98 OF THE DISEASES 



must avail ourselves of this alteration of structure 

 as a means of giving relief. 



The sole is very thin and susceptible of injury 

 on that portion which is pressed upon by the coffin 

 bone ; but anteriorly we find a considerable thick- 

 ness of tough fibrinous deposition in the space 

 which is left next the crust by the descent of the 

 toe of the coffin bone ; and again, posteriorly we 

 find an increased thickness of sole under the heel 

 of the coffin bone, which is drawn up by the descent 

 of its anterior portion. 



We must avail ourselves of this unusual thick- 

 ness of the insensitive sole both anteriorly and 

 posteriorly, as a means of relieving the crust, which 

 must be lowered to a level with the sole, and a shoe 

 with a very broad web applied, which will bear 

 evenly alike on the crust and the sole. 



In very severe cases, where the sole is completely 

 convex, or, in technical language, is " pumiced," 

 the crust will not need to be lowered. In such 

 cases, in order to accommodate the altered struc- 

 ture of the parts, the shoe must be made concave 

 towards the sole instead of flat, as has been recom- 

 mended above. 



With the view of stimulating the growth of the 

 crust, it is advisable that the coronary band should 

 be moderately blistered every nine days. 



In all cases it is essential that the shoe should 

 be continued well round to the heels. The crust 



