CHORION WITH AMNION. 



119 



(4) Part of the ehorion is hemorrhagic; the rest appears 

 normal. Sections show that some of the villi are nearly 

 normal, but with a deficient amount of syneytium, even 

 where they are well-embedded in blood. The amnion 

 and a worm-like process (30 X 5 mm.), which proves to 

 be the umbilical cord with its three blood-vessels, are 

 present. The latter are well-developed and fully 1 mm. 

 in diameter. There are also numerous vessels in the villi 

 of the ehorion. The tissue of the chorion is hyaline and 

 contains a diminished number of nuclei. 



(6) Marked infiltration and early hydatiforin degen- 

 eration. 



No. 408. 



(1) J. Park West, Bellaire, Ohio. 



(2) A 50X30 mm. 



(3) The specimen came from a delicate, anemic woman 

 who had been sick for a week with peritonitis. She 

 menstruated normally June 10 to 14, then slightly for a 

 day and a half, and considerably for three days before 

 the specimen was expelled August 13. 



(4) The solid specimen was cut through lengthwise and 

 found to be composed mostly of a hemorrhagic mass con- 

 taining a collapsed cavity lined with an amnion and 

 measuring 12X4 mm. The chorionic membrane is 

 greatly thickened and very necrotic. 



(5) 'The solid mass is filled with necrotic and fibrous 

 villi matted together in an irregular manner, and of many 

 nests of trophoblast which in places are reduced to masses 

 of nuclear dust. Beginning calcification is present. At 

 numerous points the villi are invaded by trophoblast, 

 showing that the latter continued to grow long after the 

 death of the villi (?). At the periphery of the mole there 

 is an extensive infiltration with leucocytes, indicating an 

 inflammatory process of the uterus. 



(6) Marked infiltration. 



No. 429. 



(1) Elizabeth Dunn, Chicago, Illinois. 



(2) A 45X25X10 mm. 



(4) The cavity of the vesicle is filled with a smooth 

 membrane the amnion. The chorion measures 45 X 25 X 10 

 mm. and the amniotic cavity 35X15 mm. Sections of 

 the chorion, as well as two small nodules which accom- 

 panied it, were cut, but no remnants of the embryo 

 could be found. 



(5) The villi are matted together and degenerate, and 

 many are irregular and atrophic. The amnion is in appo- 

 sition with the chorionic membrane. Apparently we have 

 here a specimen from which the embryo has escaped after 

 it had been well developed, and which, on account of the 

 detachment of the chorion, became necrotic. There is 

 but little decidua, and this shows inflammatory reaction. 



(6) Decidua infiltrated. 



No. 468. 



(1) J. M. Jackson, Pittsburgh, Pennsylvania. 



(2) A 14X11X5 mm. 



(3) The specimen was discharged spontaneously a week 

 after the cessation of one menstrual period. The mother 

 has the following history: At about the age of 18 she ac- 

 quired a gonorrheal infection which was not treated, and 

 about a year later she was treated for an infection of one 

 tube and ovary, at which time the vaginal and cervical 

 discharges were examined, but no gonococci were found. 

 After a later exacerbation of the tubal trouble, one ovary 

 and tube were removed by the abdominal route. Three 

 years later she married, and after two years of .sterility 

 became pregnant. Pregnancy normal, and fetal life was 

 determined up to within three days of delivery. No 

 fetal heart-beat could be heard thereafter, and after an 

 easy labor a slightly macerated dead child was born. The 

 placenta was adherent and the microscopic appearance 

 presented a gritty, granular area at the adherent portion. 

 Specimen No. 4(38 was discharged one year later. She 

 is now pregnant for the third time at six months. 



(4) The specimen is evidently a collapsed ovum, meas- 

 uring 14X11X5 mm. Its external surface is smooth 

 and on it blood-vessels are coursing. Along the edge of 

 one surface club-shaped villi (?) are seen. The specimen 

 is very hard from the alcohol. On opening, a fine mold- 

 like magma fills the cavity, from which it can be extracted, 

 hanging together so as to form a cast of the cavity. The 

 cavity is smoothly lined. No embryo could be seen. 

 The fragments were then stained in cochineal, and the 

 specimen afterwards cut ;n serial sections, but still no 

 trace of an embryo was found. 



(5) Sections of the chorion show that the ovum is lined 

 by an amnion which is more or less adherent to the cho- 

 rionic wall. The latter and the villi are very fibrous and 

 matted together with blood and pus, indicating that there 

 had been a very extensive inflammatory reaction within 

 the uterus. The decidua is decidedly fibrous in places. 

 Practically no trophoblast is attached to the decidua. 



(6) Severe infiltration. 



No. 469. 



(1) Joseph M. Jackson, Pittsburgh, Pennsylvania. 



(2) A 27X30X10 mm. 



(3) Father had several attacks of gonorrhea before 

 marriage, at which time he was supposed to be well. 

 Never had syphilis. Mother is a sound, healthy, robust 

 woman, age 26 years, married 6 years. Her family his- 

 tory is bad; many cases of tuberculosis on both sides of 

 her line. She has one healthy child 4 years old. One 

 miscarriage almost 3 years ago at 2 months; no ascertain- 

 able cause. The present specimen was discharged spon- 

 taneously 3 weeks after skipping one regular period. She 

 is now pregnant for the fourth time and has gone 2 weeks 

 over one period. She has no symptoms of adnexal and 

 no evidence of tubercular trouble. Menstruation nor- 

 mal, but of unusually foul odor. 



(4) Collapsed ovum 27X30X10 mm., covered com- 

 pletely on one side and partially on the other by branch- 

 ing villi about 3.5 mm. long, although some along one 

 lateral margin are fully 6 mm. long. A large, relatively 

 bare area, 20X15 mm., exists on one side, where the 

 small scattered villi are seldom branched and not over 1.5 

 mm. long. On opening the ovum, no distinct cavity ia 

 met, as many white "cheesy" trabeculse obscure it. No 

 evidence of an embryo is found. The magma is very 

 extensive, completely filling the exocoelom, and may be 

 described as reticular with much white granular or cheesy 

 substance in its meshes. 



(5) On one side of the chorion a shaggy body, about 3 

 mm. long, was found embedded in the magma. This, 

 with the adjacent chorion, was cut into serial sections. 

 These show that the body seen before cutting was the 

 umbilical vesicle, all of which is filled with round cells. 

 No embryo could be found. The chorionic wall and villi 

 are somewhat fibrous, and the trophoblast is scanty. At 

 points it seems to be invading the mesoderm of the cho- 

 rion. Some of the villi contain blood-vessels. No am- 

 nion, or only a remnant of it, is present. The magma, 

 which forms a thick layer within the chorion, is composed 

 of fine granules, through which are scattered numerous 

 .small round cells. 



No. 483. 



(1) Charles A. Lamont, Canton, Ohio. 



(2) A 20X12X6 mm.; B 3 mm. 



(3) The patient is a primipara, age 33 years. Last 

 menstruation October 23; previously had been invariably 

 regular. On January 3 she noticed a slight flow which 

 increased at times, but had little pain until the night of 

 January 5. The following morning the ovum was expelled. 



(4) The specimen consists of a smooth sac which proved 

 to be the amnion, and upon which the embryo is sessile. 

 This sac contained a granular deposit and a cylindrical 

 embryo 3 mm. long, the external form of which is irregular. 



(5) Sections show extensive changes within. The cen- 

 tral nervous system is irregular and the otic vesicles are 



