Tropical diseases : a manual of the diseases of warm climates / by Patrick Manson.

  • Manson, Patrick, Sir, 1844-1922.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Tropical diseases : a manual of the diseases of warm climates / by Patrick Manson. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    under surface of the joint flexures of the toes in many individuals of this race, even of those not aftected witli ainhum, we often find the skin, particu- larly at the proximal joint of the little toe, thick, rough, scaling, and sometimes even ulcerated. One can understand that continued irritation of this sort, produced and kept up by wounds from sharp grasses and so forth, would in time give rise, especially in the dark-skinned races so prone to keloid, to fibrotic changes in the derma, which might very well end in a sort of linear cicatricial contraction and, ultimately, in slow atrophying strangulation of the afi'ected member. The disease is said, however, to have been seen in those who wear shoes; but unless it could be shown that such individuals had always worn shoes, this objection to the explanation offered would not apply. I have seen a case in which the entire integument of the little toe was involved in a sclerodermia, and the part in consequence shrunken and hide-bound, whilst the little toe of the other foot was affected with well-marked ordinary ainhum ; the process was diffuse, as it were, on the one side and localised on the other. Treatment.—It has been suggested that division of the constricting fibrous band would delay the evolu- tion of the disease. In the early stage this might be tried. When troublesome, the afiected toes should be amputated. THE END.