NODULAR CYEMATA. 



135 



what inflamed, showing a general infiltration. Its inner 

 border is formed by a fibrinoid layer. The embryo con- 

 tains a large cavity, the walls of which are very thick and 

 fibrous, and the lumen of which is filled almost entirely 

 with cells. The thickened wall of the cavity passes into 

 the nodular embryo, which has undergone fibrous de- 

 generation and contains degeneration areas. Towards the 

 tip of the embryo the central nervous system is indicated, 

 but its lumen is entirely filled with cells which grade into 

 the surrounding mesenchyme. Sections of the central 

 nervous system are not characteristic. The epithelial 

 lining is crescent-shaped. The entire epidermis is still 

 intact, but otherwise no structure can be recognized. 

 (6) Mild infiltration. 



No. 795. 



(1) C. S. Minot, Boston, Massachusetts. 



(2) A 40X35X15 mm.; B 3 mm. 



(4) The ovum is pear-shaped and smooth on the outside 

 and measures 40X35X15 mm. The wall is relatively 

 thin, and the ovum completely surrounded by a layer of 

 blood which is covered by a thin layer of decidua. The 

 interior is lined with a smooth membrane and filled with 

 blood and magma. On one side, closely attached to the 

 chorion, is a very opaque nodular embryo, with a sharply 

 pigmented eye. It measures 3 mm. in length and is 

 markedly deformed. 



(5) The chorionic wall is thickened and lined with the 

 amnion. The villi are atrophic and buried within a large 

 mass of maternal blood. The nodular embryo is entirely 

 dissociated and its cells stain intensely. The free end 

 contains a vesicle which may represent an eye or the 

 brain. At the attachment of the embryo to the chorion 

 there is a semicircular space, and within this is a body 

 lined with cylindrical epithelium. This may be inter- 

 preted as representing the alimentary canal surrounded 

 by ccclom. Below this the body of the embryo is closely 

 attached to the chorion, and in this region a great many 

 blood-vessels pass from the embryo into it. 



No. 799. 



(1) V. Van Williams, Baltimore, Maryland. 



(2) A 40X25X25 mm.; embryo 1.5 mm. long. 



(3) Patient aged 43 years, mother of 14 live-born 

 children; 5 miscarriages. Only 3 or 4 children living, and 

 these are all boys. Last period three weeks previous to 

 abortion. Both husband and wife use alcohol to excess. 



(4) The chorion, which measures 40x25X25 mm., is 

 covered with long, irregular villi which make the specimen 

 appear pathological. The wall is thin and closely lined 

 with the amnion. The latter, which measures 25 X 18 X 18 

 mm., contains a small white nodule 1.5 mm. in diameter. 



(5) The chorion and villi, which are thick, have under- 

 gone mucoid degeneration and most of the trophoblast 

 is necrotic. The nodular mass is also completely disso- 

 ciated and is attached to the amnion, where it is greatly 

 thickened. At the point of attachment there is a large 

 vesicle which may represent the alimentary canal. Below 

 this is a second small vesicle and also numerous spaces 

 which reach far out into the detached amnion, and appear 

 to be remnants of distended and degenerated blood-vessels. 



(6) Early hydatiform degeneration. Decidua absent. 



No. 807. 



(1) Raymond Sanderson, Canandaigua, New York. 



(2) A 18X12X12 mm.; B 3mm. 



(4) The ovum is partly covered with decidua, which 

 comes off as a shell and shows the ovum covered with a 

 broad zone of irregular villi which divide twice. The two 

 poles are bare and opaque. Through one of these the 

 ovum was opened. The ccelom is filled with reticular 

 magma. Near the point of opening is a spherical cavity 

 5 mm. in diameter containing an opaque, irregular embry- 

 onic mass 3 mm. long. 



(5) The chorion is markedly fibrous and sparsely 

 covered with non-vascular villi which are also fibrous, and 



attached to some of them is a small quantity of tropho- 

 blast. The umbilical vesicle apparently is normal and 

 somewhat macerated. The wall of the amnion is also 

 fibrous, and at its point of attachment to the embryo it 

 appears somewhat like the umbilical vesicle. The exo- 

 ccelom is wide open up to the body of the embryo, and 

 from the latter a small yolk-duct appears to arise. How- 

 ever, this can be followed through the free space to the 

 yolk-sac with which it communicates. The embryo is 

 markedly stunted and dissociated, but most o! the organs 

 can be made put. The central nervous system has we 

 lumen filled with round cells, and the heart is fairly still 

 defined, but dissociated. The eye-vesicles are still present, 

 although very small. 



No. 820. 



(1) C. W. Crum, Brunswick, Maryland. 



(2) A 45X25X20 mm.; B 1 mm. long. 



(3) Patient aged 38 years; married in 1899; 11 preg- 

 nancies 10 births at term and this abortion. Began 

 bleeding 6 days before, which was attributed to lifting. 

 Uterus not infected; no fever; no venereal disease. Family 

 fertile. 



(4) The specimen is an irregular mole 45X25X20 

 mm., containing a sharply defined cavity, 25X7 mm., 

 which is lined by a smooth membrane and filled with 

 reticular magma. On one side is a small nodule, a milli- 

 meter in diameter, which may represent the embryo. The 

 wall of this specimen is composed of numerous villi which 

 have undergone mucoid degeneration, and are matted 

 together by fresh blood, considerable fibrinoid and tropho- 

 blast. On the outside is an inflamed decidua. 



(5) The chorionic membrane is very fibrous and the 

 ccclom filled with granular magma. Arising from one 

 side are small strands of tissue which may possibly repre- 

 sent the amnion. Lying in the granular magma are 

 remnants of tissue which probably come from the chorion. 

 The epithelium of the latter is largely destroyed, and the 

 infectious process seemed to be attacking the chorionic 

 membrane from the outside. 



(6) Marked infiltration. 



No. 830. 



(1) Austin Miller, Portersville, California. 



(2) A 80X38X35 mm.; B 4 mm. 



(3) Woman aged 41 jears, married in 1889. Pregnant 

 10 or 11 times; 8 living children, last child 6 years old. 

 Last period at end of June, abortion September 26 follow- 

 ing. Uterus presumably normal. No venereal diseases. 

 Family fertile. 



(4) The specimen is a pear-shaped abortion mass, 

 measuring 80X38X35 mm. At the larger pole a clear 

 bluish membrane was exposed through an opening 30X15 

 mm. The mass was opened through this membrane and 

 found to contain a cavity 60X30X30 mm., lined by a 

 smooth membrane which crosses it in a large, clear fold. 

 To this was attached a small opaque white embryonic 

 rudiment, 4 mm. in length, as well as what seemed to 

 be a yolk-sac about 1.5 mm. in diameter. The wall of 

 the oval mass is thin throughout except at the smaller or 

 upper pole, where it measures about 9 mm. in thickness, 

 and is very hernorrhagic. 



(5) The chorionic wall is composed of non-vascularized 

 villi matted together by an inflammatory material, a 

 great deal of fibrinoid substance and inflamed decidua. 

 The trophoblast is fairly active, and there are numerous 

 plaques of nuclear dust. 



(6) Marked infiltration. 



No. 888. 



(1) Oliver T. Logan, Changteh, Hunan, China. 



(2) A 70X50X50 mm.; B 1 mm. in length. 



(3) Chinese woman, age 32 years, married 16 years. 

 First child born 4 years after marriage; second child still- 

 born at 7 months. Two children died in infancy of fever. 

 Three living, healthy children, the youngest 2 years old. 



