WRIST-JOINT (ABNORMAL ANATOMY). 



1509 



puytren did not suppose had been fractured, 

 was deformed, and only six inches and a half 

 long. 



At the period when this case, the subject of 

 so much difference of opinion between two 

 such eminent pathologist^, attracted the atten- 

 tion of the profession in Dublin, the writer 

 hail under his care, in the House of Industry, 

 a patient who was born with deformity of 

 both her wrist-joints and forearms, but whose 

 right wrist-joint presented appearances closely 

 resembling those described as characterising 

 the deformity of the wrist and forearm in 

 Cruveilhier's case. As the history of this 

 woman's case was known from her birth, it 

 was calculated to throw light on the subject 

 in dispute. It seemed on this and other ac- 

 counts so interesting, that on the 15th of De- 

 cember, 1838, I laid it before the Pathological 

 Society in Dublin. It was as follows : 



CASE II. Deborah O' Neil, aged thirty, 

 has been an inmate of the House of Industry, 



for the last seventeen years. She is liable to 

 occasional attacks of epilepsy. She cannot 

 be said to be insane, but she is wayward and 

 refractory, and will not submit to any rational 

 control. Yet she is very industrious. Her 

 upper arms and hands bear in size and length 

 a just proportion to the rest of her stature, 

 which is about the middle sixe, but her fore- 

 arms appear scarcely more than half their 

 normal length. 



Her left forearm is dislocated forward at 

 the radio-carpal joint, while the right forearm 

 is dislocated, as in the preceding figure, back- 

 ward on the dorsum of the carpus. 



The lower extremities of the bones of the 

 right forearm could be seen and felt on the 

 dorsum of the carpus, where they formed a 

 very remarkable projection. The lowest ex- 

 tremity of the ulna could be seen to descend 

 below the level of the lowest extremity of the 

 dislocated radius, and when the hand of the 

 patient was flexed could be made very promi- 



Fis. 925. 



Rigid Forearm, dislocated at Wrist. Case of O'Neil. 



nently to distend the skin posteriorly. When 

 the surgeon introduced his fingers in front of 

 the wrist-joint, and made a slight extension of 

 the hand, the superior extremity of the carpus 

 could be felt to be placed superiorly and ante- 

 riorly to the lowest extremities of the bones 

 of the forearm. The hand inclined to the 

 radial side, it could be extended on the fore- 

 arm freely, but flexion was incomplete. 



The left wrist-joint presented an unique 

 example of dislocation of the bones of the 



forearm exactly in the opposite direction to 

 those already described. The forearm \vas 

 thrown forwards, and the carpus with the hand 

 on the back of the radius and ulna (fig. 920.). 

 This woman presented a very grotesque ap- 

 pearance in consequence of the remarkable 

 shortness of both her forearms (Jigs. 92(>. and 

 9^7.) ; still she had a very good use of her 

 hands, and showed admirable dexterity and 

 skill in cutting out minute patterns on paper 

 with her sci.ssors. 



5 D .1 



