44 ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



From this strand, which is a collapsed ovum, delicate fibrous strands reach to the 

 surface of the clot. One of these is shown in the figure. It can be seen that the 

 epithelial covering is separated from the body of the villus. The space between 

 the villus and its covering is filled with a coagulated fluid which takes on the eosin 

 stain. In different portions of the specimen this fluid contains numerous red blood 

 corpuscles, indicating that the surrounding villus is composed of red coagulated 

 plasma. As the epithelial covering lies free in this fluid and was undoubtedly fixed 

 when the specimen was preserved, we must view this relation as being normal for 

 this stage of degeneration. According to the history of this specimen this ovum was 

 46 days old, while a normal specimen of this size would not be more than half as 

 old. This shows the probable duration of degeneration in the specimen. The clot 

 itself is highly organized and permeated with stratified fibrils, which form a very 

 dense network on the outside of the specimen. There is no hemorrhage in it and 

 not much infiltration of leucocytes. We have here an example of a tubal pregnancy 

 with almost complete destruction of the ovum through fibrous degeneration. 



Specimen No. 754- Now that I have given a somewhat detailed account of the 

 magma and the various kinds of degeneration of villi, I can take up the description 

 of small pathological ova without repeating too often the description of the various 

 kinds of degeneration found in them. This specimen seems to have been dead some 

 time before the operation, as most of the trophoblast is necrotic and there is also a 

 great deal of nuclear dust. Outside of the chorion there has been quite an extensive 

 invasion of leucocytes. There are a few small masses of syncy tium, which still appear 

 to be alive, but some of them are vacuolated. The magma is mottled and at its 

 periphery some delicate fibrils are seen. Otherwise, each of the two types of granular 

 magma is quite homogeneous in structure. Occasionally they are mixed, that is, 

 the particles of darker magma invade the lighter, and vice versa. All this is shown 

 in plate 3, figure 2. The relation of the chorion to the tube wall is shown in the 

 outline of plate 9, figure 3. Most of the chorion and its villi are lodged between the 

 blood clot and the folds of the tube wall, but nowhere is the chorion attached to 

 the surrounding structure through the trophoblast. The conclusion is that the ovum 

 was attached high in the tube; it is now being aborted into the peritoneal cavity. 



Specimen No. 4$S. This specimen, which was discussed at some length when 

 speaking of the etiology of tubal pregnancy, is also of especial value at this time, as 

 it shows the structure of a small ovum in process of abortion. The ovum had 

 attached to it numerous small, slender villi, which are outlined in text-figure 9. 

 These were embedded in a fresh blood-clot, as is indicated in text-figure 8. On 

 account of the great interest of this specimen, we also give a drawing of the tube 

 with part of it cut open (text-figure 7). The tissues of the ovum are pale and 

 do not stain very well. The villi are partly necrotic, partly granular, and partly 

 fibrous. The trophoblast is scanty. The ccelom is filled with granular magma, 

 through which radiate some mesoderm cells and in which is lodged a crumpled 

 membrane, as shown in plate 5, figure 4. This mass has also scattered through it 

 a good deal of maternal blood. No doubt some of this blood was dragged in as a 

 result of the manipulations which were required to free the specimen from the tube 



