MULTIPLE NEUROMATA OF THE CENTRAL NERVOUS SYSTEM. 735 
Fatk (1907) describes a ganglio-neuroma whose origin was traced to the solar 
plexus. ‘Ihe essential constituents of the tumour were non-medullated fibres with 
interstitial connective tissue. The fibres were very delicate and undulating, with 
regularly situated, elongated nuclei along their course. Ganglion cells, isolated and in 
groups, were also found amongst the nerve bundles. The cells were of very various 
size and shape, mostly in various stages of degeneration, and all allowed to be 
recognised their derivation from one common parent cell. Axis-cylinder processes 
could be traced in only a very few ganglion cells: the great majority gave the 
impression of being a-polar cells. The author noted also the presence of small round 
or oval cells with metachromatic staining granules similar to the chromotrope cells 
found in the medulla of the adrenal and in the carotid gland. 
The nerve fibres stained distinctly by Bielschowsky’s method. Numerous sections 
were observed which contained only a few ganglion cells, and nerve fibres formed the 
great mass of the tumour. In teased preparations the fibres showed clearly that the 
nuclei were within the nerve tube. Faux found it impossible to believe that this 
great mass of fibres was derived from the ganglion cells, which were not only mostly 
a-polar but degenerated. He therefore turned his attention to the possibility of the 
Schwann cells being the formative cells of the new nerve fibres: he found that these 
were present in great abundance, that the direction of their growth was parallel to the 
new axis-cylinder, and that within the cells a continuous plasmatic stripe, which later 
became the specifically staining axis-cylinder, was present. With Bielschowsky’s 
silver method the axis-cylinders showed no differentiation into actual fibrils. Fak 
felt justified in coming to the conclusion that the new axis-cylinders had arisen by the 
differentiation of the protoplasm of the proliferated sheath of Schwann cells. He adds 
that with medullated sheath staining the axis-cylinders took on the myelin stain, and 
that if the sections were only slightly differentiated a weakly-staining myelin sheath was 
evident in the nerve tubes. ‘The non-medullated character of the great majority of the 
fibres, therefore, does not seem quite proved. Fatk thinks it possible that the 
degenerated ganglion cells constituted the chemiotropic influence which caused the 
marked proliferation of the nerve fibres. 
WEGELIN (1909) records a case of ganglio-neuroma at the level of the lower margin 
of the kidney. The cells again were of very varied size, the fibres again greatly 
preponderated, and numerous sections consisted exclusively of nerve fibres. These were 
collected into interlacing bundles to form a dense felt-work. In longitudinal sections 
the fibres appeared as bright undulating bands, with distinctly marked sheath and 
nucleus of Schwann. Most of the fibres were non-medullated and showed a dark 
thread in the centre corresponding to the axis-cylinder. The medullated fibres 
stained pinkish and showed numerous varicosities. In contrast to FaLK’s case, WEGELIN 
found no proliferation of the sheath of Schwann cells, z.e. no increase over the normal 
nuclei of the sympathetic fibres. He also found no spindle-shaped cells forming proto- 
plasmic bands which could be looked upon as the early stages of non-medullated fibres. 
