738 DR ALEXANDER BRUCE AND DR JAMES W. DAWSON ON 
bundles of nerve fibres in the condition of protoplasmic nucleated bands, together 
with ganglion cells in various stages of development: VeERocay starts from the 
assumption that ganglion cells and nerve-fibre cells (cells of Schwann’s sheath) are 
derived in normal development from the same mother-cell (embryonal neurocytes of 
Kohn). He looks upon the ganglion cells as integral constituents of the tumour- 
development, and believes that they and the nerve-fibre cells which have produced 
the nucleated bands have developed from the same undifferentiated cell. The 
undifferentiated nerve-fibre cells, he thinks, had proliferated greatly, and by their 
increase and differentiation nerve-fibres were developed on the one hand and ganglion 
cells on the other. He thinks that the assumption of the pre-existence of ganglion 
cells in such cases is altogether unsatisfactory and unnecessary. 
To VERocay the tissue of multiple neuro-fibromata, considered by most writers as 
a connective tissue, is a specific neurogenous tissue. Nerve fibre cells (peripheral 
neuroblasts) which have not been used up in the normal construction of the nerve 
fibre are to be regarded as the parent cells of both ganglion cells and nerve fibre cells 
present in the tumour ; he suggests the name ‘‘ neurinoma” for tumours of this nature. 
Such tumours may undergo certain modifications, and to the term neurinoma might 
be added a qualifying word signifying the dominating elements, e.g. neurmoma- 
gangliosum, -gliosum, -fibrosum, -sarcomatodes, etc. VEROCAY’s views thus differ from 
those of previous writers on neuro-fibroma, who have regarded the developmental 
disturbance as affecting the connective tissue in nerves. It seems quite unintelligible 
to VERocay that only the connective tissue of the nerves is affected, when this in 
early development is in direct association with the other connective tissues of the 
body. He finds it much easier to believe that the primary disturbance lies in 
ectodermal elements, the connective tissue in relation to which may be secondarily 
affected. 
Verocay has described the tumours in the cerebello-pontine angle as cellular neuro- 
fibromata. This agrees with the term ‘“‘acoustic neuroma” frequently applied to 
some of these tumours. FRoENKEL and Hunt (1903) have also pointed out that 
histologically these tumours are neuro-fibromata, arising in relation to the intracranial 
portion of the cranial nerves. In advanced stages they may become sarcomatous, 
fibro-sarcomatous, or glio-sarcomatous. The glia elements may be explained by the 
fact that glia tissue accompanies the intracranial nerve trunks for a short distance, or, 
according to Verocay, who has investigated four such cases, the tumour formation 
relates to a developmental disturbance of the specific elements of the nerve tissue, 
affecting undifferentiated cells (neurocytes) which are capable of differentiating along 
three lines to form ganglion cells, glia cells, or nerve fibre cells. 
