26 A NEW TYPE OF BBACHYPHALANGY IN MAN. 



11.4 9 L. A. H. H. (Sept. 15, 1822-Feb. 11, 1907). All information 

 concerning her, including that from her daughter, is in accord concerning 

 the fact that her fingers were normal. The correctness of this state- 

 ment is confirmed by a photograph. She married, in 1846, district 

 physician A. H. H. (Aug. 17, 1815-May 29, 1880), who was quite 

 unrelated to her. They had 12 children (114.1-114.12). 



11.5 cf C. A. B. H. (Jan. 11, 1825-July 21, 1910), bailiff. He is the 

 first member of the family whose hands were photographed and radio- 

 graphed. Dr. Frimaim Koren, who took these photographs, at the 

 same time obtained casts of his hands. His hands show the B !-type 

 of brachyphalangy in a very characteristic form. Genetically he was 

 heterozygous for the factor for brachyphalangy. The photographs 

 (fig. 4) give a good idea of the shape of his hands and make it easy to 

 understand how the affected members who show the B !-type generally 

 believe that the second phalanx of their index is missing. It will be 

 seen that the entire brachyphalangous index is only a little longer than 

 the basal phalanx of the third finger. The left index is straight, but on 

 the right the basal phalanx forms a slight angle with the terminal one, 

 the latter being somewhat bent in a radial direction. Except for the 

 indices the hands are normal, as shown in the photograph. 



The radiographs (fig. 39) give a clear conception of the nature of the 

 B !-type brachyphalangy. They show that the shortening is com- 

 pletely restricted to the second phalanx of the indices. This bone is 

 not absent, but remains as a rudimentary sesamoid bone. This small 

 bone is in both hands dislocated in the vdnar direction, thus leaving 

 the basal and the terminal phalanx to constitute the main articulation 

 surfaces. At the ulnar side of the j oint the rudimentary second phalanx 

 sticks between the other two and the articular surface of the terminal 

 phalanx is oblique, articulating with the basal only on the radial 

 side. The striking symmetry of the malformation needs only to be 

 mentioned. 



It wiU be noticed that some of the other phalanges of the hands 

 show indications of pathological alteration. The individual was, 

 however, nearly 80 years old when the radiographs were taken and 

 our large collection of radiographs from brachyphalangous hands 

 permits us to conclude that these alterations are of another nature and 

 bear no relation to the brachyphalangy. The lengths of II 2 and IV 2 

 measured from the radiographs are respectively 6 and 27 nun. on both 

 hands. 



This individual married twice and his first marriage is of especial 

 interest, being the only intermarriage between- members of affected 

 Hues. He married, namely, first his cousin 17.1 9 F. G. 0. (Mar. 15, 

 1829-Mar. 22, 1872), the only child of his uncle 1.7 c? L. p., who had 

 the B!-type of the brachyphalangy (p. 24). We have made numerous 

 efforts to determine whether she was brachyphalangous, but it has not 



