EXTRA DIGITS. 
BURT G. WILDER, M.D. 
READ JUNE 2, 1868. 
(Extracted from the Publications of the Massachusetts Medical Society, Vol. II. No. 3.] EXTRA DIGITS. 
A child comes into the world with two thumbs instead of 
one, or with an extra little finger, or, it may be, with an 
additional great or little toe. 
The parents, if ignorant and superstitious, are dismayed; 
like the ancient physician, “whose pathology was mythology,” 
they bewail the deformity as an omen of evil, past, present 
or future, rather than as detrimental to the elegance or 
usefulness of the afflicted member. 
But if they are intelligent and disposed to take the matter 
calmly, they console themselves by recalling instances of 
cats and dogs, and even of innocent lambs, which had more 
than the usual number of digits, yet whose dispositions and 
those of their parents and offspring gave no sign of demo- 
niacal influence. Some of their friends, too, have seen or 
heard of other children with the like peculiarity, whose 
parents, nevertheless, were Christians, who themselves came 
to no bad end, and whose descendants, even if they inherited 
the deformity, were in no way remarkable, or, at any rate, 
not objectionably so. 
And so when the physician comes again, and is consulted 
in the matter, they are quite prepared to receive his more 
accurate information upon other cases, and to follow his 
advice with their own. If he be only a practising physician, 
with no other object in life than to get his patients into good 
condition as soon as possible, he either advises to leave the 4 
EXTRA DIGITS. 
extra digit alone, since it is not greatly in the way and may 
even be useful, or, if this is not the case, proceeds to remove 
it after the approved methods: meanwhile recounting to his 
hearers the like cases which have come within his knowledge; 
some who had seven, eight, nine and even ten fingers or toes; 
others, six fingers on each hand and six toes on each foot; 
while in other cases, these lesser peculiarities of the limbs 
had been associated with such extraordinary malformations 
of the body and head, that the astonished parents now con- 
gratulate themselves that it was no worse, and that their 
child was not born a Cyclops or a Hydrocephalus, instead of 
a simple “ Sexdigitist.” 
But if, on the other hand, our physician is one who while 
exerting his utmost skill for his patient, yet allows his mind 
to pass from visible effects toward invisible causes, from 
isolated facts toward general principles, then will he take 
careful note of this case, will make perhaps a sketch and a 
dissection of the specimen, and then, as opportunity occurs, 
will ponder the whole subject and seek to solve the many 
questions which now crowd upon his mind. 
What are the causes of such malformations, and how are 
they produced ? in which of the two sexes are they more 
commonly found ? on hands or on feet ? on the right or the 
left side ? on the ulnar or the radial, the tibial or the fibular 
border ? and what is the occasion of the difference if any 
exists ? All these, and many others which readily suggest 
themselves, now impart to such anomalies a far deeper 
interest than before, and if he looks upon succeeding cases 
with something more than a practical eye as to whether 
the digit shall be removed or not, and if he now makes 
inquiries which seem to have no reference to the physical 
well-being of the child or the mental anxiety of the parents, 
it is not, as some would have it, because science has dulled 
his heart to sympathy; his former feelings were merely EXTRA DIGITS. 
5 
human; they have not now degenerated into what is less, 
but have rather been elevated to what is more than human. 
But here, let me insist that our hypothetical Doctor, and 
every one who takes up this subject, shall get together as 
large a number of cases, and as full a history of each, as is 
possible, before attempting to draw from them any general 
conclusions. For in these days when the scientific world is 
flooded with theories as to the nature, the causes and the 
significance of the variation of organized beings; when yet the 
normal standards have not been determined; when there is 
with some a willingness to ascribe such variations to mere 
chance, and with others a disposition to attribute them to phy- 
sical laws and condition, acting as if of themselves and inde- 
pendently of a Supreme Intelligence; when it is so easy to 
speculate, and so tedious to investigate; now, of all times, is 
it necessary that we restrain ourselves, and utter no theory 
which has not the best foundation in facts, which it is in our 
power to gain. 
