From Bockenheimer’s Iconograms Illustrating Interesting Surgical Conditions. 

An elephantiasic thickening of the toes, developed in connection with a varicose ulcer of the leg. The whole foot is enormously enlarged and the arch of the foot is obliterated. The thickening increased and extended to the ankle. 

Varicose ulcers generally occurred in old people of the poorer classes, who cannot take care of their varices [distended veins, known as varicose veins in legs now] and have to do much standing; uncleanliness makes matters worse.