In falling down, the _calcaneum_ is pushed backward making the long-heeled foot, while the bones forward of the _astragalus_ must advance more or less in _their_ direction, thus adding to the foot’s length at both ends, and making the leg appear to be set far toward the middle. The ends must necessarily be separated before the middle of the arch can sink, and this is why its flattening is accompanied by the long heel. In a foot that is well arched, the projection of bone at the upper part of the heel extends farther back than the lower edge at the sole. In a flat foot, on the contrary, the bottom part extends back farther than the bony projection above, which, in fact, is pretty sure not to project at all. It may be asked, Why not keep the ends of the arch together by a boot that is short at both ends, supposing such a one could be made that would not distort the toes? Simply because it would prevent the _use_, and consequent _strength_, of the muscles of the under side of the foot, _which are themselves the natural bands for holding the ends together_, and the whole arch in its raised position. These muscles, being weakened by the cramping of a short boot, would allow the arch to sink whenever the artificial support was taken away. This reasoning seems to indicate such a treatment as one of the causes by which flatness is produced, and as pinching the foot lengthwise has been a common fault, this cause may have been quite effective. Dr. Meyer thus refers to another bad influence: “We have already seen that the foot forms an arch, _the efficiency of which in a special manner depends on the tensity of its ligaments being maintained. If then, an unnatural and flattening pressure be constantly exercised on this arch, the binding ligaments get slackened and the arch falls down_; a broken-down arch, as we have already seen, causes flat-foot. The pressure of the upper leather on the instep must, therefore, and particularly in the case of narrow boots, favour the origin of this deformity. The same cause must further interfere with locomotion, for at every step the increased arching of the instep, which takes place the moment that the foot is set to [? raised from] the ground is resisted by the upper leather, and an injurious influence is thus exercised on the action of some of the muscles used in walking, and which runs from the anterior aspect of the lower leg to the back of the foot.” _All_ cramping, binding, and confining of _any part of the body_ weakens it, as is well known to every intelligent reader. Hence the manifest impropriety of wearing anything unnecessarily tight or binding to the arch of the instep. Every boot that is uncomfortably tight has to some degree the effect of weakening, and rendering it more liable to fall down.