102. Dr John Struthers on Variation in the Number 
middle finger, either a phalanx or a prolongation of the metacarpal 
bone. The fourth and fifth fingers have no phalanges. The fingers 
have no voluntary motion. Viewed on the palm, the “ball” of the 
thumb is flat and narrow, but the eminence formed by the muscles 
of the little finger is prominent. 
The other hand and the feet are normal. She is the third child 
in a family consisting of six daughters and three sons, all the rest 
of whom, as well as the father and mother, are normal. No such 
formation is known to have been presented by any ancestor. The 
mother’s story is that in her third month of pregnancy she had a 
vivid dream that she saw a man killed and his fingers cut off, at 
her own door; that she told this at the time to her husband and 
neighbours, and could not for long get rid of the idea of the cut- 
off fingers. 
25, Case of Five Rudimentary Digits on one Hand. 
Mr James R. Crease of Gateshead, sends me the particulars and 
asketch of the case of a female child, M J pl , ten days 
old, whose right hand presents a very rudimentary condition. The 
four fingers are present as mere rudiments, without nails; the thumb 
is about 4+ inch in length and has a nail. After the radius and 
ulna there are no bones to be felt in the hand, except one support- 
ing the thumb. The rest of the limb is well formed. 
Digital variety was previously unknown in the family history. 
There are three other children, boys, all well formed. An aunt by 
the father’s side, had all the fingers, but not the thumb, of the right 
hand amputated, but the mother had not seen her for many years. 
When the mother was three months pregnant, her attention was 
attracted by a woman singing in the street who had a deformed 
right hand. For a time she always thought she saw this woman, 
but had no idea that anything would be wrong with the child. 
Section 2._INCREASE IN THE NUMBER OF PHALANGES. 
26. Case of Additional Phalanx in the Thumb, on both Hands. 
Probably of Hereditary Origin. 
J J et. 21, Roxburghshire, now in Edinburgh, has the 
thumb on both hands of unusual length and form, as represented 
in Fig. 6, which is taken from a photograph. In examining the 
thumbs I was surprised to find an additional joint, giving three. 
phalanges besides the metacarpal bone, the additional bone being 
placed in the position of a middle phalanx. A case so unusual 
deserves careful examination. 
The metacarpal bone is 2} inches in length and appears to be 
quite normal. The first phalanx is 14 inch in length, and is, there- 
fore, longer than usual. The addztional bone, occupying the position 
of a middle phalanx, is broader on the inner, or radial, side than on 
the side next the index finger, having a triangular or wedge-shaped 
figure, which gives the distal phalanx an inclination towards the 
index. It measures along the radial side 2 inch, along the ulnar 
