34^ The Fttiigus Disease of hidia. [part ti. 



below the line of the bones. The thickening had occurred both below and above the 

 plantar fascia, foci of degeneration being present in both situations, although more 

 abundantly below than above the fascia. 



These foci consisted of cavities lined by smooth membrane and containing 

 gelatinous and caseous matter, or distinct roe-like masses of minute rounded particles. 

 These roe-like aggregations were quite free in the cavities, and were surrounded with 

 more or less mucoid or gelatinoid semi-fluid material. In some instances the cavities 

 appeared to ha\?e penetrated the plantar fascia, or rather, perhaps, to have passed 

 between the several strips of its tissue. They presented a curiously symmetrical 

 arrangement in some places, especially immediately beneath the skin, where the 

 normal series of fat masses was in great part replaced by a row of cavities containing 

 roe-like masses. These cavities in many cases coincided in size and form with the 

 loculi usually occupied by fat — their lining membrane, although somewhat thicker, 

 being composed of the same anatomical elements as those normally separating and 

 limiting the masses of fat, and only differing from the normal partitions in being 

 denser and containing a somewhat larger proportion of common connective tissue in 

 relation to the elastic fibres. In some cases the cavities were perfectly isolated, 

 occurring among healthy fat-masses, in others they were close to one another, only 

 separated by their limiting membranes ; in others they communicated directly or 

 indirectly with one another, and in some cases two or more appeared to have 

 coalesced entirely, so as to form one large, frequently somewhat irregular, cavity. 

 In almost all instances the openings on the surface of the foot were found to lead 

 by means of channels into such cavities, whilst another series of channels connected 

 cavities or sets of cavities with one another. Similar cavities containing degenerate 

 miaterial were also present in the subcutaneous fat of the dorsal aspect of the foot. 



The bones, although softened and oily in texture, were in great part distinctly 

 traceable, especially towards the inner half of the foot, but even here the base of 

 the second metatarsal bone was disorganised and completely obscured by the degenera- 

 tion. The muscular and tendinous structures were little, if at all, affected, and 

 appeared to have contributed to the deformity of the foot by their action on the 

 soft and weakened bones, although the greater part of the extreme flattening of 

 foot was, no doubt, due to the extent of the disease in the fat, and connective 

 tissue. 



The membranous lining of the cavities and the various materials contained in 

 the latter were carefully examined microscopically. The caseous matter and roe-like 

 masses were found to consist of oily matter in various conditions. The caseous 

 matter was formed of yellowish amorphous material mingled with oil globules ; it 

 was readily acted on by liquor potassse, and when treated with this reagent 

 frequently gave rise to an abundance of tubes, filaments, and globules of myeline. 

 The particles forming the roe-like masses were composed of a large central mass 

 or nucleus of similar caseous matter densely clothed with radiating crystals. These, 



