84 Pathological Belations of the Diphtheritic Memhrane, ^c. 



diphtheria and croup demand a nosological separation, as they most 

 undoubtedly differ from each other, both in their general and 

 histological characters. To speak of " a diphtheritic croupous 

 membrane " is to mislead the student in medicine, for there can 

 be no doubt that one affection is essentially of an inflammatory 

 destructive nature, " a specific fever," epidemic or endemic in its 

 course ; * while the other is a local manifestation of a simple 

 disease, entu-ely wanting in the features of an inflammatory exuda- 

 tion. It is, however, not denied that occasionally similar casts 

 may be found in connection with an inflammatory affection of the 

 larynx, but this is a question upon which I do not now propose 

 to enter. 



* Dr. Oscar Giacchi tells us that even on the hills of Arno, where a pure 

 balsamic air distinguishes the country, diphtheria rages ejiidemically. The robust 

 peasantry are victims to it equally with the inhabitants of towns. His opinion is 

 that the disease does not belong to the specific fevers, and that the paralysis which 

 occasionally supervenes is a neurosis, while the albuminuria is the result of para- 

 sitic infiltration. — ' On the Nature and Treatment of Diphtheria.' by Oscar Giacchi, 

 1872. Other observers think that its contagious nature depends upon a parasitic 

 fungus or algre ; some again maintain that in cases where a fungus is found, " its 

 presence is probably explained by the view that the false membrane is a nidus 

 favourable to its development." 



