MULTIPLE NEUROMATA OF THE CENTRAL NERVOUS SYSTEM. 737 
fusiform cells, the elements from whose fusion in a chain a great part of the protoplasm 
bands are formed. There appear to be also fibres growing into the tumour from the 
radial nerve, that after a short course are modified in such a manner as to be transformed 
into elements similar to the above-mentioned protoplasmic bands. And, finally, there 
are present germ areas which seem to consist entirely of fusiform cells with elements a 
little further evolved. 
BaRILE concluded that in this tumour were to be found all the various phases between 
the fusiform elements, from whose fusion protoplasm bands have arisen, to the complete 
nerve fibre which had arisen from the differentiation of these protoplasm bands. ‘The 
fibres of the radial nerve have undergone cellular regression, and the individualised 
cells—from the proliferation of the nucleus of the sheath of Schwann—had again formed 
protoplasm bands which were found in a greater or lesser degree of differentiation from 
the formation of granular filaments to the constitution of the true axis-cylinder and 
myelin sheath. Here the new-formed fibres take their origin from a nerve that retains 
its normal connection with the centre. 
Traumatic Neuroma must be included in this section. The bulbous enlargements 
which form in relation to the ends of a nerve that has been injured, or to nerves in a 
stump, have been proved to consist of a dense plexus of nerve fibres. The origin of 
these new fibres has been usually accepted to be from the dissociation of the old axis- 
eylinder into its primitive fibrils and their prolongation onwards. Kennepy, however, 
has shown that the young nerve fibres have arisen within the proliferated cells of the 
sheath of Schwann, and that they form interlacing bundles in the scar-tissue. 
(c) Neuro-Fibroma. 
Verocay (1910), in a long article ‘‘ Zur Kenntnis der Neurofibrome,’ discusses with 
very great detail the microscopic structure of multiple neurofibromata occurring in the 
same individual and the relation of these tumours to each other. After shortly referring 
to a previously published case in which he found multiple tumours of the cerebral and 
spinal dura, true gliomata of the cord, multiple neuromata of numerous cerebro-spinal 
nerves, and tumours of sympathetic nerves in the stomach wall, he passes to the de- 
scription of a most remarkable case. In a man thirty-one years old, who was admitted 
to hospital with symptoms of cerebral tumour and died one month after the operation 
for its removal, there were found multiple tumours on the inner surface of the cerebral 
dura of the nature of fibro-endotheliomata, small gliomata in the medulla oblongata 
and cord, tumours in both cerebello-pontine angles of the nature of very cellular 
neuro-fibromata, multiple tumours of the lumbo-sacral plexus, and finally, multiple 
tumours of peripheral nerves. It is to the last group that we wish to draw attention 
in this section. The relation of the groups to each other will be referred to later. 
The microscopic structure of the multiple tumours of the nerves consisted of 
TRANS. ROY. SOC. EDIN., VOL. XLVIII. PART III. (NO. 27). 106 
