over the body.

Macland of the French navy describes an affection of the bones of the
face known as anakhre or goundron (gros-nez). It is so common that
about one per cent of the natives of certain villages on the Ivory
Coast, West Africa, are subject to it. As a rule the earliest symptoms
in childhood are: more or less persistent headache, particularly
frontal, sanguineous and purulent discharge from the nostrils, and the
formation of symmetric swellings the size of an almond in the region of
the nasal processes of the superior maxilla. The cartilage does not
seem to be involved, and, although it is not so stated, the nasal duct
appears to remain intact.

The headache and discharge continue for a year, and the swelling
continually increases through life, although the symptoms gradually
disappear, the skin not becoming involved, and no pain being present.
It has been noticed in young chimpanzees. The illustration represents a
man of forty who suffered from the disease since puberty. Pressure on
the eyeball had started and the native said he expected that in two
years he would lose his sight. Figure 251 shows an analogous condition,
called by Hutchinson symmetric osteomata of the nasal processes of the
maxilla. His patient was a native of Great Britain.

Among neuromata, multiple neurofibroma is of considerable interest,
chiefly for the extent of general involvement. According to Senn,
Heusinger records the case of a sailor of twenty-three in whom all the
nerves were affected by numerous nodular enlargements. Not a nerve in
the entire body was found normal. The enlargement was caused by
increase in the connective tissue, the axis-cylinders being normal. In
this case there was neither pain nor tenderness.

Prudden reports the case of a girl of twenty-five who, during
convalescence from variola, became paraplegic, and during this time
multiple neuromata appeared. At the postmortem more than a thousand
tumors were found affecting not only the peripheral branches and the
sympathetic, but also the cranial nerves and the pneumogastric. Under
the microscope these tumors showed an increase in the interfascicular
as well as perivascular fibers, but the nerve-fibers were not increased
in size or number. Virchow collected 30 cases of multiple
neurofibromata. In one case he found 500, in another from 800 to 1000
tumors.

Plexiform neuroma is always congenital, and is found most frequently in
the temporal region, the neck, an