Variation is boundless and infinite. Probably no two 
individual things or beings are exactly alike. The cells of 
the bee and the webs of the geometrical spider, which have 
so long been held up to us as examples of mathematical 
exactness, are now found to differ widely among themselves. 
No two crystals are identical; nay, even no two symmetrical 
halves of crystal are identical; more marked, though too 
often overlooked, are the differences between the two halves 
of the bodies of animals and of men; males and females 
correspond, but are not the same; parent and child are alike, 
yet diverse; even species are by some supposed to vary and 
to change so as to lose their identity. 
Merely expressing in passing my total disbelief in the 
truth of this last supposition, let me call attention to the 
individual variations of the Fingers and the Toes, a group of 6 
EXTRA DIGITS. 
cases ■which appeal to the medical man from nearly every 
stand-point of our most comprehensive profession. 
For the surgeon they are a not infrequent occasion for 
operation. For the anatomist, their own structure and their 
connections with adjacent parts afford material for dissection; 
and the physiologist is interested in their various degrees of 
mobility and usefulness. The embryologist is still in doubt 
as to the manner of their formation and especially the means 
of their occasional reproduction; and the teratologist may 
record and consider their not infrequent association with other 
and more serious deformities. To the psychologist, the degree 
of influence which the mother’s mental condition may exert 
upon the production of these and other physical peculiarities 
should be a subject of serious consideration, before the ancient 
and still popular opinion upon this matter is set aside as 
groundless. The statistician may find ample employment 
for his industry in recording the prevalence of extra digits 
in certain localities, among certain peoples, and more 
strikingly in certain families, where they disappear and again 
appear after several generations in a most remarkable man- 
ner. And finally, to each and every one of the above men- 
tioned classes of medical men, these extra digits are too 
often a source of regret and disappointment; since it is rarely 
the case that the specimen is preserved or drawings made, 
or the history recorded to such an extent as to fully answer 
the inquiries of any two of them. 
All the cases of polydactylism, a synopsis of which I shall 
now present, are from the human species: for though cats 
and dogs and other animals and birds are known to possess 
extra digits, their number is too small and the individual 
histories too incomplete for our present purpose; in addition 
to which, hardly any two of the common species possess the 
same normal number of digits. 
I have also confined myself on this occasion to what is EXTRA DIGITS. 
7 
called sexdigitism; the presence of a single supernumerary 
finger or toe; partly on account of the greater number of 
such cases and the greater ease of recording and tabulating 
them, but chiefly because there are high authorities who 
look upon every extra digit as a rudiment of a second indi- 
vidual ; so that it is better to confine my statements to these 
cases, which, whatever may prove to be the correct view as 
to the higher numbers, are, in my own opinion, simply the 
result of the undue subdivision of, or an after growth from, 
the primitive limb, and not in any way the indication of a 
double monster.* 
From various sources, specimens, casts, figures, descrip- 
tions, letters, and word of mouth,t I have brought together 
the principal facts which could be obtained concerning one 
hundred and fifty-two individuals who have or have had six 
fingers or toes upon one or more of their extremities. The 
number may seem large, and it is really more than three 
times as great as any one has had before: but I wish before 
proceeding farther to express my regret that it is not one 
thousand, rather than one hundred and fifty-twobut as these 
are all which are now accessible to me, I am induced to offer 
them at this time, with three principal objects in view:— 
1st. That I may impress upon others the value of each and 
every fact relating to these cases, since most of them bear 
directly upcm questions now under discussion. 
* How do the advocates of the view referred to, account for the presence of 
extra digits upon more than one of the limbs ? do they represent portions of as 
many imperfect monsters ? or of one and the same monster, accurately, and as 
a general thing, evenly, distributed upon the perfect individual ? Neither hy- 
pothesis is very reasonable. 
f Lest others may take the pains to record the same cases again, the writer 
has recorded all the cases published by Otto, Monstrorum Sexcentorum Descriptio 
Anatomica, 1841; by Simpson, in his Obstetrical Memoirs and Contributions, ii. p. 
