‘Festered Corn’

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Wikis > Dermatology > Keratinisation Conditions > Mechanical Hyperkeratosis > Heloma Durum (Hard corn) > 'Festered Corn'

Neurovascular and Festered Corns, from Durlacher’s 1845 book

A ‘Festered Corn’ is an infected (suppurating) heloma durum (corn) and was the terminology used by Lewis Durlacher in his book, A Treatise On Corns, Bunions: The Diseases Of Nails, And The General Management Of The Feet, from 1845. This is different to the corn, Durlacher’s Corn that is named after him.

Here is the text of Chapter V – Festered Corns:

In many cases of deformity, where the toes are by contraction drawn from their normal position downwards and inwards upon the metatarsal bones, the joints of the middle phalanges become very prominent, and the skin covering them thin and tightly stretched. Whenever severe pressure or friction is exerted on these projecting points, a very painful and troublesome corn is produced.
The first appearance of this complaint is indicated by redness of the skin over the joint, and the whole toe being sensitive to the least pressure; as the disease proceeds, the epidermis becomes slightly thickened, semi-transparent, and less laminated than in any other species of corns.
In some cases inflammation supervenes, and matter forms under the thickened cuticle to the whole extent of its circumference.
As the inflammation increases, a corn is fully developed about the centre of the induration, seldom exceeding in size the head of a large pin, and decreasing inwardly to a thin thread-like point. This excites vascular irritability of the dermis, and rapidly causes suppuration to take place in the bursa beneath, which has been inflamed by the pressure of the point of the corn, which, when extracted, has generally a part of the sac adhering to it. Sometimes the bursa is diseased without any thickening of the epidermis, and only external appearance is the redness and dwelling of the toe, with a very small white spot having a minute speck in the centre, usually situated upon the most prominent part of the joint.
When the corn is in this state, and not properly attended to, the serous fluid which is effused will cause great irritation, with excruciating pain and violent inflammation, not only in the toe, but over the whole foot.
The inflammatory action may sometimes be traced by the course of the lymphatics, in red streaks or lines running along the foot and up the leg, and not infrequently extending up to the femoral and inguinal glands. In the worst cases where the contents of the bursa have not been evacuated in proper time by the removal of the corn, the irritation to the structures of the joint, ulceration soon commences, and frequently involved the periosteum, and in some instances causes caries of the bones.
The treatment must commence by the removal of the cause; and if the corn is fully developed it should be extracted, so as to give issue to any serous fluid that may be extravasated beneath, and to prevent its re-collection. The greatest difficulty in curing this disease is to keep the opening of the sac or bursa from closing too rapidly. This can only be effected by rubbing an escharotic on the edges of the orifice, and dressing the toe with lint dipped in cold water, and covering it with oiled silk. The application of the caustic must be repeated every second or third day, with the same dressing, until the oozing ceases, after which soap cerate may be applied. It will be necessary for the patient, while this treatment is pursued, to rest the foot, and it that should be impracticable from the nature of his avocation, a hole must be cut in the shoe opposite to the corn, so as to prevent it being subjected to pressure. if the absorbents should be inflamed, absolute rest is them imperatively necessary.
In some cases, when the disease has become chronic, the inflammatory action being quite local, and where it is impossible to keep the bursa open, so as to prevent any accumulation of the serum, I have succeeded in destroying the lining membrane by inserting a minute particle of potassa fusa into the cavity, which has afterwards granulated, and the cure has been readily effected.
When the inflammation is sever, and extends over the foot, leeches may be applied in addition to the other treatment; cold spirit lotion should also be used; and the patient should be strictly prohibited from walking, and directed to keep the leg in a horizontal position until the inflammation subsides. In the more severe cases, where the bone or periosteum is affected, the strict antiphologistic regimen must be enforced, in addition to the usual surgical treatment.

Other UK Classic Books:


An Introduction to Appliance Making in Chiropody (Coates)	Practical Orthotics for Chiropodists (Coates)	An Encyclopaedia of Materia Medica and Therapeutics for Chiropodists (Le Rossignol)	The Foot (Lake)	Essentials of Chiropody for Students (Kuipers & Dalton)

A Treatise On Corns, Bunions: The Diseases Of Nails, And The General Management Of The Feet (Durlacher)	Chiropodial Practice Management (Watts)	Introduction to Therapeutics for Chiropodists (Read)	Chiropody – Theory and Practice (Charlesworth)