CORNS AND CALLOSITIES.
Preventive treatment is important and consists in attention directed to footwear. The epithelial hypertrophy will disappear as soon as the cause is removed—i.e., the intermittent pressure of a tight boot; some times, however, owing to the boots being too large, the friction caused by the skin of the foot rubbing against the leather in walking is enough to produce painful corns. Children frequently have their boots made too long, in order to allow for the growth of the foot during the wear of the boot. The result is that they get into the habit of strongly flexing their toes in walking, to prevent the slipping up and down of the foot inside the boot. The result is, corns appear on the upper surface of the phalangeal joints, and deformities of various kinds result which last during life. The first indication in the treatment of these conditions is to obtain properly fitting boots. (See Bunion.) When corns continually grow again in spite of bootwear of faultless make, they will be found to originate in the pressure caused by the weight of the foot resting on a hard mattress during sleep, which can be obviated by wearing a large bunion plaster at night.
The corn should be pared with a sharp knife, and, if skilfully done, it can be entirely removed at one operation, but this requires skill and much practice. Sometimes previous soaking of the foot facilitates the operation, but many chiropodists prefer to have the corn in its natural hard state before paring.
When it cannot be cut entirely out, a little Glacial Acetic Acid may be applied with a bit of wood (the end of a match), and, after the superficial film peels off, the application can be renewed till the diseased cuticle disappears.
Salicylic Acid is the basis of nearly all corn cures. It appears to possess the strange property of only dissolving or acting upon the diseased epithelium, having no effect upon healthy tissue.
The usual formula is— It. _4 i 3j.
EAtracti Cannabis Ind. gr. x.
3vj.
Ftheris sulphurici 3ij. Hisce.
Fiat solidi°. Signa.—To be daily tainted over the corn.
Soft corns may be best treated by the separation of the opposing surfaces with felt or Amadou Plaster, with a circular hole cut in the centre. This hole may be filled with dry Salicylic Acid, and afterwards the above solvent may be applied to seal up the powder.
Chase dissects out the little lymph sac in the areolar tissue which is connected with the apex of the corn, and, failing its complete excision, he swabs it with Phenol and inserts a small drain for two days, keeping the toes strapped for immobility.
Callosities as well as corns and warts can be removed by Rosen's plan: The growth or patch having been well moistened with an antiseptic solu tion, is thickly covered with Salicylic Acid. Upon the top of this are placed several layers of moistened Boracic lint, and over all a piece of gutta percha tissue and a bandage. At the end of five days, when the dressing is removed, the thickened epidermis easily peels from the subjacent struc tures.
Unna treats plantar corns by painting a broad ring of Glycerin Jelly round them with a stiff brush. When the jelly has finally set, the interior of the ring is filled with a circular piece of strongest Salicylic Plaster (Sali cylic Acid, 4o; Creosote, 4o), and the whole covered up with two layers of glycerin jelly, and when dry a small pad of cotton-wool. This dressing will last for a week, and may be renewed till the horny layer of the epi dermis is entirely removed.
Lewis Jones considers that corns are caused, like warts, by an infective process, and should be best treated by direct ionisation with a zinc salt.
CORYZA—see Catarrh and Bronchitis.