In the Suppurating Corn, as in moist corn, we have pathological changes due to the tissue reaction to the injury, plus the addition of pus organisms. Confined within the horny box we have a discharge that, by reason of the living and constantly multiplying elements it contains - the pus organisms - is always increasing in bulk. This must be at the expense of the softer structures of the foot. Accordingly, as the formation of pus increases, we get pressure upon and final gangrene of the sensitive sole and of the sensitive laminae of the bars and the wall. With no outlet below, the pus formation increases until finally it finds its way out of the hoof by emerging at the coronet.

This in some instances it may do by confining its necrotic influences solely to the sensitive laminae of the wall, in which case, if a dependent orifice is quickly made at the sole, the injury to the laminae is soon repaired by the healthy tissue remaining.

In other cases, however, the necrosis has spread deeper. Caries of the os pedis, of the lateral ligaments of the pedal-joint, or of the lateral cartilages, is a result. When this occurs the exuding discharge from the coronet becomes thinner and more putrescent, and its feel, when rubbed between the fingers, sometimes gritty with minute fragments of broken-up bone. Here, unless operative measures prevent it, necrosis soon spreads deeper still. The deeper portions of the os pedis become affected. The capsular ligament of the joint is penetrated by the suppurative process, and a condition of septic arthritis results. The cavity of the joint becomes more or less tensely distended, according to the amount of drainage present, which in this case is almost nil, with matter in a state of putrescence. As a consequence, the surrounding ligaments become softened and yield, and the articular surfaces displaced. The articular cartilages also suffer, become necrotic in patches, and frequently wholly destroyed. The end result is one of anchylosis of the joint and permanent lameness.

Prognosis. - With the ordinary dry corn a return to the normal may nearly always be looked for. Similarly, with moist corn, and even with careful treatment of the suppurating variety, the same favourable termination may be looked for and promised.

What cannot so safely be assured is that a relapse will not occur. In other words, the extent of the injury, no matter how serious, does not often offer anything that cannot be overcome by Nature and careful surgery; but the conformation of the animal does. A vicious predisposing conformation once there is there always, and although the injury resulting from it may easily give way to correct treatment, the same injury is bound to re-occur when the animal is again put to work.

Although with care suppurating corn, like other cases of suppuration within the hoof, may yield to treatment, the owner of the animal should, nevertheless, be warned that the condition is a serious one, especially should the joint become affected. It may so happen, as sometimes in fact it does, that the animal may die as a result of the infective fever so set up. From no surface in the body can absorption take place quicker than from the synovial membrane of a joint. So soon, therefore, as this membrane comes in contact with septic material, so soon does a severe septic fever make its appearance. The septic matter has gained the blood-stream, and the patient succumbs to septic poisoning.

Apart from death occurring naturally, the changes taking place in the joint in the shape of bony growths or of actual anchylosis may be so severe as to render the animal useless, and slaughter may have to be advised.

Treatment. - We have already said that by far the most active cause in the production of corn is the shoe. It follows from this that it is to the shoeing we must largely look for a successful means of their prevention, and that the treatment of corn in its most simple form is really a matter for the smith, and not for the veterinary surgeon.

The faults in connection with the shoeing we have mentioned fully when treating of the causes of corn. From those we learn that a shoe with a flat-bearing surface, or one moderately seated but flat at the heels, is the correct shoe for nearly all feet. The heels of the shoe should not be too high, should not be too short, and should be wide enough apart from each other to insure the wall of the foot obtaining a fair share of the bearing. Finally, even with the present method of shoeing, whenever it is possible to allow the frog to come to the ground, it should be encouraged to do so, and excessive paring either of the latter organ or of the bars or the sole should be strictly discountenanced. Where the sole is thin, or the frog wasted, use a leather sole or a rubber pad. With these precautions, corns may be prevented from occuring even in a foot with a predisposing conformation.

When corn is present, the first treatment usually adopted is that of 'paring it out.' This is advocated by Percival and by many other writers. We cannot say, however, that we agree with it - at any rate, not in the case of simple dry corn.

'Paring it out,' and by that we mean thinning down the sole until close on the sensitive structures, can only be advised in the case of suppurating corn, or in cases where doubt exists as to whether pus is present or not. In the latter case paring becomes necessary as an exploratory means to diagnosis.

When it appears fairly certain, even in the case of a moist corn, that pus does not exist, then paring is to be discountenanced, for the reason that it only tends to weakening of the parts and to assist largely in the corn's recurrence.

Those who advocate it do so for the reason that it relieves pressure on the injured parts.

That it does so directly from below cannot be denied; but that it also favours contraction and compression from side to side is equally certain.