The Poot. 393 



part of the foot being everted. This variety is very com- 

 monly acquired, and is due to a yielding of the ligaments 

 and tendons supporting the arches, so that they become 

 lost, as arches, and the bones forming them come in con- 

 tact with the ground, while the anterior part of the foot is 

 more or less abducted and everted, leaving the head of the 

 astragalus partly exposed on the inner side of the foot. 

 In talipes caviis the sole is arched and the plantar fascia 

 tense. This deformity has been considered as due to paraly- 

 sis of the interossei muscles, but Walsham states that he 

 has not found these muscles affected. Hallux valgus means 

 an inclination outwards of the great toe at the metatarso- 

 phalangeal joint, and it frequently happens that pressure 

 of the boot causes an inflammation of the soft structures 

 overlying the joint, i.e., a bunion. Hammer toe is the con- 

 dition in which the second toe (the one usually affected) 

 is hyperextended at the metatarso-phalangeal joint and 

 flexed at the first interphalangeal joint. This condition is 

 quite frequently caused by hallux valgus, and both, when 

 acquired, are due, as a rule, to the wearing of ill-formed 

 boots. Metatarsalgia (Morton's affection) is character- 

 ized by intense pain in the neighborhood of the fourth 

 metatarsal bone, and depends on a flattening of the trans- 

 verse arch which permits the head of the rnetatarsal bone 

 to compress the contiguous nerve. Whitman advises the 

 building up of the anterior transverse arch by means of 

 a steel support, while Gibney draws attention to the need 

 of specially constructed boots in the treatment of this 

 affection. 



Amputation through the foot. The incision for 

 disarticulation of the last phalanx of the great toe is made 

 by entering the knife just over the side of the head of the 

 first phalanx, a little nearer to the dorsal than to the 

 plantar surface, and then cutting along the toe to the 



