478 



Nachdruck verboten. 



A Case of six Toes on the left Foot. 



By C. J. Patten, M. A., M. D., So. D., Professor of Anatomy, 

 Sheffield University. 



With one Figure. 



While I was acting as resident pupil in Sir Patrick Dun's Hospital, 

 Dublin, a child, aged about eleven, was brought to the out-door dis- 

 pensary to be treated for some minor ailment. She was well-nourished, 

 bright and happy-looking, despite the fact that her garments were 

 scanty and tattered. She was without boots and stockings, and on 

 being questioned, told me that she had never worn any. 



She was a nervous child, constantly moving her hands and feet. 

 These digital movements attracted my attention, and I discovered that 

 there was an extra toe on the left foot. When the foot was raised 

 and the heel placed on a foot-rest, I asked the child to move the toes 

 as much as she possibly could. 



I found that she possessed considerable power of abduction in the 

 great toe, marked power of abduction and of flexion — almost as much 

 as a baby usually displays — in the outer most toe, and certainly more 

 capacity to flex the second, third, and fourth toes than is possessed by 

 the average person. While these free digital movements of the foot are 

 not uncommon in individuals who do not wear boots (I have several 

 times observed such in the feet of the peasantry in remote parts of 

 Ireland, where they seldom put on boots save on religious and festive 

 occasions), it was here necessary to test such movements with special 

 interest, in order to determine if the extra digit were fully developed 

 and bore its own metatarsal with its accompanying musculature, or were 

 but a fleshy bud-like process. It would appear that the extra toe was 

 not the outermost one or sixth, as counted in numerical order from 

 within outwards, but rather the fifth, which, though perfectly developed 

 and a shade longer than the sixth, displayed practically no movement 

 except in conjunction with the fourth to which it remained closely 

 adducted. 



I was able to determine a wide and prominent fourth metatarsal 

 bone with which the proximal phalanges of the fourth and "fifth" toes 



