152 



STUDIES ON PATHOLOGIC OVA. 



embryo is attached by means of a fibrous umbilical cord. 

 Its tissues are dissociated and infiltrated with round cells. 

 The blood-vessels and heart are greatly distended with 

 blood. The liver is necrotic. In front of the head the 

 tissue is broken away, leaving a pocket which contained 

 the forebrain, and above this the brain protrudes. The 

 cord and fourth ventricle are distended and dissociated. 

 The epidermis is intact. 



(6) Marked infiltration of the decidua; insufficient 

 chorion. 



No. 344. 



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



(2) A 45X45X45 mm.; B 16 mm. 



(5) The wall of the chorion is very thin and non- 

 vascular, with a few fibrous villi scattered over it. The 

 long, thin umbilical cord is fibrous and shows remnants 

 of blood-vessels. The embryo has a rounded head and 

 stumpy legs. Its tissues are dissociated, the brain being 

 distended and macerated as well. The medulla has 

 expanded towards the mouth. Heart and blood-vessels 

 are distended. In many places the walls are destroyed 

 and the blood-cells extend into the surrounding tissue. 

 This condition is very marked in the liver. The legs are 

 rilled with an even mass of round cells, i. e., the tissues 

 are dissociated. Some of the epidermis has fallen off. 



(6) Decidua absent. Chorion suggestive of lues. 



No. 346. 



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



(2) B 13 mm. 



(4) A piece of hemorrhagic chorion, which may have 

 been 50 mm. in diameter, is attached to the embryo. 



(5) Its tissues are macerated, but preserved well 

 enough to show that there is mucus and pus between some 

 of the villi. The latter are matted, very degenerate, non- 

 vascular, and fibrous. The chorion has undergone hyaline 

 degeneration and contains remnants of blood-vessels only. 

 The decidua is markedly infiltrated. The umbilical 

 vesicle is filled with a necrotic mass. The embryo is 

 dissociated and macerated. The central nervous system 

 is dilated and the heart is distended with blood, some of 

 which infiltrates the surrounding tissues. 



(6) Marked infiltration of the decidua. 



No. 348. 



(1) R. M. Pearce, Albany, New York. 



(2) A 50X30X25 mm.; B 12 mm. 



(4) 1'he specimen is smooth, being covered with numer- 

 ous small hemorrhagic spots and irregular masses of 

 small villi. 



(5) Sections show that the decidua is infiltrated with 

 leucocytes, with a consequent fibrous degeneration of the 

 villi of the chorion. Some of the villi, as well as the very 

 degenerate portions of the wall of the chorion, have under- 

 gone invasion by leucocytes and syncytial cells. The 

 stroma of the villi is largely non-vascular and shows 

 "granular hyperplasia. " The epithelium and tropho- 

 blast are fairly well preserved. The dissociation of the 

 tissues of the embryo is extreme, the blood from the blood- 

 vessels having passed through their walls to infiltrate the 

 surrounding tissues. This is especially well marked in 

 the heart and liver. The nervous system is pretty well 

 broken up and the epidermis has fallen off. 



(6) Marked infiltration of the decidua and changes 

 suggestive of lues. 



No. 357. 



(1) E. J. Russell, Baltimore, Maryland. 



(2) A 90X40X40 mm.; B 17 mm. 



(3) "The specimen came from an unmarried woman 22 

 years old. Her menstruation was irregular, sometimes 

 every two weeks, sometimes every six weeks. The last 

 period occurred about the middle of January. On March 

 29 she began to bleed and aborted April 19. Apparently 

 her uterus is normal." 



(4) The unruptured specimen was inclosed in a layer 

 of decidua and covered with villi of unequal size, some 

 being very large. Within it was a stumpy embrjo with- 

 out a neck and with atrophic leg-buds. The cord was 

 transparent and partly filled with granules, indicating 

 that the embryo had been dead for some time before the 

 abortion. 



(5) The main wall of the chorion is very thin, being 

 composed in many places of epithelial cells onl> . The 

 mesoderm of the villi is unusually fibrous and contains no 

 blood-vessels. The very large villi are degenerated, often 

 hollow, and do not stain. The syncytium is very de- 

 ficient in quantity, but at points invades the mesoderm. 

 Over the villi there is a mass of fibrin and disintegrated 

 blood. Leucocytes are not numerous, even in the decidua, 

 which appears to be normal. The tissues of the embryo, 

 which are dissociated and macerated, do not stain well. 

 The sharp boundaries are lacking, showing that adjacent 

 tissues have begun to coalesce.' In fact, the whole head, 

 down to the thorax, seems to have been converted into a 

 bag in which fragments of cartilage and nerve tissue may 

 be seen. The front of the head is adherent to the thorax 

 immediately over the heart. The contour of the cartilages, 

 liver, heart, and adrenals can be made out, but that of the 

 blood-vessels is obscure. According to the menstrual 

 history, this embryo was in the seventh week when bleeding 

 began, which was followed by the abortion three weeks 

 later. However, the degree of development of the car- 

 tilages and other structures places the embryo in the 

 sixth week. The continued bleeding may have been the 

 primary difficulty, being followed by death and degen- 

 eration of the enibryo. 



(6) Decidua is very degenerate and possibly infiltrated; 

 hydatiform degeneration of the chorion. 



No. 364. 



(1) B. J. Merrill, Stillwater, Minnesota. 



(2) A 90X50X40 mm.; B 16 mm. 



(3) "Last menstruation April 7, abortion July 5. The 

 first flow and pain appeared on the night of July 4. The 

 woman has been married four years, but this was her 

 first conception. Both she and her husband are very 

 anxious to have a child, so the miscarriage could not have 

 been aided. There was no incident, accident or other- 

 wise, to give cause for the abortion. The woman is 

 unusually healthy and the miscarriage took place without 

 chill or rise of temperature. She had been operated upon 

 several years ago for appendicitis. She has not been 

 altogether regular with her menstrual periods, and there 

 is some pain connected with them. She had been treated, 

 some time before I saw her, for vaginal discharge; there 

 may have been edometritis. Prior to her conception I 

 gave her some treatment for leucorrhoeal discharge, and 

 also made some slight dilatation of the cervix. She had a 

 long cervical os with a narrow canal. There was some 

 vaginitis and, as I remember, some endocervicitis rather 

 than endometritis, none of them very marked. Probably 

 there was enough uterine trouble to cause the delayed 

 development of the embryo and the abortion. The 

 husband is ordinarily healthy, but about a year ago, his 

 wife states, he had some trouble with his genital apparatus. 

 He has night emissions and I judge took medicine for 

 them. As far as I can ascertain from her outline, he has 

 not had venereal disease. If so, he did not contaminate 

 her. If he has, as she states, night emissions, perhaps the 

 virility of his semen is below par." 



(4) The ovum is covered with a few ragged villi, over 

 which there is some decidua more or less detached. 



(5) Sections of the chorion show that the villi are far 

 more numerous than was suspected from the simple 

 unaided eye inspection. The main wall of the chorion is 

 thin, atrophic and lined with the amnion, which is fully 

 detached where it connects with the umbilical cord. 

 However, it must have been attached at one time, as 

 remnants of blood-vessels from the embryo are seen in the 

 villi of the chorion. The mesoderm of the villi is very 



