MEDICAL INTRO |
BOOKS ON OLD MEDICAL TREATMENTS AND REMEDIES |
THE PRACTICAL
HOME PHYSICIAN AND ENCYCLOPEDIA OF MEDICINE The biggy of the late 1800's. Clearly shows the massive inroads in medical science and the treatment of disease.
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ALCOHOL AND THE HUMAN BODY In fact alcohol was known to be a poison, and considered quite dangerous. Something modern medicine now agrees with. This was known circa 1907. A very impressive scientific book on the subject. |
DISEASES OF THE SKIN is a massive book on skin diseases from 1914. Don't be feint hearted though, it's loaded with photos that I found disturbing. |
Part of SAVORY'S COMPENDIUM OF DOMESTIC MEDICINE:
19th CENTURY HEALTH MEDICINES AND DRUGS |
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CLAVUS
Synonyms.—Corn; Fr., Cor; Tylosis gompheux; Oeil de perdrix; Ger., Leichdorn; Hühnerauge.
Definition.—Clavus, or corn, is a small, circumscribed, conic, deep-seated, horny formation or callosity, usually seated about the toes, with the small end of the growth pressing down upon the corium.
A corn resembles a callosity, the epidermis being thickened, pol ished, and horny. It differs, however, from callosity in being smaller and circumscribed, averaging a pea in size, and in being provided with a central prolongation or horny peg, shaped like the head of a nail, known as the core. The base of the corn is directed upward and the apex downward, the latter by its pressure on the nerve filaments giving rise to pain. Two varieties of clavus are recognized—the hard and the soft. The former is the common one, and generally occurs on the dorsal surface of the toes or on the plantar aspect of the foot; although they may, however, appear on any other part which is subjected to pressure or friction long continued. One, several, or more may be present. A soft corn is generally seen between the toes; it is depressed in the center, and of a grayish color, and, owing to the constant heat and moisture of the parts, it becomes soft. Not infrequently, when improperly treated, corns are the starting-point of erysipelas and suppuration, and even ulceration may occur. From accidental causes or as the result of con stant pressure or from some unknown factor a corn exceptionally be comes the seat of inflammatory and suppurative action which may be more or less persistent—suppurating corn. They are prone to become quite sensitive during climatic changes, and are usually at all times painful when pressed upon, and sometimes spontaneously so. On the sole of the foot, when well developed, they may give rise to considerable
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discomfort, making locomotion or standing painful; doubtless some of these latter cases more properly belong under verruca plantaris (q. v.).
Etiology and Pathology.—A corn results from pressure with counterpressure and friction, attributable generally to tight or badly fitting shoes. It appears, however, that apparently similar formations may occur spontaneously independently of pressure, as in the cases of Davies-Colley, quoted by Crocker, in which the palms and plantar surfaces of a Hindoo were the seat of numerous clavi. Primarily the growth is, as in callositas, an attempt to protect a part pressed upon, but its subsequent peculiar development is difficult to understand. It consists of a circumscribed hyperplasia of the epidermis, of conic shape, with the base external, variously elevated, and with the apex directed downward and pressing upon the papillae. It is, in fact, a peculiarly shaped callosity, the central portion and apex being dense and horny, forming the so-called core. The corium beneath the down-pressing apex is thinned, and the papillae are usually atrophied, although occasionally hypertrophied. There is, Robinson states, more or less hypertrophy of the papillae at the circumference. Unna noted “well-preserved condi tion of the sweat-glands, and even those glands whose pores disappear in the core do not atrophy.” Minute hemorrhages frequently occur beneath the thickened epidermis, due to rupture of capillary vessels of the papillae. Structurally, the growth is made up of closely packed epidermic cells arranged in concentric layers.
Treatment.—Removal of the cause and the wearing of properly fitting shoes are a sine qua non of successful treatment. In fact, if pressure is removed, corns will in most instances disappear sponta neously. In an affection so common, the plans of treatment recom mended, as is to be expected, are almost innumerable. A simple and popular method of treatment consists in shaving off, after a preliminary hot-water soaking, the surface portion by means of a razor or sharp knife, and then applying a ring of felt wadding or like material having an adhesive side, to be found in the shops, over the region of the corn, with the hollow part directly over the site of the core. This should be worn for some time—usually several weeks—thus relieving the growth of all pressure and friction; and if well carried out, this plan quite frequently will bring a good result. Another method is to pare off; as before, the thickened broad surface, and then carefully to dissect out the core; in some instances, after thorough soaking and surface removal, this can be extracted with the forceps. Chiropodists have become quite expert in their removal, often dissecting them out without previous softening, and with scarcely any pain and rarely any bleed ing. In manipulations of this character it is absolutely imperative that the instruments employed should be aseptic, as unpleasant complica tions or consequences have occasionally been noted. In some cases touching the base of the cavity left by the removal of the corn with a droplet of a solution of caustic potash will prevent a return; but the application must be made with care, and with a solution of not more than 5 per cent, strength, and its action almost immediately neutralized with vinegar or dilute acetic acid.
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HYPERTROPHIES
A safe and conservative plan, sometimes successful, consists in the repeated application of a solution of salicylic acid in collodion, for which the common formula is: Salicylic acid, gr. xxx-xl (2.-2.65); ext. cannabis indica, gr. x (0.65); collodion and flexible collodion, ŕâ f5ij (8.).—M. This is to be painted on the corn night and morning for several days, at the end of which time the parts are soaked in hot water, and the horny mass, or a greater part of it, will, as a rule, come readily away with a little rubbing or scraping. If it is then at all tender, treatment is to be discontinued for a few days, and the paintings resumed. Several repe titions are usually necessary. After apparent relief the wearing of a ring- pad, as already referred to, for a few weeks, is to be advised. Salicylic acid has the peculiar property, especially when so applied, and also in the form of a plaster, of softening and removing the horny layer of the epidermis, and this drug is the active principle in most of the adver tised corn-cures. The various caustics are also occasionally employed, but their use requires care and caution. Of the milder caustics, lactic acid may sometimes be applied, in minute quantity, with benefit, weak ened or full strength.
In soft corns the same mild plans mentioned may also be employed. Nitrate of silver is useful in these cases, the outer surface first being re moved by salicylic acid or weak solution of caustic potash. The essen tial measure is the prevention of friction and maceration by keeping the toes slightly separated with a piece of soft lint or absorbent cotton, changing frequently. When extremely sensitive, dilute lead-water is a soothing application.
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