On neuroma and neurofibromatosis.

  • Thomson, Alexis.
Date:
1900
Catalogue details

Licence: In copyright

Credit: On neuroma and neurofibromatosis. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    which the patient, a farmer, suddenly felt a stinging pain over his chest, and tliought a bee had crept up under his clothes. He discovered the tumour on examining the seat of pain. Pressure on the nerve trunk above the tumour may arrest the pain, or may excite it; in the latter case, the pain is referred to the tumour. In tumours involving the larger mixed nerve trunks, there is, on the whole, less liability to pain than when the smaller cutaneous and purely sensory filaments are affected, because the larger nerve trunks are relatively poorer in sensory fibres, they are less exposed to thermal and mechanical influences, and their fibres are more extensible (Virchow). In a nerve trunk, usually described as purely motor in function, there may be, however, the most exquisite sensitiveness in addition to severe pains excited by pressure. In a case observed by the author involving the pos- terior interosseous nerve in the middle of the forearm, pains were excited even by a dependent position of the limb, and were severe enough to cause a feeling of weakness in the hand, so that the patient, a muscular youth, was unable to grasp anything so long as the pain lasted. The sensory nerve fibres involved in this case, were derived from other tissues than the skin. There is this diflFer- ence, however, when a purely motor nerve is implicated by a tumour, that the pain is localised to the area of the tumour, and does not shoot down the peripheral distribution, as it does when sensory cutaneous fibres are implicated. In the rare cases in which minute sensitive and painful tumours have been described as occur- ring in the periosteum and capsule of joints, the pain was also quite localised. The powers of sensation and of voluntary motion are, in general, very slightly impaired, unless by the severe pain which may result from attempted movements of the limb. Disordered sensations may, however, be present in the shape
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