Page:Diphtheria - a lecture delivered at the Norfolk and Norwich Hospital (IA b22345656).pdf/15

 likewise claims some special attention. It has been variously described as a fibro-plastic membrane similar to that thrown out in true inflammatory croup, and, on the other hand, as an aplastic secretion which exhibits a lower type of vascular exudation, and does not admit of organization, but acts as a foreign body, and as such if not removed, undergoes rapid putrefaction. This is the description of it given by the reporter in the 'Lancet,' and is, I believe, the most trustworthy of the two. The membrane is sodden by the sanious secretions in which it is enveloped, and which are exuded from the abraded mucous membrane below it. The colour is at first whitish, but, from the cause above mentioned, soon becomes of a dirty yellow or ash-grey colour. Under the microscope, in addition to corpuscles and irregular fibrillar structure one observer more particularly. Dr. Laycock of Edinburgh has detected the presence of a parasitic fungus, which he is disposed to look upon as the fons et origo mali. Dr. Laycock's communication, it must, however, be conceded, fails to impress the reader with the confidence in his theory which it would have done, had his case' been one of uncomplicated diphtheria, whereas it is a case only of an exudation resembling that of diphtheria occurring at the close of a long-standing disease of the supra-renal capsules. The fungus alluded to by Dr. Laycock is the "Oidium albicans" a parasite which he admits to be also discoverable in the patches of muguet or aphtha, and which has been recognised by other microscopic observers in the secretions of the mouth during the course of many other diseases; so that it is, I think, no unfair inference that it must be looked upon as an accidental and secondary