter of fetishistic men are homosexual but caution needs always to be attached to these numbers.  Because fetishism is something which many happily enjoy their whole adult lives, it never comes to the attention of doctors and a high proportion of the statistical material about fetishism is from patients self-reporting.  The statistics in a sense reflect thus not the whole cohort of the population with the condition but rather those who either want to talk about it or are responding to surveys.  That is of course true of other mental illnesses but is exaggerated with fetishism because so much lies with the spectrum of normal human behavior and the definitional limitations in the DSM-5 reflect this, including three criteria for Fetishistic Disorder and three specifiers:

Criterion 1: Over a six month period, the individual has experienced sexual urges focused on a non-genital body part, or inanimate object, or other stimulus, and has acted out urges, fantasies, or behaviors.

Criterion 2: The fantasies, urges, or behaviors cause distress, or impairment in functioning.

Criterion 3: The fetishized object is not an article of clothing employed in cross dressing, or a sexual stimulation device, such as a vibrator.

Specifiers for the diagnosis include the type of stimulus which is the focus of attention (1) the non-genital or erogenous areas of the body (famously feet) and this condition is known also as Partialism (a preoccupation with a part of the body rather than the whole person), (2) Non-living object(s) (such as shoes), (3) specific activities (such as smoking during sex).

Not AOC’s feet.

The foot particularists also do PSAs (public service announcements).  When an image of feet was posted to Instagram with a caption claiming they belonged to Alexandria Ocasio-Cortez (AOC, b 1989, US Representative (Democrat-New York) since 2019 and one of "the squad"), the alleged foot-selfie was lent a whiff of scandal by their owner being in the bath, holding a vape with a bottle of pumpkin-scented shampoo nearby.  Quickly the story was debunked by the online foot fetishists at WikiFeet, the internet’s most comprehensive collection of pictures of women's feet.  In this case, Ms Alexandria Ocasio-Cortez’s Wikifeet page was used to C&C (compare and contrast) against the images in their library and it wasn’t a difficult task for the Wikifeet experts because the toes in the image were mildly brachydactyly (an inherited trait whereby the bones of the digits are relatively short) whereas AOC’s are not so afflicted.  Wikifeet’s users rate AOC’s feet at “3.92 stars” (nice feet), based on the 83 images in her page (many in sandals but some daringly bare).  Further research by the Wikifeet particularists revealed the feet surfacing provocatively from the pink bath-water really belonged to Sydney Leathers (b 1991) who became even better known by parlaying the publicity she attracted for being the sexting partner of disgraced New York politician Anthony Weiner (b 1964) into an apparently brief career as an aspiring porn star.  Why that didn’t flourish isn’t clear because rarely has there been a better porn star name than "Sydney Leathers" and Australian fellmongers and fetishists alike missed a marketing opportunity there.

Gianvito Rossi 85 suede pumps, US$1,210 at net-a-porter.

Noting the definitional model in the DSM-IV-TR (2000), despite the history in psychiatry’s world of paraphilias and a notable presence in popular culture, there were those who claimed the very notion of a foot fetish was false because of that critical phrase “non-living” which would seem to disqualify a foot (unless of course it was no longer alive but such an interest would be seriously weird and a different condition; although in this context there are deconstructionists who would make a distinction between a depiction of a live foot and the foot itself, clinicians probably regard them as interchangeable tools of the fetishist although the techniques of consumption would vary).  The critic noted many fetishes are extensions of the human body, such as articles of clothing or footwear but that did not extend to feet and that diagnostically, a sexual fascination with feet did correctly belong in the category of “Paraphilia Not Otherwise Specified,” and thus be regarded as partialism: Foot partialism.

Design by Davina-India.  Although the extreme examples won’t be possible to render as practical products without (unanticipated) advances in materials, 3D printing offers possibilities for the shoe-oriented faction of the foot partialists.

