The Chemical Inhibition of Fibre Regeneration and Neuroma Formation in Peripheral Nerves.

Introduction THE problem of suppressing the regenerative growth of nerve fibres by chernical or other means owes its clinical interest to the need for preventing or stopping the acute pain that sometimes develops after injury to peripheral nerves. The conditions under which acute pain develops have not been closely defined. It cannot be definitely attributed to any one particular cause, and it is not invariably accompanied be neuroma formation. Reactions from islands of infection and foreign bodies in the nerve itself (Marinesco 1918, 1920), the involvement of escaping nerve fibres in scar tissue and muscle (discussed by Corner, 1918b), and pressure upon " young " unmyelinated fibres (Cone, 1918) may each play a part. Clinical evidence nevertheless shows that pain in some form, particularly in amputation stumps, is associated with neuroma formation and other consequences of unorganized regenerative growth. Pain of this sort is sometimes relieved by excising the neuroma, and is prevented from recurring, or from arising in the first instance, by taking certain preventative measures. These may be reviewed shortly under two headings: