|Year : 2015 | Volume
| Issue : 3 | Page : 194-198
Homoeopathic treatment of Heloma durum-Case Report
KM Nisanth Nambisan1, Smita N Nambisan2
1 Department of Surgery, Government Homeopathic Medical College, Bhopal, Madhya Pradesh, India
2 Department of Pharmacy, Narayan Shree Homeopathic Medical College, Bhopal, Madhya Pradesh, India
|Date of Submission||06-Jan-2015|
|Date of Acceptance||15-Jul-2015|
|Date of Web Publication||30-Sep-2015|
K M Nisanth Nambisan
E-11/2, Char Imli, Bhopal - 462 016, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
Heloma durums also known as corns are areas of hard, thickened skin which commonly occur on the feet, and can cause pain, discomfort, and they also tend to reoccur. Two cases of plantar heloma durums illustrated here were treated with same medicines with similar genetic make-up, that is, father and daughter. Father received the medicine after case taking whereas 15 years later, the daughter received homoeopathic treatment given to the father. Both tried other modes of treatment including invasive procedure before being successfully cured in a short span of time with homoeopathic treatment protocol. Here, the same treatment cured both father and daughter, which indicates that the same homoeopathic medicine is effective, in similar genetic make-up for a given disease (genetic similimum). Several studies show the potential of homoeopathic medicine to regulate gene-expression in animal and plant models. It seems that the present treatment is also acting in the same fashion by regulating the gene responsible for predisposing corn formation.
Keywords: Corn, Gene-expression, Genetic similimum, Heloma durums
|How to cite this article:|
Nisanth Nambisan K M, Nambisan SN. Homoeopathic treatment of Heloma durum-Case Report. Indian J Res Homoeopathy 2015;9:194-8
|How to cite this URL:|
Nisanth Nambisan K M, Nambisan SN. Homoeopathic treatment of Heloma durum-Case Report. Indian J Res Homoeopathy [serial online] 2015 [cited 2019 May 19];9:194-8. Available from: http://www.ijrh.org/text.asp?2015/9/3/194/166391
| Introduction|| |
Heloma durum or corn (clavi) is acquired areas of thickened skin (keratosis) that appear over sites of repeated or prolonged trauma to the epithelium. These lesions arise because of pressure, friction, and shearing forces of bone (through the overlying skin) against adjacent digits, metatarsal heads, or footwear. They are associated with poorly fitting footwear, underlying anatomic deformities, and high levels of activity. The formation of the center (nucleus, radix) of corn is secondary to vascular changes, and fibrosis underlying the point of maximum stress. There is marked hyperkeratosis of the stratum corneum overlying an epidermis that has otherwise the same thickness as the adjacent skin. 
Corns are a common foot problem and surveys have indicated that between 14% to 48% of people suffer from them. Many of these will seek podiatry treatment; however, there is little evidence to indicate which current treatments in conventional medicine provides a long term resolution.  Disorders of cornification are a group of diseases that share abnormalities in the manufacture or desquamation of corneocytes. 
A hard lesion in the plantar area is kept under a larger term plantar keratosis which includes warts. Surgical treatment is usually not indicated since the rate of recurrences is as high as with the conservative therapy, and the resulting scars may lead to the same complaints.  Conventional treatment methods are usually invasive, have low efficacy, and need long recovery periods. 
| Case studies|| |
Case No 1
A male patient aged 36 years, forest ranger by profession, presented with multiple painful corns on the plantar aspect of both feet at our OPD March 3, 1999.
Painful corns, four corns on the plantar aspect of the left foot and two on the right foot. Aggravation of pain on standing and walking, more so walking bare foot on the floor. The continuous pain of the stitching character.
History of presenting complaints
Corns were present since about 6 months, for which he was taking analgesics, local application of Salicylic acid, and had already taken the opinion of a surgeon, who had advised him surgery followed by 4 weeks of medication, and rest for healing the wound as a result of surgery, with a word of caution, that, it may reoccur. This prompted him to seek homeopathic consultation. Due to his occupation, he had to continuously walk in the forest in difficult terrain, therefore, frequently took analgesics to control pain.
- Illness/disease: Nothing significant
- Surgical treatment: Single corn removal in the past
- Medical treatment: Analgesics, corn cap
- Causation: Walking with ill-fitting heavy shoes.
Family history - No specific history except father being hypertensive.
- Sleep/dream: Nothing significant
- Urine/urinary tract: Nothing significant
- Bowel: Regular
- Thirst: Adequate.
Constitution: Medium built.
Height: 5 feet 3 inches, weight: 71 kg.
Relation to heat and cold: Ambient.
Mentals: Well behaved, yielding gentleman.
Physical general: Desire/aversion: Nothing significant.
Personal habit: Nothing significant.
Systematic examination: Nothing significant.
Local examination: Corn tender on direct pressure, no signs of discharge or inflammation, striae on the corn.
Plantar warts are often similar to calluses or corns, but they are differentiated by skin striations. Skin striae go around plantar warts; if the lesion is not a plantar wart, the striations continue across the top layer of the skin. Plantar warts tend to be painful on the application of pressure from either side of the lesion rather than direct pressure, unlike calluses (which tend to be painful on direct pressure instead).  In the present case, local examination, and clinical presentation indicates the case to be of heloma durum.
With the help of Kent's Repertory, the case was repertorised with the following rubrics:
- Extremities; corns; painful
- Extremities; corns; painful; aching
- Extremities; corns; painful; stitching, stinging
- Generalities; intoxication, after; medicaments [Table 1].
