314 PROCEEDINGS OF SOCIETIES. 



Exudation of fibrin would fully account for the false membrane 

 upon the mucous membrane, without interfering with the epi- 

 thelium covering the latter, through which wanderin'^ cells might 

 easily pass ; and a precedent for tibriuaus exudation on a mueou3 

 surface might be found in croupous pneumonia. 



Mr. Needham thought that, as pus could come from a serous, 

 fibrin might from a mucous membrane. 



Dr. Coupland thought the different layers in the false 

 membrane showed a mixed origin ; thus the surface of it was 

 more coarsely fibrillated than the deeper parts, which were much 

 finer, as though there had been first a catarrh, destroying the 

 epitbelium, and then fibrinous exudation last of all. 



Mr. Stowers asked for a verification of the observation made, 

 that the histological appearances in the angina form of scarlatina 

 and in a blistered surface were those of diphtheria. 



Mr. Miller referred to Rindfleisch's remark that the exudation 

 in pharyngeal affections was more cellular and less fibrillated 

 than in laryngeal ; as well as to the existence of apertures in the 

 basement membrane of the aftected parts. 



The President thought the non-homogeneity of the false mem- 

 brane might be explaiui^d by the different ages of its component 

 parts, and suggested that the fungi so commonly found in diph- 

 theria might owe their presence to the open-mouthed mode of 

 respiration in diphtheritic patients; in the two cases of diphthe- 

 ritic conjunctivitis already mentioned the eyes had been kept 

 constantly bandaged, and, as stated, no fungus had been found. 



Dr. Grreenfield, in reply, quoted German authority for the 

 constant presence of fungus in diphtheria ; and, since fungi in 

 the kidney had also been described, they might serve to explain 

 the renal complications so constantly present. The only way to 

 get at a life history of a false membrane was to examine in the 

 same subject the patches in all stages of growth. He had done 

 this, but had only found at first a catarrhal state, and later on 

 pus-globules and fibrillation on the deeper surface of the mem- 

 brane. The fibrinous exudation in pneumonia was no precedent 

 for the same process in diphtheria, since the air-cells might be 

 proved, and were by some tiiought to be, part of the lymphatic 

 system. Epithelium in place would not allow fibrin to exude, but 

 once destroy the former and then exudation was easy. Two 

 theories existed with regard to the part played by fungi in diph- 

 theria, one that they were its cause, the other only the cause of 

 the rapid disintegration of the membrane ; it was a subject still 

 suh judice. 



Numerous specimens in illustration of Dr. Greenfield's paper 

 were exhibited, as well as others of new growths, and of the 

 glandular stomach of the crow. 



