STUNTED CYEMATA. 



155 



in nuclei and practically devoid of trophoblast. The 

 tissues of the embryo have undergone extensive disso- 

 ciation and maceration. The brain is nearly solid, as 

 are the eye-vesicles, the lens forming small, solid bodies 

 immediately below the skin. The heart, as well as the 

 structure of the lower part of the body and the lumen of 

 the spinal cord, appears to be normal' in form. The dis- 

 sociation is most pronounced in the stunted extremities. 

 (6) Decidua absent. Early hydatiform degeneration. 



No. 516. 



(1) J. M. Hundley, Baltimore, Maryland. 



(2) A 65X50X40 mm.; B 15 mm. ' 



(3) "The patient missed her menstrual period February 

 15, 1911, had a slight show of blood March 15, and aborted 

 April 15. 



(4) The chorion is thin and transparent and covered 

 with long, ragged atrophic villi which accumulate in 

 tufts on one side. Attached to the villi are numerous 

 opaque bodies about a millimeter in diameter, which no 

 doubt represent clumps of necrotic trophoblast. The 

 amniotic cavity lines the entire chorion and contains a 

 transparent fluid with a small granular deposit. 



(5) Sections of the chorion do not include the amnion. 

 The chorionic wall is thin, fibrous, and degenerate. The 

 villi are non-vascular, fibrous, and hyaline, with a fenes- 

 trated stroma in some. Small clumps of trophoblast and 

 small mounds of fibrin bind a few of the tips together. 

 In this region there are buds of syncytium, some of which 

 have undergone nuclear fragmentation. Sections of the 

 amnion which include the attachment of the cord show 

 that it is thick and fibrous. The tissues of the embryo 

 are dissociated and macerated, the dissociation at the 

 tips of the extremities being typical and pronounced. 

 The brain and cord are badly macerated and folded, the 

 former protruding from the front of the head through what 

 appears to be an artificial rupture. The face is atrophic 

 and round, and there is no well-formed neck. The veins 

 are gorged with blood, the cells of which radiate more or 

 less into the surrounding tissues. The umbilical cord 

 contains numerous large spaces quite characteristic of 

 specimens of this kind. 



(6) Decidua absent. Possibly early hydatiform degen- 

 eration. 



No. 521e. 



(1) Francis Carpenter, Baltimore, Maryland. 



(2) A 40X30 mm.; B 15 mm. 



(4) The specimen is badly macerated and the embryo 

 broken. It has a round head, atrophic legs, and a very 

 atrophic umbilical cord. 



(5) The tissues of the embryo are dissociated and 

 extremely macerated. The chorionic wall is thin and 

 fibrous, and the non-vascular villi are more or less hyaline 

 and fenestrated. Very little trophoblast is present. 



No. 521/. 



(1) Francis Carpenter, Baltimore, Maryland. 



(2) A 50X70 mm.; B 22 mm. 



(4) The embrj'o shows a thick ridge along the dorsal 

 midline of the trunk. The head is smaller than usual. 



(5) Sections through the chorion show that the tissues 

 are macerated and necrotic in places, nor do they stain 

 well. However, this much can be made out: the chorionic 

 wall at the attachment of the cord is fibrous and the villi 

 have undergone fibrous, mucoid, and hyaline degeneration. 

 They are matted together with a mass of fibrin, mucus, 

 and necrotic trophoblast, and are capped by a layer of 

 degenerated decidua. A thick layer of fibrin arid de- 

 generate blood covers the maternal surface of the decidua. 

 Sections of the embryo show extensive maceration, as 

 well as dissociation of the tissues. The spinal cord is 

 disintegrated, the fragments being mixed up throughout 

 the main cavity of the spinal canal. The distended 

 macerated cord accounts for the ridge seen in the dorsal 

 midline before the embryo was cut. 



No. 566. 



(1) A. F. Fuchs, Loyal, Wisconsin. 



(2) A 24X19X19 mm.; B 6.5mm. 



(2) Patient gave birth to a healthy child 5 months 

 before. This specimen came away spontaneously in what, 

 appeared to be the first menstruation after pregnancy. 



u 4,. beautiful white specimen, completely covered 

 with vilh, somewhat more dense on one side than the 

 other. The villi are about 2 mm. long and divide once or 

 twice. The ccelom is filled completely with granular and 

 reticular magma. The amnion is filled partly with a clear 

 'd an p contains a nice white embryo, 6.5 mm. in length 

 L-R), slightly bent towards the right immediately below 

 the arms, and apparently normal. The internal surface 

 of the amnion is smooth, the coelom large, and filled with 

 dense reticular magma. The umbilical vesicle is spherical, 

 2.5 mm. in diameter. 



(5) The chorionic vilh seem to be capped with a layer 

 of blood which filters down between them. They are 

 macerated, almost wholly non-vascular, and the stroma 

 has undergone mucoid degeneration. The trophoblast is 

 abundant and well preserved. The chorionic membrane 

 also is degenerate and macerated. The embryo and um- 

 bilical vesicle show extensive dissociation of "the tissues, 

 but the myotomes and peripheral nerves, as well as other 

 organs of the body, can still be made out. The blood- 

 vessels are gorged with blood and the brain and spinal 

 cord are macerated. The tissues of the wall of the heart 

 appear quite normal. 



(6) Decidua absent, but the coagulum is infiltrated; 

 early hydatiform degeneration. 



No. 595. 



(1) Caleb Athey, Baltimore, Maryland. 



(2) A 33X27x'25 mm.; B 9 mm." 



(4) The entire specimen is club-shaped, with an ovum 

 at the larger end. The latter is vesicular and covered 

 entirely with villi which branch several times. Upon open- 

 ing, it was found to be lined with a smooth membrane. 

 The embryo is nearly normal in form, but injured. 



(5) The thin chorion appears to be normal in structure 

 and surrounded by a layer of matted villi intermingled 

 with blood and covered with decidua, showing a consider- 

 able degree of inflammatory change. The villi are non- 

 vascular and have undergone fibrous degeneration. The 

 trophoblast is scanty and disintegrating, but certain of 

 the villi and part of the chorionic wall contain blood-vessels. 

 The embryo is greatly dissociated and somewhat macer- 

 ated, and the blood-vessels and heart gorged with blood. 

 The central nervous system is folded, indicating macer- 

 ation, and a macerated and dissociated brain fills the 

 entire cavity of the head. The front end of the latter is 

 atrophied, and what remains is growing down, to later 

 become attached to the thorax. Such organs as can be 

 outlined show a marked dissociation of tissues. 



(6) Marked infiltration of the decidua. 



No. 601c. 



(1) Charles K. Winne, Jr., Albany, New York. 



(2) A 44X41 X20 mm.; B 10mm. 



(3) Patient is 39 years old; married 7 years; two chil- 

 dren, ZYz years and 21 months respectively. First two 

 pregnancies miscarried, at 6 and 3 months, respectively; 

 cause unknown. Last menstruation April 20. Two days 

 before the physician saw her she had been working very 

 hard, packing and closing her house in Washington. Heat 

 intense. She came to New York June 27, and from there 

 to Albany on the night boat, arriving there next morning. 

 While on the boat she was nauseated and vomited, and 

 had slight vaginal bleeding, which continued. Despite 

 appropriate treatment, the threatened miscarriage pro- 

 ceeded to full completion a few hours later, early in the 

 morning of June 28. This history can be relied upon, as 

 both the patient and her husband were anxious for the 

 child and distressed at the outcome of the pregnancy. 



