1GG THE TREATMENT OF DISEASES. 



look of the thing." The shape of modern boots is purely conventional, and is not at 

 till adapted to the natural form of the foot. Boots to fit properly we mean really 

 properly must have square toes, and should not be made to taper off to a point. 

 There is no reason why a comfortable boot should be ugly, and some of the prettiest 

 boots we have seen have been constructed with a due regard to the natural shape of 

 the foot. 



In addition to the direct effect produced by the pressure of misshapen boots, the 

 material of which they are made often exercises a predisposing influence on the 

 formation of bunions. Patent leather, or any material like it which prevents the 

 evaporation of the perspiration, must exert an injurious effect. 



There undoubtedly exists in many persons an hereditary tendency to the forma- 

 tion of bunions, which nothing but the greatest attention to the shape and construc- 

 tion of their boots will overcome. Though generally situated over the first joint of 

 the great toe, bunions are not unfrequently developed over bony prominences, in 

 other parts where the natural conformation of the foot fails to correspond with the 

 artificial and arbitrary shape of the shoe. 



In its early formation a bunion generally attracts attention as a painful and 

 tender spot, on some point exposed to pressure and irritation by distortion of the 

 toes. By-and-by the part enlarges in consequence of an effusion of fluid, the design 

 of which, is obviously to protect the part from undue pressure. The irritation con- 

 tinuing, inflammation is set up, causing progressive enlargement, with possibly the 

 formation of matter. Sometimes this matter is discharged, leaving a nasty ulcer 

 which is very difficult to heal. 



It is only in the early stage of a bunion that treatment is likely to effect a com- 

 plete cure, though palliative measures are practicable at all times. The tender spot 

 preceding the formation of a bunion should be covered at night with wet lint and 

 oiled silk, whilst care should be taken to see that the boots are wide in the sole and 

 not sloped off on the inner side towards the middle line of the foot. Should the 

 part be very tender, it may be covered with soap plaster spread 011 kid or wash- 

 leather. When the formation of fluid has already occurred, steps should be taken, in 

 addition to the above precaution, to procure its absorption by painting the part with 

 tincture of iodine. As soon as one coat has cleared off, another should be applied. 

 Sometimes it is advantageous to use the iodine liniment, which is stronger than the 

 tincture, but it will have to be applied less frequently, and with greater caution. If 

 there be inflammation of the part, a hot foot-bath, followed by linseed-meal poultices 

 or water-dressing, will prove of service. Benefit is sometimes experienced from an 

 arnica lotion made by mixing two drachms of tincture of arnica with eight ounces of 

 water. It should be applied on lint, covered with oiled silk, and its use should be 

 continued for three or four days. Tincture of Veratrum Viride, painted on inflamed 

 bunions, often gives speedy and lasting relief. 



It is the custom with many people who suffer from bunions to wear boots made 

 to fit accurately their distorted feet. The wearing of a shoe so constructed as to aid 

 in the restoration of the toes to the natural position is recommended; except in cases 

 of very extreme distortion of the joints, the sole should be cut exactly as if the toes 

 were in their natural position. 



