(Conditions Affecting the Ball of the Foot As a consequence of the anterior arch's falling or flattening their arc two very important conditions which attract our attention. They are namely, callous formations on the sole of the foot over the heads of the metatarsal bones (ball of the foot), accompanied either with or without pain and meta tag-salvia (pain in the fourth metatarsal joint). These conditions although not as prevalent as flat-foot still are of such a disabling character that their description should be given. 1. Callous Formations on the Ball of the Fool over the Metatarsal Heads with or without Pain—When the distal ends of the metatarsal bones which form the anterior arch fall, they press downward upon the underlying muscles, tend( ins, fat, and skin. Nature, to protect the skin and to form a supporting pad, causes callous to be formed which may cause exquisite pain upon pressure similar to the familiar acute pain of the "stone bruise." The callous is formed most frequently over the head of the second metatarsal bone. In severe claw-feet, where the toes are contracted to present high prominences on their upper surface, callosities may be present over the heads of all the metatarsal bones and give rise to great pain and disability.

2. Metatarsalgia (Morton's Disease).—In this condition, there is a severe neuralgic pain, sharp or burning in character, often of paroxysmal occurrence beginning on either side of the distal (far) end of the fourth metatarsal bone and passing up the foot and often up to the leg. The cause is badly fitting shoes which cause the arch to fall; the metatarsal bones to be displaced and pinching of the nerves between the heads of the third and fourth and fifth metatarsal bones. The transverse arch formed by the distal ends of the metatarsal bones is flattened and the foot broadened; there may or may not be flat-foot (See illustration No. 5).

The pain usually comes on when walking is attempted and is often so severe as to cause the patient to immediately remove the shoe and rub the foot.

Treatment. The cause of both conditions being essentially the same, and since they are often associated, their treatment is practically identical. Relief may be had by mechanically supporting the depressed arch. Where the pain is acute, and temporary relief is imperative, resort may be had to adhesive straps applied transversely back of metatarsal heads (ball of foot) over properly shaped gauze or felt pads. Supports as used in civil life are incompatible to the a tivity of military life. The best appliance, in military life is a cleat of leather one-fourth of an inch thick and one inch wide fastened to the sole of the shoe just back of the metatarsal heads. (Ball of foot).