Bunion

Bunion is a term applied in Surgery to enlarged bursa, or synovial sacs, situated on any part of the foot; but most common over the metatarso-phalangeal joint of the first or the fifth toe (see FOOT), and accompanied by more or less distortion of the joint. In the great majority of cases, bunions are directly produced by the pressure of badly-fitting boots; and if the boots are constructed of patent leather, or any material which stops the excreting action of the skin, this, too, may be regarded as an indirect cause of their formation. Sometimes, however, the tendency to suffer from bunions is hereditary, and almost irremediable. A bunion begins as a painful and tender spot at some point exposed to pressure; the part gradually enlarges, and there are indications of an effusion into a natural bursa or a newly-formed sac. The progress of the affection may stop here, the enlarged bursa remaining, and serving to protect the subjacent parts from pressure; but far more frequently the bunion undergoes repeated attacks of inflammation, causing further increase in size; or becomes the seat of corns or of suppuration. The last action may be followed either by obliteration of the cyst and a cure; or, especially in persons of languid circulation, by a troublesome form of ulcer. The one great thing, when there is a tendency to bunions, is the wearing of roomy boots or shoes, of soft and pervious material, and so shaped as not to press upon susceptible points. When pain occurs, wet lint covered with waterproof material, or poultices, should be applied, at all events at night. Enlargement may sometimes be reduced in its earlier stages by the application of iodine or a mercurial ointment. Where suppuration takes place, the sac should at once be laid freely open. The disease sometimes proves so troublesome that amputation of the toe, or excision of the ends of the bones affected, has been resorted to.