e in the
investigation of ainhum. In China a case has been seen, and British
surgeons speak of it as occurring in Ceylon. Von Winckler presents an
admirable report of 20 cases at Georgetown, British Guiana. Dr.
Potoppidan sends a report of a case in a negress on St. Thomas Island.
The disease has several times been observed in Polynesia.

Dr. Hornaday reports a case in a negress from North Carolina, and,
curious to relate, Horwitz of Philadelphia and Shepherd of Canada found
cases in negroes both of North Carolina antecedents. Dr. James Evans
reports a case in a negro seventy-four years of age, at Darlington,
S.C. Dr. R. H. Days of Baton Rouge, La., had a case in a negress, and
Dr. J. L. Deslates, also of Louisiana, reports four cases in St. James
Parish. Pyle has seen a case in a negress aged fifty years, at the
Emergency Hospital in Washington.

So prevalent is the disease in India that Crawford found a case in
every 2500 surgical cases at the Indian hospitals. The absence of pain
or inconvenience in many instances doubtless keeps the number of cases
reported few, and again we must take into consideration the fact that
the class of persons afflicted with ainhum are seldom brought in
contact with medical men.

The disease usually affects the 5th phalanx at the interphalangeal
joint. Cases of the 4th and other phalanges have been reported. Cooper
speaks of a young Brahman who lost his left great toe by this process.
Crombie speaks of a simultaneous amputation of both fourth toes.
Potoppidan reports a similar case in a negress on St. Thomas Island.
Sen reports a case in a supernumerary digit in a child, whose father, a
Hindoo, lost a toe by ainhum. Eyles reports a case in a negro in whom
the second finger was affected. Mirault, at Angiers, speaks of a case
in which two fingers were lost in fifteen days, a fact which makes his
diagnosis dubious. Beranger-Ferraud has seen all the toes amputated,
and there is a wax model by Baretta, Paris, in the Army Medical Museum
at Washington, in which all the toes of the right foot have been
amputated, and the process is fast making progress at the middle third
of the leg.

Ainhum is much more common in males than in females; it is, in fact,
distinctly rare in the latter. Of von Winckler's 20 cases all were
males.

It may occur at any age, but is most common between thirty and
thirty-five. It has been reported in utero by Guyot, and was seen to
extend up to the thigh, a stateme