54 STUDIES ON PATHOLOGIC OVA. 



dothelium degenerates, it leaves a faint, more or less incomplete outline marked 

 by the degenerating nuclei. Consequently it happens that the surviving remnants 

 of a vessel may be represented merely by a small number of poorly preserved nuclei. 



The epithelium of the villi usually is preserved longer, but finally the syncy- 

 tium may fuse with the Langhans layer, forming a dense coagulum. Or the pyc- 

 notic nuclei of both layers may retain their relative positions, ultimately becoming 

 resolved into fine granules which Mall, in several of his publications and also 

 repeatedly in the protocols, has spoken of as nuclear dust. This fine granulation 

 seems to herald beginning calcification. Later the granules may fuse with each 

 other and with the necrotic cytoplasm, forming a hyalin band at the periphery of 

 the villus, which stains heavily with eosin and also with iron hematoxylin. It 

 alone may make the outline of the pre-existent villus evident. Fibrosis of the 

 villi is seen but rarely in these early specimens, and when it occurs, hyalin degenera- 

 tion is not infrequently present in the form of trabeculse or a framework in the mid- 

 portion of the villus. Remnants of the syncytial masses or of trophoblast usually 

 survive everything else. 



Since no decidua and very little trophoblast were found upon the villi of several 

 young conceptuses, it seems doubtful in some cases whether good implantation 

 occurred at all, as suggested by No. 1843, shown in figure 7. In these specimens the 

 villi nevertheless seem to undergo considerable development, but the embryo, 

 after it becomes dependent upon the circulation, finally dies, probably by asphyxia- 

 tion, and then the processes of maceration, digestion, and absorption begin. In 

 other cases it also seems likely that the young ovum becomes embedded quite 

 normally, but that strangulation results from severe hemorrhage which loosens 

 the attaching villi, thus interrupting the intervillous circulation. Since the result- 

 ing stagnation of the blood must make impossible the indispensable chemical inter- 

 changes upon which the life of the cyema depends, the latter probably dies first. 

 It is decidedly interesting that considerable hemorrhage, sufficient to result 

 in the death of both cyema and chorionic vesicle, can occur while the whole con- 

 ceptus is still surrounded by the early decidua capsularis without rupture of the 

 latter. Such a specimen was discovered in No. 698, which is in the final stages of 

 absorption. In this unique specimen (received from Dr. N. E. B. Igelhart), which 

 has a menstrual age of 56 days, there remains only the merest trace of a chorionic 

 vesicle in the form of a striated coagulum, a few questionable "shadows" of villi, 

 several small fragments of syncytium, and a few detached accumulations of tropho- 

 blast. The place of the conceptus is occupied by blood-clot formed into an elon- 

 gated body 50 by 20 by 13 mm. This body is completely surrounded by an intact 

 decidua capsularis. The latter is easily recognized, both in the gross and in the 

 microscopic specimen, and the decidua vera, which also is intact, can be seen 

 clearly with the unaided eye in every detail of its relations, as shown in figure 8. 

 This indeed is a unique specimen and especially significant in connection with 

 No. 970, to be discussed in the next group, and with certain better-preserved 

 specimens recorded in the literature. The failure of complete absorption of the 

 last few small remnants of this conceptus is probably due to the fact that the small 



