Finding the right fit for your shoes is not that difficult. All you need to do is take a short walk through the store in the new pair. Squeezing the front end of the shoe, or sliding the index finger behind the heel is another common practice. But back in the 1920s through the 50s, many shoe stores across America and Europe had live x-ray viewing machines, like those in airports for checking luggage, only smaller. These machines clearly showed the bones and flesh of the feet as well as the outline of the shoes, eliminating all the guesswork and allowing customers to choose better fitting shoes. They were also a nice sales gimmick.
Front and side view of a Shoe Fitting Fluoroscope.
The shoe-fitting fluoroscope consisted of an upward-facing x-ray tube mounted inside the bottom of a metal box and a fluorescent screen at the top with three viewing ports. An opening on the side of the box allowed the customer to place his or her foot between the tube and the fluoroscopic screen. The x-rays penetrated the shoe and foot and then struck the fluorescent screen, lighting it up with the image of the customer’s foot. This image could be viewed by the customer, the salesman and another person through the three viewing ports at the same time.
The machine was usually shielded, but sometimes those necessary shields were removed in order to improve the image quality or make the machine lighter. A substantial amount of radiation was thus scattered in all directions bathing the entire bodies of the customer as well as the salesman in radiation. A typical viewing lasting about 20 seconds delivered half the amount of radiation a CT-scan of the chest did. Because many of the machines were poorly maintained, some of them delivered potentially hazardous doses. Particularly bad ones were found to deliver three hundred times the permissible limit. Even those seating in the waiting rooms were irradiated with radiation. This was exacerbated by the fact that a customer rarely tried a single pair of shoes, and these customers often kept coming back over and over again.
The most at risk were the salesmen, who caught stray radiations throughout the day, every day they went to work. In a 1957 issue of The British Medical Journal, H. Kopp of Copenhagen’s Finsen Institute describes the case of a 56-year-old woman with severe pain and skin damage on her right leg and foot, consistent with radiation burn. On inquiring, the doctors learned that the woman had been working in a shoe shop for ten years. She operated the shoe-fitting fluoroscope 15 to 20 times a day, sometimes even demonstrating to scared kids by putting her own foot into the apparatus to show that “it did not hurt”.
The shoe-fitting fluoroscope was originally built by Dr. Jacob Lowe that enabled him to x-ray the feet of wounded soldiers during World War I without removing their boots. The device helped speed up the process and Dr. Lowe was able to go through a large number of patients in a short time. After the war, he modified the device for shoe-fitting and showed it for the first time at a shoe retailer’s convention in Boston in 1920. Seven years later he was granted a US patent for the device. “With this apparatus”, Dr. Lowe claimed, “a shoe merchant can positively assure his customers that they never need wear ill-fitting boots and shoes; that parents can visually assure themselves as to whether they are buying shoes for their boys and girls which will not injure and deform the sensitive bone joints.”
At around the same time, a similar machine was patented in Britain; this was called the Pedoscope. Within a few years, the shoe-fitting fluoroscope and the Pedoscope became prominent features of high-class shoe stores across the UK and North America. At their peak in the 1950s, there were three thousand machines in Britain and ten thousand in the United States, and another thousand in Canada.
An X-ray fluoroscope, manufactured by Watson Victor Ltd., Australia & New Zealand, 1950. Photo credit:MAAS
It was no secret that x-rays were harmful. In 1927, Hermann Joseph Muller published a paper establishing the connection between the incidence of bone cancer in radium dial painters and chronic exposure to radiation. However, there was not enough data to quantify the level of risk. It wasn’t until after the bombing of Hiroshima and Nagasaki, that scientists began to understand the long-term effects of radiation. In 1946, for the first time, the American Standards Association issued guidelines for the manufacture of shoe-fitting fluoroscope putting a limit to the amount of radiation the devices can emit. Also for the first time, shoe stores were required to place warning signs on the machines urging customers not to have more than twelve examination in a year. But when a study conducted two years later in Detroit found the majority of machines emitting hazardous doses of radiation, it sparked a country-wide concern. Subsequent surveys across forty states of the United States found 75 percent of the machines to be unsafe.
The first warnings were issued in 1950, and machines were began to be pulled from the stores. But it would take another three decades before the last of these machines were put out of service.
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