INTRODUCTORY. XLVII 



4. Extensive deep cicatrices, adhering to the bones and impeding the free movenaents 



of the member. 



5. Curvatures, inequahties, or shortenings of the long bones, interfering with the free 



use of the members. 



6. Paralysis of a limb. , 



b. — The upper extremities. 



1. Loss of the index-finger or of the thumb ; loss of other fingers or parts of fingers, 



if the handling of a gun or the guidance of a horse be thereby hindered, or the 

 employment of the man as a sailor, or in any military capacity, be made 

 impossible. 



2. All malformations and maimings of the hand by which its usefulness is materially 



diminished. 



c. — The loiver extremities. 



1. Large anastomosing varicose veins, with varicose tumors. 



2. Chronic incurable ulcers of the foot, or extensive cicatrices, which open easily and 



frequently, and are located in such places as to be liable to compression by 

 the dress. 



3. Inveterate lameness. 



4. Web-footedness. 



5. All malformations and maimings of the foot by which its usefulness is materially 



diminished. 



6. Prominent and extensive deformity, such as excessive cambering of both knees, 



bow-legs, or unnatural curvature of the leg. 



7. Incurable sweating of the feet, so severe that the skin appears as if macerated and 



raw, whether fetid or not. 



8. Completely flat feet, which, however, are to be carefully distinguished from broad 



feet. 



Note. — Flat-footedness is meant to express that condition of the foot in which the 

 dorsal surface is not sufficiently arched, and the sole is not concave at its inner border. 

 In consequence of this condition, all parts of the sole will touch the ground when the 

 man is standing, so that it will be found impossible to insert a finger, from the inner 

 side of the foot, between it and the ground. This deformity can also be recognized 

 by the fact that the inner condyle is very prominent and situated lower than usual, 

 and that below the external condyle a concavity, more or less considerable in propor- 

 tion to the defoi-mity, can be perceived. The man thus afflicted will walk usually 

 with bent knees, as if he were pushing a wheel-barrow ; and the articulation of the 

 foot, although not entirely stiffened, shows plainly a lack of free movement (mainly 

 on stretching the foot) more or less marked, according to the extent of the deformity. 



A broad foot is to be distinguished by the following signs : the dorsal surface is 

 nomially arched and not broader than usual at the articulation, and the plantar surface 

 is concave ; the extension in breadth of the foot begins in the region of the metatarsus, 

 and increases toward the toes, so that in some cases the toes terminate in a nearly 



