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



and fibrous. Some are long and slender. The strangulation here is also nearly 

 complete, and the ovum is pretty well inclosed within an organized clot. A stage 

 intermediate to those just described is found in No. 553. The ovum here is also 

 partly collapsed. It is hourglass-shaped, showing that it is in a process of division. 

 The chorion and its few irregular processes have undergone marked fibrous degen- 

 eration. In No. 686 the condition is similar, but the ovum is encircled by a larger 

 clot. 



We have represented here, on a larger scale, what was found to take place in 

 the case of the small ova found free within the tube lumen. There occurs a rapid 

 destruction of the main wall of the chorion, leaving the villi free; they then become 

 rounded and atrophic as a result of fibrous degeneration. These small remnants 

 then become surrounded by a well-organized fibrous clot. In larger specimens 

 (e. g., No. 418) the main wall itself not only disappears, but also undergoes fibrous 

 degeneration. Such an ovum then becomes encircled by an organized clot. In 

 order to bring out this point more clearly, we have illustrated three stages by means 

 of diagrams, which have been made from the entire section of the tube containing 

 the degenerated ovum. Plate 8, figure 4, is taken from a case in which there 

 was a pus tube on one side of the uterus and a pregnancy in the other tube. The 

 tube had gradually become distended and contained within it a collapsed and 

 fibrous ovum, as indicated in the figure. From this body a few slender villi reach 

 to the wall of the tube. On one side there is a small lumen of the tube, showing 

 undoubtedly that these sections were taken from the beginning of an interstitial 

 implantation. Radiating through the clot from side to side are large fibrous 

 strands, and immediately surrounding the ovum and elsewhere are large masses of 

 fresh blood. 



A different type of specimen is shown in plate 10, figure 1. Here there is a 

 large crescent-shaped tube lumen; otherwise the arrangement is somewhat similar 

 to that in plate 8, figure 4. The ccelom is entirely obliterated and from the col- 

 lapsed ovum are radiating numerous slender fibrous villi. In this specimen fresh 

 hemorrhages are neither so numerous nor so pronounced. A combination of these 

 two specimens is shown in plate 9, figure 1. The ccelom is very small and filled 

 with a dense reticular magma, and the villi are numerous and radiate in all direc- 

 tions throughout the specimen. The clot is only slightly attached to the tube wall, 

 and is almost entirely encircled by the tube lumen. The hemorrhages have prob- 

 ably occurred successively, as the fresher blood is of two different colors. It has 

 gradually leaked in, no doubt through the point of attachment of the fibrous ovum 

 to the folds of the tube wall. The following specimens are very similar. No. 765 

 has within it a fibrous chorion with a considerable amount of reticular and granular 

 magma within the coelom. The villi are mostly necrotic, partly fibrous, and radiate 

 through the large clot. About the same condition prevails in No. 815, but the main 

 wall of the chorion is not necrotic and some villi reach to the tube wall. Most of 

 the villi are necrotic, some are fibrous. In No. 809 there is a general destruction 

 of the ovum. The main wall is fibrous and contains within it a stellate cavity. The 

 villi are large and necrotic and there has been a very extensive invasion of leucocytes. 



