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They are formed by the great prolongation and growth of the projections, or papillæ of the middle layer of the skin just described.
Flat Warts, raised but slightly above the surface are more common in old people.
Moist Warts occur where they are softened by secretions of the body, as about the sexual organs (in connection with diseases of the same), and about the anus (or opening of the bowel). They are of a white, pink, or red color, and consist of numerous, little, fleshy projections, usually covered with a foul-smelling
Warts most commonly appear on the hands of children, but may appear on any part of the body and at all ages. They may disappear quickly or remain indefinitely. They are not communicable from one person to another.
Treatment.-Warts may be removed by painting them frequently with the fresh juice of the milkweed, or with acetic acid or tincture of iodine. These remedies are all harmless, but somewhat slow and not always effective. Application, morning and evening, of a saturated solution of "washing soda" (impure bicarbonate of potash) will often remove a wart.
CORNS.-Corns are local, cone-shaped thickenings of the outer layer of the skin of the feet, due to pressure and friction of the shoes, or opposed surfaces of skin between the toes. They are not in themselves sensitive, but pain follows pressure upon them, as they
act as foreign bodies in bearing down upon the sensitive lower layers of the skin. Continued irritation often leads to inflammation of the skin around and beneath the corn with the formation of pus. Ordinarily, corns are tough, yellowish, horny masses, but, when moistened by sweat between the toes, they are white, and are called "soft corns."
Treatment.-Comfortable shoes are the first requisite; well-fitting and neither tight nor loose. Pressure may be taken off the corns by surrounding them with felt rings or corn plaster. To remove the corn the foot should be soaked for a long time in warm water, in which is dissolved washing soda, and then the surface of the corn is gently scraped off with a clean, sharp knife. Another useful method consists in painting the corn, night and morning for five days, with the following formula, when both the coating and corn will come off on soaking the same for some time in warm water:
Tincture of iodine.
Extract of Cannabis Indica ..
When the tissues about the corn become inflamed the patient must rest with the foot elevated and wrapped in a thick layer of absorbent cotton saturated with a hot solution of corrosive sublimate (one tablet
to the pint of water) and covered with oil silk or rubPus must be let out with a knife which has been laid in boiling water.
If corns are removed by the knife the foot should be previously made absolutely clean, the knife boiled, and the paring not carried to the extent of drawing blood. The too-close removal of a corn may lead to infection of the wounded tissues with germs, and in old people, and those with feeble circulation, gangrene or erysipelas may result. Soft corns are treated by removal of the surface layer, by soaking in washing soda and hot water and scraping as above stated, and then the corn should be dusted with a mixture of boric acid and zinc oxide, equal parts, and the toes kept apart by pads of absorbent cotton.
CALLUS AND CRACKS OF THE SKIN.— Callus consists of round or irregular, flattened, yellowish thickenings of the upper or horny layer of the skin. The skin becomes hypertrophied and resembles a thick, horny layer, caused by intermittent pressure of tools, shoes, etc. The whole palm of the hand or soles of the feet may be the seats of a continuous callus. Callus is not harmful, except in leading to cracks of the skin near the bend of joints, and, rarely, in causing irritation, heat, pain, and even the formation of pus in the skin beneath. Callus usually disappears when the exciting cause or pressure is removed. Treatment.The hands and feet should be soaked continuously in hot baths containing washing soda,
and then should be covered with diachylon (or other) ointment. This may be done each night; or collodion (one ounce containing thirty grains of salicylic acid) may be painted, night and morning for several days, on the callus, and then, after soaking for some time in hot water, the surface should be scraped off with a dull knife and the process repeated as often as necessary to effect a cure. Fissure or cracks of the skin caused by callus are treated in the same manner: by prolonged soaking in hot water, paring away the edges, and applying diachylon ointment or cold cream to the part. Inflammation about callus must be cared for as recommended above for inflamed corns.
BOILS. A boil is a circumscribed inflammatory process, caused by the entrance of pus-producing germs into the skin either through the pores (the mouths of the sweat glands) or along the shafts of the hair, and in this way invading the glands which secrete a greasy material (sebaceous glands). In either case the pus germs set up an inflammation of the sweat or sebaceous glands, and the surrounding structures of the skin, and a small, red, itching pimple results. Rarely, after a few days, the redness and swelling disappear, and the pus, if any, dries and the whole process subsides. This is called a "blind boil." But usually the boil increases in size for several days, until it may be as large as a pigeon's egg. It assumes a bright-red sharply defined, rounded shape, with a conical point, and is at first hard and then softens as pus or matter forms. There is
severe pain of a throbbing, boring character, which is worse at night, and destroys the patient's sleep and appetite. There may be some fever. The glands in the neighborhood may be enlarged and tender, owing to some of the pus germs' escaping from the boil and lodging in the glands.
If the boil is not lanced, it reaches its full development in seven to ten days with the formation of a central core" of dead tissue and some pus, which gives to the center of the boil a whitish or yellowish-brown appearance. The boil then breaks down spontaneously in one or more places (usually only one) and discharges some pus, and, with a little pressure, also the white, central core of dead tissue. The remaining wound closes in and heals in a week or two. Boils occur singly or in numbers, and sometimes in successive crops. When this happens it is because the pus germs from the previous boils have invaded fresh areas of skin.
Causes. Boils are thus contagious, the pus germs being communicated to new points on the patient's skin, or to that of another person. Local irritation of the skin, from whatever cause, enables the germs to grow more readily. The existence of skin diseases, as eczema ("salt rheum "), prickly heat, and other sources of itching and scratching, is conducive to boils, as the pus germs contained in ordinary dirt are rubbed into the irritated skin. Whenever the skin is chafed by rough clothing, as about the wrists and neck by