346; by T. Annandale, of Edinburgh, in the Prize Essay upon Malformations, 
Diseases and Injuries of the Fingers and Toes, 1866; by Arthur Mitchell, in a paper 
upon Blood Relation in Marriage, Mem. Anthropological Society of London, ii. 
402; by Dr. Foltz, Homologie des Membres Pelviens et Thoracique; Journal de 8 
EXTRA DIGITS. 
2d. To suggest a general method of recording such cases. 
3d. To indicate, so far as these cases go, the direction 
which wo may expect will be taken by the final results of a 
much larger number. 
The following table indicates the principal results of this 
record and tabulation of cases: 
SEXES. 
No 
Individ- 
uals. 
. of 
Affected 
Limbs. 
Region. 
Ant.Post. ? 
Side. 
R. L. ? 
U. 
Bore 
R. ? 
ers. 
T. 
Fib. ? 
Males 
86 
168 
109 
59 
81 
78 
9 
66 
23 
20 
12 
16 
31 
Females 
39 
81 
56 
25 
41 
40 
20 
18 
18 
3 
8 
14 
Doubtful 
27 
40 
30 
10 
20 
17 
3 
24 
4 
2 
6 
3 
1 
152 
289 
195 
94 
142 
.135 
12 
110 
45 
40 
21 
27 
46 
Ant. Anterior extremity. U. Ulnar border. 
Post. Posterior ” R. Radial “ 
R. Eight. T. Tibial “ 
L. Left. F. Fibular “ 
No one, so far as I know, lias hitherto offered any facts or 
expressed any opinion as to the comparative frequency of 
extra digits in the two sexes; and in some cases the sex of 
Physiologie, vol. vi. p. 49, 1863; by Reaumur, L’Art de Faire Eclose Oiseaux 
Domest., 1751, p. 377, quoted incorrectly by Huxley, on the Origin of Species, p. 
93; by Darwin, on Animals and Plants in Domestication, 1868, vol. ii.; by Dr. John 
Struthers, Variation in the number of Fingers and Toes and of the Phalanges, 
Edinburgh New Phil. Journal, July, 1863; by Dr. J. B. S. Jackson, Catalogue 
of Museum of Boston Society for Medical Improvement; by Vrolik, Cyclopedia 
of Anatomy and Physiology, iv.-ii. p. 948. He has also had Access to all the 
specimens in the Warren Anatomical Museum of the Harvard Medical College, 
in Prof. Wyman’s Museum in Cambridge, and in the Museum of the Boston 
Society for Medical Improvement; and has likewise found a large number of 
isolated cases in books, and by inquiring has procured reliable accounts of cases 
now living. Several important and interesting cases which were sent by Dr. 
George J. Fisher, of Sing-Sing, New York, the only one who has devoted him- 
self especially to these malformations, and who has published a valuable treatise 
upon Diplo-teratology (concerning Double Monsters), were unfortunately 
received too late for tabulation; but these and all others which can be obtained 
the writer hopes, at some future time, to publish both singly and by tabulated 
results; the present contribution being intended only as an incentive and help 
to others. Probably there is scarcely a neighborhood where one or more cases 
may not be discovered. EXTRA DIGITS. 
9 
the patient is not even mentioned, although it must have been 
known to the recorder. 
It is a generally received opinion that not only is the 
male the more highly organized, but that he is also more 
liable to malformations resulting from an excess of develop- 
ment, such as double monsters, &c., while the female is 
thought to be more commonly subject to arrests of develop- 
ment. Now whether extra digits are always so many 
primary subdivisions of the rudimentary hand or foot, or 
whether they are subsequent outgrowths from the hand or foot 
already formed, they are in both cases the result of an excessive 
action in one form or another, and so it is interesting to find 
that of one hundred and fifty-two individuals affected with 
extra digits, eighty-six are males and only thirty-nine females : 
the sex of the remaining twenty-seven is not known. 
