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seat. This modification will be especially useful in the more advanced stages of weakness or deform- ity. The heel of the shoe may be made of rubber, or the outer half of live rubber which when receiv- ing the weight will cant the heel in 'adduction. In all other respects the therapeutic shoe for the pronated foot should conform to the physiological shoe. A prescription for a shoe for a painful or de- formed foot should be as definite as Cialis Price Walmart a prescription ing the heel straight down from Cialis Price Walmart the rand. The breast one lift higher than the posterior elevation makes the heel seat more secure and elevates the arch of the shoe when weighted by the foot. The heel seat is one eighth inch lower on outer side to receive the lesser tubercle of the calcaneus. The sole is one eighth inch inner side elevation more than outer side. The control of the os calcis will be Cialis Price Walmart most difficult when modi Cialis Price Walmart tying the ordinary shoe, because the Fig. 13. — Here the left foot Cialis Price Walmart has become right foot in the shoe Cialis Price Walmart is getting a good Cialis Price Walmart start. to a druggist. To illustrate, the following example is submitted : Miss M. S., 6000 Riverside Drive. R Oxford ties. Russet brown calf. Walking shoes. Snug, strong counter ; snug waist ; broad toe, pointed tip. Heel, ^-]/2 ; rubber ; nonslip ; full pitch ; flaring in- ner side Vs ; breast, one lift higher. Heel seat '/i lower on outer side. Shank narrow. flexible. Sole strong, flexible; Yg inner side elevation. ■A. snug, strong counter is ordered to hold the calcaneus; Cialis Price Walmart a snug waist prevents the foot sliding forward. A broad toe gives plenty of toe room. Straight inner Cialis Price Walmart vamp line to the end of great toe is undersood and toe points bevond the end of great toe. The heel is to be five eighths inch inner'side, one half inch outer side elevation or thickness. Full pitch means sloped forward much as a French heel : the flaring inner side, one eighth inch, widens the heel to the innner forward corner after carry- loose heel counter ( Figs. 4 and 6 ) and flat heel seat afford no grasp to hold Cialis Price Walmart the posterior foot. For want of something better, a slip in counter may be worn to fill the space. In a more advanced stage of weakness we find the flat or valgus foot, more or less restricted in the excursions of adduction, extension and flexion, painful or nonpainful, but crippling when walking or running is necessary. A valgus foot is angulated in its longitudinal axis at the so called mediotarsal joint, with prominence of the navicular process of the scaphoid, and is nearly always associated with the extreme pronation of the lieel and more or less flattening of the internal longitudinal arch. This is a difticult condition to correct with the shoe alone, and should he assisted by vigorous manipula- tion to correct deformity, and by strapping or plaster of Paris. When the foot is flat, or of valgus tendency, a strong, short, rigid shank will be nec- essary to control the stress and strain, the impulse 500 ASHLEY. SflOES. (New Yoex Medical Jouehal. tending to deform the shoe imparted by the me- chanically impaired foot. The strong, unyielding shank and generally strong shoe with more exag- gerated cant in heel and sole will mark the differ- ence between this shoe and the shoe for the un- balanced, flaccid foot. The objection to the sole wedge is the produc- tion of corns and bunions on the little toe. This is overcome largely by a shoe adhering to Meyer's line, a low heel, elevated breast, and plenty of room zinc oxide plaster or placed in plaster of Paris in correction. In order to do this with ease and with comparatively slight pain to your patient it is nec- essary to relax the muscular spasm and resistance that the patient will unconsciously exert against you. To this end you should have the confidence Cialis Price Walmart of your patient. Grasp the foot firmly (3) and direct your jjatient to move, or "wiggle," the great toe and continue to do so. If he will move Cialis Price Walmart the great toe frequently you can correct and make over the distal end of the Cialis Price Walmart fifth metatarsal. If your Ijatient's foot is broken down, flat, and stift" and he will not submit to correction, or if he has a great hamlike foot and no disposition to cultivate muscu- lar development, you would better give him a ]^late or a rigid shank with extended inner heel prop under an elongated heel counter. This treatment will seldom, if ever, restore normal function. It is a poor treatment for any condition but the most ho|5eless, and is equivalent to giving up tiie t'lght