T. Lewis and D. Embleton 
33 
Left hand. This is the most inalfornicd of the series (Fig. 17). There are three heavy 
metacarpals articulating with the trapezium, os magnum and unciform bones. They probably 
represent the 3rd, 4th and 5th metacarpals. From the 4th springs a bone resembling a 
phalanx which articulates with the outer side of a welded mass of bone which itself springs 
from the head of the 5th metacarpal. The welded mass is 2 inches long and about 1 inch 
broad. It lies in the line of the metacarpal, from which it springs. At the free end of the mass 
are two terminal projections resembling short horns. The inner bears two small nodules of bone 
and a double nail. The outer has no nail. Between it and the inner are two small nodules of 
bone. There is thus evidence that the mass as a whole represents the portions of at least 
the inner three fingers. 
The feet. There is one digit on each foot in the position of the 5th toe. Each bears three 
phalanges. The metatarsal at its base is thick and articulates with the whole of the anterior 
surface of the cuboid. The base of the 1st metatarsal is represented on both sides, and on the 
right probably the base of the 3rd also. 
(V, 25.) Miscarriage, 4 months pregnancy. The mother states that the child had one 
finger and one toe on each limb. 
(V, 27.) L. A. (1885, single, suffering from tuberculosis of the lungs). Right handed. 
Screening of all extremities. 
Right hand. This is almost perfect but shows contractures, the thumb is small, the index 
finger is flexed. There is skin union of the 3rd and 4th fingers and slight bony union of 
the terminal phalanges. The bones are otherwise normal. 
Left hand. The 1st metacarpal is surmounted by a small nodule of bone only. The 2nd 
metacarpal has one complete and a second incomplete phalanx. The remaining three fingers are 
normal. Between the 2nd and 3rd fingers is a small piece of bone about 1^ cm. long, thin and 
narrow. It is on a level with the 1st phalanges and has the shape of a diminutive phalanx. 
Right foot. On the inner side of the cleft the 1st toe is complete. On the outer side 
the inner toe is complete and to its inner siilc is a mass of bone obviously re^Jresenting the 3rd 
and 4th metatarsals. 
Left foot. On the inner side of the cleft the 1st toe is complete. On the outer side the 5th 
toe has metatarsal only. The 4th metatarsal has one complete and one incomplete phalanx, it 
is united at its base with the remains of the 3i'd metatarsal. 
(V, 28.) H. A. (1887- approx. 1895). Tubby states that this child had two fingers on each 
hand and two toes on each foot. 
(V, 31.) J. A. (approx. 1892-1897). We are indebted to St Thomas's Hospital for notes of 
this child*. 
Right hand. The thuml) is not represented. The 5th finger has a full complement of 
phalanges. The 2nd, 3rd and 4th metacarpals are poorly developed and have no phalanges. 
Left hand. Much the same as the right, but has two sets of phalanges for 4th and 5th 
fingers. 
Right foot. Great and little toes only, of which the metatarsals are alone perfect. The cleft 
extends to the articulation between the metatarsal and the internal cuneiform. 
Left foot. The same as the right, but the great toe has the stump of a metatarsal only. 
(V, 36.) M. A. (approx. 1902-1905). The mother states that there was the usual deformity 
of the feet, each having two toes. The hands are said to have had one finger each. 
* The notes are ward notes, there was no screening. 
Biometrika vi 
