286 ARTHUR WILLIAM MEYER. 



theless may have carried a great many fragments of embryonic 

 tissue away with it beforehand. Furthermore, Polano does not 

 claim his case as one of complete intrauterine absorption but 

 merely as one of remarkable intrauterine maceration under 

 aseptic conditions. 



The history of the case of Rosenkranz, on the other hand, 

 shows quite clearly that the fetus was destroyed by putrefactive 

 changes. Rosenkranz himself emphasized this, but strangely 

 enough ruled out entirely the occurrence of maceration. Rosen- 

 kranz further stated that the patient herself noticed the dis- 

 charge of some bones with the "menstrual" flow. However, 

 under the above conditions the recurrence of true menstruation 

 is exceedingly unlikely unless the fetus was dead a considerable 

 period before the rupture of the membranes occurred, and the 

 placenta had been detached at least partly, for only under such 

 circumstances could considerable regeneration of the mucosa 

 occur and thus make the return to normal menstruation possible. 

 It nevertheless is possible, however, that the time of abortion 

 was co-incident with the date on which menstruation might 

 have recurred. A small number of cases in the Mall Collection- 

 give a history which makes such a suggestion probable. Just 

 why the expulsion of a- dead, retained conceptus should occur 

 at the time when menstruation would have recurred normally 

 had pregnancy not supervened, is difficult to say, but since the 

 inhibitory effect upon the menstrual cycle exercised directly or 

 indirectly, by the living fetus is absent in cases of premature 

 death and retention, it is possible that the abortion might occur 

 at a time when the impulses of a return to the normal nonpreg- 

 nant status of the maternal organism becomes more evident; 

 that is, at the time of the recurrence of the normal menstrual 

 cycle. 



One can not but recall in this connection another group of 

 cases which give a history of uninterrupted menstruation through- 

 out the entire period of pregnancy. In some of these cases it is 

 evident that it is a question of more or less regular hemorrhage 

 rather than of true menstruation, and it may be possible that 

 in the others these hemorrhages happened to fall at intervals of 

 the same length as the normal inter-menstrual periods. In the 



