32 Split-Hand and Split-Foot Deformities 
Right hand. The 1st and 2nd digits are entirely absent. The 3rd metacarpal bears a small 
nodule of bone. The 4th and 5th digits arc complete and syndactylised by skin. 
Left hand. This is similar, it has in addition a thin 2iid metacarpal. 
The feet. These ai'e alike. The usual deep cleft occurs at the 2nd toe. The 1st and 
5th toes are alone present and arc complete. 
Generation V. (V, 6.) A. S. (1870, living, married). All extremities screened. 
Right hand. The last three fingers are normal. The 2nd misses the terminal phalanx, and 
the proximal phalanges are thin. The 1st metacar^^al is present and bears two short deformed 
phalanges. From its inner side and about | of an inch from its end, a small movable piece 
of bone springs. This is the remains of an amputated digit. There appears to be slight move- 
ment in the shaft of the metacarpal at this point. The amputated digit originally traversed the 
palm of the hand. 
Left hand. The metacarpal bone of the thumb is l)road at its distal end and bears on 
its inner facet three phalanges. The outer facet is unoccupied, but a scar indicates the position 
from which an additit)nal digit was removed. It is said to have consisted of two bones and to 
have been as long as its neighbour. The rest of the hand is normal. 
Right foot. The cleft occupies the position of the 2iid toe which is absent with the middle 
cuneiform. On the inner side of it lies the 1st metatarsal with two united phalanges. On the 
outer side lie a complete 5th digit and the metatarsal of the 4th, the phalanges of the latter and 
the bones of the 3rd toe are absent. 
Left foot. This is the same but for the absence of union of the phalanges of the 1st toe. 
(V, 7.) H. G. (approx, 1872, living, unmarried). Right handed. All extremities screened. 
Right hand. The 1st metacarpal is small and weak ; it has an extra phalanx. The 2nd, 
4th and 5th metacarpals have complete sets of phalanges. The 3rd metacarpal has one com- 
plete and one incomplete phalanx. There is no syndactyly. 
Left hand. The thumb is composed of metacarpal only. The bones of fingers 2, 3 and 5 are 
perfect throughout. From the 4th metacarpal springs a phalanx which is bifid distally, each 
facet bearing a complete set of phalanges. These sets are united by skin to the neighbouring 
fingers 3 and 5, but are themselves distinct up to the level of the common 1st phalanx. There 
are thus three fingers. That containing phalanges from metacarpals 4 and 5 has a single, and 
that containing phalanges from metacarpals 3 and 4 a double nail. 
Right foot. There are the 1st and 5th toes, thickened and sejiarated by a deep cleft. To the 
outer side of the cleft is the remains of a 4th metatarsal. 
Left foot. This is similar. 
(V, 18.) The illegitimate son of W. G. (IV, 9). Date of birth not known. He is said 
to have died. His hands are reported to have been similar to those of I. G. (IV, 25). The feet 
having each two toes. 
(V, 24.) W. H. A. (1882, living, single). Right handed. All extremities screened, and left 
hand skiagraphed. 
Right hand. This is very deformed and the identification of the bones is not quite certain. 
The arrangement is probably as follows : — The thumb is represented by a small nodule only. 
The remaining metacarpals are all present but the outer two are closely united by bone through- 
out There is a wide gap between the 3rd and 4th. The united 4th and 5th bear a common 
double 1st phalanx, which in turn bears two short single phalanges, articulated end to end. 
From the metacarpo-phalangeal joint of the combined 4th and 5th fingers a cross-bar runs 
to the head of the 3rd metacarpal with which it articulates. 
