ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



The larger percentage of normal specimens in the first line of the table is also 

 easily explained. There was a tendency to send us "beautiful specimens," and these 

 often contained normal embryos, for example, No. 657. We must assume that, in 

 the routine of a laboratory, practically all normal specimens will be discovered by 

 the pathologist, and with this assumption we may conclude that the first set of 

 statistics (line 1, table 2) represents 455 cases, and the second set (line 2), 520 

 cases, provided the diagnoses were as accurate and as early as at the Johns Hopkins 

 Hospital. 



The small tubes which have been received are, in many respects, the most 

 interesting, and I regret very much that we have been deprived of the privilege of 

 examining more of them. In this material the very small ova were found, as well 

 as tubes without ova, showing also most interesting pathological changes. In such 

 specimens the younger normal embryos will ultimately be found. The question 

 that interests us most, namely, the cause of tubal pregnancy, will be answered 

 satisfactorily only from the study of very .early specimens. 



This paper is to be viewed as our fourth contribution to the pathology of the 

 human embryo. The first was published in the Welch Festschrift in 1900, the 

 second in the Vaughan Festschrift in 1903, and the third in the Journal of Mor- 

 phology in 1908. In the third study a group of tubal pregnancies was considered, 

 inasmuch as it gave us an opportunity of comparing pathological embryos found in 

 the tube with those obtained from the uterus. 



The first tubal specimen was obtained in 1897 from Dr. Harvey Gushing. It 

 contained a normal embryo, 10.5 mm. long, which was studied with great care and 

 has been found useful and referred to in some forty publications. Not long after 

 pathological tubal specimens began to be added to the collection, and a small group 

 of these was first considered in my paper on monsters mentioned above. Since 

 1908 I have made an especial effort to collect tubal pregnancies, and of late these 

 have accumulated so rapidly that I am enabled to include 117 in this report. 1 



ACKNOWLEDGMENTS. 



The 117 specimens of tubal pregnanc} r have been received from the following 

 sources: From the Johns Hopkins Hospital, 26; from the Hebrew Hospital, 5; from 

 the Church Home and Infirmary, 5; from the Franklin Square Hospital, 3; from the 

 Union Protestant Infirmary, St. Joseph's, St. Agnes', the University and Woman's 

 Hospitals, Baltimore, 1 each; from the Brooklyn Hospital, 2; from Bellevue Hos- 

 pital, 5; from the Bender Hygiene Laboratory, 3; from St. Peter's Hospital, 1; from 

 the Ontario County (New York) Laboratory, 1; from the Bridgeport (Conn.) 

 General Hospital, 1; from Christ Hospital, New Jersey, 1; from the Marine Eye 

 and Ear Hospital, Maine, 1; from Sibley Hospital, Washington, D. C., 1; from the 

 Frederick City (Maryland) Hospital, 1; from the New England Hospital, Massa- 

 chusetts, 1 ; from physicians and hospitals undesignated, 54. 



The physicians sending me the specimens have been credited in the protocols. 

 To them, as well as to the hospital authorities, I am deeply indebted for the oppor- 

 tunity which has made this study possible. 



lr rhe "Addendum" includes 29 new specimens, making 140 in all. 



