m diabetes or from chronic poisoning
with lead or arsenic, or from bacterial infections and intoxications
such as occur in diphtheria, gonorrhoea, syphilis, leprosy, typhoid,
influenza, beri-beri, and many other diseases.

It is, as a rule, widely distributed throughout the peripheral nerves,
but the distribution frequently varies with the cause--the alcoholic
form, for example, mainly affecting the legs, the diphtheritic form the
soft palate and pharynx, and that associated with lead poisoning the
forearms. The essential lesion is a degeneration of the conducting
fibres of the affected nerves, and the prominent symptoms are the result
of this. In alcoholic neuritis there is great tenderness of the muscles.
When the legs are affected the patient may be unable to walk, and the
toes may droop and the heel be drawn up, resulting in one variety of pes
equino-varus. Pressure sores and perforating ulcer of the foot are the
most important trophic phenomena.

Apart from the medical _treatment_, measures must be taken to prevent
deformity, especially when the legs are affected. The bedclothes are
supported by a cage, and the foot maintained at right angles to the leg
by sand-bags or splints. When the disease is subsiding, the nutrition of
the damaged nerves and muscles should be maintained by massage, baths,
passive movements, and the use of the galvanic current. When deformity
has been allowed to take place, operative measures may be required for
its correction.

NEUROMA[5]

[5] We have followed the classification adopted by Alexis Thomson in his
work _On Neuroma, and Neuro-fibromatosis_ (Edinburgh: 1900).

Neuroma is a clinical term applied to all tumours, irrespective of their
structure, which have their seat in nerves.

A tumour composed of newly formed nerve tissue is spoken of as a #true
neuroma#; when ganglionic cells are present in addition to nerve fibres,
the name _ganglionic neuroma_ is applied. These tumours are rare, and
are chiefly met with in the main cords or abdominal plexuses of the
sympathetic system of children or young adults. They are quite
insensitive, and their removal is only called for if they cause pain or
show signs of malignancy.

A #false neuroma# is an overgrowth of the sheath of a nerve. This
overgrowth may result in the formation of a circumscribed tumour, or may
take the form of a diffuse fibromatosis.

_The circumscribed or solitary tumour_ grows from the sheath of a nerve
which is