6. Amputation was, until within the last ten or twelve years, the usual resource after the failure of tenotomy of the extensor. It affords a curious comment upon the surgery of the pre-antiseptic period that the chief reason given against this operation by the early writers was its danger to life. At the present time it can rarely be needed unless, by any accident, the antisepsis of the resection operation fails and acute inflammation sets in. The objections to it are the mutilation, and the tendency to lateral distortion of the adjacent toes to fill the gap left by the lost member. HALLUX FLEXUS. _Hallux flexus_ appears to have been first recognised as a separate affection only a few years ago, in 1887, and it is to Mr. Davies-Colley that we are indebted for the name and for the earliest discussion of the characters and causation of the disease. It is stated, however, by Blum that Nélaton described a “cou de cygne” of the great toe, and attributed it to the use of short boots. I have been unable to discover the reference in the works of this surgeon, but if the citation can be verified, the credit of recognising the existence and nature of the deformity will fall to him, for there is no doubt that hallux flexus is pathologically a “cou de cygne” or hammer toe. Since Mr. Davies-Colley’s introduction of the subject various contributions have been made, by Mr. Howard Marsh, Mr. Reginald Lucy, Mr. Cotterell, Mr. Ellis, and others, and I must draw especial attention to a valuable analysis of thirteen cases by my colleague, Mr. Makins, in the St. Thomas’s Hospital Reports for 1888. The complaint is by no means a rare one, for since 1887, when I began to take notes of all the cases that were brought under my observation in private and hospital practice, I have accumulated a list of thirty examples of what may be termed true “hallux flexus,” besides a number of contractions presenting a superficial resemblance to it, but resulting from arthritic lesions. I propose, as in the case of hammer toe, to separate these latter entirely from the former, because the pathological, and even the clinical, distinctions between the two classes are perfectly well marked, and it hence can only mislead to place them in the same category.