It was Sigmund Freud (1856-1939) who admitted that, lawfulness aside, as animals, the only truly aberrant sexual behavior in humans could be said to be its absence (something which the modern asexual movement re-defines rather than disproves).  It seemed to be in that spirit the DSM-5 was revised to treat podophila and many other “harmless” behaviors as “normal” and thus within the purview of the manual only to the extent of being described, clinical intervention no longer required.  Whether all psychiatrists agree with the new permissiveness isn’t known but early reports suggest there’s nothing in the DSM-5-TR (2022) to suggest podophiles will soon again be labeled as deviants.

Most Beautiful Ankle competition, Hounslow, England, 1936. What such competitions did was “level the playing field” to ensure a woman was judged only on the body-part being assessed, the rest of her concealed behind a screen so a judge wouldn't be influenced by extraneous aspects”.

The matter of podophilia is not exactly a neglected field but beyond the particularists it’s a niche topic for study, probably because despite being often curated as collections of images of objectified, un-clothed body parts, the stuff inherently is SFW (suitable for work) so is not as controversial as some fetishes.  Indeed, even were someone found to be in possession of many images of the feet of minors, unless the circumstances were unusual and disclosed suspicion of other behaviours, it’s likely no offence has been committed.  There have though been some academic studies including Sexualization of the Female Foot as a Response to Sexually Transmitted Epidemics: A Preliminary Study (1998) by A. James Giannini, Andrew E. Slaby, Gale Colapietro, Steven M. Melemis & Rachel K. Bowman.  A review of historic literature, the authors hypothesized a relationship between epidemics of sexually transmitted diseases and foot fetishism, the research prompted by an exponential increase in the behaviour seen in the 1980s, before AIDS had been listed as a pandemic.

Most Beautiful Legs competition, Palisades Amusement Park, New York, 1951.  Note the judge crouching to achieve the perfect angle, presumably a podophile with a well-trained eye.

The paper noted that during the second millennium there have been four major epidemics of STDs (sexually transmitted diseases, then the preferred term for what are now classed as STIs (sexually transmitted infections)): (1) what’s believed to have been an outbreak of gonorrhoea in the thirteenth century, syphilis in (2) the sixteenth and (3) nineteenth and (4) AIDS in the late twentieth and during each “there seemed to emerge a sexual focus on the female foot” which “disappeared with the epidemic's subsidence, usually after 30-60 years.”  What was intriguing was “the focus on feet was unique to each of these epidemic periods” whereas in all other eras studied, “eroticism was attached to breasts, buttocks and thighs.”  It was not suggested feet (bare or otherwise) didn’t appear in Biblical, Egyptian or Classical art and literature but they were not depicted as “sexual foci”.

It was in the thirteenth century things began to change as romantic writings came to include paeans to women's feet and the details were often not metaphorical but anatomical, describing in loving admiration the “aesthetically idealized woman's foot” which was to be “narrow with high arches.  The toes were to be somewhat long with no ‘webbing’ or folds of skin in between.  The great toe was longer than the second toe. The nails were to be elongated with large white moons and pale-pink nail-beds.  The perfect foot was expected to be “white on both plantar and ventral aspects” so clearly, like thighs, buttocks and breasts, women’s feet were expected to conform to what men had decided was “beautiful” and those with body parts outside the “standardized image” could not be beautiful. Plus ça change…

Most Beautiful Ankle competition, Cliftonville open air swimming pool, Margate, England, 1936.

