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