The earliest examples of “congenital hypertrophy” recorded in this country were those of Dr. Reid, published in the _London and Edinburgh_ _Monthly Journal of Medical Science_ for March 1843, but before this date a characteristic case of makrodactyly had been carefully described by von Klein,[15] and other instances had been brought forward by Beck[16] and Wagner.[17] Reid’s paper was followed by a valuable article by Curling,[18] and contributions by Ideler,[19] Adams,[20] Devouges,[21] Chassaignac,[22] Annandale,[23] and others, but the first attempt to classify the cases was that of Busch,[24] in 1866. Since this time many additions have been made to the literature of the subject, the most important of which are those of Trelat and Monod,[25] Vogt,[26] von Fischer,[27] Wittelshöfer,[28] and Humphry.[29] The condition may be defined as a gigantic growth, congenital in origin, of various segments of the body exclusive of the viscera. It is generally unilateral, and limited to one extremity or portion of an extremity; it tends to implicate especially the bones and joints, and the adipose and vascular elements of the subcutaneous tissue. It does not, as a rule, impair to any important extent the functional capacity of the part. The name “congenital hypertrophy” is open to criticism. There is little doubt that the abnormality always has its origin in fœtal life, but it has seldom been noticed immediately after the delivery of a child; and, on the other hand, in one case recorded by Lannelongue,[30] a “_macrodactylie elephantiasique_” in a child is said to have followed an operation for the separation of two united fingers. It is, at any rate, certain that if the enlargement be always present at birth, it is seldom so disproportionate as to attract attention and never so great as to interfere with parturition. Hence the colossal proportions subsequently observed are the result of excessive growth in early infancy and childhood, and occasionally in adult life. The hyperplasia, moreover, is rarely hypertrophic in the higher sense of the term, for, although in a few cases the increased growth has been associated with apparent increase of functional utility, in the great majority of instances it is relegated to a lower status by its unequal distribution amongst the different tissues of the parts involved, its frequent association with other congenital deformities, and especially by the defective ratio of functional capacity to the amount of constructive material. In other words, the process is wasteful and unserviceable.