62 STUDIES ON PATHOLOGIC OVA. 



it was found that a severe endometritis with abscess formation was nevertheless 

 indicated histologically. Only five cases (Nos. 661, 663, 753, 876, and 986) were 

 reported as having no infection, but four of these contained evidence of the 

 existence of an intense endometritis, accompanied in two instances (Nos. 876 and 

 986) by abscess formation. The specimen from the fifth case (No. 663) was so very 

 necrotic that a positive diagnosis could not be made, but it is unlikely that a severe 

 infection was present. Infiltration of the endometrium was present in 30 of the 

 48 cases, including 2 doubtful ones. This makes a percentage of 62.5, but since 

 the decidua was not included in 20 cases, was too degenerate for study in 3 

 of the rest, and especially since only a relatively small portion of each abortus was 

 examined microscopically, it is very probable that this percentage of evidence of 

 infection, high as it is, nevertheless is entirely too low. Omitting the doubtful 

 cases, the decidua was found infiltrated in 28 of 29 cases, or in 99.6 per cent. In 

 82.8 per cent of these the infiltration was marked. In 5 cases the infiltration of the 

 endometrium was comparatively slight, but in 24 it was severe. In one case 

 infection was found to be present within the chorionic vesicle, and although no 

 decidua accompanied this specimen, it is unlikely that the infection was confined 

 entirely to the vesicle. In 4 cases both the interior of the vesicle and the decidua 

 undoubtedly were infected, and in 2 (Nos. 435a and 750) no decision could be 

 reached. 



Twenty specimens, or 41.6 per cent, were identified as showing hydatiform 

 degeneration, 3 cases being doubtful and 2 others probable. In 15 of these cases 

 in which the decidua was included it showed inflammatory changes. These changes 

 were marked in 12 and slight in 3 cases. 



Among the alleged causes of the termination of pregnancy in the cases not 

 accounted for otherwise, we find that a fall was mentioned in case No. 71, in which 

 evidences of chronic endometritis were present; anxiety is given as the proximate 

 cause in No. 664, and fright in No. 883, both of which cases show the presence of 

 an intense infection, which in one was so severe that the chorionic vesicle was 

 destroyed almost completely. Two of the 3 abortions reported as having been 

 spontaneous (Nos. 750 and 829) show the presence of a severe infection. In 4 

 instances in which the uterus was considered to be normal, evidence of infection 

 was found in 2. In No. 883 it was found to be severe and in No. 978 it was mild. 

 Although only one of these 39 specimens was said to have been induced, it is more 

 than likely that this is true of more of them, although it seems exceedingly unlikely 

 that an ovum could become implanted, and decidual formation actually progress in 

 a normal way in so infiltrated and abnormal an endometrium as is present in many 

 of these specimens. The anatomical condition of some of the chorionic vesicles 

 among the non-infected group suggests that some of these abortions also were 

 induced. 



The histological changes found in this group differ in no essential respect 

 from those present in group 1. Mall also found that the changes in the villi of the 

 chorionic vesicle from an ovarian pregnancy (see No. 550 in the next group) showed 



