66 STUDIES ON PATHOLOGIC OVA. 



The regenerated mucosa, too, is infiltrated and contains islands composed exclu- 

 sively of round cells. In view of the condition of the decidua, the clinical observa- 

 tion of the presence of a weakly positive Wasserman reaction may have special 

 significance. Besides maceration effects evident in the chorionic vesicle, many 

 of the villi show changes undoubtedly hydatiform in character. It is decidedly 

 unlikely that the cause of this intrauterine destruction, and probably also of the 

 absorption of the embryo, is to be sought in the presence of the cervical myoma. 

 Indeed, it is unlikely that the latter played any role other than that of obstruction 

 of the cervical canal, and so furthered absorption of the conceptus. We have here, 

 then, perhaps an evidence of the effect of endometritis upon the implanted ovum. 

 Since the latter contained no evidence of violence, and since it was wholly unopened 

 and noninfected, and above all, since the infiltration within the decidua suggested 

 a chronic rather than an acute condition, such a conclusion would seem to be 

 justified, although interference with the gestation can not be excluded absolutely. 

 The dimensions of the abortuses in this group (in many instances, at least) 

 convey a very incorrect idea of the actual size of the conceptuses. This is due 

 to the fact that the main bulk of the specimen often is blood-clot and decidua. 

 Besides, chorionic vesicles which originally were recorded as having a certain 

 diameter, later were recorded in three dimensions, because they appeared ap- 

 proximately spherical. In still other cases, such as No. 71, the chorionic vesicle 

 is folded so extensively that accurate measurements are impossible. Then, too, 

 the increase in size of the vesicles, in consequence of maceration and infection, also 

 must be borne in mind in considering the true size of the normal specimen from 

 which they may have arisen. Although the large dimensions of some of the abor- 

 tuses suggest that their menstrual age is considerable, most of them really are rela- 

 tively young. The longest menstrual age recorded for any of those among the first 

 1,000 specimens is 280 days. However, an inspection of the specimen with this 

 age, as well as a microscopic examination of it, suggests that the menstrual his- 

 tory is not a reliable criterion, even if we assume, as suggested by Mall, that in 

 this instance the chorionic vesicle grew somewhat after the death of the embryo. 

 A comparison of the histologic picture in this specimen with that found in placentae 

 retained only approximately as long, shows a very marked contrast indeed, largely 

 because of the absence of the inevitable age changes present in the latter. 



B. TOTAL. 



Any lingering doubts as to the correctness of the conclusion that a very large 

 percentage of the tubal specimens composed of villi only when received really 

 belong in the class of hydatiform degenerations were dispelled quickly by the 

 examination of this group. This is due largely to the fact that instead of isolated 

 or detached villi in more or less advanced stages of degeneration and embedded 

 completely in blood-clot, the preparations contain sections of whole chorionic 

 vesicles, sometimes entirely free from blood. Some of them were implanted almost 

 perfectly in the wall of the tube, and although many of them were folded 

 extremely and collapsed more or less, small areas of several were nevertheless 



