Spastic conditions following local injury are very rare. An example was brought before the Medical Society by Dr. Beevor[6] in April 1888, in which a contusion of the right hand in a boy of fifteen was followed five days later by permanent contraction of the hand with total anæsthesia as far as the shoulder and loss of the muscular sense, the movements of the arm and forearm remaining unimpaired. In the discussion a similar case was referred to by Dr. Hadden. All the nerves which govern the muscles acting upon the fingers are liable to injury—the median and ulnar more particularly by wounds, usually in the wrist, and the musculo-spiral by pressure of a crutch. An injury involving solution of continuity of the _Ulnar nerve_ is a very grave accident, unless it can be treated surgically without any long delay. The symptoms are such as might be inferred from a knowledge of the distribution of the branches. It will be remembered that the nerve supplies the flexor carpi ulnaris and ulnar half of the flexor profundus digitorum in the forearm, the whole of the muscles of the hand, except the abductor, opponens, and outer head of the flexor brevis pollicis, and the two inner lumbricales, and it gives sensation to the skin over the inner side of the wrist and hand, to the palmar and dorsal surfaces of the little and ulnar half of the ring finger, and sometimes also to the radial half of the ring finger and ulnar half of the middle finger. The effects of the nerve lesion will, of course, vary with the position of the injury. If the trunk be divided just above the wrist, the branches to the two forearm muscles and the cutaneous branch to the back of the hand and fingers will be spared; but the palmar cutaneous filament will probably be implicated by the wound. The paralysis of the interossei produces an inability to flex the first phalanges and extend the second and third, while the unbalanced action of the extensor, and superficial and deep flexors, causes the position of super-extension of the metacarpo-phalangeal joint with flexion of the inter-phalangeal joints, which constitutes the _main en griffe_ of French pathologists (Fig. 9). The clawing is chiefly marked in the ring and little digits, especially the latter, but is lessened in the index and middle fingers by the continued integrity of the first and second lumbricales. There is, in addition, great loss of power in flexion and adduction of the thumb, and complete loss of sensation over the front and distal part of the back of the little finger and the corresponding portion of the ulnar side of the ring finger. At a later stage nutritive changes appear in the paralysed structures, and the deformity becomes complicated by the atrophy of the skin and subcutaneous fat, the hollowing of the interosseous spaces and the wasting of the thenar and hypothenar eminences. If the nerve be injured at the elbow, the paralysis of the two forearm muscles, and the