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The hand assumes a characteristic attitude: the index and middle fingers are extended at the metacarpo-phalangeal joints owing to paralysis of the interosseous muscles attached to them; the little and ring fingers are hyper-extended at these joints in consequence of the paralysis of the lumbricals; all the fingers are flexed at the inter-phalangeal joints, the flexion being most marked in the little and ring fingers claw-hand or main en griffe.
In this attitude the line passing through the centre of gravity strikes the heels, the knees are hyper-extended, and the muscles of the calves and thighs are rendered tense. By interfering with the muscular development and digestion, the girl is very apt to become angular, flat-chested, anemic, and to have a muddy complexion.
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