The symptoms of the true form have been so often and so graphically described that little can be added to the current accounts. I shall, then, limit my clinical picture to a simple outline, filled in with a few details taken from the series of examples which have been under my own observation. In a typical case, a middle-aged or elderly man notices in the course of the distal furrow, and directly over the head of the metacarpal bone of the ring or little finger, a small nodule in the skin, or perhaps only a puckering and exaggeration of the flexion line. By-and-by a ridge appears running proximally from this point towards the wrist, and distally along the central axis of the finger. The ridge is prominent, round, and very hard, especially between the flexion fold and the root of the digit, and the skin is usually drawn to it tightly at the seat of the initial sign. It passes on to the front of the first phalanx, nearly always preserving the central position, but spreading out and usually sending processes to the deep surface of the integument as it reaches the first joint of the finger, and as it contracts, draws down the metacarpal phalanx towards the palm. After a while the second phalanx may become bent in like manner, and by exception even the distal bone. The articular structures show no trace of disease, the tendons are normal, the finger retains all its strength within the progressively narrowing range of motion left to it by the disease, and the utility of the hand may for a long while be little impaired. Sooner or later other fingers may become involved, and the affection may appear in the opposite hand, to follow a like course. The process of contraction is slow in progress, perhaps extending over ten or twenty years; it is painless, and is uncomplicated by any signs of active inflammation. At length, after a more or less protracted period, it may terminate spontaneously in any of its stages, but the mischief wrought is permanent, and unless the surgeon intervenes, the patient carries it to his grave.