352 STUDIES ON PATHOLOGIC OVA. 



wonder if it really pays humanity?" However, the practitioner no doubt meets 

 with great and often insuperable difficulties in determining the exact status of 

 affairs, and in the present state of our knowledge he must temporize so as not 

 to be led into unjustifiable procedures. There is no doubt, however, that con- 

 servative symptomatic treatment, no matter how unavoidable because of our 

 inability to determine the condition of the conceptus, often is directly opposed to 

 the best interests of the patient. 



No case confirmatory of that reported by Jackson (1838) came to my attention 

 among those in the Carnegie Collection. It seems strange that one of a pair of 

 human twins can be aborted weeks or even months before term and the other 

 continue in uninterrupted development to the end of normal gestation. Moreover, 

 since the authenticity of Jackson's case rests solely upon the statement of "a very 

 intelligent lady" who was "too intelligent to be deceived and too honest to deceive," 

 one scarcely can feel convinced by it alone. However, Jackson stated that Nan- 

 crede had observed a similar case in which one fetus was aborted at 4^ months 

 and the other went to term, and Fuertes (1879) reported such an instance as one 

 of superfetation. In this case a woman of 27 years gave birth to a male child on 

 March 13 and to a female on July 27. The former, which lived only 15 days, 

 was regarded as having been born in the seventh month of pregnancy, and the 

 latter at full term. Bonnar (1865) also reported a series of cases of this sort in 

 connection with a review of the question of superfetation. It is true that the 

 alleged denouement in dystocia and also in cases of interrupted labor seems to suggest 

 that even vigorous contractions of the uterus are not inconsistent with retention 

 of attachment by the placenta, but expulsion of one with retention of the other 

 fetus for some months afterward would seem to fall into a somewhat different 

 category. 



In examining the histories one is impressed by the frequent cases of so-called 

 habitual abortion. These sometimes begin with the married life of a young woman 

 and continue more or less interruptedly throughout her child-bearing period. 

 This is illustrated by the cases in which a birth at term was followed by several 

 abortions, and by another birth at term and again by abortions. Regarding 

 some of these cases, it is clearly stated that the patients took steps to terminate the 

 unwelcome pregnancies, and in others the histories concerned mothers who had 

 given birth to 6 or more, even up to 13 children, and then suffered one or more 

 successive abortions, without a history of previous abortions. This is illustrated 

 by the following seven cases, for example, in which the women had borne 6, 8, 9, 

 10, 11, 12, and 13 children, respectively. The first woman had experienced 4 

 successive abortions, the following 5 one abortion each, and the last, 3 successive 

 abortions. In some of these cases it is fairly evident that weariness with such 

 heavy burdens of child-bearing probably was responsible for the termination of 

 pregnancy, while in others abortion may have resulted from exhaustion due to 

 a large series of quickly succeeding gestations, and in still others to pathologic 

 or other causes. Experience with higher domestic animals, too, would seem to 



