412 



right, that not every process seen on the plantar side of a cuboid or 

 of a navicular is to be called a cuboides secundarium. According ta 

 him it must present the two features just mentioned to deserve this 

 title. It seems to me that this is not in accord with Pfitzner's 

 views. He held that no case of complete absence of the cuboides 

 secundarium had been observed. It is clear to me that this view 

 demands that processes from the cuboid or the navicular must be 

 accepted as representing it which very surely would not come up to 

 Schwalbe's requirements. The right cuboid of the individual whose 

 left foot presented the free cuboides secundarium which I have already 

 described, presented a process (vide fig. 2 of previous paper) which 

 can hardly be held as anything but a cuboides secundarium which 

 nevertheless has no articulation with the talus. This alone would 

 seem to be at variance with Schwalbe's theory, but the case I am 

 now to describe is fatal to it. 



The feet are those of a white man aged 65. They are extremely 

 alike; and I may mention that the element was recognized on the 

 X-ray plate. I wrote that it was free on the right and doubtful on 

 the left. There is no other abnormality. The cuboides secundarium 

 is 18 mm long in each foot; the left one measures 13 mm trans- 

 versally, and the right only 11 mm. The plantar surface is convex, 

 but with a sharper elevation in the middle on the right than on the 

 left. Its general appearance in situ is practically the same as that 

 of the two cases already reported. The proximal surface articulates 

 with the calcaneus near the mesial, dorsal angle of the anterior 

 surface, on which a slightly concave facet is clearly marked off. 

 Another articular surface of the cuboides secundarium, continuous 

 with the former, rests against a corresponding one on the plantar, 

 mesial side of the cuboid for about 8 mm from the posterior end. 

 The articular surfaces of this joint are nearly plane. Anteriorly these 

 bones are connected by ligament. The element is connected to the 

 navicular by strong fibrous tissue. It is in no relation whatever with 

 the head of the talus ; for the projection of the border of the anterior 

 articular surface of the calcaneus rests against a corresponding surface 

 on the lateral aspect of the navicular, making a bar in the sole of 

 the foot that effectually separates the talus from the cuboides secun- 

 darium. On the right foot, this bar has a transverse diameter of 

 5 mm. For about 1 cm from the plantar aspect there is a true joint 

 between the calcaneus and the navicular. Towards the dorsum they 

 are connected by fibrous tissue. On the left foot the bar is a trifle 

 narrower and the connection between the bones composing it seems 



