STUNTED CYEMATA. 



157 



(5) The tissues of the embryo are well dissociated. 

 The heart is represented by a large mass of cells, its walls 

 being practically destroyed. The liver and intestines still 

 are sharply denned. The brain is almost completely dis- 

 sociated and forms an irregular mass which fills the entire 

 pointed front of the head. The form of the brain is ab- 

 normal, and the midbrain protrudes as a solid mass be- 

 hind. Between it and the medulla there is a curious car- 

 tilaginous body which encroaches upon the hindbrain. 

 The lower part of the spinal cord is greatly enlarged, and 

 the cells have encroached upon and destroyed the vertebrae. 



(6) Slight infiltration of the decidua; probably luetic. 



No. 681. 



(1) George H. Hocking, Govans, Maryland. 



(2) A 45X45X45 mm.; B 20 mm. 



(3) Patient is a Bavarian, 42 years old, who has had 

 10 children and 2 abortions. Last period January 20 

 to 25; abortion April 25. No evidence of uterine disease. 

 Interference suspected in this as well as in the previous 

 abortion (No. 621, group 5). 



(4) The specimen was found to consist of two parts, 

 one a portion of the decidua and blood clots, the other a 

 pathological ovum with a hemorrhagic wall. The ovum 

 measures about 45 mm. in diameter and contains a cavity 

 30 mm. in diameter, in which there is an atrophic embryo 

 20 mm. GL. The cord is short and transparent, and 

 attached to the embryo. 



(5) The chorionic wall is fibrous, and the umbilical cord, 

 within which is a large cavity, is undergoing mucoid 

 degeneration. The villi are fibrous and mucoid, without 

 any active trophoblast, and are well embedded in blood- 

 clot. The decidua also looks degenerate and even necro- 

 tic in places. The tissues of the embryo are dissociated 

 and macerated, most of the blood-vessels being well filled 

 with blood. The dissociation is best shown in the hands 

 and feet. The brain and spinal cord are characteristic 

 of this type of macerated embryo. 



(6) Decidua not infiltrated. 



No. 699. 



(1) Emit King, Fulda, Minnesota. 



(2) B 13 mm. 



(3) "Patient aged 24 years. Previous history nega- 

 tive; always very good health. Married 8 months. 

 Menses regular until 10 weeks ago, then ceased; 4 weeks 

 ago felt unwell, though not in bed. Traveled some dis- 

 tance 2 weeks before abortion, June 2. As the patient 

 was in agonizing pain a hypodermic of morphine and atro- 

 pine was given and the vagina packed with gauze. When 

 the pain ceased the packing was removed and the fetus 

 and membranes were found free in the gauze. The sac 

 had been ruptured, there being a small tear in it. The 

 chorion seemed poorly developed, being very dark in 

 color and thin." It was the physician's opinion that the 

 fetus had been dead 4 weeks. 



(4) The specimen consists of a piece of chorionic wall 

 about 30 mm., one side of which is coveied with degener- 

 ate villi in a layer of uniform thickness. Within is a patho- 

 logical embryo, CR 13 mm., attached to the chorion by 

 means of a short cord. The front of the head is atrophic. 

 The right arm and lower part of the body seem to be 

 normal, while the left arm and legs are stubby. 



(5) The chorionic wall is thick and non-vascular. The 

 villi are necrotic and encircled with an inflamed decidua. 

 There is considerable blood between them, and most of 

 the nuclei of the trophoblast have been converted into 

 nuclear dust. The embryo is dissociated and the head 

 end is filled entirely with the brain. The heart, which 

 protrudes on the chest, is represented by a small mass of 

 blood. The liver is swollen. The two poles of the body 

 are rounded off, and in the legs the dissociation is quite 

 complete. 



(6) Slight infiltration of the decidua; probably luetic. 



No. 705. 



(1) C. E. Caswell, Wichita, Kansas. 



(2) B 18 mm. 



(3) Patient aged 39 years; married at 19. Two preg- 

 nanciesnormal delivery about 20 years ago, and this 

 abortion, June 8. Last normal period March 12 to 16. 

 Scanty flow April 12 and 13; also a show on May 10. 

 Examination on May 12 showed the uterus very slightly 

 enlarged (woman is stout) and cervix blue. Uterus about 

 size and depth of a 10-weeks' pregnancy. At that time 

 pus in urine; no casts. 



(4) Head and probably legs of embryo are atrophic. 



(5) Most of the structures appear to be normal, but 

 the central nervous system has undergone quite extensive 

 dissociation. The medulla and forebrain encroach upon 

 the pharynx. The large blood-vessels and heart are filled 

 with blood. The tissues, especially those of the tips of 

 the extremities, are dissociated. 



(6) Decidua and chorion absent. 



No. 711. 



(1) G. W. Cox, Hartford, Connecticut. 



(2) A 35 X 25 X 25 mm.;'B 12 mm. 



(3) "Patient aged 31 years; married 8 years. Mother 

 of three children, two living. Last child born 3 years ago. 

 Periods were regular and about 28 days apart; last one 

 March 31. In April period was missed. On April 25 

 patient had slight vaginal hemorrhage lasting only a 

 moment. On May 9 severe hemorrhage; patient was 

 packed a few days. May 9 she came to the hospital, 

 bleeding slightly and with some pain. May 21 she passed 

 the specimen, after which she was curetted." 



(4) Part of the chorion was cut away. What remains 

 measures 35 X 25 mm. The amnion, which measures about 

 20 mm. in diameter, is much thickened, fibrous, and con- 

 tains an atrophic embryo with a round head and a very 

 short cord. 



(5) The wall of the specimen consists of a thick and 

 infiltrated chorionic membrane encircled by fibrous villi 

 which are covered with curious spherules of trophoblast 

 undergoing fibrinoid degeneration. Some of these have 

 the appearance of sections of cartilage. There are also 

 small nests of nuclear dust and considerable infiltration 

 with leucocytes. The embryo is markedly dissociated, 

 the tips of the extremities being mostly disintegrated. 

 Round cells invade the cartilages. The outline of the 

 viscera appears to be normal, but the brain is greatly dis- 

 sociated and occupies almost the entire head. The tissue 

 in front of the brain is infiltrated with round cells and not 

 sharply separated from the dissociated brain. 



(6) Intense infiltration of the decidua with abscess for- 

 mation, probably luetic. 



No. 715. 



(1) M. Warren, Roosevelt Hospital, New York. 



(2) A 55X25X25 mm.; B 10mm. 



(3) Patient aged 40 years; married 2J/ years. First 

 pregnancy. Last menstrual period March 28 to April 1, 

 abortion June 22 following. No infection of uterus, but 

 multiple fibroid tumors, varying in size from a lime to a 

 small orange. No history of previous pelvic trouble. 

 Patient belongs to a healthy, fertile family. 



(4) Specimen consists of a smooth vesicular mole 

 55X25X25 mm. The cavity, which extends throughout, 

 is lined by the amnion and contains a macerated and dis- 

 torted embryo about 10 mm. long. The cord is very 

 short and thick, and the arms and legs, as well as the 

 head, are atrophic. 



(5) The wall of the chorion is relatively thin and is 

 composed of a macerated, fibrous amnion and chorionic 

 membrane. It is covered with scattered necrotic villi 

 stuck together with blood and decidua. The embryo is 

 markedly dissociated. 



(6) Decidua ver> necrotic. 



