194 STUDIES ON PATHOLOGIC OVA. 



so-called normal embryos, however, shows that in many of them the membranes 

 are decidedly pathological. For instance, the villi may be deformed, diseased, 

 atrophic or hypertrophic, or the contents of the amnion and the exocoelom may 

 be unusual. Nevertheless, in all of these cases we still classify the embryos as 

 normal, although fully cognizant of the fact that the surrounding membranes are 

 pathological; otherwise it would be difficult to account for the great number of 

 spontaneous abortions. The theory is that the embryo was developed under 

 pathological conditions, but that the chorion was not sufficiently affected to cause 

 any apparent change in the embryo. If an embryo included in this group is ap- 

 parently normal in all respects save one, we still consider it normal with a localized 

 anomaly. In fact, we are gradually forced into this position, as an embryo, at 

 first regarded as normal, may later prove to have a localized anomaly, such as 

 spina bifida or cyclopia. As far as we can determine, such an embryo would have 

 been able to survive longer had not something happened to its membranes, thus 

 causing its expulsion. I am inclined to believe that pregnancies of this sort, if 

 carried to term, would produce the ordinary monsters described by teratologists. 



The second group of specimens, which are termed pathological, are in a way 

 more interesting, and their study justifies our method of classifying localized 

 anomalies with normal embryos. We have in this group a variety of changes 

 ranging from those found in fetus compressus down to complete disintegration of 

 the ovum, leaving only a few villi. 



Having made numerous efforts to classify these specimens, I have finally 

 resolved them into seven groups, which have been considered in a previous chapter. 

 It can be readily seen that this classification into sub-groups is arranged some- 

 what in the order of the age of the ovum when it began to degenerate. Gener- 

 ally the changes are so pronounced that the embryo could not have lived through 

 the duration of pregnancy, and this accounts for the abortion. 



We naturally do not find localized anomalies in specimens from the first four 

 groups, while in the remaining three groups we encounter only such as are very 

 pronounced and stand out clearly in spite of other changes. Thus, for instance, 

 with fetus compressus we frequently recognize club-foot; in stunted forms, hare-lip 

 and spina bifida; and in cylindrical forms, spina bifida. If cyclopia is encountered 

 in any of these forms, it is looked upon as a localized anomaly in a pathological 

 embryo. On the other hand, a single anomaly in an embryo called normal can 

 easily be recognized, and it is from this group that we should expect the develop- 

 ment of monsters had the pregnancy progressed to term. 



A few illustrations of localized anomalies are given here in order to show that 

 they are identical with those found in infants at birth. Figures 83 and 84 represent, 

 respectively, a cyclopean and a double monster, the embryos being otherwise 

 normal. Figures 85 and 86 show hare-lip in an embryo and a fetus. Figures 87, 

 88, and 89 have pronounced localized anomalies and need no further explanation. 

 Finally, figures 90 to 93 show anomalies of the hands. The first and last are of the 

 hereditary variety, while figures 91 and 92 are acquired anomalies that is, they 

 were subsequently formed in an embryo whose development began normally. 



