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others, are points of great surgical importance; but he has not seen them noticed. If the great toe is fixed as it is generally fixed in the median-pointed boot, then such movement as it can make is in the natural plane, and when it is still it is really at rest. If, however, it happens to be packed beneath the second toe, then if it moves at all it must be in a plane for which the joints are not adapted. Grinding of the Aciclovir Tablets To Buy cartilage and conse- quent irritation are necessary results. Then the con- dition known as " hallux flexus," " hallux rigidus," or " hallux dolorosus," in varying degree of severity, is apt to follow. The toe is flexed because it is held down beneath the second; it is rigid because movement is painful; it is painful more or less, even when still, be- cause fixed in an unnatural position; it is never in a position of rest. If sufficient muscular inactivity is attained, flat-foot also ensues. But when the great toe is Aciclovir Bp fixed in the former Aciclovir Buy position on the top of the final phalanx of the second toe, it lies there on a sort of bed formed by the final phalanx, which in the so-called flex- ion of the toe lies flat on the ground, while there is an Buy Aciclovir Online elevation of the joint between the first and second. The toe being held in this position by the great toe and straightening prevented, a hammer-toe results. In any case, but the more important in the hallux flexus posi- tion, to set the great toe free is clearly indicated. A boot with a straight inside line is Aciclovir Tablets 200mg obviously needed. It is more difficult to get patients or surgeons to recognize the need of socks or stockings which have either a Aciclovir Cold Sore corre- sponding shape or a separate stall for the great toe: the pointed sock, tightened by friction against the side of the boot when the foot is inserted therein, effectual- ly holds the toes in the false position. The author dissents entirely from the statements of Sir G. Humphry that " the toes .are shut up in leather and not used," and that " their services can be spared Aciclovir Tablets Buy Online without detriment to the rest of the frame." It is not so. They are generally used, and, as the smaller ones move in a vertical plane, there is no reason why they should not move together, even in a tight boot. These toes are necessary if only to Buy Aciclovir Tablets Uk provide for their corre- sponding metatarsal bones the protection from pres- sure on the ground which is served by proper use of the great toe. To the want Aciclovir 5 Cream of this influence are due the callosities on the sole so often found. When the Buy Aciclovir toes are used the skin is free from anything of the kind. To want of this influence are also due the conditions known as " anterior metatarsalgia," " Morton's toe," and the unnamed sufferings in the same region from time to time described. They are all evidences of defective function. The bow-string or tie-rod influence of tlie flexor longus digitorum on the plantar arch can not be properly exercised unless the smaller toes are efficient. " Show me the condition of the toes in any foot," says Mr. Ellis, " let me Aciclovir Dispersible Tablets see how their functions are exercised, and I will predict the condition of the plantar arch." Toes which overlap each other Aciclovir Cold Sore Cream can not take such good bearing on which to act as they do when each presses on the ground line. Wlien the extensors act on toes not firmly fixed by Valaciclovir Vs Aciclovir pressure downward, they draw them upward, with resulting friction and corns. And, indeed, in almost any defective condition of the foot there is a surgical indication to correct or renew the function of the toes, to compel each of them by active use to, literally, flnd its level. All the toes, when at rest, should be straight. The semiflexed position, sometimes described as the normal, is not really so. TPIE NEW YORK MEDICAL JOURNAL, November 20, 1897. (friginal Communications. ENDEMIC MULTIPLE NEURITIS (BERIBERI).* By E. D. BOJTDURANT, M. D., PROFESSOR OF MENTAL AND NERVOl'S Where To Buy Aciclovir DISEASES, MEDICAL COLLEGE OF ALABAMA, MOBILE ; FORMERLY ASSISTANT SUPERINTENDENT OF THE ALABAMA BRYCE INSANE HOSPITAL, Aciclovir Cream Bp TUSCALOOSA. ALA. Endemic multiple neuritis, the Cingalese " beriberi," the " kakke " of Japan, while known in Asia for many centuries, and in modern times prevailing extensively Aciclovir Tablets 800mg among Aciclovir Eye Ointment the native populations of China, India, Ceylon, Japan, the islands of the Pacitic, the west coast of Africa (the " sleeping sickness "), certain portions of the coast of Brazil, and the West Indies, has been rarely seen in Europe or in North America. The infrequency of the disease in the United States, its Aciclovir 800mg intrinsically interesting clinical features, and the un- solved problems of its nature and causation, give especial value to a series of seventy-one cases which during 1895- '96 occurred among the patients in the State Insane Hospital at Tuscaloosa, Alabama. Cases of multiple Buy Aciclovir Tablets neuritis had previously occurred

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