FETUS COMPRESSUS. 



163 



Apparently the embryo tiled suddenly, for there are prac- 

 tically no tissue reactions to suggest the contrary, and 

 the changes must have taken place after death. 



(6) Decidua very necrotic; changes in chorion sugges- 

 tive of lues. 



No. 261. 



(1) W. H. Lewis, Baltimore, Maryland. 



(2) A 120X70X70 mm.; B 90mm. 



(4) The distorted fetus, which no doubt had been dead 

 for a long time, is embedded in a mass of granular magma. 



(5) Sections of the placenta show that the villi and cho- 

 rion are very fibrous and almost devoid of epithelium. 

 The stroma of the villi is clear and non-vascular. Numer- 

 ous degenerate syncytial buds are present. The vessels 

 in the decidual septa, and some of those in the chorion, 

 are obliterated or are being obliterated. The umbilical 

 cord is somewhat fibrous, but contains blood-vessels filled 

 with blood. The decidua contains large sinuses and is 

 infiltrated and fibrous. The tissues of the hand and the 

 skin are somewhat infiltrated with round cells, but other 

 changes within them are not marked. It appears as if 

 the embryo died quite suddenly. 



(6) Decidua is infiltrated. 



No. 286. 



(1) John Girdwood, Baltimore, Maryland. 



(2) A 100X50X40 mm.; B 60 mm. 



(3) This specimen must have been dead in the uterus 

 for about 5 months, the last period having taken place 

 during the latter part of May and the abortion on Janu- 

 ary 4 following. 



(4) The chorion thickens as it passes into the large, 

 fleshy placenta on one side and is very thin on the other. 

 The thin, twisted cord enters the chorion at the border of 

 the placenta. The embryo is well-embedded in granular 

 magma. 



(5) Sections from the placenta at the point where the 

 cord enters it show a most remarkable reaction. The 

 amnion is thickened, fibrous, folded upon itself, and has 

 undergone hyaline degeneration. The chorion also is 

 hyaline, thickened, and infiltrated with leucocytes and 

 syncytium. The villi are fibrous, with numerous spots 

 of hyaline matter scattered through them. The lining 

 cells of the large blood-vessels of the villi show remarkable 

 growth, forming small pearls of endothelial cells. They 

 are also invaded by syncytial cells at some points, and at 

 others by masses of leucocytes. Between the villi there 

 is a great mass of necrotic syncytium mixed more or less 

 with fresh blood. Throughout this general mass numerous 

 small islands of active trophoblast may be seen; there are 

 also a great number of scattered leucocytes. The decidua 

 js decidedly fibrous and degenerate in some places, and 

 infiltrated in others. Sections of the cord, of the abdomi- 

 nal viscera, and of the hand show that the embryo must 

 have died quite suddenly. However, the tissues do not 

 stain well and the epidermis has fallen off, although the 

 large blood-vessels are filled with blood containing the 

 usual number of leucocytes. 



(6) Decidua infiltrated, fibrous, and degenerate. 



No. 316. 



(1) Thomas J. Simms, Baltimore, Maryland. 



(2) B 44 mm. 



(4) There are peculiar patches upon the skin, the cord 

 is atrophic, feet and hands club-shaped, and one hand is 

 adherent to the side of the head. 



(5) Sections of the cord show that it is fibrous and infil- 

 trated with round cells along the course of the blood-ves- 

 sels. The skin is thickened locally and much of the epi- 

 dermis has fallen off. At points the epithelial cells form 

 mounds without any horny changes. The muscles, blood- 

 vessels, and nerves of the extremities are converted into 

 a mass composed of spindle-shaped cells, giving much the 

 appearance of myomatous tissue, infiltrated at points 

 with round cells/ The cartilages are still hyaline, but 



richer in nuclei than is normal. Bone formation is present, 

 and at the border-line between it and the cartilage the 

 latter shows peculiar changes. There is a mass of this 

 changed cartilage in the os calcis, without any surround- 

 ing bone formation. In general the cartilages are de- 

 formed, a condition in part producing distorted joints. 

 Where the hand is adherent to the side of the head the 

 epidermis of the two is blended. The skin and subcu- 

 taneous tissue are thickened, being composed of a mass 

 of round cells. At some points of the body .here are 

 thickened areas in the skin. The form and structure of 

 the brain are pretty well preserved, while the tissues of 

 the liver and intestine are necrotic and macerated It 

 appears as if the growth of the embryo had been retarded 

 by a continued growth and change in the connective tissue 

 and that, after its death, it was retained in the uterus for 

 some time. 



(6) Deeidua and chorion absent. 



No. 345. 



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



(2) A 60X50X50 mm.; B 19 mm. 



(4) The fleshy ovum is composed largely of decidua in 

 which are buried plugs of mucus and necrotic villi of the 

 chorion. The embryo is normal in shape. 



(5) Its tissues are greatly macerated, but on account 

 of the distended medulla, which encroaches upon the 

 mouth, it is probable that the tissues were dissociated 

 before they became macerated. 



(6) Slight general infiltration of the decidua; chorionic 

 membrane absent. 



No. 379. 



(1) A. W. Meyer, Baltimore, Maryland. 



(2) A 35X25X15 mm. 



(3) Last menstrual period early in August: abortion 

 October 20. 



(4) The specimen is well covered with villi and filled 

 with a considerable amount of reticular magma. The 

 amnion measures 10 mm. in diameter and contains a 

 granular mass, which, when floated from alcohol into water, 

 revealed an embryo of the fourth week. No internal struc- 

 tures could be seen, and in handling the embryo it fell 

 to pieces. No doubt it had been dead for some time. 

 The wall of the amnion is composed of two layers of cells 

 and appears to be normal. 



(5) Sections show that the mesoderm of the umbilical 

 cord, the wall of the ehorion, and the villi are fibrous, 

 with a curious growth of blood-vessels in some places. 

 The stroma of most of the villi is clear, non-vascular, and 

 has undergone mucoid degeneration in some. Maceration 

 changes also are present. Within the vessels of the villi 

 are numerous fragmented cells which may have come from 

 the blood of the embryo. The syncytium is very exten- 

 sive and necrotic at points. In many places it dips deep 

 into the mesoderm of the villi and forms islands of epi- 

 thelial nests. The wall of the amnion is composed of two 

 layers of cells and appears to be normal. 



(6) Decidua absent. Very early hydatiform degener- 

 ation. 



No. 445o. 



(1) J. L. Fewsmith, Newark, New Jersey. 



(2) B 60 mm. 



(3) "Patient first menstruated at about 14, and as far 

 as she can recall was pretty regular at first. At 19 the 

 periods became rather irregular. She could count upon 

 skipping two months in summer, usually July and August. 

 This irregularity has continued up to the present time, 

 though not so marked during the last two years since she 

 has been under treatment. Each period, as a rule, is 

 accompanied by severe pain lasting for the first 12 to 14 

 hours. This has been so severe at times as to need small 

 doses of morphine or cocaine. The flow, when established, 

 has usually lasted for about 5 days. During the last 2 

 years it has been less in amount and has ceased on the 



