_Symptoms._—In a typical case of hallux flexus the patient, usually a boy near the age of puberty, suffers some little pain about the metatarso-phalangeal articulation of the great toe in walking, at the moment when the weight of the body falls chiefly upon this joint. Rest affords complete relief, and the structures about the articulation show no signs of inflammation. As time goes on the pain increases and becomes associated with a sense of rigidity of the toe, and the power of full extension becomes lost. The diminution of the range of movement is very gradual, and usually it is not until the proximal phalanx can no longer be extended beyond a line corresponding to the prolonged axis of the metatarsal bone that the condition is brought before the surgeon, but in more extreme examples the toe becomes actually bent below this axis, so that it forms with the metatarsal bone an obtuse angle with plantar opening. The foot is now seriously crippled. Over-use in walking induces much suffering, and any attempt at passive extension is extremely painful, while flexion still remains unimpaired. The head of the metatarsal bone thrown into prominence by the unwonted position of the proximal phalanx looks abnormally large. In some cases a reflex hyperæmia of the tissues surrounding the joint may be induced by forced exercise; but there is rarely, if ever, any effusion within the capsule. The patient finds walking more and more difficult, and to avoid pressure upon the contracted articulation limps on the outer edge of the foot; but this gives little relief, and at last he is compelled to rest. In the more severe cases the patient consults the surgeon; in the slighter forms he puts up with the inconvenience, and we may assume that he recovers without professional assistance, for the condition is very seldom found after the attainment of full adult life.