STUNTED CYEMATA. 85 



tion was present in small areas in only a few specimens, which had the characteris- 

 tics of old retentions. Coagulation necrosis, or so-called "infarct" formation, so 

 common in the next group, was rare here; but fibrosis and cytolysis of the decidua 

 were as common in this as in the other groups. Rarely, the decidua was so 

 fibrous as to simulate the degenerate chorionic membrane very closely. 



B. TUBAL. 



Since 2 of the 5 specimens originally placed in this group were found to contain 

 no embryo, only 3 remain. Of these, No. 697 contains a very small nodule of 

 embryonic tissue, the appearance and structure of which suggest that it very 

 probably belongs in the preceding group of nodular cyemata. However, since the 

 sections of this nodule do not form a complete series, one can not be absolutely 

 certain of this. Another specimen, No. 346, also belongs to the group of nodular 

 cyemata, for neither the caudal nor the cephalic end can be distinguished with the 

 naked eye. This leaves only one specimen, No. 729, in the group of cylindrical 

 tubal cyemata. Since the only remnant of the cyema itself found in this specimen 

 is a small group of cells on the end of the umbilical cord, the existence of a cylindri- 

 cal cyema in this case can be a matter of surmise only, for the condition of the cord 

 has not been found to be a reliable criterion for distinguishing between the previous 

 existence of a nodular or a cylindrical cyema. Moreover, since Mall thought it 

 probable that the cyema was normal, this specimen can be retained in this group 

 only if we desire to classify portions of the cords as cylindrical cyemata. From 

 these considerations it follows that the group of cylindrical cyemata is left without 

 a true representative from among the tubal pregnancies found in the first 1,200 

 accessions. This does not mean, however, that cylindrical forms can not or do 

 not occur among tubal pregnancies. 



Infiltration of the tube was present in 3 of the 5 specimens originally placed 

 in this group in which it was included in the sections. Hydatiform degeneration 

 was found in 3 specimens, but the tubes of 2 of these have not been examined 

 microscopically. One of these 3 cases was a very fine example of hydatiform degen- 

 eration. A second was very clearly an early case, but too few villi were included in 

 the third to make a definite decision possible. 



GROUP 6. STUNTED CYEMATA. 

 A. UTERINE. 



It was emphasized in Chapter III that stunting, in a physiological sense, can 

 not be limited to cyemata in any particular group; but since the difficulty of 

 recognition increases with the decrease in the size of the specimen, it is only rarely 

 that stunting can be detected by inspection alone in cyemata below the stage of 

 limb formation. Furthermore, if the limbs themselves are to be used as a criterion, 

 limb formation must not merely have begun, but must have proceeded far enough, 

 and normal growth must have been inhibited sufficiently to effect a change in 

 form clearly recognizable with the unaided eye. This, however, does not imply 

 that the effect or the recognition of stunting is confined to the limb-buds. Rarely, 

 it is noticeable quite early in the entire caudal or cephalic extremities, or even in 



