136 



STUDIES ON PATHOLOGIC OVA. 



No history of lues in either parent. Last menstrual period 

 October 10. On the following February 21 the patient 

 flooded badly and was anemic. Came to the hospital on 

 the 22d, when uterus was emptied. 



(4) The specimen consists of an abortion mass 70X50 

 X50 mm., one half of which exposes villi probably about 

 9 mm. long, while the other half is covered by decidual 

 tissue. The ovum was opened freely and a distended 

 spherical vesicle (amnion) protrudes. It is attached to 

 one end of the chorion. The structure of the amnion is 

 very fibrous, and when opened a nodular but irregular 

 mass, about 1 mm. in diameter, was found attached to one 

 side of it. The chorionic membrane is very fibrous and 

 the villi have undergone partly fibrous and partly mucoid 

 degeneration. There is an overlying trophoblast present. 

 The decidua is degenerate, but some villi are still well 

 implanted in it. 



(5) The embryonic mass is in the form of a cone with 

 the entire base attached to the thickened amnion. Below 

 this base there is a large mass, the debris of which stains 

 intensely with hematoxylin. This may be a remnant of 

 the yolk-sac. On either side of this is a large, sharply 

 cut space which may represent the ccelom. The embryo 

 itself is composed of two parts, one part forming a large 

 cavity lined partly with a thickened layer of epithelium; 

 the other has undergone fibrous degeneration and includes 

 several round epithelial tubes which may be remnants of 

 the intestines. The large cavity seems to be the central 

 nervous system. It lies entirely within the amniotic 

 cavity; otherwise it might readily be construed as the 

 yolk-sac, its walls having much the appearance of some 

 yolk-sacs. 



(6) Marked infiltration; hydatiform degeneration. 



No. 9156. 



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



(2) A 7X7X7 mm.; B 2 mm. GL. 



(4) The specimen consists of a clear piece of chorionic 

 wall about 7 mm. in length, with scanty, thread-like villi 

 with irregular enlargements. A small, pear-shaped and 

 opaque, featureless nodule, about 2 mm. in length, is 

 adherent to the inner surface. 



(5) The chorion and villi are very fibrous, and the latter 

 are covered with a small amount of trophoblast. The 

 embryo forms a curious crescent-shaped body with a well- 

 defined neural tube. This on its ventral side spreads out 

 through the rest of the embryo, so that cells seem to be 

 directly confluent with the main tube. Between the em- 

 bryo and its attachment to the chorion there is quite a 

 plexus of spaces. Numerous villus-like bodies protrude 

 into the exoccelom. Within the embryo there are myo- 

 tome-like bodies on one side of the cord; otherwise the dis- 

 sociation is almost complete. In addition to this embryo 

 there is a well-defined, fibrous vesicle lined by epithelium. 

 In this are a few groups of cells which may represent blood- 

 cells. 



No. 930. 



(1) F. H. Bacon, Peoria, Illinois. 



(2) A 34X34X25 mm.; B 1 mm. 



(3) Patient aged 38 years, married 19 years. Six chil- 

 dren, all living; eldest 17 years and the youngest 14 months. 

 No previous miscarriages. Missed menstruation in April, 

 flowed slightly May 23; missed June period. On July 4, 

 after working harder than usual, began to have abdominal 

 cramps and started to flow some in the evening. Cramps 

 and blood increased on the 5th and 6th. On the 7th pa- 

 tient had severe hemorrhages. Examination showed 

 uterus to be about the size of a two-months' gestation. 



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

 measuring 55X37X37 mm., the upper portion of which 

 consists of "fresh" deciduous tissue; the lower, of a 

 spherical ovum, measuring about 34X34X25 mm. 

 Villi, 7 mm. in length and few in number, are exposed. 

 On opening, the ovum showed a smooth-walled cavity in 

 which was found a nodular embryo 1 mm. long. 



(5) The chorionic membrane is very fibrous, and at- 

 tached to it are short fibrous villi matted together by 

 considerable trophoblast, mucoid substance, and blood. 

 A decidual mass 2 mm. in diameter has in its center a 

 large accumulation of leucocytes. The nodular embryo 

 has undergone degeneration, and only the coalom and 

 several large vesicles which are buried in the chorion can 

 be made out with precision. Part of the embryonic tissue 

 looks a little like cartilage, and another portion is com- 

 posed of small round cells. There is also a small papilli- 

 form body at the tip of the embryonic mass. 



(6) Severe infiltration. 



No. 943. 



(1) Elizabeth Comstock, New York City. 



(2) A 50X50X50 mm.; B 2 mm. 



(3) Patient aged 28 years; married in December 1906. 

 Seven pregnancies: (1) abortion at 6 months; (2) abor- 

 tion at 4 months; (3) term, child now living; (4) term, 

 child died at 3 months; (5) term, child died at 4 months; 

 (6) term, child died at 8 months; (7) this abortion, at 3 

 months. Last menstrual period May 21 to 23; abortion 

 August 25 following. There was a slight redness of the 

 cervix and a blood-tinged, albuminous, glistening dis- 

 charge the day before the abortion. Syphilis acquired 

 from husband. Ovaries and tubes in good condition. 

 Family fertile. 



(4) The mass consists of a hard body 80X40X40 mm., 

 from which protrudes a chorionic vesicle 50 mm. in diam- 

 eter, partly covered with relatively small villi. This con- 

 tained a clear fluid, a few large flakes which float easily, 

 and a small body 2 mm. long, which appeared to be the 

 remnant of the embryo. 



(5) The chorion is fibrous and the few villi have mostly 

 undergone mucoid degeneration. These are matted to- 

 gether with degenerate trophoblast, and there is also con- 

 siderable blood between them. The amnion lines the 

 entire chorion. The nodular embryo is greatly degener- 

 ated and very fibrous, and contains a cavity which ramifies 

 and seems to be composed of the nervous system. In the 

 head end there seem to be two rudimentary eye-vesicles, 

 while at the other end, where the embryo is attached to 

 the chorion, the tissues have undergone fibroid degener- 

 ation. 



The decidua is well preserved, but shows considerable 

 local infiltration. Beginning fibrous and obliterative end- 

 arteritis are evident in certain areas. 



(6) Mild infiltration. 



No. 1019. 



(1) Joseph S. Lewis, Buffalo, New York. 



(2) A 70X35X30 mm. 



(3) The patient had had three previous abortions one 

 at 7 months, two at 3 and 4 months. The last two were 

 self-induced. The last period occurred about September 

 15. Hemorrhage began September 27. No infection is 

 present. 



(4) The abortus consists of a chorionic sac almost cov- 

 ered with clotted blood which adheres firmly to the villi. 

 The chorionic vesicle is filled with a reddish fluid contain- 

 ing an embryo 2X4 mm., which is adherent to one side 

 of the chorionic wall. Subchorial hematomata are pres- 

 ent, but the chorionic wall is so thin that it is difficult to 

 identify the villi with the unaided eye. 



(5) The clot contains a very degenerate chorionic mem- 

 brane, villi, and decidua. The stroma of many of the 

 villi is quite fibrous, and no remnant of the vessels is seen. 



No. 1022/1. 



(1) Ernest C. Lehnert, Baltimore, Maryland. 



(2) 35X25X20 mm. 



(4) A little more than half of the chorionic sac is bare. 

 A small white nodule can be seen on the interior. It ia 

 about 1 mm. in diameter, and apparently represents the 

 embryo. The remainder of the chorion is covered by a 



