SINUS-PLEURITIS.

That attacks of pleurisy often pass unnoticed during life appears perfectly evident from the frequency with which adhesions and other signs of that condition are found postmortem in cases in which death has resulted from some independent disorder. There also come under clinical observation a very considerable number of cases in which fever of varying type, intensity and duration is the most conspicuous manifestation and for which no adequate primary cause can be discovered. That in many of these cases the febrile manifestations are dependent upon some obscure inflammatory disorder there can be no reasonable doubt and it can scarcely be considered hypercritical to question the actual existence of such a state as simple continued fever. It is possible that local elevation of temperature may result from purely local influences, but the cause for general elevation of temperature must be sought in some disturbance of the thermotaxic mechanism, resulting in