skin eruptions,
and may prove obstinate and lead to shedding of the nails. They also
occur in inherited syphilis. In addition to general treatment, an
ointment containing 5 per cent. of oleate of mercury should be applied
locally.

_Ingrowing Toe-nail._--This is more accurately described as an
overgrowth of the soft tissues along the edge of the nail. It is most
frequently met with in the great toe in young adults with flat-foot
whose feet perspire freely, who wear ill-fitting shoes, and who cut
their toe-nails carelessly or tear them with their fingers. Where the
soft tissues are pressed against the edge of the nail, the skin gives
way and there is the formation of exuberant granulations and of
discharge which is sometimes foetid. The affection is a painful one and
may unfit the patient for work. In mild cases the condition may be
remedied by getting rid of contributing causes and by disinfecting the
skin and nail; the nail is cut evenly, and the groove between it and the
skin packed with an antiseptic dusting-powder, such as boracic acid. In
more severe cases it may be necessary to remove an ellipse of tissue
consisting of the edge of the nail, together with the subjacent matrix
and the redundant nail-fold.

_Subungual exostosis_ is an osteoma growing from the terminal phalanx of
the great toe (Fig. 107). It raises the nail and may be accompanied by
ulceration of the skin over the most prominent part of the growth. The
soft parts, including the nail, should be reflected towards the dorsum
in the form of a flap, the base of the exostosis divided with the
chisel, and the exostosis removed.

_Malignant disease_ in relation to the nails is rare. Squamous
epithelioma and melanotic cancer are the forms met with. Treatment
consists in amputating the digit concerned, and in removing the
associated lymph glands.

CHAPTER XVIII

THE MUSCLES, TENDONS, AND TENDON SHEATHS

INJURIES: _Contusion_; _Sprain_; _Rupture_--Hernia of
muscle--Dislocation of tendons--Wounds--Avulsion of tendon.
DISEASES OF MUSCLE AND OF TENDONS: _Atrophy_; _"Muscular
rheumatism"_--_Fibrositis_; _Contracture_; _Myositis_;
_Calcification and Ossification_; _Tumours_. DISEASES OF TENDON
SHEATHS: _Teno-synovitis_.

INJURIES

#Contusion of Muscle.#--Contusion of muscle, which consists in bruising
of its fibres and blood vessels, may be due to violence acting from
without, as in a blow, a kick, or a fall; or from within,