chap, xxiii.] THE ANKLE AND FOOT. 465 



The subcutaneous tissue about the ankle and foot 

 varies greatly both in quantity and character. It is 

 abundant and well provided with loose fat in the 

 immediate neighbourhood of the tendo Achillis. Over 

 the front of the ankle and dorsum of the foot it is 

 very lax and fairly extensive, although possessing 

 but little adipose tissue in its meshes. In the 

 sole the subcutaneous tissue is most developed 

 where most pressure is received. Thus, beneath 

 the heel it is often three-quarters of an inch in 

 thickness, and is more extensively distributed along 

 the outer than along the inner margin of the foot. 

 It is here composed mainly of little lobules of fat 

 bound down and enclosed by numerous fibrous bands 

 that pass vertically from the skin to the deep fascia. 

 Over the centre of the sole it is more scanty, and 

 the union between the integument and the plantar 

 fascia is more direct. It very closely resembles the 

 subcutaneous tissue found in the palm and upon 

 the scalp. Beneath the heel it forms an actual pad or 

 cushion that must much diminish the force of shocks 

 transmitted to the body through the foot. The laxity 

 of the tissue upon the dorsum of the foot permits of 

 great swelling occurring in cases of diffuse inflammation 

 of the part, and in conditions producing oedema. In 

 the commencement of general dropsy the dorsum of 

 the foot is often the first part of the whole body to 

 show the morbid swelling. In the sole, on the other 

 hand, inflammatory affections and effusions of various 

 kinds can produce but little external change, owing to 

 the unyielding character of the parts concerned. 

 Collections of pus upon the dorsum may form readily 

 and extend rapidly, but in the sole of the foot and 

 in the heel the abscess remains small, is unable to 

 spread, and causes intense pain by reason of the dense 

 structure of the tissues involved. 



The integuments of the foot are well supplied 

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