ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 45 



wall, but since so many cells are embedded within the mass of magma, it can not 

 be admitted that all of them were introduced by mechanical processes. It may be 

 that the crumpled membrane represents the amnion, but this could not be estab- 

 lished with certainty, although the specimen was cut into serial sections. We have 

 in this specimen a repetition of the condition found in No. 754. 



Specimen No. 367. In this, the third specimen in this group, the process of 

 degeneration is not so far advanced as in the other two. The ccelom is filled with 

 reticular magma, as shown in the figure. The villi are fairly well developed and 

 there is some trophoblast, most of which is necrotic. This specimen has entirely 

 separated itself from the tube wall and lies free within the lumen. It was removed 

 from the tube wall by Mr. Brodel, who made a sketch of the clot and the ovum. 

 He peeled the ovum out of the clot and found on one side a small tuft of villi. This 

 was cut into serial sections. Some of the villi are undergoing mucoid degeneration, 

 and one of these is shown in text-figure 5, and plate 4, figure 2. 



Another specimen which belongs to this group is No. 520. It was found on the 

 side of a tubal clot which measured 35 mm. in diameter. The ovum itself is 5 mm. 

 in diameter and is filled with a reticular mass. Most of the chorionic wall is ne- 

 crotic, but there are a few slender fibrous villi, one of which penetrates the clot to its 

 middle. There are loose villi within this clot. This specimen has become entirely 

 separated from the tube wall and is surrounded by a large highly organized clot, 

 indicating that the tubal pregnancy is of considerable duration. In many respects 

 the fibrin within the clot corresponds with that of the next specimen. 



Specimen No. 570. In this the most advanced stage of degeneration is shown. 

 It is possible that when degeneration began this specimen was somewhat older 

 than the ones just described. The ovum has been reduced to a single mass of 

 fibrous tissue without a ccelom, and from this central mass several long, slender 

 villi arise, which reach to the periphery of the highly organized clot containing the 

 ovum. The tip of one of these villi is shown in plate 3, figure 1. The tropho- 

 blast is entirely degenerated, and the clot is composed of a dense network of fibrils 

 which stain intensely with haBmatoxylin. Here we have a detached ovum which 

 has undergone complete fibrous degeneration within a highly organized clot. 



There are a number of other small specimens which belong to this group, and 

 which, therefore, can be treated collectively. In No. 154 considerable activity is 

 apparent. The villi are somewhat fibrous, and have upon them a considerable 

 amount of trophoblast, which at points is quite active, especially where it comes in 

 contact with the blood. No. 367 was found free in the abdominal cavity. The 

 ovum is 10 mm. in diameter and is well developed. The villi appear normal. The 

 coelom was filled with a dense reticular magma, but no embryo could be found. 

 Specimen No. 378 has an appearance somewhat similar to that of No. 754. It is 

 dumbbell-shaped, and is 12 mm. in length. This specimen had parthy eroded the 

 tube wall, and one end of the dumbbell was projecting into the peritoneal cavity, 

 while the other extended back to the middle of the clot. The ccelom contained a 

 considerable amount of granular magma. The syncytium was necrotic, showing 

 that the ovum was partly strangulated. The other portion of the syncytium 



