Malformation of fingers and toes

Malformation of Fingers and Toes.
BY OSCAR H. ALLIS, M.D.
The following history was taken while I was one of the
resident physicians of the Philadelphia Hospital, at the request
of Dr. Maury, to whom this journal is chiefly indebted both for
this account and for the accompanying photograph.
The case, so far as I can find, is unique.
Josiah F., æt. 25, colored, and a native of Philadelphia. Is
married, and had one child, which was well formed. His parents
are both perfectly formed.
The photograph represents him as having but two fingers
and two toes—the little and ring fingers on each hand, and the
great and little toes on each foot; but a more careful descrip-
tion may prove of interest to some.
The thumb, with its corresponding metacarpal bone, is absent
on both hands, nor is the index finger present on either hand.
The middle finger is apparently absent, but on careful examina-
tion the first phalanx may be felt (covered by the integument),
turned from its course, and joined to the base of the first phalanx
of the ring finger. This description holds good of both hands.
The metacarpal bones of the index and middle fingers are
small, while those of the ring and little fingers are well de-
veloped.
The feet appear to have but two toes, distinct and separate
from each other, even to the tarsal articulation. The meta-
tarsal bones of these respective toes are very large. The great
toe of the left foot consists of but a single phalanx, without
the nail, while the great toe of the right foot consists of two
phalanges, with the ungual development. The little toes are
perfect.
Though he has but two fingers, and these the two one would
suppose to be least serviceable, yet with their use he can
dress himself and button his clothes with as much ease as if he
had a fully-developed hand. He says that his trade is that
of a shoemaker, and that he can do a good day's work at
pegging. He can write tolerably well.
The remainder of this history I cannot vouch for.
He stated that he was the eldest of eleven children, and that
three out of the number had imperfectly-developed hands and
feet. That his brother had no index finger on either hand, and
that on the left hand the middle and ring fingers were joined in
their entire length.
He moreover stated that his sister had but the thumb, and
ring and little fingers on the right hand, but that the left hand
was perfect, save the distal phalanges of the index and middle
fingers. He also said that both his sister and brother had feet

very similar to his own.