44 STUDIES ON PATHOLOGIC OVA. 



as a normal fetus with localized anomalies. Nor is provision made for such 

 specimens in the pathologic group. Since an embryo or fetus may be entirely, or 

 at least approximately, normal in form, even if somewhat macerated, it follows 

 that macerated specimens also are found in these grades of the normal. But, as 

 will appear later, maceration soon changes the form of the embryo. Hence it 

 follows that none except perhaps extremely small specimens can be markedly 

 macerated and still apparently retain their normal form. In these the maceration 

 which is present may become evident upon microscopic examination only. 



None of the specimens in grades 2 and 3 is perfect in form, and these grades 

 contain relatively more macerated specimens than grade 1. A splendid example 

 of a normal, slightly macerated fetus is No. 782; although obtained at hysterectomy, 

 it undoubtedly is macerated, yet in spite of this fact it is found in grade 1. This 

 fetus probably died some time before operation, perhaps in cohsequen.ce of en- 

 dometritis. The embryonic tissues are markedly macerated in spite of the fact 

 that the entire uterus was placed in formalin immediately. Since the chorionic 

 cavity was not infected, this maceration must have taken place under absolutely 

 aseptic conditions, yet it nevertheless is quite evident. 



A series of embryos that really does not belong within these two grades of 

 normal specimens are those with localized anomalies. These, of course, really 

 are abnormal, though not necessarily pathologic in the sense of being themselves 

 diseased. They may, however, be the products of disease elsewhere or have arisen 

 from defective ova or spermatozoa. The division of normals also contains speci- 

 mens not perfect in form merely because they have sustained fractures or have 

 been mutilated, and since no separate group is maintained for those possessing 

 hereditary abnormalities, some of these too are included among the normal. 



Specimens which are not included in any of the above three grades of normal 

 embryos or fetuses are classed as pathologic. This does not imply, however, that 

 they themselves necessarily are diseased. In fact many (most?) of these specimens 

 probably were the victims of accident, interference, or untoward conditions, and 

 hence may have been entirely normal at the time of death. In this division also 

 are found empty normal chorionic vesicles from which the embryo was expelled 

 after the membranes had ruptured, or in which the embryo had become disinte- 

 grated in consequence of maceration changes due to interference or to other causes. 

 It also contains specimens of fetuses which, for one reason or another, died after 

 the escape of the amniotic fluid, and which then were retained for some time in utero 

 after being expelled from the chorion. The same thing is true of some normal 

 specimens which died in consequence of degenerative changes in the chorion or the 

 placenta. All these specimens, although possibly wholly normal in development, 

 might, if retained long enough, even under aseptic conditions, fall into the 

 pathologic division. This division, as well as that for the normal embryos, no 

 doubt also contains embryos and fetuses which have been affected by maternal 

 uterine or constitutional diseases, especially by endometritis or lues. Since, as 

 already stated, abnormal embryos or monsters are not grouped by themselves, 



