NEUROMA. 



315 



patients suffer for years from neuralgic pain or spasmodic attacks in 

 the parts supplied by the inflamed nerve. 



TREATMENT. In the first place the causal indications must be ful- 

 filled ; with this view foreign bodies driven into the nerve must be re- 

 moved, and inflammations in its vicinity must be carefully treated. 

 Leeches, or wet cups may also be applied along the course of the 

 nerve ; cold applications may be made, or, if the disease continue long, 

 mercurial ointment may be rubbed in if the nerve lie near the surface. 

 Chronic neuritis may be treated by derivatives, such as blisters, and, 

 hi obstinate cases, moxae, and superficial linear cauterizations of the 

 skin with hot iron. If the disease has run its course, and the nerve has 

 not been destroyed, but its functional activity is affected, we may use 

 electricity to restore its normal excitability, if possible, by methodical 

 excitement of the nerve. 



CHAPTER II. 



NEUROMA. 



ETIOLOGY. Strictly speaking, we can only designate as neuromata 

 those tumors originating from nerves which are chiefly, or at least to a 

 great extent, made up of nervous elements. The tumors, not unfre- 

 quently occurring on nerves, which have developed without hyperpla- 

 sia of the nerve-elements, and in which consequently the number of 

 nerve-elements has remained the same or even actually diminished, 

 are not neuromata, but, according to their structure, come under the 

 head of carcinoma, fibroma, or glioma, etc. ( Virchow). Neuromata 

 which consist chiefly of nerve-filaments, or where these exceed the 

 intercellular substance in amount, are termed pure neuromata, in con- 

 tradistinction to those where the intercellular substance is in excess ; 

 this division, however, has more pathological-anatomical than clinical 

 interest. 



The etiology of neuromata is obscure. Occasionally they may be 

 referred to a congenital or hereditary predisposition. Such cases, as 

 well as the frequent occurrence of numerous neuromata on different 

 aerves, and their repeated recurrence after removal, speak for the con- 

 stitutional orgin of some neuromata. Others unmistakably result 

 from injury of the affected nerve, by a puncture, contusion, etc. In 

 most cases no cause can be discovered. 



ANATOMICAL APPEARANCES. Neuromata generally form hard, elas- 

 tic tumors, from the size of a hemp-seed to that of a fist, or larger ; 

 they are usually round or oval ; in the latter case their long axis lies 