Review of Materia Medica
Pain in the corns (27 th day). About 4 p.m., and all the afternoon, constant pain in the corns, as if the boot pressed on them, and frequent alternation of a drawing penetrating pain, combined with the feeling of stiffness, now in the joints of the left great toe, now in the right ankle-joint, now in the ligamentous connection of the right ankle, with the metatarsal bone (at rest and when moving), (1 st day). Corns painful, as if pressed by a tight shoe. Pains in the corn of the right little toe (127 th day). Frequent violent sticking in the corns. Sticking in corn, at night, in bed. Violent stitches in the corn, in the evening, in bed, and several evenings. Sticking burning in corn, in a wide shoe. 
Large horny places on the skin of the soles of the feet, close to where the toes commence, which pained like corns, and always returned after having been cut out. Great sensitiveness of the soles of the feet, when walking, especially upon the stone pavement, for a long time (after 7 days). 
Sulphur 200 single dose was given in the morning, next day onward Antimonium crudum 30 TDS for 7 days.
| Results|| |
The patient did not turn up after 7 days, and it was assumed that the patient had left treatment. But, several months later the patient came back for another minor ailment, on this consultation he was enquired about his corns, this is when he reported that the corns became painless the very next days after taking Sulphur and all of them disappeared in 10 days time. In a recent conversation, the patient confirmed that the corn did not reoccur in the past 16 years.
Case No 2
After 15 years, the same patient brought his daughter, aged 18 years on 12 September 2013 with single painful corn in plantar aspect of left foot with sign of desquamation due to application of corncap [Figure 1]. Before coming to us, she had tried several treatment options in another city including corncap tapes, and Homoeopathy. Application of corncap reduced the size for a short period of time, but, it grew back after sometime. She had received homoeopathic treatment for about 4 months, without any relief, the patient could not give the details about previous homoeopathic medication, but, was assertive that the detailed case interview was done before starting the treatment. Assuming that she might have already received the commonly indicated medicine from the previous homoeopath, we once again prescribed the same medication given to her father 15 years ago [Figure 1].
Sulphur 200 single dose was given in the morning, next day onward Antimonium crudum 30 TDS for 7 days followed by placebo [Table 2].
| Results|| |
On 23 rd September 2013, the patient reported no pain, and 90% of the corn had resolved, on 10 th October 2013, the corn had completely disappeared while on placebo [Figure 2].
| Discussion and conclusion|| |
Heloma durum (corn) a so called surgical disease with sycotic miasm in the background, with high chances of recurrence, has no answer in the modern medicine other than surgical removal. Surgical removal is not only painful but, also requires immobility for 4-6 weeks till the wound heals up. Both the cases discussed above had tried other treatment modes before taking the above homoeopathic treatment protocol.
Pathogenetic trails (homoeopathic proving) of Sulphur and Antimonium crudum has shown a definitive role in thickening of the skin (keratosis), and also that it adapts well to persons constitutionally having thick skin. Determination of constitution in homoeopathic case taking tries to ascertain the genetic make-up of an individual or diseased part, and choosing a medicine picture of similar genetic make-up from the Materia Medica derives the right similimum, effecting a cure. Is this also true for hereditary diseases?
In above mentioned cases, Case no. 1 received medication after case taking, and Case no. 2 daughters of Case no. 1 received repetition of medication received by case no. 1 that is., her father without case taking, both cases cured in short span of time. Here the same treatment cured both father and daughter, which indicates that the same homoeopathic medicine is effective, in similar genetic make-up for a given disease (genetic similimum).
Several studies show the potential of homoeopathic medicine to regulate gene-expression in animal and plant models. , It seems the present treatment protocol is also acting in the same fashion by regulating the gene responsible for predisposing corn formation. More detailed study both clinical and laboratorical is needed to ascertain the role of genetic similimum in treating incurable diseases.
Financial Support and Sponsorship
Conflicts of Interest
There are no conflicts of interest.
| References|| |
Arndt KA, Hsu JT. Manual of Dermatologic Therapeutics. 7 th
ed. Philadelphia; Lippincott Williams and Wilkins; 2007. p. 47.
Farndon LJ, Vernon W, Walters SJ, Dixon S, Bradburn M, Concannon M, et al
. The effectiveness of salicylic acid plasters compared with ′usual′ scalpel debridement of corns: A randomised controlled trial. J Foot Ankle Res 2013;6:40.
Shwayder T. Disorders of keratinization: Diagnosis and management. Am J Clin Dermatol 2004;5:17-29.
Haneke E. Differential diagnosis and therapy of calluses, corns and plantar warts (author′s transl) Z Hautkr 1982;57:263-72.
El-Mohamady Ael-S, Mearag I, El-Khalawany M, Elshahed A, Shokeir H, Mahmoud A. Pulsed dye laser versus Nd: YAG laser in the treatment of plantar warts: A comparative study. Lasers Med Sci 2014;29:1111-6.
Khuda-Bukhsh AR. Potentized homeopathic drugs act through regulation of gene-expression: A hypothesis to explain their mechanism and pathways of action in vivo
. Complement Ther Med 1997;5:43-6.
Ganger HU. Management and control of genetic processes in cotton plants through homeopathy. Indian J Res Homeopath 2007;1:1-5.
[Figure 1], [Figure 2]
[Table 1], [Table 2]