Between the proximal border of the fibres of Gerdy and the point of bifurcation of the digital bands of the radiating fascia is a space about half an inch in length, in which is seen a portion of the _vaginal fascia_ that invests the tendons, vessels, and nerves in the palm. (Fig. 3.) The connective-tissue fibres in this latter are for the most part transversely arranged. They are connected superficially with the deep surface of the radiating fascia, where they lie beneath it, and deeply with the aponeuroses of the interossei, transverse metacarpal ligament, and glenoid plates, and form septa between the flexor tendons of the four fingers. Where they ensheath the tendons above the ligamenta vaginalia they are separated from them by a kind of lymph space. If we examine a case of Dupuytren’s contraction in the light of our anatomical knowledge, we shall be struck by the circumstance that the morbid structure which causes the permanent flexion of the fingers bears no resemblance in position or character to the normal fibrous tissues of the part, although it is apparently continuous in the proximal direction with the digital bands of the radiating fascia. The band is best developed beyond the point where the radiating fascia normally ceases, and maintains its longitudinal fibrillation while crossing the vaginal fascia and the transverse fibres of Gerdy. The varieties and modes of branching already described are only to a limited extent related to the anatomical arrangements—that is, where the morbid tissue spreads proximally over the radiating fascia, and sends lateral branches along the course of Gerdy’s fibres; but it is certain that the tendon-like cords are of entirely new formation, and that they exist at the expense of the normal structures. The well-known preparation in St. Bartholomew’s Hospital, which has been figured by Mr. Adams, affords a demonstration of this, as the band, instead of following the direction of the radiating fascia, runs towards the inter-digital cleft and there bifurcates, sending branches to the adjacent sides of two fingers. In a specimen of my own the band runs axially to the little finger and spreads out in front of the first phalanx as a fatless fan-like expansion, that differs altogether in character and arrangement from the normal subcutaneous tissue and becomes closely connected with the skin, the structure of which, however, remains unchanged. The firmest point of integumental adhesion is opposite the distal flexion fold over the head of the fifth metacarpal bone. The first phalanx is flexed to about 90°, and over the metacarpo-phalangeal joint the contracted cord lies in a plane considerably anterior to the tendons, vessels, and nerves, all of which maintain their normal relation to the bones and muscles. There is no tendency on the part of the morbid growth to follow the deep connections of the fascia in the palm.