In the initial stage there is a localised induration in the palm opposite the metacarpo-phalangeal joint, and the skin over it is puckered and closely adherent to the underlying fascia. After a variable interval, the finger is gradually and progressively flexed at the metacarpo-phalangeal joint. The ring finger is usually the first to be affected, less often the fifth, although both are commonly involved. It is rarest of all in the index. The flexion may be confined to the metacarpo-phalangeal joint, or the middle and distal phalanges may also be flexed; and as the deformity becomes more pronounced, the nail of the affected finger may come into contact with the skin of the palm. Dissections show that the flexion of the finger is the result of a chronic interstitial overgrowth or fibrositis and subsequent contraction of the palmar fascia and of its prolongations on to the sides of the fingers. The digital processes of the fascia are thickened and shortened, and come to stand out like the string of a bow. The adipose tissue in the skin of the palm disappears, and the skin and fascia thus brought into contact become fused. The tendons and their sheaths are not implicated; they are found lying deeply in the concavity of the curve of the flexed digit. There is no pain, but the grasp of the hand is interfered with, the patient is unable to wear an ordinary glove, and he may be incapacitated from following his occupation. The condition is easily diagnosed from congenital contraction by the fact that in the latter the proximal phalanx is dorsiflexed. _Treatment._--When seen in the initial stage, contraction may be prevented by passive movements of the finger and by massage of the indurated fascia; we have observed cases in which these measures have held the malady in check for many years, but when flexion has already occurred, they are useless, and according to the social position, habits, or occupation of the patient, the condition is left alone or the deformity is corrected by operation. Adam's operation consists in multiple subcutaneous division of the contracted fascia in the palm and of its prolongations on to the finger; in addition to dividing the fascia, the tenotomy knife should be used also to separate the skin from the fascia. The finger is then forcibly extended, and a well-padded splint secured to the hand and forearm. The skin on the palmar aspect opposite the first inter-phalangeal joint may give way when the finger is extended; should this occur, the resulting gap may be covered by a skin graft.