434: LECTURE XVII. 



a case of genuine hepatitis. Just as little is there 

 fibrine to be found in the ordinary inflammation of the 

 substance of the heart (myo-carditis). 



On the other hand, you must bear in mind that, 

 starting with certain preconceived notions, observers 

 have imagined fibrinous exudations to take place in 

 many parts , where they are not really to be seen. If 

 because pus has been obtained from a fibrinous exuda- 

 tion, it is therefore imagined that, wherever pus shows 

 itself, a fibrinous exudation must be regarded as its 

 source, no very great power of observation is required 

 to convince oneself, that this is an error. Take any 

 ulcerated surface you please, wipe off the pus, and col- 

 lect what then comes out ; you will either have a serous 

 fluid or pus, but you will not see that the surface you 

 have wiped becomes covered with a fibrinous layer. If 

 we confine ourselves to those parts, where inflammations 

 with real, unquestionable fibrinous exudation do occur, 

 we have a category nearly as limited as that of the mucous 

 inflammations. In such a category the first place is 

 occupied by the serous membranes proper, which even 

 upon slight inflammatory irritation generally produce 

 fibrine ; the second place is filled by certain mucous 

 membranes, in which, in a great number of cases, 

 fibrinous inflammations unmistakably arise, as an aggra- 

 vation out of mucous ones. Ordinary croup does not 

 generally at its very outset manifest itself in the form of 

 fibrinous croup ; at the commencement, at a time when 

 the danger may already be very considerable, there is 

 often nothing else found than a mucous or muco-purulent 

 false membrane. Not until after a certain lapse of time 

 does the fibrinous exudation set in, and then it does so 

 in such a manner, that we can trace the transitions in 

 the same false membrane, and see that a certain portion 

 is manifestly mucous, another manifestly fibrine, whilst 



