484 THOMAS DWI(41IT OX THE 



imitate a radius. On tlie Iroiit of the projection of the coronoid process is a surface 

 resembling a part of the head of a radius and the lower end is broader than that of the 

 ulna proper. Evidently the bone which developed as a supernumerary ulna made, so to 

 speak, an effort to adapt itself to the functions of a radius. 



It is curious also to notice the change in the arteries from the normal type. Thus 

 the brachial after a high division gave off an ulnar which runs deeply and gives origin to 

 the interosseous, as is natural. The other branch runs at first superficially like a radial and 

 then changes into an ulnar giving, as docs the other, a characteristic deep l)ranch to the 

 palm. 



Still more curious is the origin from tlie musculo-spiral nerve of a branch in the place 

 of the I'adial which becomes an ulnar. 



We now come to the most important part of the discussion, namely, to the resem- 

 blance of the best described of the cases of this deformity to each other. It is more 

 important than the aetiology, for any prospect of solving that (question is extremely remote, 

 while there is rea.son to hope that this dissection will serve as a clue to some of the cases 

 already described. We shall now take in turn several of the features of this case. The 

 one with which it shows a very striking resemljlance is that recently reported by Jolly. 

 In both the persons were German males and in both the deformity was on the left side. Dr. 

 Jolly's patient was of a peculiar mental and moral organization. There is some (but not 

 conclusive) reason to think that the same could be said of this individual. In Dr. Jolly's 

 case there was flattening in the deltoid region and an inability to raise the arm above a 

 horizontal line. The scapula is peculiar in this case and there is indication of weakness 

 in the same region. In both cases the affected arm was shorter. What can be felt about 

 the elbow in Jolly's case agrees almost perfectly with the conditions of this one. Dr. 

 Jolly states that where the biceps should he there is felt ;i strong bony ridge ending in a 

 blunt prominence. This is the supernumerary internal condyle which may have had a 

 stronger development than in this case. It is perhaps not impossible that the strong 

 muscular or tendinous band running to it may have given the impression that the boiie 

 extended higher than was really the case. The restriction of angular motion and the 

 almost complete absence of pronation and supination give sti'ong confirmation of the 

 similarity of the joints. The photograph shows something of a tendency to flexion and 

 pronation of the hand at the wrist, which Dr. Jolly does not allude to, but it certainly is far 

 less marked than in this case. It is hardly possible to doubt that, except in the condition 

 of the wrist, the cases were similar in all important respects. It is not easy to guess what 

 relation there can be between want of development of the shoulder muscles and this mal- 

 formation of the hand and arm ; but the simultaneous occurrence of these conditions in 

 two cases cannot be regarded as accidental. 



Mr. Murray's case is less fully reported and seems somewhat difficult to class with 



