'H. S. St ANNUS 
17 
I saw at Bandawe a female infant aged 1^ years presenting multiple defor- 
mities. The astragalus of the left foot was apparently implanted in a cup- 
shaped depression on the lower end of a very much shortened thigh. The femur 
of this leg was short but around it there was an abnormal amount of muscle as 
if the usual amount of muscle for a normal had been cramped up into the 
shortened limb ; the foot could be freely moved by the child. The left foot had only 
a hallux and two toes with a partial cleft between the hallux and the adjacent 
toe, but I think four metatarsal bones. The right thigh was also somewhat 
shortened but the bones of the leg apparently both present, the knee-joint could 
not be distinctly made out and was flail. Right talipes equinovarus present, also 
right internal strabismus. No history of similar deformity in family, a brother a 
year older was born with two upper incisors. Father and mother noi'raal. The 
father has two other wives with six and ten children respectively, all normal. 
Such gross congenital deformities are from time to time recorded in Europe, thus 
Lockart Mummery described a case of congenital absence of the femur in a male 
child, etc., in the Brit. Med. Jour, for November 5, 1910. 
In a male 35 years of age I found Congenital Absence of the Right Fibula, the 
tibia being bowed forward with 8 inches shortening of the limb, the foot on the 
same side had only three metatarsal bones and three digits including the hallux. 
A woman was seen with congenital shortening of one leg to the extent of four 
inches. 
A single case of unilateral Congenital Dislocation of the Hip has been met 
with. 
(20) Split Hand and Split Foot Deformities. The photograph, Plate IV, (15), 
serves to shew moderately well the deformities met with in a male child aged 
5 years (1905) : in the absence of a skiagram it is impossible to go into the detail 
of the bony conditions present. There was no admitted history of similar or 
other deformity in the family. 
A second case, Ndala of Njalusi's Mangoche, shewed a similar deformity of the 
left hand but in a less degree ; he was otherwise normal and stated that no other 
members of his family were similarly affected (Plate VI, (20)). 
These cases are interesting to compare with those collected and classified by 
Lewis and Embleton in Biometrika , Vol. vi, 1908. 
(21) Shortening of the Fourth Metatarsal Bone. When first I entered the 
country my attention was attracted by a number of natives who presented a 
shortening of the iourth toe. 
Since then Captain Hughes has noticed the condition in Egypt. The descrip- 
tion he gives is as follows {Lancet, July 16, 1910): — "The fourth toe is markedly 
retracted usually behind the level of the fifth toe. The phalanges are not appa- 
rently abnormally short, and the metatarsal bone can be felt unfractured but with 
the head very much farther back than usual. Commonly the digit is pushed 
Biometrika x 3 
