CEOUPOUS INFLAMMATION. 427 



recur to the assumption of reflex spasm of the glottis to account 

 for death by apnoea. Accordinglj, a number of physicians have 

 gone so far as to deny the occurrence of a fibrinous exudation 

 altogether. We must not fall into this error. The development 

 of a false membrane is connected in the closest manner with the 

 catarrhal state, and constitutes the anatomical acme of the mor- 

 bid process. We often find the two conditions side by side, a 

 layer of catarrhal secretion being interspersed here and there 

 with patches of fibrinous exudation. Acetic acid enables us to 

 distinguish at once between the muco-purulent and the fibrinous 

 elements ; no uncertainty is therefore possible upon this point. 



Histological examination of the false membrane shows, first of all , 

 that here too, corpuscular elements predominate. These are far more 

 easily recognisable than in the pharjmgeal false membrane ; they 

 resemble for the most part, the cells of ordinary embryonic tissue. 

 In vertical sections (fig. 124) however, we find that these em- 

 bryonic cells are not the only constituents of the false membrane. 

 It presents an exquisitely laminated structure, the corpuscular 

 layers alternating at tolerably regular intervals with layers of 

 fibrin ; these alternate layers recurring from one to ten times, 

 in proportion to the thickness of the membrane. Whether I am 

 justified in calling the alternate layers " fibrinous " or not, must 

 remain open for the present. I call them so from the first im- 

 pression which their configuration makes upon the observer's 

 mind, and with the reservation that I mean no more by the 

 word than a fiuid albuminous substance, which has coagulated 

 after transudation on exposure to the air. The substance in 

 question is lustrous and homogeneous ; I have not been able to 

 resolve it into cells, like those of the pharyngeal false membrane ; 

 it forms thin plates with upward and downward processes which 

 penetrate into the interstices between the contiguous cells, form- 

 ing by their anastomoses a beautiful network, whose meshes 

 correspond very nearly to the individual cells (a). Under such 

 circumstances, I think we may fairly infer, that a fluid, in which 

 a large number of cells are suspended, and which holds the 

 '^ fibrinoid " substance in solution, has been secreted by the 

 mucous surface ; further, that the coagulation of tliis fluid has 

 fixed the cells in their original position, while the extension of 

 the coagulation to the lacunar interstices between the spheroidal 

 bodies of the cells, has given rise to the appearance of a network. 



