1510 



As to this case of Deborah O'Neil, no am- 

 biguity existed. At the time the writer thus 

 laid her case before the meeting, accompanied 

 by casts of her forearms, she was, and had 



WRIST-JOINT (ABNORMAL ANATOMY). 



been for many years previously, an inmate in 

 the House of Industry, under the constant 

 observation of the whole medical staff of the 

 institution. The history of her life was known. 



Fig. 926. 



Left Forearm. Case of O'Neil. 



It was stated that she never met with any 

 accident, and that the peculiar deformity 

 observable in each forearm and wrist-joint 

 had existed from her birth. 



The writer, in continuation, observed, that 

 while congenital malformation was known very 

 frequently to affect simultaneously both sides of 

 the body, yet it would, on the other hand, be 

 very difficult for any one to suggest what pro- 

 bable accidental causes could be imagined 

 capable of dislocating the bones of both wrist- 

 joints, in opposite directions, as in the case of 

 O'Neil : besides, the mere displacement of the 

 bones of both forearms at the wrist-joint, con- 

 stituted only a part of the abnormal state of 

 things noticed, because both of the forearms 

 were so short as to measure only half the length 

 of the arm, and did not exceed in length the 

 measurement of the long axis of the hand. 

 The history of her case, then, from her birth 

 the negative evidence as to the existence of 

 any previous accidental cause adequate to ac- 

 count for the appearances, and the actual 

 abnormal condition of both the upper extre- 

 mities of O'Neil all taken together, suffi- 

 ciently proved her case to offer a curious spe- 

 cimen of congenital malformation of both 

 wrist-joints and forearms." 



When the writer presented this case to the 

 meeting of the Pathological Society, he laid 

 before the members two casts of the mal- 

 formed extremities of the patient, and when 

 the drawing of Cruveilhier's case (pi. 2. 

 liv. ix.), was placed along s<de of the cast of 

 the right forearm of O'Neil, every one pre- 

 sent agreed in the opinion that the cast pre- 

 sented an exact counter-part of Cruveilhier's 

 drawing (fig. 924.). 



Deborah O'Neil, five years subsequently to 

 this date, died suddenly of apoplexy, in the 

 Government Asylum, Island Bridge. Dr. R 

 W. Smith, the surgeon of the institution, made 

 a post mortem examination of the affected arti- 

 culations. The result fully proved, as had 

 been anticipated, that her right wrist-joint in 

 every respect resembled the remarkable case 

 brought forward by Cruveilhier. 



Post Mortem Examination. Upon the 15th 



of December, 1843, Mr. Smith exhibited be- 

 fore a meeting of the Dublin Pathological 

 Society, the skeleton of the limb in this case. 



The right extremity presented an example 

 of luxation of the carpus forwards, while in 

 the left was afforded an instance of displace- 

 ment of the carpus backwards. 



Right Extremity. The upper arm and 

 hand, as already mentioned, bore a just pro- 

 portion to each other, and to the stature of 

 the individual, but the forearms were scarcely 

 one half the usual length. The first range of 

 the carpus was articulated with the anterior 

 aspect of the radius, which bone was only 



Fig. 927. 



Skeleton of Right Forearm. Case of O'Neil. 

 (After Smith.) 



four inches and a half in length (fig. 927.). 

 The ulna, six inches in length, was prolonged 

 below the radius nearly half an inch, its lower 



