of the bones (Fig. 11) is an abnormal growth which requires the saw, knife, and gouge of the surgeon for its extirpation. The toes are especially liable to this disease.
Fig. 12 is a specimen of splay or flat foot. It is caused by a breaking down of the arch of the foot, whereby locomotion becomes painful and sometimes impossible. Impairment of the general health accompanies it; in its worst forms a partial displacement of the bones occurs, the toes turn up, and the sole grows convex, while the ankle is very likely to thicken and lose strength by fatty degeneration. It is most common among youth. Some writers attribute it to "vicious eversions of the foot in attempts at polite walking"; by others it is attributed to overwork. It is most common among the children of the wealthy classes. Old people are subject to it from a breaking down of the tissues with age. For its cure local means must be used, and special attention be given to the general health.
A disease called elephantiasis, sometimes necessitating amputation of the whole limb, may result from injuries to the foot. A case of this sort is found in the books, where a dislocation of the foot, caused by drawing off a boot, induced the disease.
It is now time to consider defects in shoes, by which most of these diseases may be provoked or aggravated.
Dowie, who was a practical as well as theoretical shoemaker, and so full of enthusiasm that he studied the foot under skillful anatomists, and sent all his journeymen to a course of lectures on the feet, enumerates as the principal evils, that shoes are worn too short; that they are cut too narrow at the toes and in the sole; that the soles do not conform to the shape of the inner curve of the foot, nor to the line of the great arch or instep and the great-toe; that at the waist, or middle, the sole is too stiff and unyielding; that the toe is vertically too