STUNTED CYEMATA. 



149 



attachment between the cord and the broken embryo. 

 The villi are non-vascular and fibrous, with a clear stroma 

 in some. The entire chorion is covered with its decidua, 

 which is rich in blood-sinuses and infiltrated with leu- 

 cocytes. But few remnants of the syncjtial layer of the 

 chorion remain. The whole embryo is still covered by 

 epidermis, except on top of the head, at the tail end of the 

 body, and at the attachment of the umbilical cord. At 

 these points there is a marked destruction of the tissues, 

 which are beginning to disintegrate. The top of the head 

 is ulcerated, and in front it is necrotic and pigmented, as 

 is frequently noted. The nervous system shows the usual 

 changes seen in strangulated embryos. The vascular 

 system is gorged with blood, but none is within the vessels 

 of either the cord or the chorion. Within the body there 

 is quite an extensive migration of blood-cells in the tissues, 

 obliterating them in part. The majority of the organs 

 can still be outlined. We have here a rapid infiltration 

 with migrating cells of an embryo of 40 days, with cytol- 

 ysis rather than dissociation of the tissues. The changes 

 in the broken embryo are practically the same as in the 

 unbroken one, although they are more advanced. Only 

 the head extremities and cord remain entire, and in these the 

 changes are more marked than in the corresponding parts 

 of the unbroken embryo. In the former it is practically a 

 mass of individual cells, while in the latter the brain is 

 swollen and quite solid. 



(6) Marked deeidual infiltration; chorionic changes 

 somewhat suggestive of lues. 



No. 216. 



(1) A. Wegefarth, Baltimore, Maryland. 



(2) A 35X35X25 mm.; B 17mm. 



(3) This specimen was entered as pathological, but later 

 was transferred to the normal group. The original note 

 is dated January 28, 1903. 



(4) On further consideration, it appears that this is 

 really a pathological embryo, as the head is somewhat 

 rounded and the extremities are not well developed. The 

 cord has two enlargements, and there is considerable 

 granular matter within the amniotic cavity. 



(5) Sections show the embryo to be both macerated and 

 dissociated, the dissociation being especially marked 

 around the cartilage and in the extremities. The blood- 

 vessels are gorged with blood, and in the lower part of 

 the body their walls are well defined. They seem to be 

 normal within the head. The small segment of the chori- 

 onic vesicle which was cut is thin and only slightly vascu- 

 lar. The slender villi also are non-vascular and fibrous, 

 and the thin amnion is fused with the chorion. 



(6) Decidua absent; not enough chorion. 



No. 232. 



(1) M. Brodel, Baltimore, Maryland. 



(2) A 45X25X25 mm.; B 14 mm. CR. 



(4) Most of the chorion is devoid of villi, except im- 

 mediately over the attachment of the cord, which appears 

 to be normal. The villi are somewhat fibrous, with less 

 numerous blood-vessels than usual, and are covered with 

 a rich layer of syncytium. The amnion reaches the 

 chorion. 



(5) The embryo is atrophic and embedded in a mass of 

 granular magma containing numerous round cells. Most 

 of the epidermis has fallen off. The head is cylindrical in 

 form, containing a solidified brain and dissociated eyes. 

 The lenses are composed of broken cells surrounded by a 

 very thick hyaline capsule. The organs of the body are 

 not sharply defined, being filled with many round cells. 

 Even the nerves and cartilages have lost their sharp 

 borders. The extremities are stubby, being composed of 

 densely packed round cells which show no differentiation. 

 The blood-vessels are mostly empty. 



(6) Endometritis. 



No. 251. 



(1) A. H. Ritter, Brooklyn, New York. 



(2) A 30X25X25 mm.; B 9 mm. 



(3) Last period January 16; abortion April 3. 



(4) Half of the chorion is covered with villi; the other 

 half is bare, thickened, and hemorrhagic. The amnion 

 lines the entire chorion and the cord is very thin. 



(5) Sections show that the mesoderm of the villi is 

 rich in cells, fibrous, and devoid of blood-vessels. The 

 main wall of the chorion apparently is normal, with a 

 large number of vessels containing blood scattered through 

 it. The head of the embryo is atrophic and is nearlj filled 

 with a distended, dissociated, and macerated brain, 

 which protrudes from the back of the head. The ejes are 

 solid and the lenses have become dissociated, but are en- 

 circled with sharply denned and thickened hyaline cap- 

 sules. The heart and blood-vessles are distended and 

 filled with blood. The organs and tissues of the body are 

 not well defined and are filled with round cells. The 

 epidermis is lacking. The extremities are stubby, without 

 structure, and filled with round cells. The cartilages are 

 sharply denned and the liver appears to be about normal. 

 The decidua is very hemorrhagic and contains a large 

 number of abscesses. Apparently there was an extensive 

 endometritis. 



(6) Decidua necrotic and infiltrated; probably early 

 lues. 



No. 262. 



(1) H. F. Giering, Baltimore, Maryland. 



(2) A 80X15X15 mm.; B 14 mm. 



(4) The interior of the specimen is filled with a large 

 amount of granular magma, in which was embedded a 

 necrotic embryo 14 mm. long. 



(5) The decidua is filled with small abscesses, the 

 leucocytes invading the villi as well as the main walls of 

 the chorion. The changes in the embryo are extreme, the 

 nervous system being solid and filling' the stumpy head. 

 The outlines of the organs are hazy, they being filled more 

 or less with round cells. The embryo is falling to pieces, 

 but some of the epidermis is still intact. 



(6) Marked infiltration of the decidua. No chorion. 



No. 263d. 



(1) Albert B. Lyman, Baltimore, Maryland. 



(2) A 27X27X27 mm.;B 17mm. 



(4) The villi apparently are normal in form. 



(5) In structure they possibly are a little fibrous and 

 some are macerated. The blood-vessels appear to be 

 normal. The cord is dilated, showing the double enlarge- 

 ments, which are rnucoid in structure. The brain and 

 spinal cord are dissociated, the brain protruding into the 

 mouth, but the other organs are fairly well outlined. The 

 heart and large blood-vessles are filled with blood, and 

 there is some infiltration of the surrounding tissues with 

 round cells. The epidermis has fallen off. The changes 

 within the embryo may be due to maceration, but on 

 account of the sharply defined tissues of the chorion and 

 slight amount of fibrous changes in the villi and the mucoid 

 dilatations in the cord, with some wandering cells in the 

 tissues, it is probable that this specimen represents the 

 earliest stage of a strangulated embryo of the sixth week. 



(6) Decidua absent. Maceration of chorion and prob- 

 ably early hydatiform degeneration. 



No. 270. 



(1) L. R. Wilson, Baltimore, Maryland. 



(2) A 40X30X20 mm.; B 14 mm. 



(5) The chorion is only partly covered with villi, which 

 are atrophic and fibrous in structure but contain some 

 blood-vessels. The main wall of the chorion is also fibrous 

 and of irregular thickness, but contains some blood- 

 vessels. The amnion has reached the chorion and is 

 filled with granular magma, which completely envelops 

 the embryo. The central nervous sjstem is distended, 

 dissociated, and macerated. The large blood-vessels and 



