Fig. 106
Distorted foot, from pressure and bunion. (Erichsen.)
These lesions are not met with among the savage races or those who go barefooted. They are essentially products of the footwear affected in modern society. Were shoes made to fit the natural foot and not to constrain it in abnormal positions, corns and bunions would be practically unknown.
Treatment.
—Preventive treatment is the most important and pertains to properly adapted footwear. Unfortunately the treatment of these minor lesions is too frequently left to charlatans and so-called chiropodists, who may give temporary relief in many instances, but have no knowledge of either the nature of the difficulty or its proper surgical treatment.
Soft corns will usually disappear if the parts can be kept clean and dry. Hard corns are essentially callosities, which should be pared down or trimmed off until the surface is almost ready to bleed. It may then be painted with a collodion containing 20 per cent. of salicylic acid and a little alcohol. If this mixture be applied to the surface of a clean and dry corn it can often be peeled away with the corn after a few days. When it is desirable to soften any callosity of this kind, previous to paring or trimming it, it can be done by applying for a few hours a mixture of equal parts of glycerin and liquor potassæ; this will so soften a callosity as, when applied over night, to make it endurable through the following day.
Bunions are so often associated with hypertrophy of the underlying bone as to entitle them to consideration under deformities of the feet. The most pronounced expressions are usually seen in connection with [hallux valgus] (q. v.), and their treatment comprises excision of the bunion and its underlying bursal sac, along with exsection of the joint. By this radical local measure complete relief is usually afforded.
Cutaneous Horns.
—These have the consistence of an ordinary nail, are epiblastic products, varying in size, length, color, and shape. They have been alluded to in the chapter on Tumors. Sutton has divided them into sebaceous, which occur most often upon the head and spring from an old [sebaceous cyst] (see above); warty horns, which much resemble them; cicatricial and nail horns, which are instances of exaggerated growth of the finger-nails.