This makes the cause, according to Eyles, an inflammatory and
trophic phenomenon due mainly to changes following pressure on
the vasomotor nerves.
Etiology.--The theories of the causation of ainhum are quite
numerous. The first cause is the admirable location for a furrow
in the digito-plantar fold, and the excellent situation of the
furrow for the entrance of sand or other particles to make the
irritation constant, thus causing chronic inflammatory changes,
which are followed subsequently by the changes peculiar to
ainhum. The cause has been ascribed to the practice of wearing
rings on the toes; but von Winckler says that in his locality
(British Guinea) this practice is confined to the coolie women,
and in not one of his 20 cases had a ring been previously worn on
the toe; in fact all of the patients were males. Digby says,
however, that the Krumens, among whom the disease is common, have
long worn brass or copper rings on the fifth toe. Again the
natives of India, who are among those most frequently afflicted,
have no such custom.
Injury, such as stone-bruise, has been attributed as the initial
cause, and well-authenticated cases have been reported in which
traumatism is distinctly remembered; but Smyth, Weber, and
several other observers deny that habits, accidents, or work, are
a feature in causation.
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