loss of sensation over the ulnar side of the back of the hand would add to the symptoms, but would not sensibly affect the deformity. [Illustration: FIG. 9. Deformity in case of wound of ulnar nerve above wrist.] The treatment is to seek for the divided ends of the nerve, and to unite them if possible. Should the interspace be too great to allow direct suture, an attempt might be made to restore continuity by cutting a long flap from the proximal extremity of the nerve and bringing it down to the distal end; or by the transplantation of a portion of nerve from an amputated limb, or from one of the lower animals. Where the wound lies immediately above the wrist, it is well to remember that the ulnar nerve and vessels are covered by a fibrous band, which passes from the radial side of the flexor carpi ulnaris tendon in this situation to blend with the anterior annular ligament. It should also be recollected that the deep branch of the nerve, which is occasionally implicated in penetrating wounds over the hypothenar eminence, runs around the ulnar side of the tip of the unciform process, and may there be exposed without much difficulty.[7] After operation the hand should be placed in a position of adduction and flexion, and the wound dressed antiseptically. Should this measure fail, the apparatus devised by Duchenne may be applied to replace the action of the paralysed muscles. _Musculo-spiral paralysis_ may be induced by ordinary wounds or contusions, by fractures of the humerus, or by long-continued compression of the nerve against the bone, either by the handle of a crutch, or while the patient is sleeping with his head resting upon an arm which is supported by the back of a chair. The consequences are paralysis of the elbow extensors, the supinator longus, the supinator brevis, and the whole of the extensors of the wrist, thumb, and fingers; and loss of sensation over the cutaneous areas supplied by the nerve in the arm, forearm, and hand. For the patient the most striking symptoms are the flexion of the wrist and fingers, the loss of power to abduct the thumb, and especially the enfeeblement of grasp due to the inability to fix the wrist during the action of the finger flexors. If the wrist be held firmly by the other hand, or by another person, in the position of extension, the power of grip becomes restored. A similar condition is present in lead poisoning; but here the loss of power is confined to the extensor muscles, and the supinator longus remains unaffected. The possibility of a crutch paralysis should lead the surgeon to warn every patient who is compelled to use the implement, in order that the paralysis may be prevented, or, should it occur, that it may be perceived and arrested in its earliest stages. When the condition has become established, an attempt should be made to restore function by massage and electricity, and if these fail, the nerve should be exposed at the seat