confess "thai I "am "not- satisfied about 'the condition in all of syphilis, and the man
particulars. There was no history was healthy in all other respects. 9th August 1880.
A CASE OF ANIHUM. By Dr. G. C. Rot, M. D., F. R. C. Civil
S.,
Surgeon, Bccrbhoom,
in the silk factory Goopeenatli, aged 33 years, a labourer with at Gontea, came to the Dispensary on the 21st July the little toe of right foot. a circular constriction round knock against It commenced 5 or 6 months ago after a slight abraded nor was the hurt a stone, but neither was the skin After a few at the time. of a nature to attract his notice months after the hurt he days the toe was painful, and threethe base of it on the inner noticed a groove forming round The pain is now so excruciaside, which gradually deepened. that it has virtually disabled him ting on the slightest touch to the toe, but now he from work. At first it was confined constriction. There feels it also on the proximal side of the on its is a deep furrow encircling the base of the toe except is lined outer side, where the skin is not indented, The groove with thick epidermic scales which, on being removed, expo-ed The groove had extended to nearly an ulcerated surface. three-fourths the depth of the toe which was slightly hyperin the skin tropliied and everted. There is no loss of sensation of thj neighbourhood. No history of syphilis can be traced. On examining the other toe a shallow groove was found in the course of formation. It was confined to its inner side and tailed off over the dorsum. The skin was thickened in the ulceration. He had not noticed it groove, but there was no a himself until we drew his attention to it. The toe had as yet. tendency to eversion, but there was no pain in it was removed at the p oint of ; ; The little toe of the right foot constriction. Examined after removal, the distal phalanx The place of the first phalanx was was found* healthy. supplanted by an indurated tissue surmounted by the shell of its cartilaginous articular surface, so that during amputation the knife passed smoothly through its structure. Under, the microscQpe it was found to consist of white fibrous tissue in which were sparely interspersed fusiform nucleated cells and oil globules. "
??
ItcviarJ/s,
r
f
This disease is of very
rare occurrence ; I case within 8 years
do not remember of my practice, to have seen another certainly not since it was so prominently brought to notice ii\ the pages of the Indian, Medical Gazette by Dr. Crombie. The symptoms followed 3 months after a slight hurt. Could this have,been.the exciting cause ? But the appearance of the other toc^ independent of any such injury, groove on the precludes the idea of^ its local origin. All symmetrical diseases own a constitutional cause, and the both-sidednesa in the present instance stamps it as coming under that category. What is the nature of the pathological change ? If one? can the testimony of one individual' case, \enture an opinion on it appears to be a sort of fibrous degeneration of the bone. But the appearance of the symptom first shows itself on the is perceptibly diseased. In the skin long before the bone all that we observed on the other toe in case under notice in the course of formation, was a Which the disease was the bone was yet firm and the part shallow groove, whilst Whether the groove deepens healthy in all other respects. ulcerates till the toe and certain off, drops circumferentially it "is that the bone coincidently undergoes a fibrous degenerastructure entirely tion in which its proper disappears. We that softening of the bone will destroy its* can understand the preponderating action of the flexors leverage,,and thatmuscles of the toe will make it gradually over the extensor that direction and first show itself in abend on itself on shallow groQve which deepening by ulceration completes the of the limb. This is the only exspontaneous amputation of this pathological eliange, but I must planation I can give
particulars. There was no history was healthy in all other respects. 9th August 1880.
A CASE OF ANIHUM. By Dr. G. C. Rot, M. D., F. R. C. Civil
S.,
Surgeon, Bccrbhoom,
in the silk factory Goopeenatli, aged 33 years, a labourer with at Gontea, came to the Dispensary on the 21st July the little toe of right foot. a circular constriction round knock against It commenced 5 or 6 months ago after a slight abraded nor was the hurt a stone, but neither was the skin After a few at the time. of a nature to attract his notice months after the hurt he days the toe was painful, and threethe base of it on the inner noticed a groove forming round The pain is now so excruciaside, which gradually deepened. that it has virtually disabled him ting on the slightest touch to the toe, but now he from work. At first it was confined constriction. There feels it also on the proximal side of the on its is a deep furrow encircling the base of the toe except is lined outer side, where the skin is not indented, The groove with thick epidermic scales which, on being removed, expo-ed The groove had extended to nearly an ulcerated surface. three-fourths the depth of the toe which was slightly hyperin the skin tropliied and everted. There is no loss of sensation of thj neighbourhood. No history of syphilis can be traced. On examining the other toe a shallow groove was found in the course of formation. It was confined to its inner side and tailed off over the dorsum. The skin was thickened in the ulceration. He had not noticed it groove, but there was no a himself until we drew his attention to it. The toe had as yet. tendency to eversion, but there was no pain in it was removed at the p oint of ; ; The little toe of the right foot constriction. Examined after removal, the distal phalanx The place of the first phalanx was was found* healthy. supplanted by an indurated tissue surmounted by the shell of its cartilaginous articular surface, so that during amputation the knife passed smoothly through its structure. Under, the microscQpe it was found to consist of white fibrous tissue in which were sparely interspersed fusiform nucleated cells and oil globules. "
??
ItcviarJ/s,
r
f
This disease is of very
rare occurrence ; I case within 8 years
do not remember of my practice, to have seen another certainly not since it was so prominently brought to notice ii\ the pages of the Indian, Medical Gazette by Dr. Crombie. The symptoms followed 3 months after a slight hurt. Could this have,been.the exciting cause ? But the appearance of the other toc^ independent of any such injury, groove on the precludes the idea of^ its local origin. All symmetrical diseases own a constitutional cause, and the both-sidednesa in the present instance stamps it as coming under that category. What is the nature of the pathological change ? If one? can the testimony of one individual' case, \enture an opinion on it appears to be a sort of fibrous degeneration of the bone. But the appearance of the symptom first shows itself on the is perceptibly diseased. In the skin long before the bone all that we observed on the other toe in case under notice in the course of formation, was a Which the disease was the bone was yet firm and the part shallow groove, whilst Whether the groove deepens healthy in all other respects. ulcerates till the toe and certain off, drops circumferentially it "is that the bone coincidently undergoes a fibrous degenerastructure entirely tion in which its proper disappears. We that softening of the bone will destroy its* can understand the preponderating action of the flexors leverage,,and thatmuscles of the toe will make it gradually over the extensor that direction and first show itself in abend on itself on shallow groQve which deepening by ulceration completes the of the limb. This is the only exspontaneous amputation of this pathological eliange, but I must planation I can give
