ly on the face or scalp or because its bulk
interferes with function. When involving the ophthalmic division of the
trigeminus, for example, it may cause enlargement of the upper lid and
proptosis, with danger to the function of the globe. The results of
excision are usually satisfactory, even if the removal is not complete.

[Illustration: FIG. 88.--Multiple Neuro-fibromas of Skin (Molluscum
fibrosum, or Recklinghausen's disease).]

_The cutaneous neuro-fibroma_ or _molluscum fibrosum_ has been shown by
Recklinghausen to be a soft fibroma related to the terminal filaments of
one of the cutaneous nerves (Fig. 88). The disease appears in the form
of multiple, soft, projecting tumours, scattered all over the body,
except the palms of the hands and soles of the feet. The tumours are of
all sizes, some being no larger than a pin's head, whilst many are as
big as a filbert and a few even larger. Many are sessile and others are
distinctly pedunculated, but all are covered with skin. They are mobile,
soft to the touch, and of the consistence of firm fat. In exceptional
cases one of the skin tumours may attain an enormous size and cause a
hideous deformity, hanging down by its own weight in lobulated or folded
masses (pachy-dermatocele). The treatment consists in removing the
larger swellings. In some cases molluscum fibrosum is associated with
pigmentation of the skin and with multiple tumours of the nerve-trunks.
The small multiple tumours rarely call for interference.

[Illustration: FIG. 89.--Elephantiasis Neuromatosa in a woman aet. 28]

_Elephantiasis neuromatosa_ is the name applied by Virchow to a
condition in which a limb is swollen and misshapen as a result of the
extension of a neuro-fibromatosis to the skin and subcutaneous cellular
tissue of the extremity as a whole (Fig. 89). It usually begins in early
life without apparent cause, and it may be associated with multiple
tumours of the nerve-trunks. The inconvenience caused by the bulk and
weight of the limb may justify its removal.

SURGERY OF THE INDIVIDUAL NERVES[6]

[6] We desire here to acknowledge our indebtedness to Mr. James
Sherren's work on _Injuries of Nerves and their Treatment_.

#The Brachial Plexus.#--Lesions of the brachial plexus may be divided
into those above the clavicle and those below that bone.

In the #supra-clavicular injuries#, the violence applied to the head or
shoulder causes over-stretching of the anterior branches (primary
di