STUNTED CYEMATA. 



153 



fibrous and the villi are matted together by a slimy mass 

 rich in blood and leucocytes with fragmented nuclei. The 

 syncytium is well developed and extends into the blood and 

 slime. The decidua over the chorion has large sinuses 

 within its walls, is quite hernorrhagic, and at points has 

 large islands of luecocytes, usually situated along the 

 course of the blood-vessels. The embryo has hare-lip and 

 displaced ears. The viscera protrude in the front and 

 there is spina bifida. The large blood-vessels and heart 

 are still filled with blood, and there is quite a general 

 infiltration of the tissues with round cells. The vessels 

 of the embryo end in the cord and do not reach to the 

 chorion. In general, there is mainly a destruction of the 

 tissues possibly due to the irregular growth of the embryo. 

 The central nervous system has been converted in great 

 part into a mass of connective tissue, with remnants of 

 the cord below and a rudimentary brain above, which 

 forms a shield upon the protruding mass. A portion of 

 this shield has grown into the connective tissue below, 

 forming a gland-like structure. The clavicle, mandible, 

 and maxilla have begun to ossify, and some of the muscles 

 are fairly developed. 



(6) Slight infiltration of the decidua. 



No. 365. 



(1) A. G. Pohlman, Bloomington, Indiana. 



(2) B 14mm. 



(4) This embryo, with spina bifida, iniencephaly, and 

 anencephaly, but the extremities of which are normal in 

 form, has a straight body and is attached to the end of a 

 very large umbilical cord. 



(5) Sections show that the spinal cord is absent, but 

 there is a solid brain which is more or less infiltrated with 

 round cells at its periphery. The same is the case with 

 the eyes. The mouth is closed by the tongue, which has 

 become adherent to the lips. The nodules in front of the 

 body are composed of necrotic epithelial cells. Some of 

 the other tissues of the body also are necrotic, but most 

 of them are infiltrated with round cells. Those of the 

 head are quite fibrous in character. The walls of the 

 alimentary canal and the lungs are also pretty well filled 

 with irregular patches of round cells. Especially well 

 marked is this change in the region of tendons and peri- 

 chondrium, showing that there is an irregular growth of 

 the mesodermal tissues. The clavicle, maxilla, and man- 

 dible are well ossified, which should not be the case in 

 so small an embryo. 



No. 375. 



(1) Simon H. Gage, New York. 



(2) B 13 mm. 



(4) A piece of chorion, accompanied by the mutilated 

 embryo. Both appeared quite normal. 



(5) Sections of the chorion, however, show that the 

 mesoderm of the villi is non-vascular, somewhat degene- 

 rate, and very fibrous. That of its main wall also is non- 

 vascular, edematous, and macerated. The syncytium 

 seems to be deficient in quantity and the epithelium 

 degenerate. The mesenchyme of the cord is very de- 

 generate and the vessels have disappeared completely. 

 Sections of the embryo indicate that it is nearly normal, 

 with some dissociation of tissues. The larger blood- 

 vessels are gorged with blood, and some of the tissues, 

 especially those in front of the head, are infiltrated with 

 round cells. The central nervous system is swollen and 

 dissociated, as is so frequently the case in many of the 

 other embryos. 



(6) Decidua absent. Chorionic changes suggestive of 

 lues. 



No. 401. 



(1) Dr. Hay (Bardeen collection). 



(2) B 5.5 mm. 



(5) Much of the chorion and many of the villi and the 

 syncytium are necrotic and infiltrated with many leu- 

 cocytes. The umbilical vesicle is necrotic and filled with 



a mass of broken-down cells. The tissues of the embryo 



are dissociated, macerated, and infiltrated with round cells. 



(6) No decidua, but evidences of infection are present. 



No. 402. 



(1) Edmund J. O'Shaugnessy, New Canaan, Connecti- 

 cut. 



(2) A 40X25X20 mm.; B 4 mm. 



(3) "The woman, aged 30, is strong and healthy. She 

 was married Z } A years before she became pregnant, and 

 menstruated regularly. After the birth of the first child 

 she had a slight discharge, which was diagnosed by her 

 attending physician as an ulcerated cervix, and which he 

 treated by local applications. Since the birth of the 

 second child patient has had some discharge, but again 

 became pregnant, this time aborting at 6 or 8 weeks. She 

 has never done anything to prevent pregnancy, and both 

 she and her husband are anxious for a large family." 

 At the time the specimen was sent the patient was men- 

 struating and still had a chronic discharge. 



(4) The villi of the ovum are well developed and 

 regularly distributed over its surface. Within, the ccelom 

 is well rilled with reticular magma. The embryo is club- 

 shaped, its head being much too large for the body. 

 Umbilical vesicle normal in size and shape, and the heart 

 is well outlined. Extremities beginning to develop. The 

 embryo is lying free within the ccelom and is attached 

 but slightly to the amnion, some distance from the letter's 

 attachment to the chorion. 



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

 matted together with a fibrinous mass extending more or 

 less between them. Within this mass there is quite an 

 active trophoblast, which at numerous points forms large 

 nodules, many of which have necrotic centers. The 

 chorionic membrane appears to be normal in texture, and 

 from it arise great masses of reticular magma which are 

 brought out well by the Van Gieson method of staining. 

 The mesenchyme of the villi is partly fibrous and partly 

 mucoid, and many villi contain numerous Hofbauer 

 cells. The nervous system of the embryo is completely 

 dissociated, the cells forming a uniform layer throughout 

 the canal. It is impossible to outline the different por- 

 tions of the brain. The spinal cord has a lumen at its 

 lower end. The vascular system is also destroyed almost 

 completely, only a portion of the heart being recognizable. 

 The ccelom is more or less filled with round cells. No 

 myotomes can be outlined. Small remnants of the 

 pharynx and the ccelom are present at different points. 



(6) Marked infiltration of the decidua and hydatiform 

 degeneration. 



No. 450. 



(1) John Girdwood, Baltimore, Maryland. 



(2) A 60X45X45 mm.; B 18 mm. 



(3) Patient had missed two periods. She is the mother 

 of several healthy children, and has also had several 

 previous miscarriages. 



(4) The unopened specimen came with its decidua 

 partly stripped off. The portion of the chorion which is 

 exposed is covered with very long and extremely delicate 

 villi, with an unusually thin chorionic membrane. The 

 embryo's head is nearly detached, and is atrophic, with 

 rounded atrophic forehead. The body of the embryo is 

 normal in shape. The cord is sharply dilated in its middle 

 and very small and pointed at its attachment to the 

 chorion. 



(5) The decidua appears to be normal in form and 

 thickness, but shows a very extensive inflammatory re- 

 action. At points there is such an accumulation of leu- 

 cocjtes as to form small abscesses. The villi are small 

 and fibrous, with practically no trophoblast attached to 

 them. The main wall of the chorion also is thin and 

 fibrous. Serial sections through the umbilical vesicle 

 indicate that it is necrotic and undergoing disintegration 

 on one side, while on the other its wall is fibrous and 

 seems to be growing quite actively, tufts appearing upon 



