274 STUDIES ON PATHOLOGIC OVA. 



the villi and the chorionic membrane are structureless. In the absence of the 

 clinical history one must needs be cautious, but I think it can be safely assumed 

 that in this case neither embryo nor amnion disappeared solely as a result of post- 

 partum maceration. That this assumption probably is correct is shown also by 

 other specimens, the histories of which fortunately are known. Nevertheless, 

 maceration, although not necessarily putrefactive maceration, undoubtedly was 

 an important factor in the production of the state in which this specimen is found. 

 This conclusion is confirmed by the occurrence of all manner of transitions between 

 the almost perfectly preserved structure and the pure shadow or gossamer pictures 

 such as are presented in the photograph of the cross-sections of the villi of this 

 specimen shown in figure 11 (plate 1, Chap. IV). All that remains of the villi are 

 spiderweb-like outlines, the fibers of which are exceedingly fine, but which never- 

 theless preserve the form of the villi and of the chorionic membrane so perfectly 

 that Mall especially recorded that the external appearance of the chorionic vesicle 

 was normal. 



Since chorionic vesicles devoid of an embryo when examined form about 32 

 per cent of those classed as pathologic in the Carnegie Collection, it is evident that 

 absence of the embryo itself is relatively common in early abortuses. It would 

 be incorrect, however, to assume that they had undergone absorption in all these 

 cases. A fine example of one of these empty chorionic vesicles is No. 1224, a 

 portion of which is shown in figure 10 (plate 1, Chapter IV). 



This specimen was found in an unopened uterus removed at hysterectomy 

 for cervical myoma. The chorionic vesicle, which measured 36 by 25 by 13 mm., 

 was collapsed, free from the uterus, and embedded in coagulum. The only con- 

 tent of this chorionic vesicle was a dark grayish coagulum which contained no 

 remnant of the embryo or of the amnion. This almost amorphous so-called magma 

 included only a few isolated cells. In spite of this fact, the trophoblast, which had 

 markedly proliferated, is well preserved over large areas, and many of the 

 vessels in the chorionic membrane are filled completely with erythroblasts. A 

 few degenerate masses of trophoblasts and fused degenerate villi are also present. 

 Some villi show evidences of maceration, others of "mucoid" degeneration, al- 

 though they still may contain vessels. Some, however, are represented by a 

 hyaline outline only. The stroma and the epithelium of many of the villi are well 

 preserved, however, and the same thing holds for the chorionic membrane. The 

 decidua shows slight general and very marked local infiltration. Some remark- 

 ably dense periglandular and perivascular zones of infiltration are also present. 

 The mucosa, too, is infiltrated and contains islands composed exclusively of round 

 cells. Besides maceration effects, many of the villi show marked changes, un- 

 doubtedly hydatiform in character. In this case it is possible that we are dealing 

 not so much with absorption as with dissolution of the embryo, for the digestion 

 products of embryo, yolk-sac, and amnion, instead of having been wholly absorbed, 

 may still be contained in the fluid within the chorionic vesicle. 



Before briefly considering the evidence regarding absorption offered by tubal 

 and ovarian specimens, I wish to refer to No. 1843. This unique specimen, which 



