Identifier: systemofsurgery01trev (find matches)
Title: A system of surgery
Year: 1895 (1890s)
Authors: Treves, Frederick, Sir, 1853-1923
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ndicated.In many cases where the joint sur-faces are carious, good results maybe obtained without operation, butsometimes it becomes necessary togouge away the diseased bone inorder to promote a cure. When theulcer has healed, it must be pro-tected from pressure by a suitablefelt pad with a central hole, insertedin the boot, or else applied in theform of a corn-plaister. These ulcersare very liable to break out againand again, as the result of renewedpressure in walking, and constantcare is necessary to keep the footsound. In a very few cases winch resist treatment, as above, there isextensive sloughing of the soft tissues of the sole of the foot. Amputation may be performed : but amputation, as a routine treatment, isuncalled for and most unsatisfactory in its results, as the ulcer oftenrecurs in the stump. It is best to reserve such treatment for thosecases where there is not merely an ulcer, but sloughing or gangreneas well; and in these also the results are usually disappointing,x
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Pig. 198.—Bones from a Case of Perforat-ing1 Ulcer, showing caries and alsodestruction of the terminal phalanges. XXVIII. DISEASES OF THE SKIN. By JONATHAN HUTCHINSON, Junk., F.R.C.S., Assistant Surgeon to the London Hospital; Surgeon to the Lock Hospital. o Corns.—As the result of prolonged pressure or friction the hornyor epidermic layer of the skin is prone to take on local hypertrophy,preceded by congestion of the papillary layer beneath. A simplethickening of the epidermis at one spot, such as is often seen onthe fingers of seamstresses or workmen, or on the palmar aspect ofthe first phalangeal bases, is kriown as a callosity. A corn differsfrom a callosity in the fact that there is in addition a central down-growth of epidermis displacing the papillae, which at the edge ofthe corn are elongated and enlarged as well as abnormally congested.True corns are not often met with except on the feet, where thecompression of the toes by ill-fitting narrow or tight boots rendersthe dor

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