'Forget her previous woes (being cuckolded by a philandering former husband or flattened by a dose of malaria), this was worse ? much worse. And as a cankles sufferer, I should know.' 
Wasn't there a Victorian obsession with a 'nicely turned ankle'? I guess because that was the furthest up anyone was allowed to see so it had an erotic charge. As a Victorian novel-reading child I spent some time staring at my ankles trying to decide if they were nicely turned. (The answer is no, not at all, but it hasn't bothered me from that moment to this.)