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 greatly with the use of the foot, but too often requires for its relief medical and even operative interference.

Not less important are the evils arising at the root of the great toe from the same cause. It has already been stated that the pressure of the upper leather pushes the point of the great toe against the smaller toes. The joint at the metatarsal bone thus becomes bent aside (Fig. 11), so that it forms a protuberance on the inner side of the foot. If the point of the toe is now pressed against the ground in walking, this protuberance must be made still greater, and so pressed more forcibly against the upper leather. At the same time, moreover, the great transverse wrinkle in the upper leather—the result of the bending of the toes—presses directly on the same point; and the protuberance at the root of the toe is thus constantly subjected to a twofold and very injurious pressure. In these circumstances it is by no means wonderful that this joint becomes subject to continual inflammation, which, by extending to the bones, must, in this situation, produce permanent and painful swellings, which become in their turn, and even from slight causes, the source of inflammations and new growths of bone.

In this manner arise those unseemly and painful swellings at the root of the great toe, which, either from mistaking their true nature or from wilful deception, are called chilblains or gout, just as the one or the other term appears the more interesting. In many cases, moreover,