INFLAMMATIONS. 47 



" This is the idea which I am willing to entertain as to this 

 sort of inflammation, but I am adverse to forming any absolute 

 universal conclusion. What gives me doubts with regard to 

 my opinion, is the fact of affections of the cellular texture 

 sufficiently detached from the membranous parts; such as 

 purulent affections and abscesses, which are allowed to be un- 

 doubtedly the consequence of inflammation ; but let me ob- 

 serve that this does not apply, in many cases, for the purulent 

 affections found upon dissection in the brain, the lungs, and 

 particularly the liver, are such as have passed through the in- 

 flammatory state unheeded or without any inflammatory symp- 

 toms. I think they are to be considered as originally effusions 

 depending upon some other cause than that of inflammations, 

 and in which the matter at length, by its bulk and acrimony, 

 came to stimulate and to excite inflammation in the contiguous 

 part. There still remains a probability, therefore, that there is 

 no inflammation which arises suddenly, or discovers itself by 

 its symptoms, but that which has its chief seat in membranous 

 parts. I must moreover add, that there are membranous 

 parts where the affected vessels are laid in so firm and com- 

 pact a manner as will not admit of effusion, as in the case 

 of Rheumatism and Ophthalmia, and others. As these com- 

 municate with a lax cellular texture, the effusion, if it takes 

 place, makes the seat of the disease appear to be in that cellu- 

 lar texture. 



" In this way I suppose that there is still some foundation 

 for the distinction of parenchymatous and membranous inflam- 

 mations, and therefore that the seat in the parenchyma of cellu- 

 lar texture of the lungs is not totally to be excluded. 



" Thirdly, In the Pleura, or that membrane which includes 

 the lungs and invests their whole surface. This inflammation 

 may be different according to the parts which it occupies : 1. 

 In that portion of the pleura, which invests the lungs them- 

 selves (Pleuritis pulmonalis) ; 2. In that portion which lines the 

 insides of the ribs (Pleuritis costalis) ; 3. In that portion which 

 is extended over the diaphragm (Pleuritis diaphragmatica) ; 4. 

 In that portion which forms the mediastinum (Pleuritis mediasti- 

 na) ; 5. In that portion which forms the outer sac or membrane of 

 the pericardium (Pleuritis pericardiaca.). Whether these distinc- 



