102 STUDIES ON PATHOLOGIC OVA. 



blood-clot. Of another specimen (No. 535) it is stated that it also was apparently 

 normal, and consequently these 3 may be regarded as macerated normal fetuses, 

 which leaves only 3 others. Of these, No. 307 had no head in any true sense, for 

 the place of the head was taken by an empty fold which overhung the chest, and 

 gave to cross-sections of the cephalic extremity of the embryo a form resembling 

 the head of a grasshopper. Marked maceration and dissociation were present 

 throughout the entire body of the specimen. The other two specimens (No. 685 

 and No. 846) were small, macerated, and dissociated fetuses, No. 685 being also 

 disintegrated. Although No. 846 had not been cut serially, it was very similar in 

 structure to No. 685, and it is not unlikely that both of these specimens also could 

 be regarded as macerated normal cyemata; or, if we emphasize the hydatiform 

 degeneration, we may prefer to group them as macerated, stunted, or cylindrical. 

 Hydatiform degeneration was present undoubtedly in two specimens, and 

 probably in four. In a fifth (No. 846) the appearance was that of a very 'degen- 

 erate and macerated hydatiform change. This does not necessarily imply, 

 however, that the cyemata contained in all these chorionic vesicles were abnormal, 

 for I have found hydatiform degeneration in a number of chorionic vesicles, the 

 cyemata in which appeared perfectly normal and which had been regarded and 

 classified as such. Moreover, since relatively few villi were contained in any of 

 these specimens, it is possible that the hydatiform degeneration, especially in 

 these, although also in some of the specimens in other groups, may have been 

 purely local instead of general in character. Furthermore, the villi contained in 

 the clots which surrounded the specimens in this group usually were very macerated 

 and necrotic even, so that the true picture was often decidedly masked. Marked 

 infiltration of the wall of the tube was present in 2, or 40 per cent, of the 5 specimens 

 in which it was included in the section. In the other 3, or 60 per cent, the infil- 

 tration was slight. 



SUMMARY. 



Uterine. As shown in table 4 (Chapter III), the number of specimens in the 

 different groups varied from 17 in the first to 74 in the sixth. The other groups con- 

 tained almost an equal number of specimens. The percentage of instances in which 

 the decidua was included in the specimens varied from approximately 44 to 76.8 per 

 cent, the first and last groups being comparable in this respect. The high per- 

 centage of presence of the decidua in the first group is due to the fact that implanted 

 villi remain attached to the decidua until the latter is expelled, but this explana- 

 tion manifestly can not hold for the high percentage of its presence in the specimens 

 in group 7. Here it probably is due to the fact that a sluggish but contracting 

 uterus often molds into a ball the secundines, the chorionic vesicle, and the contained 

 fetus, together with the decidua and blood-clot, the ball being finally expelled as 

 a unit. In the younger specimens, and especially in undelayed abortion, this is 

 less frequently the case, and decidua and conceptus are more frequently expelled 

 separately. In some instances, too, the decidua is purposely removed by the 

 practitioner in order to expose the contained conceptus and free it from the sur- 

 rounding clot. 