The one hundred and fifty-two individuals represent six 
• hundred and eight limbs, of which two hundred and eighty- 
nine or nearly one half were affected. Of these two hundred 
and eighty-nine affected limbs, one hundred and forty-two 
were on the right side and one hundred and thirty-five on 
the left side. The difference between the two sides is there- 
fore very slight; it does not even appear that the two hands 
differ any more than the two feet, and while the preponder- 
ance of cases is upon that which is generally regarded as 
the dynamic side of the body, perhaps it was not to be ex- 
pected that parts which vary so slightly in their normal 
structure and uses should present any striking differences 
in their malformations. 
We come now to a most important and interesting division 
of the subject: namely, as to the relative frequency of a 
sixth digit upon the anterior and posterior extremities, the 
hands and the feet. 
Here I must admit having been very decidedly predisposed 
towards the result which has been reached, for it was this very 
question which led me first to take up the subject. 10 
EXTRA DIGITS. 
While studying the various comparisons of the fore and 
hind limbs of man and animals which have been instituted 
by different anatomists, it appeared to me that far too much 
weight had always been attached to the structure and atti- 
tude of the fore limbs, on account of their greater functional 
importance; so that they were generally unable to see how 
nearly the two limbs may be made to correspond in a 
symmetrical or antagonistic manner, as do those of the right 
and left sides. 
The greater functional value of the hand was not to be 
questioned; but it occurred to me that if it could be shown 
that the hand and the whole arm are more variable than 
the foot, in attitude, in proportion of parts and in the number 
of digits, then their morphological value would be diminished 
to a corresponding degree; and anatomists would be more 
ready to accept the posterior limbs as the surer guides in 
their comparison of the two. Now it is known to all that 
the more various and complicated motions are executed by 
the hands; also that among the different species of animals, 
the anterior limbs undergo the greater modification of struc- 
ture and position to suit the wants of the monkey, the bear, 
the bird and the fish; also that when, as in the cat, 
the number of digits is not the same upon the two limbs, 
the greater number is generally on the hand. 
These considerations, anatomical, physiological and zoolo- 
gical, as to the variability and consequent less morphological 
value of the hand, are now strikingly confirmed by the 
statistics of sexdigitism. For of the two hundred and eighty- 
nine affected limbs, one hundred and ninety-five, or more 
than two thirds, are hands, the remainder being feet. 
Here there is a possible disturbing clement; for it may 
be said that the extra digit would be more often removed from 
the feet than from the hand; indeed the additional thumb is 
sometimes thought by the possessor to be a decided advan- EXTRA DIGITS. 
11 
tage, either in grasping a pen-handle or in taking anything 
from his vest pocket, by opposing the tips of the two 
thumbs.* 
But I hardly think the consideration above mentioned 
will account for the great difference which exists between the 
hands and the feet in this respect. The result confirms the 
opinion already expressed by Struthers, which, however, was 
based upon a much smaller number; while it is directly 
opposed to the opinion of Darwin, who in his last work, on 
Animals and* Plants under Domestication, says that he has 
tabulated forty-six cases and finds a slight preponderance in 
favor of the feet, there being seventy-five feet and only 
seventy-three hands; but this probably includes all varieties 
of polydactylism. 
No less striking than the above is the comparative fre- 
quency of the extra digit on the ulnar and radial borders of 
the hands, the tibial and fibular borders of the feet; and as 
this, too, bears directly upon a part of the question as to 
the comparison of the fore and hind limbs, I will dwell 
upon it for a moment. 
A distinguished French anatomist,t who has declared his 
belief in the existence of a true symmetrical or polar relation 
of the fore and hind limbs, has coupled with it a theory as 
to the binary composition of the thumb and great toe; the 
desire for this arises from his feeling that both these digits 
arc too large for a qorrespondence with the little toe and 
little finger, opposite which they come when the hand and foot 
are symmetrically placed; but his only facts in its support 
* There are also one or two families in Germany whose mepibers pride them- 
selves upon the possession of an extra thumb, and there is an Arab Chieftain 
whose ancestors have from time immemorial been distinguished by the double 
thumb upon the right hand. But in view of the great difficulty of eradicating 
the malformation from a family, one is reminded in all these cases of the fable 
of the fox who had lost his tail, and ever afterward recommended others to get 
rid of theirs, 
f Dr. Foltz. 12 
EXTRA DIGITS. 
are a few cases of extra or double thumbs and great toes, which 
he thus conceives to represent the normal condition of the 
parts. But the facts we have to offer indicate that the little 
finger and little toe are by far the more often double or 
supernumerary: for of the one hundred and ninety-five hands, 
one hundred and ten had a supernumerary little finger, and 
only forty-five an additional thumb; while upon the feet there 
are twenty-seven extra little toes and only twenty-one great 
toes. 
