76 Inheritance of Defonnity hiown as Split-Foot or Lobster-Claw 
tarsal elements in the more pronounced cases. The bones of the forearm and leg 
are normal in their disposition as far as they appear in the photographs. 
In the mother, III. 21, the left hand has a well-developed carpus which may be 
regarded as normal, while in the right hand the distal row of the carpus shows only 
three bones, the outermost of which probably represents the fused trapezoid and 
trapezium. In both hands the fifth digit (little finger) is well developed ; the 
whole thumb is missing, as are also the phalanges of the index, middle and ring 
fingers, those digits being represented only by the metacarpal bones, of which the 
proper second (that of the index finger) is the smallest, and indeed in the right 
hand is reduced to a small piece of bone corresponding to the basal portion only 
of the normal bone. 
In the left band of the daughter, IV. 21, there are three bones in the proximal 
row of the carpus, the pisiform being as yet unossified, two only in the distal row, 
magnum and unciform, the three inner metacarpal bones, diminishing in size from 
the fifth to the third, and the normal three phalanges of the little finger. Sup- 
pressed are the two outer bones of the distal row of the carpus, trapezium and 
trapezoid, the first and second metacarpal bones, and the phalanges of the thumb, 
index, middle and ring fingers. The right hand shows a greater degree of reduction, 
the scaphoid being suppressed in the proximal row of the carpus, while in the 
distal row there is only one bone representing the fused magnum and unciform, 
and the third metacarpal is smaller than in the left hand. 
IV. 23 has only three carpal bones, pyramidal, magnum and unciform, in each 
hand, but she is still too young for ossification to have started in the others ; the 
fourth and fifth metacarpal bones are fairly well developed ; the third metacarpal 
is small, in the right hand merely a nodular vestige of the basal portion ; the 
phalanges of the little finger are present and of good size. 
The malformation of the hands consists therefore of suppression or reduction of 
parts proceeding from the radial (thumb) side towards the ulnar (little finger) side, 
and carried to the greatest extent in the young child, IV. 23. 
The feet are not so homogeneous as the hands, and fall into two well-marked 
groups. In the one, comprising the two feet of the mother and the right foot of 
the younger child, IV. 23, the three middle digits are suppressed, including meta- 
tarsal bones and phalanges, while the first and fifth are fairly well developed, 
especially in the mother. The tarsus may be regarded as complete in the mother, 
only in the right foot the number of elements is apparently reduced by the fusion 
of the internal and middle cuneiform bones ; while in the right foot of IV. 23 the 
middle and external cuneiform bones are missing, but it may be that they are still 
in the cartilaginous stage, ossification not having yet begun. 
The two feet of IV. 21 and the left foot of IV. 23, v/hich constitute the second 
group, are also very much alike. Here the inner four digits are suppressed, and 
only the fifth (little) toe is represented. In all the talus, calcaneum and cuboid of 
the tarsus are well developed, the navicular is ossified (just beginning to ossify in 
