What parent who loves babies has not gazed with rapt admiration and with the tenderest feelings at the lovely little feet of his infant! Babies, with the fewest exceptions, are born with normal feet, feet that are as perfect in their design and structure as any artist could wish, having in them all the potentialities for their future correct functioning. What wonderful and beautiful little struct­ures they are ! Soon—all too soon—they have to submit to the requirements of the modern age by becoming encased in shoes that neither conform to the natural shape of the feet, nor to the stress they have to bear, which, according to calculations made is no less than 250 tons, in the adult, to the walking mile.

The word "Bunion" is derived from the Greek and means "turnip." It is an inflammation and swelling of a small mem­branous sac which secretes lubricating fluid at the metatarso-phalangeal articulation of the great toe. A distortion of this joint is usually associated with a bunion, which is accompanied by various degrees of pain, ranging from an acute type to a dull ache, depending upon the stage of the inflammation. It is really a form of bursitis and when it becomes infected it is then called purulent bursitis. There is thickening of the overlying skin covering this prominent joint.

The abuse meted out to the feet paves the way to these un­sightly distortions, which are eventually brought about by the wearing of short shoes, narrow, pointed shoes, high heels and socks or stockings that are too short.

How many adults to-day can abduct, i.e. separate voluntarily the big toe from the second toe? Baby can, so can primitive people. How can one possibly feel happy with unhappy feet? Feet that should carry one through life without themselves suffering?

Although much has been said in the past about the evils that can arise from the wearing of high-heeled shoes, it must certainly be mentioned here in some detail that together with shoes with pointed toes—that other "civilised" abomination—they are the greatest cause of that ugly and often exceedingly painful distor­tion of the great toe commonly called a bunion. This distortion is, in point of fact, nothing more or less than a Dislocation of the great toe joint and is technically known as Hallux Valgus.

Let us now see what happens to the bodily posture of the wearer of high heels and pointed toes and the great strain that the organism has to contend with quite unnecessarily.

Were it not for the pull of the powerful back muscles the balance of the body could not possibly be preserved; but this 'pull' must make the wearer of high heels bend~ somewhat at the knees, cause the small of the back to take on an undue forward curve, and this exaggerated curve in turn causes the unsightly protrusion of the abdomen followed, in the course of time, by prolapse of the abdominal organs with its unpleasant sequelae. To compen­sate for this excessive lumbar curve the upper back takes on a rounded curve over and above the normal in this region, which results in drooping shoulders. To compensate for this again, the neck is thrust forward giving one the impression that the neck is trying to run away from the body. How these bodily changes can upset the economy of the organism can be left to the imagination.

At each step in walking the foot of the high heeled individual is jerked forward in the shoe with some force—especially in the court variety—is squeezed into the narrow part of the shoe, and, meeting with resistance, the repeated blows upon the end of the big toe cause the great toe-joint to buckle between the head of the great or first metatarsal bone and the base of the big toe. This is complicated by the malalignment and functional disorder of the whole foot.

A bunion can develop on the little toe. It is then known as a "bunionette" or "Tailor's Bunion," as it was at one time very prevalent in tailors due to their squatting upon their work-table with crossed legs, thus putting excessive weight or pressure upon the outer border or the little toes, which were constantly being rubbed on the table.

Usually a bunion is associated with Hallux Valgus, which is an outward bending of the great toe. What can osteopathy do here? Well, nothing so far as affecting a permanent reduction of the dislocation of the great toe joint is concerned. Nothing short of surgical interference can alter this condition. This is successful in some cases; but only in very severe cases where great pain and crippling are present do I advise patients to chance the operation. Some are gratified at the result, whilst others are not quite so.

In sufferers from bunions with hallux valgus it is found that other bones of the foot are also involved and these CAN be osteopathically dealt with and with success, so that as a result of the required adjustments the great toe joint itself is relieved of its former strain, always providing that suitable foot wear has been adopted by the sufferer.

With the greatly improved circulation of the blood, with the rehabilitation of the foot as a whole brought about by osteopathic treatment, with the release of muscle tension and joint strain, the inflammation of the bunion soon subsides, and with the mobility that is restored to the joint the patient is freed from the discom­fort, which can, indeed, be most acute. But although there may be greater mobility in the joint and the inflammation gone together with the reduction in the swelling, please note that the deformity as such still remains, and remain it will until surgically treated.

A helpful tip for home treatment of inflammation of a bunion is to soak a wad of cotton wool or a handkerchief folded into a pad in cold water in which three tablespoonfuls of Epsom Salts have been dissolved: i.e. to the pint of water. Squeeze or wring out and apply to the affected part. Cover with a thick piece of woollen material and keep this compress on all night. In the morning throw away the wad of cotton wool or wash the hand­kerchief-pad and apply the compress in the same way on the following and subsequent nights for a while.

The following, specially designed exercises for the feet may prove helpful.

1. Walk up and down a room on the outer edges of the feet, the soles and heels not touching the floor. To do this at the commencement it will perhaps be necessary to walk with bowed legs. This exercise should be done several times a day, without shoes or stockings, of course.

2. Raise the heels, the feet tiptoeing straight ahead: repeat this up-and-down movement for a few minutes several times a day. Endeavour when performing this exercise to rise on to the toes and lower to the outer edge of the feet, not allowing the inner side to touch the floor.

3. Sit on a chair with the feet raised from the floor. Bring feet upwards towards the knees and at the same time curl the toes towards the soles of the feet. Repeat this until tired: rest, then repeat as many times as possible during the day.

4. Same position as for number 3, but stretch the foot down­ wards, at the same time curling the toes upwards. Repeat as for number 3.

5. Feet raised from the floor, rotate the whole foot from the ankle inwards and alternately outwards until fatigue warns you to stop. Repeat as opportunity occurs.

6. Slow walking in a room, carefully observing that the feet are placed straight in front, Toe and Heel movement as in ballet walking i.e. the Toe is placed down first with the heel raised. Do not allow the inner side of the feet to touch the floor. If each foot can be placed directly in line with the other, as in the walk of the North American Indian, so much the better.

7. Stand with the feet parallel, i.e. close together, raise the toes from the ground keeping on the outer edge of the heel and part of the foot: repeat until tired.

N.B. After performing the above exercises bathe the feet in hot water with a handful of Epsom Salts added: then bathe in cold water for a minute. Dry thoroughly.

8. If the toes be flexed and extended to their fullest extent under water when lying in a full bath, this exercise of "wriggling" the toes will not only be more easily performed, but will also be more effective. Extension and flexion of the whole foot in order to mobilise and strengthen the ankle joint will be facilitated under water, and so will the exercise of the fingers and wrists.

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