eral side are contracted.

In women, the chief complaint may be of the disfigurement of the boot;
in others, of pain and disability resulting from the sensitiveness of
the joint and of the enlarged bursa over the head of the first
metatarsal. The inflamed bursa, which sometimes communicates with the
joint, may suppurate, and the infection may spread to the joint.

The _treatment_ varies with the severity of the deformity. In mild
cases, a great deal can be done by wearing properly made boots and
stockings with a separate compartment for the great toe, or a pad of
cotton wool or tent of rubber between the great and second toes. The
patient should practise manipulations and exercises of the toes and
feet, and putting the foot to the ground properly in walking. In
pronounced cases, the pain and tenderness must first be got rid of by
rest and soothing applications. At night, the attitude of the toe may
be corrected by a moulded splint fixed to the medial aspect of the
foot by strips of plaster; the toe is then bandaged to the distal end
of the splint. Scholl has devised a prop, made of rubber, to be worn
between the great and second toes. If there is flat-foot, this must
receive appropriate treatment.

In aggravated cases, the deformity can only be corrected by an
operation which consists in resecting the head of the metatarsal bone,
and the tendon of the long extensor may be detached from its
insertion and secured to the medial side of the first phalanx. A bar
may be placed across the sole just behind the balls of the toes, and
the boot should also comply with the anatomical shape of the foot.

#Hallux Varus or Pigeon-toe# (Fig. 158).--In this deformity, which is
extremely rare, the great toe deviates from the middle line of the
foot; it occurs chiefly in children in conjunction with other
deformities, and interferes with the wearing of boots. Treatment
consists in straightening the toe and retaining it in position by a
splint or plaster of Paris. The medial collateral ligament and the
tendon of the abductor hallucis may require to be divided.

[Illustration: FIG. 158.--Radiogram of Hallux Varus or Pigeon-toe.]

#Hallux Rigidus and Hallux Flexus# (Fig. 159).--These terms indicate
two stages of an affection of the metatarso-phalangeal joint of the
great toe, first described by Davies Colley. In the earlier
stage--_hallux rigidus_--the toe is stiff and incapable of being
dorsiflexed, although plantar-flexion is, as a r