ARTHRITIC CONTRACTIONS 124 PARALYTIC CONTRACTIONS 127 SECTION III CONGENITAL DEFORMITIES OF THE HANDS AND FEET MAKRODACTYLY 128 SUPERNUMERARY FINGERS AND TOES 144 SYNDACTYLY 145 ECTRODACTYLY 147 BRACHYDACTYLY 149 THE DEFORMITIES OF THE FINGERS AND TOES The section of surgical disease treated in the following pages is unambitious in its scope, but it is, nevertheless, one that deserves the attention of every surgeon and pathologist, because it comprises a group of ailments which are the source of much pain and crippling, and because it offers many problems of causation that are still unsolved. It is true that none of these affections threaten life, but in medicine, as in law, it is often the value of the principle involved rather than the magnitude of the interests immediately at stake that invests the case with importance. There is a material advantage to be gained by studying the deformities of the hands together with those of the feet, for it will be found that nearly all the forms of contraction that appear in the one are represented in the other, and a comparison of the conditions under which the two sets of affections arise may throw light upon the pathogeny of both. At the same time, if we glance at the structural and functional differences in the hand and foot, and at the fact that civilised life imposes artificial restraints upon the freedom of action of the one, while it cultivates to a marvellous degree of perfection the variety and precision of movement in the other, we shall understand that although certain deformities of the fingers may have a strict pathological analogy with those of the toes, the effects produced, and the treatment required may differ essentially in the two sets of cases. It will be seen that our knowledge of some of the affections to be described is of very recent date, and that certain diseases, frequent in occurrence, obvious in character, and very inconvenient or painful in results, have only found a place in our text-books within recent years. Even the most ancient in point of literary existence scarcely dates beyond the third decade of the present century; while the youngest, when regarded in the same aspect, is merely a child of a few winters; and yet both the one and the other may be nearly as old as mankind. SECTION I CONTRACTIONS OF THE FINGERS