The group of affections known as _Writer’s cramp_ usually fall within the province of the physician, and will only be briefly referred to. They are of uncertain pathology, vary considerably in their manifestations, and, although most common in persons much engaged in writing, are by no means confined to these. The symptoms may assume three different types—spastic, paralytic, and tremulous—affecting the muscles of the hands and forearm, and these may be combined in various ways. The prognosis is unfavourable; but the treatment found most hopeful is to relieve the affected muscles from the strain to which they have been accustomed, and strengthen them by massage and galvanism. Interference by surgical operation has been unsuccessful, except in one case, in which Stromeyer divided the flexor longus pollicis tendon. CONGENITAL AND INFANTILE CONTRACTIONS. These are usually of paralytic origin, but include a proportion of cases of true hammer finger. The common form is that already described by Mr. William Adams (Medical Society, December 1890), in which the inter-phalangeal joints of one or more fingers (most frequently the fifth) are flexed, and the integument on the palmar aspect forms a longitudinal fold, which becomes tense when an attempt is made to straighten the digit; the metacarpo-phalangeal joint is super-extended. At first the finger may be fully extended by passive force, but after a few years the position of flexion at the first inter-phalangeal joint is rendered permanent by imperfect development of the ligamentous fascial and even cutaneous structures in front of the articulation, while the terminal phalanx usually remains more or less helpless. The condition is probably dependent upon an infantile paralysis of the flexors of the affected digit. The use of friction, passive movement, and electricity, may be of value in the early stages. TRIGGER FINGER. The description of this curious affection has been left until the last because its true nature is still an unsolved problem, and it is hence difficult to place it in any of the groups already described. It is indeed rather a pathological curiosity than an important item in surgical disease, and many surgeons of long experience have never met with a single example. Of the mechanism of its causation we know almost nothing, of its ultimate tendencies we know little more, and its morbid anatomy is almost entirely speculative. Nevertheless, it has a literature extending over forty years, and comprising nearly a hundred separate contributions, the last of which, a model in its way, is a monograph of 250 closely printed large octavo pages, the work of Dr. Carlier.