Distribution of Tropical Diseases in Africa. 463 
Ainhum. 
This is a peculiar disease affecting the Negro race of both 
sexes. It always occurs in the small toes of the feet, and 
is diagnosed from leprosy and elephantiasis by there being 
no constitutional disturbance. The origin of the disease is 
unknown; it commences by an almost semicircular furrow 
in the digito-plantar fold on the internal and inferior surface 
of the root of the little toe. There is no marked inflammation 
or ulceration. The toe, however, increases in bulk until it is 
four or five times its ordinary size. The furrow gradually 
deepens until the toe hangs by a small pedicle to the 
foot. Sensibility of the toe is not lost. The treatment 
of the disease consists in amputation, after which it is not 
found that the other toes become affected. 
Beri- Bert. 
Beri-beri is a disease which manifests itself in anemic 
or debilitated individuals; also in those following sedentary 
occupations. It is never met with in people until they have 
resided in the country, where it is endemic, for about a year. 
It is a fatal disease, death taking place either by syncope or 
from embolism. Its cause is unknown; there are, however, 
two theories in regard to it. The one is, that it is due to 
water impregnated by saline material, and the other that it is 
akin to Egyptian chlorosis (g.v.), and that water conveys to 
the individual the larve of the Anchylostomum duodenale. 
I incline to the former theory. 
It has long been thought that a specific micro-organism 
must cause beri-beri, and two observers—Drs Mosso and 
Morelli—have examined the blood of eleven patients suffering 
from the disease, with uniform results. When rabbits and 
guinea-pigs were inoculated with cultures made from the 
micro-organisms of the blood, the animals apparently died 
from beri-beri, and after death three prominent conditions 
were found—ascites, hydroperi cardium, and nephritis. The 
liquid found in the abdomen and pericardium was strongly 
albuminous, and contained salts—corresponding, therefore, in 
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