MULTIPLE NEUROMATA OF THE CENTRAL NERVOUS SYSTEM. 738 
imbibe mucin, or absorb fat; the tumours would then appear as fibromata, myxomata, 
or lipomata, respectively, but would remain in their nature essentially neuromata. In 
one and the same individual the tumours might appear under various forms. In all 
the various forms of neurofibromatosis the neoplastic element is the segmental cell 
which undergoes cellular regression. Neurofibromatosis, or Von Recklinghausen’s 
disease, is a polynévrome, the elements of which for the most part undergo a fibrous 
transformation instead of differentiating themselves into young nerve fibres, or of 
remaining at the stage of cells of myelinogenous type. 
Dorantr’s conception of the nervous nature of these lesions is in direct contrast to 
Von RECKLINGHAUSEN’S conception of a progressive fibrosis beginning in the peri- 
neurium and evolving in the endoneurium. Txomson, while agreeing with Von 
RECKLINGHAUSEN, has pointed out that the fibrillar tissue had no tendency to compress 
the nerve trunks, and was thus distinguished from other connective tissue new forma- 
tions, e.g. cirrhotic conditions. To numerous factors has been attributed a share in 
the pathogenesis, and nearly all writers have invoked a primary developmental mal- 
formation of the connective tissue elements related to nerves as the essential cause. 
Durante thinks that the exaggerated vegetative activity of the segmental cell must be 
due to an inherent instability im the differentiation of the nerve fibre, which renders it 
liable to be affected by determining causes. 
(a) Ganglio-Neuroma. 
The great majority of observations referring to ganglio-neuromata have related 
these tumours to the sympathetic nervous system. ‘Their frequent occurrence in the 
medulla of the adrenal is explained by the generally accepted view of the invasion of 
the anlage of the cortex of the adrenal by “indifferent” cells of the sympathetic to 
form the medulla. In a few cases cranial nerves have been the starting-point of 
ganglio-neuroma. 
Bussk (1898) has described a very large diffuse ganglion-celled neuroma involving 
the entire abdominal portion of the sympathetic. Microscopic examination of the 
tumour proved the presence of large ganglion nerve cells similar to those found in the 
normal sympathetic ganglion, numerous non-medullated, and a few medullated nerve 
fibres. Bussk thought it probable that the tumour had arisen in the lumbo-sacral 
sympathetic cord, and on account of its diffuse character allied it to the plexiform 
tumours of spinal nerves. 
Kwavuss (1898) records a case of very numerous ganglio-neuromata in the 
subcutaneous tissue of the thorax, abdomen, and thighs. The tumours were of very 
various size, and the microscopic investigation showed that all represented tumours of 
nerve tissue consisting of ganglion cells, medullated and non-medullated nerve fibres. 
The ganglion cells were found isolated and in groups embedded amongst the nerve 
