30 
Split-Hand and Split-Foot Deformities 
refuse an interview. Her son's account agrees with that of Anderson. There is deformity 
of the feet only ; each of these bears two digits. 
Generation IV. (IV, 1, 18 and 19.) M. A. (IV, 17), who has hved with her mother for 
the last 17 years, states emphatically that there were three miscarriages in her generation. The 
first of these was deformed (IV, 1) ; and of the others, whose position in the family is uncertain, 
one was deformed the other nndefornied (IV, 18 and 19). 
(IV, 3.) H. C. G. (1845, still living, widower). Right handed. All four extremities 
sci-eenod. Anderson makes no mention of this man (cp. IV, 9 who also had illegitimate 
children). 
Right hand. This is perfect with the exception that there is partial syndactyly of the 
4th and 5th digits, and the terminal phalanx of the thumb is bent inwards. 
Left hand. The last four fingers are normal. The 1st metacarpal is broad and its distal end 
is double. The inner facet bears a digit composed of three phalanges. The outer bears a small 
nodule of bone, the remains of an amputated digit which the man states was as long as its 
neighbour. 
Right foot. The 4th and 5th toes have a normal complement of bones and are syndactylised 
throughout. The first toe shows no loss of bone. A deep cleft occupies the position of the 
absent 2nd toe. Between the cleft and the 4tli toe lies the metatarsal of the 3rd toe, which has 
no phalanges. The cleft runs into the tarsus and the middle cuneiform appears to be absent. 
Left foot. This is precisely similar to the right, but that it misses the terminal phalanx of 
the 4th toe. 
(IV, 7.) Of this child we have no further information than that it was deformed and died in 
childhood ; it is referred to by Anderson. 
(IV, 9.) W. G. (approximately, 1852-1883). The hands and feet are stated by M. A. (IV, 17) 
to have been similar to those of her son W. H. A. (V, 24). Anderson makes no mention of this 
child, but the family have always been very reticent about him, as he had illegitimate children. 
(IV, 10-13.) A. G. (approx. 1854-?), Ph. G. (1855-?). J. P. G. (1857- ?), A. M. G. (1858-?). 
These four children are with one exception (IV, 10), mentioned by Anderson, and are said 
by him to have been deformed and to have died in childhood. Our enquiries make it probable 
that there were four deformed children lost at an early age, and the place of A. G. is taken 
in Anderson's account by a deformed son who died. No reliable details of the deformities 
are obtainable, apart from the fact that as usual all four extremities were aflected. 
(IV, 17.) M. A. (1861, still bearing children). Left handed. Skiagrams of all four 
extremities. 
Right hand, Fig. 11. The thumb and 2nd finger are represented by the base of the 2nd 
metacarpal only. The 3rd metacarpal is normal, the 4th and 5th thickened*. From the 
apex of the 4th to the metacarpo-phalangeal articulation of the 5th a cross-bone extends, making 
a triple articulation from which a complete set of thickened phalanges arise. 
L^eft hand, Fig. 10. The base of the 1st metacarpal is represented by a small nodule 
of bone. The 2nd metacarpal is thin at its distal end, the other three metacarpals are 
present. Between the extremities of the 3rd and 4th is a small bone articulating with the 
head of the 3rd and the cross-bone ; it is the only representative of the phalanges of the 
outer three fingers. The cross-bone extends from the apex of the 4th metacarpal to the short 
1st phalanx of the 5th. From the last articulation spring the terminal phalanges of two fingers, 
united throughout by bone. The corresponding nail is double. 
* In the hands where the affection is mainly preaxial the postaxial metacarpals are always thickened, 
and in the following mention of it will be omitted. 
