of injury, and its continuity restored by the excision of the atrophic portion and union of the two free extremities. In paralysis of the _Median nerve_ by a wound above the wrist, the most distressing symptoms are referable to the trophic lesions in the integuments of the thumb, index, middle, and ring fingers (radial side) on their palmar surface and the distal half of their dorsal aspect. There is, in addition, a partial loss of power of flexion and abduction of the thumb, with wasting of the thenar eminence and some interference with the delicacy of the movements of the index and middle fingers, owing to the paralysis of the first and second lumbricales. If the nerve be divided above the elbow, the pronators and all the flexors of the wrist, thumb, and fingers, except those supplied by the ulnar nerve (flexor carpi ulnaris, and ulnar half of the flexor digitorum profundus), are paralysed, and consequently the hand is, for all practical purposes, quite useless. The rules for treatment are similar in principle to those laid down for injuries of the musculo-spiral and ulnar nerves. _Spastic Paralyses_, in connection with central disease, need not be discussed; but the surgeon is sometimes consulted for conditions of persistent spasm which apparently depend upon excessive use of certain muscles. Erichsen refers to, and figures, a case of flexion with pronation attributed to cutting with heavy shears. He notes that when the wrist was extended the fingers became flexed, and when the wrist was extended the fingers became bent in. It is not stated whether the permanency of the contraction was tested by the use of an anæsthetic, but the patient, as well as another in whom the extensors were affected in like manner, became cured by means of friction and galvanism, with the use of a straight splint. A case of spastic contraction of the right little finger of thirty-five years’ duration was recently in the Mile End Infirmary. The flexion of the finger is associated with slight adduction of the hand, but the parts can be straightened completely by passive force. The condition is attributed to a wound near the elbow. There is no lesion of sensation.