The Church looked askance at this “new” fetish, damning it as a “further form of degeneracy as Europe” and though the paper finds the trend faded to oblivion with the end of what is now believed to have been an epidemic of gonorrhoea, with the outbreak of syphilis in the sixteenth century, there appears again a “near-simultaneous reappearance of the foot fetish” which began in southern Europe before spreading north and the art of the time suggests it was then “toe-cleavage” was first identified as a motif, as a “voyeuristic mark of this time period as decolletage for other generations”.  Interestingly, 300-odd years on, the ideal structure was re-imagined and an “elongated second toe” became suddenly fashionable.  When syphilis re-appeared in the 1800s, so did the focus on women’s feet and because photography was available to the Victorians, there’s a record also of the reaction of polite society with the female foot “removed from photographic tintypes”: While men’s boots commonly remained exposed, women's boots or shoes were either covered with fabric or “mechanically cropped from the plate”.  Ballerinas would perform bare-footed (critics writing of her feet as they “flexed and extended”) ice-cream confections (called the “Trilby”) were sold in the shape of a woman’s foot and the “Cinderella fairy tale was revived with foot fetishistic overtones not now reflected in twentieth century versions”.  

Sometimes, statistical methods are purely lineal: Technicians recording (in metrics) the metrics of a contestant in Miss Italia, Rome, 1949.

“Body part” contests offered scope for those who wouldn’t be “competitive” in mainstream beauty contests.  As a footnote, the perfection (in the sense of digital depiction) of generative AI (artificial intelligence) may see the end of the industry’s “body part model” niche in which those with exceptional hands, feet, eyes etc were contracted for photo-shoots involving just that one part.

In the nineteenth century, some did offer explanations (sometimes fanciful) for the phenomenon and although in the medical literature there were observations of the use of the foot “as a safe-sex alternative”, no systematic studies seem to have been undertaken.  The AIDS pandemic revived the interest and the proliferation of foot-fetish publications in the 1980s (before the internet was a mainstream product) was a marker of the trend and interestingly, the titles of what were usually glossy magazines avoided the words “feet” & “foot”, instead using “neutral” terms such as “Leg Action, Thigh High, Leg Show, Leg-Scene, High-heeled Women, Silk Stockings or Leg Tease”.  Despite that, the content seems overwhelmingly foot-centric and the conclusion was the publishers wished to “avoid embarrassment for the purchaser”.  That was interesting in that publications devoted to other body parts seemed to tend to use unambiguous titles and the paradox was that although feet were SWF, the perception was there was shame attached to the predilection, something not suffered by consumers of the definitely NSFW (not suitable for work) breast-related material.  Editorially, there were photographs mostly including feet and tips & techniques for “foot sex” which could be a pleasurable sexual alternative without risk of sexually transmitted diseases”, the foot described as a safe “erotic alternative to the anus and genitals”.  It was at this point even the mainstream magazines began to advocate “toe sucking” and “foot biting” between couples, not to avoid infections but because for even the most sexually jaded it would be a “genuinely new” experience, novelty in this field much valued.  Diligent washing prior to sucking and biting was recommended.

First heat of Miss Slender Legs Competition, Miami, Florida, 1952.  Many good things happen in Florida; everybody knows that.

The pop band The Monks in 1979 released the single Nice Legs Shame About Her Face so the contest in Miami was really an early example of DEI (diversity, equity and inclusion).  It's a bit of a stretch but as a Lord Chancellor might have put it, "beauty contests" are a thing of the common law while the "most beautiful body part" competitions belong to equity. 

The AIDS pandemic of course remains afoot although advances in treatment have made it manageable for most, at least in developed economies though there are concerns how cuts to foreign aid will affect outcomes in poorer regions, especially sub-Saharan Africa and the Pacific islands.  Despite the the condition fading from public consciousness, foot particularism appears still to be flourishing, the absence of foot-focused print titles an indication of the general industry shift to digital content rather than any decline in interest and the count of related internet pages is said to be in the millions.  To explain the phenomenon which has for centuries re-occurred, the neurology community has also become involved.  In Phantoms in the Brain: Probing the Mysteries of the Human Mind (1998), neurologist V.S. Ramachandran (b 1991) and science journalist Sandra Blakeslee (b 1943) offered the theory of a link with brain areas for the feet and the genitals being physically close, their speculation being there may be some “neural crosstalk between the two”, the idea a concern about STIs induces the brain to be stimulated to think about feet, purely because of the effect of directly adjacent electrical activity.