It has been stated that there appear to be two exceptions to the universality of the presence of inflammation. Of these exceptions, one is exemplified in the mildest form of the disease. In every case of fever, the function of the vascular system is disturbed in a greater or less degree, as has been fully shown: but the doubt is whether that disturbance invariably pass into the state of inflammation. Since the morbid condition of the nervous system, in the mildest case, remains only for a certain period, and then uniformly gives place to the return of health, there seems to be no possible means of determining this question. And even in the second case, where the intensity of the nervous affection is incompatible with life, and death follows with extreme rapidity, the real condition of the vascular system appears to be equally doubtful. In both, that condition may possibly be a modification of one and the same state, and that state may be identical with inflammation—inflammation existing in different degrees of intensity. On the other hand, both may differ essentially from the state of inflammation. The nervous affection in the first may be too slight to excite inflammatory action, while in the second it may be so overwhelming as completely to oppress every function of the economy, and therefore, instead of exciting, may paralyse the capillary blood-vessels; and consequently paralysis of the capillary vessels, instead of intense excitement of them, may possibly be the real condition of the vascular system, for example, in congestive fever. But however this may be, the only difficulty in the subject relates to these two forms of the disease—the very mildest and the very severest. In all the intermediate cases, the condition of the vascular system is clear and certain. In all these, there can be no more doubt that that system is in a state of true inflammation, than there can be that the capillary vessels of the pleura are in a state of inflammation in pleuritis. Yet, as we have just stated, in fever the inflammation is never the same as it is in pleuritis. In fever there is a combination of a specific affection of the nervous system, with that specific affection of the vascular system, which constitutes the state of inflammation: in pleuritis there is the specific affection of the vascular system, without the specific affection of the nervous; and this combination of the two affections in fever modifies the nature of febrile inflammation.