"Ainhum," or Spontaneous Amputation of the Toes

Dr. Menzel's case was that of a woman aged forty-four, with marked congenital deformities of all the fingers and toes, except the right thumb, which was normal The right middle finger, at the middle of the first phalanx, and the right index finger, the middle of the second phalanx, were contracted by deep furrows, with enlargement of the part beyond the constriction in the former instance. On section this presented exactly the appearances which I found in the specimens of "Ainhum" which I described last year. His hypothesis with regard to the method in which the strangulation or amputation is effected is also the same as that which I suggested. Dr. Menzel's case, however, as well as that recorded by Erichsen in his work on Surgery (Vol. II., page 298, sixtu edition) to which reference is made by the reporter, and which had escaped my notice in writing my paper last year, differs from those which occur in this part of India, in the fact that it was congenital; whereas the disease, as it exists here, commences after the individual has attained to, or even passed, middle age. The disease would appear also to have been stationary in his case, while in the cases occm-ring in the practice of Dr. Wise and myself, the disease, when it has once commenced, has advanced with varying degrees of rapidity, till the patient comes to seek relief from the annoyance caused by the pendulous mass over which he has no control. " Ainhum"