479 



articulated. This bone was more salient than is usual, and dorsally 

 stood out as a rather broad ridge. (Vide Figure.) Between it and the 

 fifth metatarsal was a hollow which became more manifest when the 

 outermost toe was strongly abducted. Inter-phalangeal joints which 

 could be made out by manipulation, were present in the supernumerary 

 toe, but only a very slight degree of flexion could be brought about 

 spontaneously, even when the child flexed as forcibly as possible the 

 adjoining fourth toe. I much regret not having secured an X-ray 

 photograph which would have cleared up the question regarding the 



Phot. C. J. Patten. 



Hyperdactyly in the Left Human Foot. Photographed from Nature. The heel is 

 raised on a foot-rest and the foot viewed from the dorsal aspect. 



a Great toe, abducted, b Supernumerary fourth toe, closely adducted. c True 

 fifth toe (occupying the outermost position in the foot), abducted and rotated, d Promi- 

 nent ridge on the fourth metatarsal, e Placed in the hollow between the fourth and 

 fifth metatarsals. ./" Fifth metatarsal. /' Spur of fifth metatarsal, g External malleolus. 



disposition of the tarsal and metatarsal bones ; however, from the 

 examination which I was able to make, it seems that the fourth meta- 

 tarsal only was enlarged, its head being reduplicated so that its two 

 articular surfaces formed joints respectively with the true fourth and 

 the supernumerary fourth proximal phalanges, each of which, in turn, 

 was succeeded by the ordinary number of distal phalanges. The Figure 

 — reproduced from a photograph — shows the disposition of the 

 toes when the child put all possible movement into them. The great 



