The subject of calcaneal spurs is very important and has not received its proper consideration. The object of this article is to review the literature and report two unusual cases. The literature on this subject is not extensive. A few excellent articles have been written, especially by Baer and Swett.
It is the customary teaching that all calcaneal spurs are gonorrheal in origin. This is grossly wrong. The various factors are as follows: First, focal infections with the ordinary cocci, gonococci and spirochetes; second, metabolic disturbances, especially of gastro-intestinal and gallbladder origin (I have seen a large number of cases in which the metabolic factor either was most important or was an element in the exaggeration of other factors, possibly in the nature of a sensitization process); third, trauma, due to injury and improper shoes; fourth, static, due to flatfeet, and fifth, a pathologic condition of the plantar fascia—a