At the commencement I used to wear collars of medium height, though not wide enough to admit my chin. An attempt to obviate the difficulty by unbuttoning my shirt and bending my head down so as to keep my chin in the opening proved abortive, owing to the weakness of the resistance, so I purchased much higher and suffer ones, in which I buried my lower jaw and prevented its moving at all. The success of this method was transitory, nevertheless, for however stiffly they were starched, the collars invariably yielded in the end and presented a lamentable aspect. I next happened on the fatuous plan of attaching a string to my brace buttons, and passing it up under my waistcoat to connect it with a little ivory plate that I held between my teeth, its length being so arranged that in order to seize the plate I had to lower my head. Admirable idea! I soon was forced to abandon it, however, for my trousers were pulled up on the right in a way that was as grotesque as it was uncomfortable. I have always had a weakness for the principle of the thing, nevertheless, and even to-day as I go down the street I sometimes catch hold of the collar of my jacket or vest with my teeth and stroll along in this way. At home it is the collar of my shirt that acts as my tether. The retrocollic attitude that O. favours seems to have had the further effect of making him forget how to look down. There is no impairment of any of the eye movements, but he has considerable trouble in directing his gaze downwards, and if with his head in the normal position he holds a book below the level of the plane of his eyes, reading is more arduous, and after a little time impossible. Yet there is no indication whatever of ocular paresis; it is rather a sort of apprehension from which he suffers. On several occasions we have remarked a synergy of function, head and eyes moving upward in unison. * * * * * Our patient's category of tics is not yet exhausted, however. He has been afflicted with a shoulder tic, consisting of simultaneous or alternate elevation, sometimes of other movements, and always with some abduction of the arms. Frequent execution of these actions has culminated in the acquisition of the faculty of voluntarily producing a rather loud "crack" in the shoulder articulations, which thus not merely originated in a tic, but supplies an ever-active stimulus for its reproduction; in its occurrence satisfaction and dissatisfaction are blended as before. At the present moment the impulse to this particular tic is in abeyance, and he has ceased to take any interest in the "crack," considering it a trivial society accomplishment of no significance or danger, analogous to voluntary subluxation of the thumb, or to the curious sounds that some people are fond of making by way of diversion.