138 



STUDIES ON PATHOLOGIC OVA. 



nion. The dimensions of the ovum and the length and 

 degree of development of the embryo indicate that the 

 pathological changes began not later than the sixth week 

 of pregnancy, while the menstrual history of the mother 

 indicates that at least 14 weeks elapsed between the con- 

 ception and the abortion. In other words, the patho- 

 logical process has been under way for at least 8 weeks. 

 The embryo itself has undergone most marked changes, 

 which also speak for this. The nervous system is mark- 

 edly dissociated and macerated. Arms and legs, external 

 features, as well as most of the internal organs, have 

 vanished. The liver is still outlined but necrotic. Wan- 

 dering cells have invaded all of the tissues and are also 

 beginning to attack the cartilaginous bodies of the verte- 

 brae. Large nests of them are also embedded in the clots 

 of blood which surround the embryo. The main blood- 

 vessels of the embryo can still be traced through the sur- 

 rounding tissues. The cord is filled with embryonic 

 blood, but likewise is necrotic. From all appearances, 

 had the ovum remained in the uterus much longer it would 

 soon have become filled with maternal blood, which in 

 turn would soon have solidified to make of the specimen 

 a typical fleshy mole. 



(6) Decidua necrotic and infiltrated; chorionic changes 

 suggestive of lues. 



No. 150. 



(1) Theo. E. Oertel, Augusta, Georgia. 



(2) A 35X30X10 mm ; B 5 mm. 



(4) There are but few villi on the chorion. The embryo 

 is distorted and the arm on one side is unusually large. 



(5) The chorion and amnion are greatly degenerated. 

 Villi are not included. The sections of the embryo show 

 an extreme degree of change. The nervous system is 

 swollen and solid, and the contour of the viscera is wholly 

 obliterated. The large blood-vessels are greatly dis- 

 tended with blood. Round cells are distributed equally 

 throughout the body of the embryo. 



(6) Decidua absent. 



No. 205. 



(1) D. S. Lamb, Washington, District of Columbia. 



(2) A 40X30X30 mm.; B 6 mm. 



(3) "The specimen which is about 4 weeks old is from a 

 woman who had been married 3 months. Syphilis is 

 suspected in the case." 



(5) The chorion is partly encircled by the decidua, 

 which is more or less necrotic and infiltrated with leuco- 

 cytes, showing that an inflammatory process was present 

 in the uterus. The chorion is fibrous at points, and at 

 others edematous, with but few villi present. These are 

 irregular and many of them fibrous. Their outlines are 

 irregular, and they are covered with a dense and very 

 irregular mass of syncytial cells. The few blood-vessels 

 present in the villi are all empty. The amnion is com- 

 pletely adherent to the non-vascular chorion throughout 

 its extent, making these two membranes appear as one. 

 On the amnion side there are numerous fibrous tuberosities 

 which look much like small villi inverted. At other points 

 the epithelial covering of the amnion builds by itself a 

 double layer of cells, which often give rise to papilliform 

 processes much like the syncytium on the outside. In 

 some places this layer of epithelium is raised, forming a 

 blister with a fibrin-like substance, possibly magma, 

 throughout which are scattered transparent round cells 

 with very small nuclei. The umbilical cord is quite 

 fibrous, with large, irregular cavities scattered through it. 

 These are filled with a mucoid substance in which a few 

 nuclei are scattered. The blood-vessels are all obliter- 

 ated, except at the point of attachment of the cord to the 

 embryo, where irregular vessels are filled with blood. 

 The external form of the embryo is well preserved and 

 covered entirely with much thickened epidermis. The 

 brain and spinal cord are swollen, the former being prac- 

 tically solid in the region of the forebrain. The heart and 

 large vessels are gorged with blood, which extends from 



them into the surrounding tissues, obliterating them almost 

 entirely. Within this mass of migrating cells can be seen 

 the outlines of some of the organs of an embryo about 4 

 weeks old. The liver, stomach, and lungs are riddled 

 by them, and only the faintest mark of an endoccelom 

 can be seen. It appears as if all the blood of the speci- 

 men accumulated within the embryo, the cord and the 

 chorion being free, the extensive epidermis preventing the 

 migration of the blood-cells into the amniotic cavity. 



(6) Probably some decidual infiltration; chorion and 

 amnion suggestive of lues. 



No. 228. 



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



(2) A 60X25X25 mm.; B 4 mm. 



(3) "The specimen is from the first pregnancy of a 

 fairly healthy woman. Last period July 1 to 3; abortion, 

 October 10.''' 



(4) The solid, blood-red specimen contains a regular 

 cavity, 30X18X18 mm., which is filled with a granular 

 magma, on one side of which is attached an embryo shaped 

 like an hour-glass. 



(5) Sections of the mole show that it is composed of 

 thick walls in which there is much blood, some villi, a 

 great deal of decidua, and some pus, especially on the 

 outside. The mesoderm of the villi and chorion is very 

 fibrous and devoid of blood-vessels. The cavity of the 

 chorion is lined with a very thick amnion, and the rem- 

 nant of an embryo indicates that its development was 

 arrested towards the end of the third week. The vascular 

 system still is represented by a mass of cells on the ven- 

 tral side of the embryo, behind which there is a large 

 vessel full of blood, extending towards the remnant of the 

 umbilical vesicle. No vessels extend to the chorion. The 

 central nervous system fills the main part of the embryo, 

 being much dilated in the head and pretty well filled with 

 round cells throughout. In front of the brain are two 

 vesicles which communicate with it through two long 

 tubes. These no doulft represent the eyes. In the neck 

 there is a small gland, possibly the thyroid. 



(6) Marked infiltration. 



No. 246. 



(1) A. Wegefarth, Baltimore, Maryland. 



(2) A 30X21X14 mm.; B 3 mm.' 



(3) "The woman from whom this specimen was ob- 

 tained is the mother of two children, the youngest about 

 7 years of age. Since then she has had five miscarriages, 

 all of about the same age as this specimen. No history 

 of syphilis, but have started to give her iodide of potash, 

 with the hope that she may give birth to a child. It would 

 be interesting if the great fire we had recently could have 

 played any part in this trouble, as she felt well up to that 

 time, and the fright, due to the fear that the fire would 

 burn out her neighborhood, kept her in a state of great 

 excitement for about 24 hours." 



(4) The external surface of the ovum is normal in 

 appearance, but when opened it was found to contain a 

 deformed embryo lying beside a very large amnion. Sec- 

 tions of the chorion show that its structure is somewhat 

 hyaline and the villi are devoid of blood-vessels. The em- 

 bryo and membranes were cut together, and the sections 

 show that the amnion is greatly hypertrophied, folded, and 

 torn, and that the embryo is deformed and injured, but 

 lying outside the amnion. The heart and great blood- 

 vessels are empty, the brain is distended and partly filled 

 with round cells; together they give the appearance of 

 an embryo of the beginning of the third week. No liver 

 can be found, but there are loops of intestine present, as 

 during the fourth week. The otic vesicles are well de- 

 fined, but the optic vesicles are absent. No umbilical 

 vesicle can be fcund, but this may have been lost when 

 the amnion was torn. The amnion, however, runs down 

 in a thickened ridge which contains two large blood- 

 vessels and an epithelial tube, the allantois, between them. 