The greater difference in the relative frequency of an extra 
digit on the ulnar and radial side of the hand, as compared 
with that between the tibial and fibular borders of the feet, 
we may associate with the greater functional distinction 
between the thumb and the little finger: but the greater 
variability of the little toe and little finger does not appear 
to be in accordance with the idea already alluded to, that 
variation is more frequent in that sex, and in that region of 
the body, where the greater development and activity exists. 
There is one matter which does not come strictly under 
the head of extra digits; but as it is a variation of a similar 
nature, and especially as the cases are both rare and ex- 
tremely valuable, I will say a few words concerning it. 
There are a few instances (of which one specimen is in the 
museum of the Boston Society for Medical Improvement) 
of a thumb possessing an additional phalanx so as to be long 
and finger-like, yet opposable to the other digits. The chief 
value of such cases consists in this: that the most serious 
objection to symmetry, in the minds of those who still in- 
sist upon a comparison of the fore and hind limbs as parallel 
parts, and who consequently consider the thumb and great 
toe to correspond with each other, is the fact that both these 
digits normally consist of only two phalanges, while all the 
others possess three. It is my own opinion that this diffi- 
culty is a wholly superficial one, and that the difference in EXTRA DIGITS. 
13 
the number of phalanges is simply a difference of quantity 
like that in the number of digits themselves, and therefore 
no basis for a morphological comparison ;* but every such 
case of a thumb or a great toe having three phalanges is so 
much toward the means of convincing anatomists that they 
really correspond, not to each other, but to the little toe and 
little finger, respectively. 
It may be interesting to know which are the more common 
extra digits among these cases. Of one hundred and eighty- 
five limbs, being all of which both the sex, side of body, limb, 
and border are known, the following is the order of frequency. 
There is a slight difference between the two sexes, but the 
numbers are too small to prove anything of single digits, and 
I give only the totals. The order of frequency is as follows : 
Right little fingers, . - - . 53 
Left little fingers, . 52 
Right little toes, 
Right thumbs, . ; . . .17 
Left thumbs, . ' • • • 17 
Left little toes, . 11 
Left great toes, . . 10 
Right great toes, .... 7 
185 
So far we have treated of extra digits according to the 
separate limbs upon which they occur, and, excepting when the 
sexes were mentioned, have dealt with the individual sex- 
digitists only in quarters, giving to each limb a distinct place 
in our results as well as upon the blanks. Let us now put 
together the limbs of each individual, and see how they were 
combined. To do this we must first make a division of the 
sexdigitists into those which had but one limb affected, those 
which had two, those which had three, and those which had 
four; these four groups being called Uniscxdigitists, Bisex- 
* Morphological Value and Relations of the Hand ; Silliman’s Am. Joum. of 
Science and Art, xliv. July, 1867. 14 
EXTRA DIGITS. 
digitists, Trisexdigitists, and Quadrisexdigitists. But a sec- 
ond subdivision, the use of which will presently be seen, may 
be into Unisexdigitists and Polysexdigitists: of the former 
there are seventy-three, and of the latter seventy-five; these 
being divided as follows among the three minor groups— 
Bisexdigitists thirty-four, Trisexdigitists eleven, Quadrisex- 
digitists thirty. 
Combination of Extra Digits in Individuals. 
No. of 
No. of 
Unisexdigitists. 
Individ. 
Bisexdigitists. 
Individ. 
