eet in front at
a right angle; (3) in the same attitude, after rising on to the balls
of the toes, the knees are flexed and then extended before the heels
descend again; (4) while seated in a chair, one leg crossed over the
other, circumduction movements of the foot are carried out; (5) while
standing, the medial border of the foot is raised off the ground
several times, then the patient walks to and fro on the lateral border
of the foot, and in the same attitude lifts one foot over the other.
These exercises should be carried out slowly and deliberately, with
the feet bare, and they should be carefully supervised until the
patient thoroughly understands what is aimed at. The movements should
be performed a definite number of times at regular intervals, but
should not be pushed so as to cause pain or fatigue. The patient
should be fitted with well-made lacing boots, with the heel and sole
raised about half an inch on the medial side so that the foot rests
mainly on its lateral border. The additional leather, which can be
applied by any bootmaker, is in the form of a wedge, with its base to
the medial side, one on the sole and one on the heel. The wedge fades
away towards the lateral border, and also forwards towards the tip. In
time, the limbs are further strengthened by sea-bathing, cycling,
skipping, and other exercises.

In _cases of the second degree_, the patient should be provided with a
metal plate inside the boot. That known as Whitman's spring is the
most popular. A plaster cast is taken of the sole while the foot is
held in its proper position, and on this a metal plate, preferably of
aluminium bronze, is modelled. This is covered with leather and
inserted into the boot. We have found the supports devised by Scholl
simple and efficient. The treatment described for cases of the first
degree is carried out in addition.

In _cases of the third degree_, the deformity is corrected under an
anaesthetic. The foot is forcibly moved in all directions so as to
stretch the shortened ligaments and to break down adhesions, it is
then rotated into an extreme varus position, and fixed in
plaster-of-Paris or to a Dupuytren's splint. It may be necessary to
have recourse to the Thomas' wrench, employed in the correction of
club-foot. When the reaction consequent upon this procedure has
subsided, the question of shortening or of reinforcing the tendons
concerned in the support of the arch of the foot may be considered;
one of