6 



ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



belong those not previously examined, which means that in these there was no 

 selection; the third is made up of unruptured specimens examined in the gynecologi- 

 cal laboratory of the Johns Hopkins Hospital before 1908. These data are given 

 in table 2. 



TABLE 2. 



Table No. 2 gives number and percentage of normal embryos, pathological 

 embryos, and pathological ova obtained (1) from specimens that had been pre- 

 viously examined; (2) from those which had not been previously examined, i. e., 

 unselected; (3) from 46 unruptured specimens from Dr. Kelly's laboratory. 



It is of interest to consider together the pathological ova obtained from tubal 

 pregnancies, for it is through a study of these that light may be thrown upon the 

 question whether their condition is inherited or is due to faulty environment. In 

 the former case, the percentage of pathological embryos should be the same as 

 among those obtained from the uterus; in the latter, the percentage should be 

 increased. 



Various writers have stated that in tubal pregnancies embryos are rarely found, 

 but that remnants of the chorion are common. Nevertheless the proviso is made 

 that when the tube has been found ruptured and much blood has escaped into the 

 peritoneal cavity, the embryo may have been present, but may not have been 

 found on account of the great quantity of blood. On the other hand, Professor 

 Brodel informed me in 1907 that among 11 cases of tubal pregnancies recorded in 

 his catalogue of human embiyos 9 normal specimens were found. At that time 7 

 tubal pregnancies out of 19 in our collection contained normal embryos. It must 

 be remembered that at that time the rule of surgeons was to withhold the patho- 

 logical specimens and to send us only the normal embryos. Taking into considera- 

 tion, then, only the tubes that were sent to us unopened, and excluding those 

 obtained from Dr. Kelly's gynecological laboratory, I found in 7 specimens 2 ova 

 without embryos, 4 with pathological embryos, and only 1 with a normal embryo. 

 The other 6 normal embryos spoken of above were all recognized by the surgeons 

 as "normal and valuable specimens" before they came into our hands. 



Following the hint obtained by considering all the specimens coming to us 

 unopened, I collected all of the histories of similar specimens from Dr. Kelly's 

 laboratory. These covered a period of about 10 years and were taken from the 

 laboratory records of over 10,000 miscellaneous cases. I found 128 cases of tubal 

 pregnancy which were carefully described from numerous microscopic sections. I 