Right thumbs 
16 
Both little fingers 
24 
Left 
11 
“ “ toes 
2 
? “ 
14 
“ great “ 
2 
41 
“ thumbs 
1 
Left little finger 
8 
“ “ or little fingers 
2 
Right “ “ 
5 
“ great or little toes 
1 
? “ “ 
8 
21 
Right little finger and little toe 
1 
62 
“ “ “ great or little toe 
1 
Right little toe 
3 
34 
Left “ “ 
2 
Trisexdigitists. 
5 ti H 
2 
7 
Both little fingers and right great toe 
5 
“ “ “ “ “ little “ 
2 
Left great “ 
2 
“ thumbs and left great toe 
1 
Right “ “ 
1 
“ great toes and left thumb 
1 
> <( « 
1 
4 
« a a u rlght «« 
1 
Recapitulation. 
11 
“ “ “ “ “ little finger 
1 
11 
73 
S r Bisexdigitists 
34 
Quadrisexdigitists. 
1 s Trisexdigitists 
11 
Both little fingers and both little toes 
6 
l Quadrisexdigitists 
30 
75 
u << i< << << great “ 
1 
Total 
148 
u a << i* a p a 
6 
Both thumbs and both great toes 
1 
*' fingers or thumbs and both great or little toes 
16 
30 EXTRA DIGITS. 
15 
As will be seen from the foregoing table, the preponder- 
ance of hands among the unisexdigitists is very great, being 
sixty-two to eleven; an exaggeration of the ratio which we 
found by using all the separate limbs: but in our former 
results the little fingers have been far more numerous than 
the thumbs, whereas taking the unisexdigitists alone, we have 
forty-one thumbs to twenty-one little fingers; from which it 
appears that if a person has but a single extra digit it is more 
than five times as likely to be on a hand as on a foot; and if 
on a hand, twice as likely to be a thumb as a little finger. 
But how is it now with the multiple group ? In fifty-four 
of the individuals the hands were affected, and in thirty-two 
the feet; the trisexdigitists and quadrisexdigitists of course 
having one or both of the hands or of the feet affected. But 
what is most remarkable is the complete reversion of the 
ratio of thumbs and little fingers from what it was with 
the unisexdigitists; for here there are forty-seven individuals 
in whom one or both the little fingers was double, while in 
only five were there extra thumbs; so that if a man has two 
or three or four extra digits, he is nine times as likely to 
have a little finger as a thumb. The number of posterior 
digits is too small for this calculation, but it is evident that 
little toes are more common than great toes. 
There is another point brought out by this table; namely, 
that when there are two extra digits the repetition is far 
more likely to be lateral than longitudinal; that is, corres- 
ponding digits are doubled on opposite sides of the body rather 
than on opposite ends: two little fingers, or two thumbs, 
rather than a little finger or thumb and a great or little toe. 
Indeed there are but two cases of this latter kind; one being 
that of a right little finger and a right little toe, the other 
being of a right little finger and either a great or little toe. 
There are not yet enough cases to afford any evidence in 
either direction upon the question whether the great toe or 
the little toe corresponds to the thumb. 16 
EXTRA DIGITS. 
The number of trisexdigitists is too small for this separate 
calculation; but the more common combination is of the two 
little fingers and the right great toe. The quadrisexdigitists 
also are too few to afford any reliable result, but here as 
usual the little fingers predominate; in six cases they coexist 
with both little toes, and in only one case with the great 
toes; while in six cases they coexist with toes of which it is 
not known whether they are great or little. 
There are many other facts concerning extra digits which 
must be passed over here with a brief mention. Nearly all of 
them possessed well-formed nails. A few were pedieellated 
and not at all under the control of the will: but more often 
the attachment was firm and the only motion whs between 
their own phalanges which generally agreed in number with 
those of the adjoining digit. Sometimes there was a sixth 
metacarpal or metacarpal bone, and there were all possible 
degrees of completeness from this to a single phalanx attached 
to the base of the terminal phalanx of the adjoining digit. 
Some of the extra digits were amputated in infancy, and they 
seldom re-appeared, though in one case it grew for a second 
and a third time. This reproduction of digits, however, is 
more common after amputation in utero, when they are some- 
times even developed upon the extremity of an arm severed 
above the wrist. 
