. Surgery, its principles and practice . d, J. M. H.: Brit. Med. Jour., Sept. 21, 1901, 797. AINHUM. The name ainhum is of African derivation, meaning to saw,and is given to a curious disease affecting colored races, more particularlythe black. It is characterized by a slow amputation of one or more 1136 TROPICAL SURGERY. digits, generally a symmetric separation of the little toes, although othertoes or even fingers may be affected. It is prevalent in Africa, in India,and in Brazil.^ In the United States^^ over a dozen cases are on record,all in negro patients. The disease begins with a fissur


. Surgery, its principles and practice . d, J. M. H.: Brit. Med. Jour., Sept. 21, 1901, 797. AINHUM. The name ainhum is of African derivation, meaning to saw,and is given to a curious disease affecting colored races, more particularlythe black. It is characterized by a slow amputation of one or more 1136 TROPICAL SURGERY. digits, generally a symmetric separation of the little toes, although othertoes or even fingers may be affected. It is prevalent in Africa, in India,and in Brazil.^ In the United States^^ over a dozen cases are on record,all in negro patients. The disease begins with a fissure at the rootof the toe, on the plantar surface. Usually the little toes of both feet areaffected simultaneously, but one foot may remain sound or subsequentlybecome diseased. The fissure deepens and extends entirely around thedigit, without pain, and with very little if anj^ ulceration and no toe, which is being very slowly amputated, enlarges and becomesalmost spherical, and finally after several years drops off. The con-. FlG. 561. AiNHUM. striction is generally at the first interphalangeal joint, but may be aroundthe first phalanx. After separation a small ulcer is left which usuallyheals without further trouble. The disease is seldom attended with annoy-ing symptoms, and gives, indeed, so little inconvenience to the patientsthat they may not seek treatment until the last stages. Occasionally theconstricting groove may be ulcerated or painful, but this is generally due toinjury when the toe has nearly separated. Ainhum is most common inadult males, but the cause of the complaint is entirely obscure. Zambaco*believes it to be a very much attenuated nerve leprosy, but the disease,as in Brazil, is common in regions where leprosy is not seen. It is notdue, as has been asserted, to the wearing of rings on the toes after the cus- GOUNDOU. 1137 torn of savages, because it occurs among people where such a custom isunknown (American negroes, for instance, do not wear to


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