nd at the time of
extirpation hung as an enormous mass from beneath the left scapula. In
operating the tumor had to be swung on a beam. The hemorrhage was
slight and the patient was discharged in five days.

The true lipoma must be distinguished from diffuse accumulations of fat
in different parts of the body in the same way that fibroma is
distinguished from elephantiasis. Circumscribed lipoma appears as a
lobulated soft tumor, more or less movable, lying beneath the skin. It
sometimes reaches enormous size and assumes the shape of a pendulous
tumor.

Diffuse lipoma, occurring in the neck, often gives the patient a
grotesque and peculiar appearance. It is generally found in men
addicted to the use of alcohol, and occurs between thirty-five and
forty-five years of age; in no case has general obesity been described.
In one of Madelung's cases a large lobe extended downward over the
clavicle. The growth has been found between the larynx and the pharynx.
Black reports a remarkable case of fatty tumor in a child one year and
five months old which filled the whole abdominal cavity, weighing nine
pounds and two ounces. Chipault mentions a case of lipoma of the
parietal region, observed by Rotter. This monstrous growth was three
feet three inches long, descending to the knees. It had its origin in
the left parietal region, and was covered by the skin of the whole left
side of the face and forehead. The left ear was plainly visible in the
upper third of the growth.

Chondroma, or enchondroma, is a cartilaginous tumor occurring
principally where cartilage is normally found, but sometimes in regions
containing no cartilage. Enchondroma may be composed of osteoid tissue,
such as is found in the ossifying callous between the bone and the
periosteum, and, according to Virchow, then takes the name of
osteochondroma. Virchow has divided chondromata into two forms--those
which he calls ecchondromata, which grow from cartilage, and those that
grow independently from cartilage, or the enchondromata, which latter
are in the great majority. Enchondroma is often found on the long
bones, and very frequently upon the bones of the hands or on the
metatarsal bones.

Figure 244 represents an enchondroma of the thumb. Multiple
enchondromata are most peculiar, and may attain enormous sizes.
Whittaker describes a farmer of forty who exhibited peculiar tumors of
the fingers, which he calls multiple osteoecchondromata. His family
history was