316 DISEASES OF THE PERIPHERAL NERVES. 



in the course of the nerve. Virchow divides them into fibro-, glio, 

 and myxo-neuromata, according as the interstitial tissue between the 

 nerve-filaments resembles fibrous tissue, neuroglia, or mucous tissue. 

 They sometimes contain small cavities filled with fluid. Neuromata 

 are occasionally seated on the nerve ; again they originate from its 

 interior, and contain more or less nerve-filaments in proportion to the 

 distance of their origin from the centre of the nerve. The most fre- 

 quent seat of neuromata is the spinal nerves ; but there are examples 

 of their occurrence on the sympathetic and cerebral nerves, particularly 

 on the auditory. Usually there is only one neuroma, and its size is 

 not at all in proportion to that of the nerve from which it originates. 

 In other cases there are several neuromata on the same nerve, in still 

 others there are great numbers, originating from the most varied 

 nerves. Under the head of neuromata appear also to belong the pain- 

 ful tumors, about the size of a pea or bean, readily moved about under 

 the skin, which are also called tubercula dolorosa, painful tubercle, or 

 neuromantia ; although their connection with a cutaneous nerve or the 

 presence of nerve-elements in them cannot always be proved. 



SYMPTOMS AND COURSE. Peripheral neuromata, which alone can 

 be recognized, show themselves as a more or less elastic tumor, seated 

 in the course of one of the cutaneous nerves, which is only movable 

 laterally, and is covered by the unaltered skin. Large multiple neu- 

 romata occasionally cause neither pain nor other inconvenience, so that 

 their diagnosis can only be made by the apparent connection between 

 the tumors and a cutaneous nerve. The case is different with the 

 customary single small neuroma. It is often accompanied by ex- 

 cruciating pain extending along the course of the nerve and to its 

 peripheral termination. This is not usually continuous, but has par- 

 oxysms with intervals of ease. Slight pressure on the tumor, often 

 even the contact and rubbing of the clothes, increases the pain in the 

 tumor to an unbearable extent. Severe paroxysms of pain are also 

 induced by movement, catching cold, etc. In neuroma, as well as in 

 neuritis, the conducting power of the nerve may be impaired, so that, 

 besides the pain, there may be a feeling of numbness or even of more 

 or less complete anaesthesia of the skin supplied by the nerve affected. 

 Rarely, when the motor filaments are affected, there are twitchings 

 and contractions and subsequently paralysis. The extension of the 

 pain from the diseased nerve to other trunks, as well as the increased 

 disturbance of innervation that occasionally complicates the local 

 symptoms, is common to neuroma, neuritis, and to neuralgias of the 

 most varied origin ; we shall therefore defer their discussion to the 

 next chapter. Neuromata generally grow slowly, and, after attaining 

 a certain size, often remain stationary. They are among the most 



