DISEASES. 613 



siiificiently softened by poultices and thinned down with the knife. 

 This suppuration, in the generahty of cases, brings on serious 

 comphcatiou, by the excessive pressure to which the sub-horny 

 tissues are then subjected. Gangrene of the velvety tissue near 

 the branches of the sole and of the podophyllous grooves which 

 have been lacerated in the suppuration, are very common comj)li- 

 cations. If the pus remains long in the hoof its gangrenous re- 

 sults may extend to the os pedis, the laternal cartilage, the j)lantar 

 cushion, and even to the plantar aponeurosis, and give rise to 

 necrosis or caries of the bones, or to quittor, to a more or less 

 variable extent. This sub-horny suppuration, which may some- 

 times be considerable, as well as the compHcations accompanying 

 it, are detected with the probe. 



V. Termination and Prognosis. — Resolution is a common 

 termination of corns. But their relapse is common also, especially 

 in feet j)i'edisposed to them by bad conformation. A kind of 

 chronic condition of the disease, and one which is more liable to 

 become serious than the accidental variety, is the ordinary ter- 

 mination in this case. The mere extent of the disease is of less 

 importance in the diagnosis than the predisposing conditions. 

 Generally the dry corn is less serious than the moist one, and 

 especially less than the suppurative. CompHcated corns, princi- 

 pally in flat, wide feet, with low heels, by reason of uncertain, 

 j)rotracted and expensive treatment, are in general fatal, and 

 necessitate the destruction of the patient. 



VI. Treatment. — The largeness of the sjjace we have consumed 

 in considering the etiology of corns will compel us to be brief in 

 our remarks upon the preventhie treatment. Shoeing, which is so 

 often the cause of corns, may also be made a means of preventing 

 them, even upon predisposed feet, if performed with intelligence 

 and proper observation, based upon the anatomy and physiology 

 of the foot. Generally speaking, one must not proceed rashly by 

 changing too suddenly the mode of shoeing. We do not think 

 that any one specified system of shoeing will with certainty pre- 

 vent corns, but we do believe that each case demands its special 

 study and care. Usually, a flat shoe, and which has the heels 

 rather thin but resisting, and which rests on the wall proper, even 

 of the diseased one, if not too painful, is to be preferred. If the 

 shoe is for a low-heeled foot, the heels of the shoe should be 

 thicker in order to supply their insufficient height and to ojffer 



