A very interesting account of this remarkable disease will be found in the August number of Indian Medical Gazette for 1873, which will amply repay perusal.
BHAXTeuiPoEE,
CASE OF By C. J. H. As
"
amJium,"
Warden, or
"
AINHUM."
Civil
Surgeon of Bhaugulpore.
spontaneous amputation of the little toes
rare disease, the accompanying notes of a case recently came under my notice, may perhaps he worth recording. This is the first case seen by the Assistant Surgeon after 10 years' service. On the 1st Jlme a man, with an ulcer encircling one half of a toe, applied for relief at the Sudder Dispensary. Assistant Surgeon N. 0. Banerjee, at once recognizing the disease from a description he had read in the Indian Medical Gazette for August 1873, kept the case for me to examine. The patient, aged about 45, a cultivator, and who had always resided in this district, gave the following history:?About two years ago the left little toe fell off ; it had never been injured, but it was gradually ulcerated through, and one night while out walking he knocked it off. Ulceration first set in on the right little toe five or six months ago, shortly after it had been injured by a blow. He has always been a healthy man. No other people in his village have ever suffered from his present disease, and he
is
a
somewhat
which
has
never
known any person who had suffered in
a
similar
manner.
On examination the little toe was hypertrophied, and measured 2| inches in circumference. It appeared to be twisted outward, so that the nail, instead of being on the dorsal surface On the dorsal surface was of the toe, was to one side. a thin line of healthy ulceration, and the ulcerative process had commenced at a point anterior to the metatarso-phalangeal articulation. No bone could be felt on probing the ulcer. On the plantar surface of the toe was a narrow shallow furrow, which was partially filled up with a soft mass of epithelial scales, on removing which the groove was slightly deepened ; " the skin at the bottom was white. There was no strict line of demarcation" to shew where the ulcerative process ceased, and the furrowing commenced?roughly, the dorsal half of the too was ulcerated, and the plantar portion grooved. There was but complaint was made of considerable no cedemaof the foot, in walking. On the 4th June toe pain in the toe, especially blood were lost. was removed, only a few drops of
The skin was very considerably hypertrophied, especially the furrow on the plantar surface of the toe. The bones appeared to be unaffected, and the cartilages covering their Tendons could not be ends were healthy in appearance. made out with certainty. The remainder of the section consisted of granular fatty matter, and fibrous tissue.
near
6th June 1877.
BHAXTeuiPoEE,
CASE OF By C. J. H. As
"
amJium,"
Warden, or
"
AINHUM."
Civil
Surgeon of Bhaugulpore.
spontaneous amputation of the little toes
rare disease, the accompanying notes of a case recently came under my notice, may perhaps he worth recording. This is the first case seen by the Assistant Surgeon after 10 years' service. On the 1st Jlme a man, with an ulcer encircling one half of a toe, applied for relief at the Sudder Dispensary. Assistant Surgeon N. 0. Banerjee, at once recognizing the disease from a description he had read in the Indian Medical Gazette for August 1873, kept the case for me to examine. The patient, aged about 45, a cultivator, and who had always resided in this district, gave the following history:?About two years ago the left little toe fell off ; it had never been injured, but it was gradually ulcerated through, and one night while out walking he knocked it off. Ulceration first set in on the right little toe five or six months ago, shortly after it had been injured by a blow. He has always been a healthy man. No other people in his village have ever suffered from his present disease, and he
is
a
somewhat
which
has
never
known any person who had suffered in
a
similar
manner.
On examination the little toe was hypertrophied, and measured 2| inches in circumference. It appeared to be twisted outward, so that the nail, instead of being on the dorsal surface On the dorsal surface was of the toe, was to one side. a thin line of healthy ulceration, and the ulcerative process had commenced at a point anterior to the metatarso-phalangeal articulation. No bone could be felt on probing the ulcer. On the plantar surface of the toe was a narrow shallow furrow, which was partially filled up with a soft mass of epithelial scales, on removing which the groove was slightly deepened ; " the skin at the bottom was white. There was no strict line of demarcation" to shew where the ulcerative process ceased, and the furrowing commenced?roughly, the dorsal half of the too was ulcerated, and the plantar portion grooved. There was but complaint was made of considerable no cedemaof the foot, in walking. On the 4th June toe pain in the toe, especially blood were lost. was removed, only a few drops of
The skin was very considerably hypertrophied, especially the furrow on the plantar surface of the toe. The bones appeared to be unaffected, and the cartilages covering their Tendons could not be ends were healthy in appearance. made out with certainty. The remainder of the section consisted of granular fatty matter, and fibrous tissue.
near
6th June 1877.
