ON THE FATE OF THE HUMAN EMBRYO IN TUBAL, PREGNANCY. 47 



course of time this clot might have been extruded into the peritoneal cavity, or it 

 might have undergone further organization, ending ultimately in absorption. It 

 is difficult to find fewer villi than have just been described in these specimens, 

 except when they are held together with a large clot. It is simply a matter of 

 chance that only a single villus is found attached to the tube, but quite frequently 

 only a few villi appear in the larger clots. Good specimens of this sort are No. 298 

 and No. 659, in which 3 or 4 villi were found. They were small, irregular bodies, 

 giving no evidence that they had been detached from the chorion that is, they 

 were rounded off on all sides. The same is the case in specimen No. 519. At this 

 point a specimen which is especially interesting is No. 794, in which the tube was 

 well distended and the clot was not adherent to the tube wall at any place. After 

 repeated examinations no villi could be found with certainty. At a few points 

 small groups of necrotic cells were seen, which may represent the last remnants of 

 degenerated villi; yet it remains a matter of opinion whether or not this tube con- 

 tains any villi, though it can be considered as a specimen from which the villi have 

 nearly or entirely disappeared (plate 5, fig. 3, and plate 6, fig. 7). 



In all the specimens just described, excepting No. 378, the ova are not attached 

 to the tube wall. In all cases they seem to have gained nutrition directly from the 

 epithelial surface of the tube, or from hemorrhages, or from blood which comes 

 from the folds to which the ova begin to attach themselves. They were speedily 

 separated and moved around free within the tube lumen. Ultimately they were 

 engulfed in a fibrous clot or were aborted into the abdominal cavity. No. 378 

 represents the transition stage; here the ovum had become well attached to the 

 tube and was then promptly torn loose. In order to make this point clear a third 

 set of specimens will be described. 



Specimen No. 540 shows the ccelom well filled with magma and its chorionic 

 wall partly fibrous and partly necrotic. Some slender villi arise from this wall and 

 reach through the blood clot to the folds of the tube, which shows a very pro- 

 nounced follicular salpingitis. At one point several villi are entering one of these 

 follicles and coming in contact with fresh blood. On these villi the trophoblast is 

 active, so this specimen may be looked upon as being still attached to a fold of the 

 tube, but in which, on account of the extensive hemorrhage, the ovum has collapsed 

 and been strangled (plate 6, fig. 6). 



Specimen No. 673 shows the process less advanced than in No. 540. Here the 

 chorionic wall is sharply defined, the ccelom contains maternal blood, and the villi 

 are very irregular, but some of them reach to the tube wall, where they are fairly 

 well attached and show an active trophoblast. At one point the trophoblast is 

 puncturing a blood vessel. On one side of the hemorrhage there is a crescent- 

 shaped space which represents the tube lumen. In this case the implantation has 

 been interstitial and abortion has taken place into the tube lumen. At any rate, 

 the ovum has been partly attached to the tube wall and is at the beginning of 

 strangulation. 



Specimen No. 772 is the last specimen of this group. The clot lies free within 

 the tube lumen; the chorion is collapsed and fibrous, and some of the villi are still 



