Only a small percentage of patients with a disorder of the foot reach the orthopedic surgeon; the rest—an overwhelming majority—are left unaided to seek relief wherever they can find it. For years they have been exploited so extensively by unqualified, nonprofessional agencies as to create a unique situation and one that has been accepted or condoned by the profession with extraordinary complacence. Why should these common ailments of the feet be so obviously the "ugly duckling" or "unwanted stepchild" of medicine?
At the beginning of this century, textbooks on orthopedic surgery suggested two primary causes of foot trouble, applying them to the disorder in the longitudinal arch and also in the metatarsal region of the foot; they were (1) badly designed footwear and (2) weakened musculature. After having received broad acceptance and approval for so long a period, it might be expected that these interpretations of primary factors would by