344 ON GROWTH AND OVERGROWTH 



belonging to the same class. Let me enumerate rapidly the 

 more important members, only treating with somewhat more 

 detail conditions which, while not generally included as coming 

 under this category, not only, I hold, are rightly so included, but 

 find their proper place and proper relationships when so included. 



One prominent and characteristic sub-group is in association 

 with the nervous system. In this belongs a most striking form 

 of " Riesenwuchs," which until recently has been regarded as a 

 fibromatosis. I refer to that condition of multiple subcutaneous 

 and perineural growths to which so many names have been 

 given : molluscum fibrosum, multiple neuro-fibromas, neuro- 

 fibromatosis, etc. The observations of Durante, Kohn, Bard, 

 and Verocay taken together demonstrate convincingly, I think, 

 that these growths are hyperplastic developments of the cells 

 of the sheaths of Schwann, of cells, that is, of neuroblastic origin. 

 These overgrowths beginning often in early life, and developing 

 slowly over long years, respect the normal boundaries of the nerve 

 sheaths, merge imperceptibly at either pole, without defining 

 capsule, into the tissues of the nerve along which they have 

 developed, and in every respect conform in their properties with 

 the multiple fatty growths already enumerated. Closely allied 

 embryogenetically is the condition of gliosis or gliomatosis. 

 Here we have the same slow progressive growth, the same diffuse 

 nature and lack of delimitation ; indeed, my own experience 

 leads to the conviction that the majority of the so-called gliomas 

 belong to this category. What is perhaps the most well-marked 

 example of this condition is seen associated with, and apparently 

 underlying, the condition of syringomyelia. 



Passing over certain less important examples such as leio- 

 myosis or leiomyomatosis (which, I would point out, is the more 

 correct nomenclature for what gynaecologists and modern text- 

 books wrongly term adenomyoma of the uterus), and endotheliosis 

 (such as is seen notably in the spleen in Gaucher's type of spleno- 

 megaly, and some cases of Banti's disease), 1 I would at greater 



1 There can now be no question as to the functional, or, indeed, superfunc- 

 tional nature of this striking overgrowth of the sinus cells in the spleen, since 

 Banti has demonstrated that operative removal of the organ terminates the 

 anaemia — prevents, that is, the excessive destruction of the red corpuscles. 

 (These cells lining the splenic sinuses possess normally the property of taking 

 up and destroying the red oorpuscles. When they are developed in excess 

 the destruction becomes also excessive.) 



