3G 
Split-Hand cmd Split-Foot Deformities 
Left hand. The hand is similar to the last, no part of the 1st metacarpal is seen however, 
and the 2nd metacarpal bears a short 1st phalanx. 
Right foot. The foot is cleft at the 3rd metatarsal which is absent. The 1st and 5th toes 
are complete, and there are two masses of bone lying between these, one on each side of the cleft 
and reiJresentiug apparently the remains of the 2nd and 4th metatarsals. 
Left foot. This is practically identical with the right. 
Generation VI. (VI, 1.) M. A. S. (approx. 1890, died a few weeks after birth). According 
to the mother, the right hand had an extra thumb, and the left had some slight abnormalitj' of 
which no trustworthy account is gi\'en. The feet ai'e said to have had two toes each with 
deep clefts between. 
In the above description the normal individuals have not been included. A number of them 
have been seen and the reports of the family in respect of them have been confirmed. For th 
families of T. G. (Ill, 5), J. F. W. G. (IV, 6), and T. C. G. (IV, 14) we have had to rely 
on the statements of the remaining members, and have cross-examined several separately and so 
confirmed the statements with regard to thein. The family of J. F. W. G. is no longer in 
England, and the present whereabouts of the other two families is not ascertainable. 
Types of Split Hand and Foot, tlieir Terminology and the 
Nature of Gross-hones. 
With those cases of split hand or foot which are split by reason of their 
duplicity we are not concerned. Such cases have eight or ten digits on the 
affected extremity and are rare (see Murray and Giraldes). Our main purpose is 
the differentiation of the scattered forms of ectrodactyly, which yield a cleft 
hand or foot, from the hereditary and symmetrical type. 
The majority of these irregular types (examples of which are referred to in 
Section C of the Bibliography), have been reported as single cases, some without 
reference to heredity, others with a definite history of normal parents. Kiimniel 
has reported a family in which five individuals were deformed, by a splitting of 
one or both hands. At the same time he analyses a number of cases of split-hand 
and split-foot but without separating the types. In the cases which have been 
enquired into, the split usually occurs at the 3rd finger, and depends on the 
absence of the corresponding bones. It may be more extensive and include 
the 2nd and 4th fingers. Only one case of single split-foot, unassociated with 
other lesion, and in any way comparable to those of the " G " family, has been 
found. It is that quoted by Kummel after Gintrovicz, in which the phalanges 
of the 3rd toe were absent. Further cases are figured in the older works in which 
anomalous forms of split-foot are associated with phocomelia and other extensive 
deformities. 
When these irregular types are eliminated there remains a by no means 
uncommon deformity of which the " G " family presents notable examples. There 
are over 180 cases* of it now on record, in all but 13 of which there is a family 
history of similar defects. It is characterised by symmetrical clefting of the feet, 
* In the following pages our account depends on an examination of about 100 cases of the 
del'oiniity, in reports or in life. 
