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If the brain cannot endure the strain, then neurasthenia, nerve exhaustion, or even insanity follows. If the thyroid cannot endure the strain, it undergoes hyperplasia, which in turn may result in a colloid goiter or in exophthalmic goiter. If the adrenals cannot endure the strain, cardiovascular disease may develop.
The histology of ainhum shows it to be a direct ingrowth of epithelium, with a corresponding depression of surface due to a rapid hyperplasia that pushes down and strangles the papillae, thus cutting off the blood supply from the epithelial cells, causing them to undergo a horny change. The disease is not usually symmetric, as formerly stated, nor is it simultaneous in different toes.
If no positive evidence of the disease exists, by means of careful exploration of sinuses with the probe, one may distinguish between true cartilaginous quittor and superficial abscess formation that is often accompanied by hyperplasia. Lameness depends upon the extent of the involvement as it affects the structures contiguous to the cartilage.
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