5. The man should then be directed to stretch his hands out in front of him, with wrists extended and fingers widely spread. Presence or absence of tremor should be looked for, and the condition of the finger-nails, as to the practice of biting, etc. The extensor power should then be tested, firstly of the fingers. While the hands of the workman remain outstretched, the surgeon places the forefinger of his hand in the outstretched palm of the workman, and the ball of the thumb upon the extreme tip of each finger, and by gently pulling it down, noting the spring present in the muscles. This test is probably the most delicate there is for detection of early extensor paralysis. The condition of the lumbricals and interossei are noted on movement of the fingers. The extensors of the wrist are then further examined, the workman being directed to flex his arm at the elbow and strongly pronate the wrist, so that the palm of the hand is directed forwards. He is then told to close the fist when the surgeon endeavours to flex the wrist, the workman at the same time resisting by forcible extension of his wrist. Ordinarily the extensor communis digitorum and minimi digiti are sufficiently powerful to resist a very powerful pull upon the wrist; and if the wrist is found to yield, it is a sign that the muscles are affected. Sometimes the strength of the wrists and fingers is judged by the surgeon placing his palms on the dorsum of the patient’s outstretched hands, and seeing whether the patient can be prevented from lifting them without flexing the wrists or finger-joints. The test detects (1) paralysis which has been recovered from to a large extent; (2) commencing partial paralysis; and (3) weakness of muscular power, especially in those who have worked in lead for a number of years. This weakness appears to be an effect of lead upon the muscular tissue or dependent on debility, the result of lead absorption, and independent of nerve implication. We have known the condition to remain unaltered for years, and also to undergo alteration, being at times absent for months together. Occasionally reports of definite paralysis refer to pre-existing weakness. 6. The pulse is next noted. The pulse-rate need not ordinarily be counted, but if it is either very slow or fast careful examination at the conclusion of the general inspection should be made. It is well to make all these points before asking any questions. After they are completed inquiry as to regularity of the bowels, existence of pain or discomfort, would follow. The speech should be noted, as slurring or hesitating speech is occasionally associated with early lead poisoning. All these points can be gone through quite rapidly, and at the conclusion of the general examination, if judgment is in suspension, careful examination in the routine medical manner should be made.