3O2 ARTHUR WILLIAM MEYER. 



continues and the tube becomes distended. If detachment of 

 the conceptus occurs very early, it is conceivable that it may 

 undergo complete disintegration also within the tube, that the 

 latter may heal and the symptoms subside completely. While 

 the occurrences of such instances of spontaneous cure of tubal 

 pregnancy undoubtedly are exceedingly rare, evidence at hand 

 seems to show that they can not be wholly excluded. This, 

 I am told, agrees also with contemporary clinical opinion. 



The possibility of tubal abortion with subsequent intraperi- 

 toneal disintegration, lysis and absorption must, to be sure, also 

 be borne in mind. The occurrence of nothing but fragments 

 of villi in a tubal clot as shown in the case of number 977 repre- 

 sented in Figure 10 cannot be accepted as positive proof that all 

 the rest of the conceptus was absorbed intratubally. A portion 

 may have been aborted, yet specimens such as number 2035 

 and 1938 speak eloquently for the possibility of absorption. 

 The embryo and yolk sac in the latter specimen are disintegrated 

 almost completely and the scarcely recognizable remnants lie 

 isolated in the chorionic cavity which is moderately filled with 

 an amorphous coagulum. The stroma of the chorionic membrane 

 is oedematous and degenerate but nevertheless contains some 

 well-preserved vessels, a few of which contain some blood cells. 

 The same thing is true of the stroma and of the vessels of the 

 villi which also are in process of dissolution. A moderate 

 amount of trophoblast is present but there is very little syn- 

 cytium. The epithelium of some of the villi has undergone 

 hyline degeneration. The blood cells in the large clot in which 

 this chorionic vesicle, which measured 8x5 mm. in section, was 

 imbedded, are preserved fairly well, especially near the vesicle. 

 Nevertheless, the old conceptus very apparently is in a state of 

 disintegration and lysis, the tube wall is very thin and the mucosa 

 congested, hemorrhagic and atrophic. 



Number 2035, a l so a tubal specimen, likewise is an empty 

 chorionic vesicle in process of disintegration, and many other 

 specimens might be listed, but these examples suffice to indicate 

 that intratubal, as well as intrauterine lysis and in part at least 

 of absorption, of conceptuses undoubtedly occurs in the human 

 being. It is of course exceedingly unlikely that in case of the 



