CHORION WITH AMNION. 69 



However, if the latter is detached completely by the first hemorrhage, and if the 

 salpingectomy is not performed until weeks later, the detached villi necessarily will 

 be found necrotic, especially if they are embedded in a clot rather than bathed in 

 fresh blood. In one case, with a history of recurrent hemorrhages during a period 

 of 44 days, only a few necrotic, detached villi were found in the sections examined; 

 and in a second case in which the period of hemorrhages had lasted 18 days, none 

 but incipent changes were present in the vessels of the villi. The chorionic vesicle 

 was ruptured in this, as in a number of other cases, a fact which probably may 

 be attributable, in part, at least, to tubal peristalsis. 



GROUP 3. CHORION WITH AMNION. 

 A. UTERINE. 



As stated in Chapter III, fetal vesicles without an embryo, except a few 

 specimens filled completely with coagulum which might make the finding of an 

 embryonic remnant difficult or impossible, never came to the attention of His 

 (1882). Yet Miiller (1847) had spoken of moles with a cord only or with a cord 

 with a fringed or free end, and even of cords without a trace of an embryo. Such 

 abortuses, according to Miiller, usually are from the second and third months. 

 The singularity of his experience was regarded by His as noteworthy, and he 

 added that "one would a priori expect that an embryo which has died in utero 

 would be dissolved completely at body temperature in the fluid in which it is 

 contained, as certainly would seem to be the case extra uterum. " 



Rokitansky (1842-1846) also believed that the embryo might disappear, for 

 he wrote: 



"The entire fetus may be atrophic, the consequence of the cachectic state of the 

 mother; but those cases are of greater importance which result from disease of the 

 membranes, the placenta, and the cord; and, if occurring in the earliest period of embry- 

 onic life, may cause the embryo to disappear entirely, or so far as to leave but few traces." 



Seiler (1832) also reported finding an empty ovum, and Robin (1854) called 

 attention to a "rapport sur un cas de mort et de dissolution de 1'embryon, par 

 suite a'hemorrhagie des membranes de 1'oeuf," observed by M. Boussi and pub- 

 lished by Robin in 1846. Hence it would seem that the experience of His was 

 exceptional, although the report of Robin would indicate that specimens devoid 

 of an embryo were regarded as rather rare. 



It was emphasized by Miiller (1847) that the amnion often is preserved in 

 macerated ova. Not infrequently it is covered or even completely embedded in 

 coagulum, as stated by Rokitansky (1861). Since, as Miiller rightly emphasized, 

 the amnion may be firmly adherent to the chorion, it is not always possible to 

 tell by inspection of the gross specimen alone whether or not it is present. This 

 difficulty is due also to the fact that the internal surface of the chorion is often 

 exceedingly smooth and the chorion itself very thin. As stated further by Miiller, 

 the amnion may be torn, fused with the embryo or with the chorion, or be destroyed 

 completely. As illustrated by several specimens in the next group, it may also 



