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be efficient in relieving all btit the most aggra- vated cases. Occurring less frequently are the corns, bun- ions on the little toe and proxi- mal and distal extremities of the fifth meta- tarsal produced by the narrow toe and the shoe "run over" to the outer side, or excessively canted heel and sole. A rebal- ancing of the shoe is here in- d i c a t e d. A Order Cialis From India rather unusual example illus- t r a t i n g the shoe's action in producing weak- ness, callosities and corns on the outer side of the I'uot seems worth recounting, as it conveys two lessons in exceptions. L'sually the well worn shoe will reveal much regard- ing the foot of the wearer. When the shoe is worn off badly on the outer side of the heel and sole we expect to find a club foot. Case. — C. Order Cialis From India M., twelve years old; seen January 9, 1917 ; female; was the third child in a Order Cialis From India family of four children, all healthy. This child for several years had been accus- tomed to returning soon from play complaining of pain in her feet. She appeared well. With shoes on she walked with toes turned slightly outward and very much on the outer side of the heel and sole of the shoe. A one inch heel had been worn Order Cialis From India away three eighths of an inch on the hese feet, great toe outer side and the sole worn through on the outer side, which apparently indicated a double club foot. Without shoes removed the child walked without pain ; the feet were long, narrow, and flat ; the great toe was very long, bent in val- gus at distal joint, and clubbed; all the toes were clubbed. Circulation was poor ; the skin was clammy ; there was a plantar corn on the distal extremity of the fourth meta- tarsal and callosities on proximal extremity of fifth meta- tarsal; all muscular movements were weak; excursions were about one tlu'rd normal ; passive movements were nor- mal. A diagnosis of very weak, flat, flaccid feet, due to exceedingly short shoes with high heel, was made. Pain was due to the cramped posi- tion in the shoe ; flaccidity was due t o impaired mo- tion ; the feet had to assume the varus position, shortening them, t o accommodate tlie short shoe. When exam- ining a foot many conditions are not recog- nized. Order Cialis From India I am con- vinced of this w h e n looking back to my early study and tlie remarks of as_- sistants today. I remember to this day the mental perturbation ex- perienced when an Order Cialis From India excellent teacher request- etl me to explain what was to be seen in a pair of feet. The re- '[uest implied that there was some thing to see. TO' me those feet were just bad, painful feet. If it is true that we see only that which we are looking for or taught to see it is to be hoped that this paper may assist some in seeing more. A very prevalent condition is the short tendo Achillis, the muse!'- bound foot of Hibbs, due generally Order Cialis From India to constant wearing of high heels. The short tendo Achillis puts a strain upon the mediotarsal joint when walk- ing in low heeled shoes or in bare feet. This shoukl be corrected bv stretching or by Doctor Hibbs's procedure, lengthening the tendon without Order Cialis From India severing. REFERENCES. I ASHI.EV: Xew York Medical Journ.\i, August s, 1916. 2. ROLAND (). MEISENBACK: American Journal of Orthopedic Sur- gery, April, 1016. (To be concluded.) nto valgus po-sition. 438 Wr.mMAN: REVERSIONAKY rslADOlilLE CASAUCILI.