14 



ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



Nos. 567, 784, 804, 846, 881, and 882 all show pathological changes in the tube 

 wall. In No. 804 there are outpocketings, in No. 846 the folds in the fimbriated end 

 are adherent, in No. 881 there are outpocketings with adherent folds, and in No. 882 

 there are outpocketings in the uterine end of the tube and follicular salpingitis on 

 the fimbriated end, with a history of gonorrhea. 



TUBAL PREGNANCY WITH PATHOLOGICAL OVA. 



In the third group of tubal pregnancies containing pathological ova there are 

 more specimens and also more data than in the first two groups. In this group 

 there are 47 specimens, in 40 of which we have data. It is definitely stated that in 

 6 cases the tube wall was normal, while in 21 it was pathological. 1 In other cases 

 the data are of a nature to indicate that some inflammatory process may have taken 

 place. The histological studies, however, are not complete enough to bear upon 

 this point. Table 3 gives the main facts of these cases. It is at once seen that the 

 changes in the tubal wall are of two varieties: (1) those in which the folds grow into 

 the lumen, and (2) those in which the ends of the epithelial lining grow away from 

 the lumen into the muscular coat. In both cases pockets are formed. The two 

 varieties are well illustrated in No. 418 and No. 472. In No. 418 the ovum and the 



TABLE 3. 47 cases of tubal pregnancy with pathological ova (40 with data). 



organized clot are encircled with a zone of large folds, which are matted together, 

 expressing a very pronounced follicular salpingitis. In the free tube lumen beyond 

 the pregnancy the hypertrophied folds anastomose freely, forming a reticulum 

 across the lumen. In No. 472, which is from a case of hysterectomy for pelvic 

 disease, a few fibrous villi are found in one of the tubes. These lie in a cleft within 

 a thick tube wall. From this cleft there are a few large gland-like outgrowths into 

 the muscular wall, forming marked pockets into which an ovum could easily implant 



'The tube wall has been re-examined and found to be pathological in Nos. 507, 513, 561. 567, 602, 659, 694, and 765a. 



