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Related post: the second case Gruber has seen after examination of 5,500 freshly
dissected wrists. Between the time when he found his first case and
that when he found the second he examined 3,700 wrists. Only two
other cases have been reported, one by Fleach and one by Turner.
Gruber is in doubt whether there were originally two cartilaginous trape-
zoids, or that two centers of ossification in one cartilaginous trapezoid,
which did not fuse, had finally produced a joint at their synchondrosis,
forming two Synthroid 5 Mg bones articulating with one another.
III. A Number of Rare Anomalies of the First Lumbrical of the
Hand. — Cases I and II. Substitution of a J/uKc/e sjjrinying from the
Thumb for the First Lumbrical— In the first case the first lumbrical
was wanting, the second and third situated normally, and the fourth,
divided into two parts, inserted into the extensor tendons on the ulnar
6ia
REPORTS ON THE PROOIiE>s or MFDWINE.
[N. Y. Mbd. Joob.,
Hide of X\w fourth unci tho riiiiial Hide of the tiftli liii^'crx. The placn
of tht> iihNi'iit HrHt hiiiihricnl wiih ttiippliivl hy n H|>iridle-Hlin|>,
which uroi« fnuii tli«Synthroid 10 Mg HfMiiiiioid lioiiu in llic cuimiiic of tli
iiu'tii(iirpo-|iiiiilAiiKciil joint Synthroid 0.88 Mg of tlie tluinih, and juiHHcd to tin- fort'linm-r
in the fold of inti'Kunicnt lictwiMMi iho tlininh itnd foicfiiif^cr, sfpariitcd
hy 11 \\\r\'» Synthroid 0.125 Mg (I'iiin^nlur npaoi' fit>mttic uddiiftor poliii-iH. It vin.* inKcitt'd,
im the niii'iiiiil liinilx'ioidis, l»y ii tt'iiiiiiioiis cxpiiiiHion into thr tendon of
tlie exleiiMH- lon^ix dinitoiuin to tlie index tinker. In I lie Synthroid 200 Mg Hccond ruse
the otiier |>urt.-i Here also ipiite almornuil. Tlie middle pliidiiiix of the
indt'X fin>;er ami the fii-st liind>ri(-alis were wanting; llie second, liiird,
and foiirtli iundtiieals were inserted resjieetively into tlie uiniir sides of
tlie extensor teiulons of the index, middle, and rin^ finders. Synthroid 88 Mg The little
finper was provided with no lundiricalis. The flexor tendons of the
index finger divided over the interphalangeal joint into two portions,
one heing Inserted in the first, the other in the last phalanx. The ex-
tensor indicis wa? inserted into the last phalanx. The nnisclc which
supplied the plaee of the nussing first hiinhrieal was very similar to the
one di^serihed in the first ease, the chief difference heinfi; Synthroid Online Pharmacy that it arose
from the hiternal sesamoiti hone of the metuear])()-phulan(;eal joint of
the thumb by two short tendons, which embraced Synthroid 0.137 Mg the sheath of the
flexor pollieis.
Cask III. DupHeature Synthroid 0.112 Mg of (he First Liiinl/ricul lii/ a Suprnuniirrari/
Mii.tclf njmiipiiip from the Thutiih. — The presence Synthroid 0.5 Mg of a su])ernuinerary
lumbrical was the only anomaly in this case. This was a slender mus-
cle, which arose from the internal sesamoid bone of the inetacarpo-
phalungeal joint of the thumb, crossed the tendon of the Synthroid 1 Mg adductor pol-
licis, passed between the first lumbrical and the outer head of the first
interosseous, and united by a tendinous expansion with the insertion of
the first lumbrical. The adductor poUicis was inserted between the
origin of this muscle and the outer head of the first interosseous.
Case IV. Snhstitution of a Muscle arisiiiff from the Anterior Annu-
lar Ligament {Lipamcntuin C'nrpi Volare Proprium) for the First Lum-
hriealis. — In this case the place of the absent first lumbrical was sup-
plied by a spindle-shaped muscle, which arose from the Synthroid 0.25 Mg posterior surface
of the anterior annular ligament some distance below its upper border,
passed down in the palm of the hand near the flexor indicis, crossed
the tendon of How Much Does Synthroid Cost the flexor longus pollicis, the inner portion of the flexor
brevis jioUicis and the adductor pollicis, and was inserted into the ten-
don of the extensor longus digitorum on the radial side of the first
phalanx of the index finger.
Case V. Duplicature of the First Lumhricalis hy a Supernumerary
Musek arising from the Anterior Annular Ligament (Ligamentum Carpi
Volare Synthroid 0.088 Mg Proprium). — Here the normal lumbricalis was in position, and
was supplemented by a muscle similar to that described in the fourth
case, which arose from the posterior surface of the Synthroid .05 Mg anterior annular
ligament, and passed beneath the palmar fascia, beside the normal lum-
brical, to be inserted with it into the tendon of the extensor longus
digitorum.
Case YI. A Second Head of the First Lumbricalii arising from the
Anterior Annular Ligament [Ligamentiiyn Carpi Volare Proprium). —
In this case the origin of the muscle was divided, one part occupying
the normal origin of the muscle, the other arising from the lower bor-
der of Synthroid 0.15 Mg the anterior annular ligament, and joining the first by means of
a tendinous insertion. Synthroid Retail Price
IT. Occurrence of the Branch to the Synthroid 0.75 Mg Index Finger of the Flexor
Digitorum Sublimis as a " Venter Synthroid 175 Mg Bifissus Digastricus Biceps." — In
the lower part of the forearm the branch of the flexor sublimis digi-
torum which supplies the index finger was divided into two fleshy por-
tions, which became tendinous, and were united in another fleshy por-
tion in the palm of the hand, which in turn became tendinous, and
was inserted in the normal manner into the lateral margins of the sec-
ond phalanx. The palmar portion seemed to be a direct continuation
of the tendon of the ulnar division, and received the tendon of the
radial division in the lower half of its radial border. The fleshy por-
tion in the palm was placed behind the anterior annular ligament and
the palmar fascia. It commenced at about the upper border of the
ligament, and ended at the metacarpo-phalangeal joint of Synthroid 112 Mg the index
finger. It received also a broad, fleshy accessory portion from the lower
border of the anterior annular ligament. A similar combination of
anomalies in a single tendon has never before been reported, to Pro-

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