PKOCEEDINGS OP SOCIETIEa 51 



trachea the raucous membrane and usually the deeper tissues in a 

 state of more or less intense inflammation of ordinary character ; 

 whilst the false membrane consisted for the most part of a stratified 

 network of a substance giving the reactions of fibrin, in the meshes 

 of which were contained altered epithelial cells and corpuscles. 



The amount of adhesion to the mucous membrane was various, 

 but in no case did the exudation actually pass into its substance ; 

 although in some cases it appeared adherent by fibrinous bands to the 

 papillae. 



After describing the views of Wagner and of other German patho- 

 logists, the author stated his belief that the false membrane consisted 

 in part of a catarrhal process, with modifications in the epithelium ; 

 and in part of a true fibrinous exudation. These views were sup- 

 ported by the comparative examination of specimens taken from cases 

 in various stages. 



In the pharynx the inflammatory process was stated to extend 

 much deeper than in the trachea, and to be accompanied by a more 

 rapid destruction of tissue. The false membrane was believed to 

 consist in a larger measure of altered cells. 



The question of the occurrence and importance of fungous growth 

 in the mi:cous membrane was then discussed, and the author showed 

 specimens from the pharynx containing numbers of minute fungous 

 sj)ores and a delicate mycelium deeply j^enetrating the inflamed 

 mucous membrane. He had not, however, been able to find a similar 

 appearance in the larynx and trachea of the same or other cases ; and 

 he considered it therefore still an open question how far the fungus 

 was an accidental occurrence and what was its relation to the disease. 



The President, after proposing a vote of thanks to the author 

 of the paper, stated his belief that fungous growths might be always 

 found in the mucous membranes in certain low states of health, and 

 considered a fungus in diphtheria an accidental rather than an essential 

 occurrence. He could not agree with Dr. Oscar Giacchi, who held that 

 the disease was owing to the presence of a fungus. He had examined 

 more than one case of diphtheritic conjunctivitis, in which disease the 

 exudation forms very rapidly, but had never found any fungus. The 

 position of a vegetable parasite ujDon the body had much to do with 

 its influence upon the disease it accompanied, or of which it was the 

 cause. Hence some importance might be attached to the specimen 

 shown, where the fungus was deep in the inflamed mucous membrane. 



Dr. Bruce remarked that croup is generally defined as owing to a 

 false membrane, on the removal of which healthy mucous membrane 

 is left ; this, however, the paper would disprove, since Dr. Greenfield 

 had shown that not only the mucous and submucous tissues were at 

 times reached in croup, but that even the tracheal rings might be in 

 part destroyed. He had also noticed the small cavities or vacuoles 

 described in the false membranes, and thought them owing to the 

 exudation from the ducts of mucous glands ; indeed, these spaces at 

 times were filled with exudation cells. The mucous epithelium is not 

 necessarily destroyed by the false membrane ; it may sometimes be 

 seen covered by the latter. Exudation of fibrin would fully account 



