FETUS COMPRESSUS. 101 



long before this time would seem to be indicated by the fact that it does not appar- 

 ently bear any definite relation to the duration of the retention. Moreover, the 

 existence of endometritis is in itself evidence of the latter fact. 



B. TUBAL. 



Although one of the six tubal specimens among the first 1,200 accessions 

 was 80 mm. long, the others were relatively small. One (No. 535) was com- 

 posed of a fragment including only the upper two-thirds of the trunk. The 

 length of No. 685 apparently was estimated from the development shown in the 

 few cross-sections, which showed it to have been macerated and disintegrated. 

 Two specimens were 20 and 22.5 mm. long, respectively, and the other measured 

 8 mm. Hence it is evident that the average length of the uterine specimens fall- 

 ing in group 7 was very much greater, for their length was almost always above 

 25 mm., instead of below, as is the case with tubal specimens. This difference 

 between the two groups is attributable, no doubt, verly largely to the different 

 conditions under which development proceeds. As already indicated, mummi- 

 fication probably is impossible below a length of 3 mm. Consequently, such 

 specimens in tubal cases could occur only if the surgeon failed to intervene and if 

 both the patient and the fetus survived the rupture of the tube and its sequelae. 

 Moreover, in the case from which the 80 mm. tubal fetus was obtained, the speci- 

 men would never have lived to reach such a length had the patient come into 

 experienced hands earlier, as is evident from the history. Furthermore, since 

 Mall recorded that all the changes in this fetus "can be accounted for by the 

 death of the fetus, which must have occurred at the time of rupture of the tube," 

 it is clear that he regarded this specimen simply as a macerated normal fetus. 

 The placenta which accompanied this fetus is of particular interest, because it 

 illustrates an atypical form of hydatiform degeneration not previously seen. 

 Although cross-sections of many of the villi are enlarged and have the clear stro- 

 mata characteristic of certain stages of hydatiform degeneration, many of them 

 contain vessels which, though relatively small in caliber, also contain blood-cells. 

 Giant cells are quite common, and epithelial vesicles also are present in the stroma 

 of the villi. 



Upon examining the placenta with the unaided eye, and also under low magni- 

 fication with the binocular, the villi again appear quite atypical and different 

 from any examined so far. Some of them are very fine, long, and filamentous, 

 but others, which are far more numerous, lack the typical hydatids, though 

 bulbous. Many of them look blunt and swollen and possess enlargements lacking 

 the tapering ends so well shown in cases typical of hydatiform degeneration. This 

 modification in form of the villi may have resulted from the crowding to which they 

 were subjected by the surrounding tube. 



Regarding No. 478, which is 22.5 mm. long, Mall wrote: "It looks normal 

 but unnatural." This fetus is very dark and hemorrhagic, and evidently is de- 

 formed by pressure, either within or without the tube, or probably even after its 

 removal from the amniotic cavity, which the protocol states was contained in the 