A large number of cases have been observed in some 
parts of Scotland where intermarriage is common; but 
although some infirmities seem to be the direct result of 
this custom, it may be that extra digits are not caused 
thereby, but only spread abroad. In one case the defor- 
mity is connected with the fact of the mother having 
worked next to a girl with double thumbs, before her 
marriage. 
As may be expected, the previous extent of extra digits in 
the family constitutes by far the most general predisposing EXTRA DIGITS. 
17 
causes; but there must have been some, or at least one, first 
and antogenous case. The oldest on record is that of a son 
of Goliath of Gath, who had six fingers on each hand and 
six toes on each foot; but it is hardly probable that all sex- 
digitists are descendants of the Philistine. 
The whole great subject of hereditary transmission must 
be passed over with a few -words: in all cases I have 
recorded what was known of the ancestors, the brothers and 
sisters and the descendants; with cross references when any 
of these constituted others of my cases. 
Dr. Struthers, who has published by far the completest 
account of original cases of sexdigitism, thinks it necessary 
to make a primary subdivision of them into the hereditary 
and the non-hereditary cases; but the second class will also 
embrace all those of which nothing is known as to ancestry; 
and moreover, though it is certain that there is a very decided 
tendency to the perpetuation of the parents’ peculiarity in the 
offspring, sometimes even, as in one remarkable family, 
gathering force as it descends through successive generations, 
there being one hand affected in the first generation, two hands 
in the second, two hands and a foot in the third, and all four 
limbs in the fourth, yet there are so many cases in which this 
s6ems to fail, or in which the malformation appears only after 
one or more generations or not in the direct line of succession, 
that I have thought best not to attempt any generalization, and 
have contented myself with recording the facts so far as they 
could be ascertained, mentioning not only those relatives who 
did, but also the number of those who did not present this 
malformation. 
Of the total one hundred and fifty-two individuals, thirteen, 
or one in eleven or twelve, had some other deformity beside 
the extra digit: two were giants; Anna Boleyn had a super- 
numerary mamma and an additional upper tooth. Hydroce- 
phalus, or some deformity of the head, existed in four cases; 18 
EXTRA DIGITS. 
harelip and cleft-palate in five; one individual was a part of 
or double monster; varus of one or both feet was present in 
four cases; and in four there was an abnormal condition of 
the organs of generation. 
In addition to the points already mentioned, it is necessary 
to state the date of record, to affix the name or initials, real 
or fictitious, of the individual, and his residence or the 
museum containing the specimen or the title of the works 
where it is figured or described,’ all this to avoid the 
possibility of using the same case a second time. 
For convenience of recording these facts I have used a half 
sheet blank, on which are figures corresponding to a list of 
questions, the answers to which are to be given; additional re- 
marks, and a tracing or drawing of the specimen may be put 
upon the back. The middle of the front is occupied by a 
diagram of the palms and soles of the four limbs, upon which 
it is easy to add the extra digits, so as to show at a glance 
what the individual possessed. 
“It is truly remarkable,” writes the gifted German 
anatomist, Oken, “what it costs to solve any one problem 
in philosophical anatomy; without knowing the what, the 
how, and the why, one may stand, not for hours or days, but 
for weeks, before a fish’s skull.” 
To know the what, the why and the how, is the aim of 
every seeker after truth, and that truth is only to be reached 
after long and patient work. The great deficiency in the 
matter we have considered, is the lack of material; and yet 
there is enough to be had; for in a single small town of 
New England there are three distinct families in which one 
or more members are sexdigitate. If I have succeeded in 
showing that extra digits may be viewed as something more 
than curiosities, or as so many pathological specimens, let 
me hope that no case will hereafter be allowed to go 
unrecorded in its most minute particular, whether of structure 
or function, or of history. EXTRA DIGITS. 
