wer part of the tumor had ulcerated. This large
tumor was successfully removed; it consisted of fibrous tissue, with
large veins running in its substance. The excised mass weighed 51
pounds. The patient made an early recovery.

Keloids are fibromata of the true skin, which may develop spontaneously
or in a scar. Although the distinction of true and false keloid has
been made, it is generally discarded. According to Hebra a true typical
keloid is found once in every 2000 cases of skin-disease. It is,
however, particularly the false keloid, or keloid arising from
cicatrices, with which we have mostly to deal. This tumor may arise
from a scar in any portion of the body, and at any age. There seems to
be a disposition in certain families and individuals to
keloid-formations, and among negroes keloids are quite common, and
often of remarkable size and conformation. The form of injury causing
the cicatrix is no factor in the production of keloid, the sting of an
insect, the prick of a needle, and even the wearing of ear-rings having
been frequent causes of keloid-formations among the negro race.
Collins describes a negress of ninety, born of African parents, who
exhibited multiple keloids produced by diverse injuries. At fourteen
she was burned over her breasts by running against a shovelful of hot
coals, and several months later small tumors appeared, which never
suppurated. When a young girl a tumor was removed from the front of her
neck by operation, and cicatricial tumors then spread like a band
encircling one-half her neck. There were keloids over her scapulae,
which followed the application of blisters. On her back, over, and
following the direction of the ribs, were growths attributed to the
wounds caused by a flogging. This case was quite remarkable for the
predisposition shown to keloid at an early age, and the variety of
factors in causation.

About 1867 Duhring had under his observation at the Philadelphia
Hospital a negro whose neck was encircled by enormous keloids, which,
although black, otherwise resembled tomatoes. A photograph of this
remarkable case was published in Philadelphia in 1870.

A lipoma is a tumor consisting of adipose tissue. When there is much
fibrous tissue in the tumor it is much firmer, and is known as a
fibro-lipoma. Brander describes a young native of Manchuria, North
China, from whom he removed a fibro-lipoma weighing 50 pounds. The
growth had progressively enlarged for eleven years, a