2QO ARTHUR WILLIAM MEYER. 



menstrual and that hence the abortion should be regarded as a 

 mere incident accompanying the return of normal menstruation 

 rather than as the predominating event. 



That considerable restoration of the endometrium may occur 

 while the conceptus still is within the uterus was shown by the 

 case of Orloff, '95. In this case the endometrium was composed 

 of a cylindrical epithelium and the uterine musculature showed 

 no evidences of the presence of gestation changes. IvanofT, 

 '98, also found the decidua absent in a case of long retention 

 and its place taken by a low cylindrical epithelium although the 

 placenta still was partly attached to the uterus. Frankel, '03, 

 also emphasized the fact that regeneration of the endometrium 

 may begin before abortion occurs and these things make it 

 possible that hemorrhage which may occur at time of abortion 

 may largely be true menstrual hemorrhage. 



The absence of blood between the capsularis and the villi 

 and the absence of a history of bleeding do not, to be sure, 

 imply that the development of this conceptus progressed unin- 

 terruptedly until birth. The histologic picture alone is con- 

 clusive proof to the contrary. In the absence of any larger 

 portion of the conceptus it is impossible to say about how far 

 development had proceeded, but it is unlikely that it proceeded 

 much beyond the first month. In any case, disintegration, 

 solution and resorption of almost the entire conceptus surely 

 must have consumed several weeks at least. Indeed, it is pos- 

 sible that the ovum never became firmly attached, though im- 

 bedded in the decidua. 



In other cases it also seems likely that the fertilized ovum 

 became inbedded quite normally but that it was strangulated 

 by severe hemorrhage which loosened the attaching villi, thus 

 interrupting the intervillous circulation. Since the resulting 

 stagnation of the blood must make the indispensable chemical 

 interchanges upon which the life of the embryo depends, impos- 

 sible, the latter probably dies first. It is decidedly interesting 

 that considerable hemorrhage, sufficient, in fact, to result in the 

 death of both the embryo and the chorionic vesicle, can occur 

 while the whole conceptus still is surrounded by the decidua 

 capsularis, without rupture of the latter. The failure of absolute 