19 
For if we believe that nothing happens by chance, and 
that male and female, right and left, anterior and posterior, 
internal and external, are not mere artificial distinctions of 
the regions of our bodies, but are truly and fully the out- 
ward embodiments of ideas and principles which have a 
physical, a spiritual, nay a Divine origin and significance, 
then the greater frequency of these anomalies in one of the 
two sexes, upon one or the other side of the body, upon the 
hand or the foot, will be a never-failing subject for thought 
and a stimulus to further investigation. QUESTIONS TO BE ANSWERED IN RECORDING CASES OF EXTRA DIGITS. 
To be filled out and sent to Burt G. "Wilder, M.D., Cornell University, Ithaca, New York, 
from whom copies of this blank may be procured. 
15. Presence of extra digits in brothers and sisters, and 
cousins. 
16. Presence of extra digits in children; giving in these 
three answers a reference to the individuals, and also 
mentioning relations which are known to be free from 
these malformations. 
17. Predisposing causes : Heredity, Intermarriage, &c. 
18. Exciting causes : Mental Impressions, &c. 
19. Operation for removal, when and by whom performed. 
20. Result of operation. 
21. Name of original observer or recorder. 
22. Reference to original work. 
23. Reference to other works in which it is mentioned. 
24. Race of the sexdigitist. 
25. Birth place of sexdigitist. 
26. Present residence of sexdigitist. 
27. Nature of specimen. 
28. Museum or collection containing it. 
29. Name of the present recorder. 
30. Residence of the present recorder. 
1. How many digits upon the hand or foot in question ? 
2. The date when this record is made. 
3. Name or initials of the person, or the species of the 
animal; if the real initials are unknown, fictitious ones 
may be used, taking care, of course, not to use the same 
ones again on the same day. 
4. How many limbs of this individual have extra digits? * 
5. Age of individual, exact or approximate. 
6. Sex of individual: <5 male ; 9 female; ? unknown. 
7. Anterior or posterior extremity. Ant. or Post. 
8. Right or left side. 
9. Ulnar or radial border. The sign + after the answer to 
either of these questions indicates that there is an extra 
digit on the foot as well as the hand, on the left as well 
as the right side, &c. 
10. Is there a nail ? -f or 0. 
11. How many joints in addition to the union of the digit 
with the adjoining digit, or with its metacarpal or me- 
tatarsal bone? 
12. Degree of mobility and usefulness of the digit. 
13. Coexisting malformations in other parts of the body. 
14. Presence of extra digits in parents or grandparents, in ; 
uncles or aunts, &c. * It is necessary to have this number in order that we may know how many blanks must be filled out in the first place, 
and got together afterward when we wish to study all the affected limbs of a single individual. Each of the blanks repre- 
sents a limb, and it takes one, or two, or three, or four of them to give the whole individual. It is not necessary to enter 
all the statistics of the individual upon each blank, but only upon the first one, which should be that which gives the first 
of the affected limbs in the order of the Roman numerals upon the diagram; for instance, if a man has an extra little finger 
on the right hand and an extra little toe on each foot, all the questions from 20 to 30 and those relating to ancestry 
may be answered only upon the little finger blank. 
When, as is sometimes the case, two or more individuals are known to have similar malformations, the same blanks may. 
answer for them all, provided a large figure be made over the left hand column, so that in all tabulation the number of in- 
dividuals so represented may be known. 
AVhen it is known which are the extra digits, the Roman numerals corresponding to them are to be surrounded by a 
circle ; but when a description leaves us in doubt, as between two thumbs, or a thumb or a little finger, each doubtful 
one may be indicated by a semicircle. A drawing or tracing of the specimen or the figure may be made on the back of the 
blank ; and on the diagram itself the extra digits may be added in their proper places, giving simply the outline of the 
digit, and indicating the bones by straight lines with interruptions for the joints; only one digit may be shown upon each 
blank, but it is also convenient to show them all upon the first blank. 
On the back of the diagram may also be made any more extended statements or explanations regarding some of the 
circumstances, especially the ancestry and the supposed causes of the malformation : it is better to put all this upon the 
iagram, for in arranging the cases for study and tabulation only that half of the sheet need be retained.