74 STUDIES ON PATHOLOGIC OVA. 



reached; 2 of them, Nos. 651d and 652e, were received at the same time from 

 the same physician, Dr. G. C. McCormick, Sparrows Point, Maryland. Other 

 similar specimens were also received from Dr. McCormick. In one of these 

 specimens, No. 651e, a remnant of the yolk-sac still was present. Since all these 

 specimens of hydatiform degeneration will be discussed separately, no further com- 

 ment is necessary here, except to add that in every case the microscopic findings 

 were confirmed by an examination, by means of the binocular microscope, of 

 portions or the entire gross specimen itself. The changes in the decidua will be 

 discussed in greater detail separately, and aside from what has already been stated, 

 it suffices here to say that, in addition to the other changes, fibrosis of the decidua 

 was noticed in a large percentage of the specimens. 



B. TOTAL. 



Of the 3 tubal specimens remaining in this group little can or need be said. 

 The walls of the tubes were infiltrated, the mucosa showed inflammatory changes, 

 and the clots were infected in two specimens. Nothing was left but a few non- 

 vascular, fibrous, and necrotic villi. In one specimen the chorionic membrane 

 was thickened somewhat and densely fibrous. The epithelium, syncytium, and 

 trophoblast of some villi also were degenerate, and the villi themselves somewhat 

 matted. Until the larger series of cases contained in the rest of the collection 

 and falling into this group can be studied, a comparison of these few with the 

 corresponding uterine group can be of no value. 



GROUP 4. CHORIONIC VESICLES WITH NODULAR CYEMATA. 



A. UTERINE. 



Panum believed that certain small nodules, which he called monstruositates 

 amorphoides, resulted from pathologic changes in the original form of the embryos, 

 which changes converted them into more or less compact, rounded masses. He 

 further believed that even older chick embryos could become transformed into 

 amorphous masses and represented some of these; also, that these changes in form 

 arose during the life of the embryos and were to be explained by regression of the 

 organs and fusion with neighboring ones, as a result of disturbances in nutrition. 



Giacomini (1889) stated that, although he could produce atrophic embryo 

 forms in the rabbit by the use of experimental methods similar to those described 

 by him in man, he did not regard these forms in man and in the rabbit as wholly 

 comparable. 



His (1891) stated that he found 5 nodular embryos in 45 cases. This is an 

 incidence of 11.1 per cent, but Mall (1917) found 51 nodular specimens among 

 396 pathologic, or a percentage of 12.9 per cent. In view of His's small series, it 

 is striking that these percentages are so nearly alike, and it might seem that nodular 

 forms occur with considerable constancy. 



Giacomini (1894) claimed to have studied the first nodular specimens micro- 

 scopically in 1893, and stated that the nodular forms have not been studied much 

 because they are more difficult to understand. Giacomini, who stated that atrophic 

 forms occur chiefly in the tubes and in peritoneal implantations, apparently used 



