584 THE SKIN. 



rapid growth, by a new formation of nodules in the vicinity of the primary 

 tumor, and by their recurrence after extirpation. An original myxo-fibroma, 

 after repeated extirpation, may gradually assume the features of fibro-mye- 

 loma. The vascular supply of myeloma is sometimes scanty, at other times 

 abundant. Some of these tumors multiply rapidly all over the skin, especially 

 in the subcutaneous tissue, and some may, after reaching a certain size, dis- 

 appear, while new nodules may form in other localities. The melanotic vari- 

 ety usually starts in the skin of the hands and the feet, and in a comparatively 

 short time invades large portions of the surface of the body, and never admits 

 of a cure. After extirpation, many of these tumors recur with great 

 obstinacy, in the scar or in its vicinity, and prove more malignant with each 

 re-appearance, until at last an operation becomes impossible. The patient 

 dies, with symptoms of inanition, from the exhausting waste of living matter 

 within the rapidly growing tumor, or from secondary formations in internal 

 organs. 



(6) Lipoma is a common type of tumor, occurring in the subcutaneous tis- 

 sue, evincing some predilection for the posterior aspect of the body, and 

 sometimes appearing as a diffuse accumulation of fat-tissue in the female 

 breast. Lipoma combines with myxoma or myxo-fibroma, constituting the 

 variety called " cutis pendula," or "leontiasis," which sometimes attains 

 enormous size. 



(7) Angioma, in its three varieties, is found in the skin. Simple and lob- 

 ular angioma is usually seated in the derma, while the cavernous angioma, 

 which is rarer, generally starts in the subcutaneous tissue. These tumors are 

 all easily compressed, the blood disappearing, but returning when the pres- 

 sure is removed. The dark red or bluish-red color is, as a rule, a marked 

 feature, though wanting in the deeply situated cavernous tumors. New for- 

 mations of lymph-vessels the so-called lympli-angioma occur in the tissue 

 of the derma ; the cavernous lympli-angioma, is a rare formation in the subcuta- 

 neous tissue. 



(8) Myoma has been observed by Virchow and others, usually occurring as 

 small, flat, erectile tumors, in the skin around the nipple and in the scrotum. 

 No case has as yet come under my observation. 



(9) Neuromata appear in the skin as nodules, not attaining a large size, 

 but characterized by their excessive painfulness. The great majority of these 

 tumors are fibrous in structure, starting from the perineurium, and separating 

 the medullated nerves. 



(10) Papilloma is often found on the hands as simple warts ; on the geni- 

 tals as condylomata, and in other localities, though rarely, as hairy and warty 

 moles (neevus verrucosus). The latter variety is congenital, while all other 

 warty tumors are acquired, being due to some local irritation. I have seen 

 the so-called venereal warts, on the skin of the back, evidently produced by 

 transmission of the blennorrhagic secretion ; on the chin conveyed proba- 

 bly by the barber and on the forehead and eyelids of a child infected by 

 the nurse. A peculiar feature of these tumors is that they are difficult to 

 eradicate. Sometimes, in advanced age, they change their nature and become 

 cancerous, especially in the face. 



(11) Adenoma appears almost exclusively in the skin as adenoma of the 

 sebaceous glands. Adenoma of the sudoriparous glands has been described 

 by Verneuil only, and its existence is very doubtful. A variety of acinous 

 adenoma, starting from the lacteal glands, is very common in the appendage 



