AINHUM. — African word meaning "to saw off." Definition. — Ainhum is a disease oc curring exclusively in negroes and con sisting in the spontaneous amputation of the little toe by an adventitious fibrous band.
Symptoms.—The first indication of the disease is a furrow on the lower surface of the little toe, and occasionally other toes, at the proximal interphalangeal joint. This furrow, the result of the circumferential pressure exerted by a fibrous ring, gradually deepens until the bone is reached, this process taking sev eral years, sometimes as many as ten.
The distal portion of the toe becomes greatly hypertrophied, then finally drops off, the stump healing without further complication in the great majority of cases. It does not give rise to much suf fering, owing to its very gradual progress. It is sometimes mistaken for leprosy.
Ainhum is an affection apart from leprosy. Cases of circular constriction in leprosy are exceedingly uncommon, are always located on the fingers, and are always accompanied by other morbid manifestations, which indicate a more or less intense infection of the blood by the virus or a localization of the affection in the nerves, the skin, or the mucous membrane. II. de Brun (Bull. de l'Acad.
de Med., Aug. 25, '96).
Etiology.—Ainhum is always observed in negroes, especially of the western coasts of Africa and South America. A number of cases have also been reported in the United States by Bringier. Hin (loos are said to also suffer from this disease. Self-mutilation has been sug gested by some observers, but the like lihood of this cause is very slight. Heredity does not seem to play any role in its production.
Pathology. — The lesions observed have been hypertrophic thickening and retraction of the derma. with consequent atrophy of the underlying bone (Her mann, Weber, Wucherer, Schtippel). It has been confounded with congenital amputation, but, as stated, ainhum is never congenital. That the disease bears some connection with leprosy is insisted upon by some authorities.
In all cases of true ainhum undoubted symptoms of leprosy are present. It should be looked upon as an attenuated form of the latter disease. Its relations
to sclerodernm are explained by the fact that this latter affection is a special fom of leprosy. Zambaco Pacha (Bull. de l'Acad. de Med., July 2S, '96).
Treatment. — Surgical measures alone prove of value in these cases. Early section of the fibrous ring is sometimes sufficient to arrest the progress of the disease or division of the skin down to the periosteum on the opposite of the seat of disease may be resorted to.
Case successfully treated by dividing the skin and all the tissues down to the periosteum, on the side opposite to the seat of the disease. Murray (Lancet, Jan. 30, '92).
is a compound of der mathl and iodine discovered and intro duced by Lhdy as a substitute for io doform. It occurs as a tasteless and odorless powder, unaffected by light, and containing 44.5 per cent. and 24.S per cent. of iodine; its color is gray green, but moist air or the discharge from a wound rapidly converts it into a red substance, with liberation of iodine. It is insoluble in ordinary reagents, but readily dissolves in strong caustic soda or weak mineral acids.
Preparations and Dose.—The powder is employed in the same manner as iodo form in the treatment of superficial lesions.
It has also been used dissolved in glyc erin, but Aemmer has recently shown that the poisonous effects of the drug were thus increased.
Bruns, of Tiibingeh, recommends airol paste as an ideal dressing for sutured wounds. It dries rapidly and adheres closely; it is powerfully antiseptic, and absolutely unirritating to the most sen sitive skin; but its chief advantage is that it permits the secretions to ooze through it. He has used it for six months, especially after laparotomies, herniotomies, and ignipunctures, and did not observe an instance of stitch-hole suppuration with it. He concludes that occlusion with airol paste furnishes the simplest means of obtaining healing by first intention. His formula is: Airol, mucilaginous gum arabic, glycerin, of each, 10 parts; bolus albus, 20 parts. He employs it even in wounds with drainage.