ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



73 



degeneration of the mesenchyme. The trophoblast is 

 scanty, often neerotic, as in fact are often the whole villi. 

 A few of the villi which have extended into the tube wall 

 are actively destroying the surrounding tissue with their 

 growing trophoblast. No coeloin was found. 



No. 418. 



(Dr. Casler, Baltimore.) 



A few fibrous villi. Tube removed 5 weeks after begin- 

 ning of last period. The unopened tube was fixed in for- 

 malin and measured 50X25 mm., then cut into slabs, and 

 the part containing the villi was cut into serial sections, 

 every tenth section being mounted. Remnants of a de- 

 generating ovum were found, with very fibrous chorion 

 and villi infiltrated with lymphocytes. The strangulation 

 of the ovum seemed to be complete. 



No. 422. 



(Professor Brodel, Baltimore.) 



Embryo, CR 9, NL 9 mm. Normal. Ovum 30 mm. 

 in diameter. Tissue not well preserved. 



No. 426. 



(Dr. Hunner, Baltimore.) 



Embryo, CR 10, AR 8, NL 8. Normal. Patient's 

 age 36. II para 13, 8; no miscarriages. Operation, 

 October 8, 1905. Ruptured ectopic pregnancy. Last 

 period due Saturday, September 30. Went to Doctor 

 October 1, and asked him to bring on flow. Some flow on 

 October 2. On Wednesday, October 4, Doctor dilated 

 uterus and that night patient had signs of general peritoni- 

 tis. I operated October 8 and found fetus floating from its 

 sac in the abdomen. Free blood. 



No. 430. 



(Dr. Casler.) 



(Plate 2, fig. 6.) 



Unruptured. 60X35X35 mm., with a cavity 25X20 

 X15 mm., filled evenly with a dense reticular magma. 

 On one side is a small nodule which in sections appears to 

 be a particle of granular magma. Chorion fibrous, no 

 amnion, the vi'li are for the most part degenerated. Tro- 

 phoblast fanty. At certain points are large masses of 

 chromatin granules, which no doubt represent the nuclear 

 remains of the syncytium. 



No. 431. 



(Dr. Griffith, Baltimore.) 



Embryo, CR 19, AR 12 mm. The unopened tube 

 60X45X35 mm., with an amniotic cavity 30X25X25 

 mm., lined with a smooth membrane and encircled with 

 much magma reticule". The embryo was cut into serial 

 sections and found to be normal in every respect. 



No. 432. 



(Dr. Chambers, Baltimore.) 



Normal embryo, CR 18.5, AR 12.5 mm. 



No. 448. 



(Professor Brodel.) 



Normal embryo, CR 52 mm. Sections of the embryo, 

 which had been injected fresh, indicate that the embryo 

 ia entirely normal. 



No. 449. 



(Dr. T. Cullen, Baltimore.) 



Normal embryo, CR 36 mm. obtained alive. Dr. 

 Evans injected ("he blood-vessels at once. Cut into serial 

 sections. 



No. 456. 



(Dr. Hunner, Brodel Collection.) 



Embryo, CR 19, AR 14 mm. Ovum 45X28 mm. 



Patient aged 31. I para, 15 years old. No miscar- 

 riages. Expected period November 13. None; more or 

 less pain in the right side, feeling of pressure, nausea and 

 vomiting. Three days before coming to hospital severe 

 pain in right side. Took to bed; nausea and vomiting. 

 No mention of bleeding in history. Conditions at the 

 operation indicate that the blood clot is older than 3 days. 



No. 458. 



(Brodel Collection.) 



Normal embryo, CR 54, AR 39 mm. 



No. 472. 



(Dr. T. Cullen.) 



(Plate 2, fig. 2.) 



Hysterectomy for pelvic inflammatory disease. Villi 

 of the chorion found in one tube. Two blocks embedded 

 in celloidin and the entire uterus sent to the Anatomical 

 Laboratory. Three blocks were cut and in one scattered 

 villi, fibrous and well degenerated, were found in the tube 

 lumen near its fimbriated extremity. These lie within a 

 cleft in the thickened tube wall. A few large glands 

 in their neighborhood make one suspect that the section 

 is through the uterus or near to it. The muscular wall is 

 unusually extensive for the tube also. At no point do the 

 villi connect with one another nor with the main wall of 

 the chorion; they are independent. Trophoblast present 

 at parts and invades the muscular tissue. The epithelial 

 "glands" are scattered in the muscular tissue and may 

 represent an attempt at regeneration of the tube wall. 



No. 477. 



(Dr. A. Miller, Portersville, California.) 



Pathological embryo, 5 mm. Tumor mass. 



"Age 24. Last baby born April 5, 1908. When baby 

 was 6 weeks old the patient flowed freely. Then there was 

 slight staining during May and June. Nothing was seen 

 during July and August. Became unwell September 1, 

 flow scanty; again in October and flowed freely. Men- 

 struated again about November 16; again December 16. 

 Flowed again January 13, at which time she had severe 

 abdominal pains, cramplike. The patient became very 

 pale and the abdomen was distended and tender. There 

 has been a blood-stained vaginal discharge since January 

 30, 1910. Laparotomy. Removal of left tubal preg- 

 nancy." 



The embryo is in a small cavity, 10 mm. in diameter, 

 irregular in form, about 5 mm. long. Sections show that 

 it is markedly changed, being dissociated and possibly 

 macerated. The body wall is greatly thickened. Sections 

 of the tube show beautiful villi, active at some points and 

 degenerating elsewhere. Trophoblast scanty. The main 

 wall of the chorion has small tufts of epithelial cells upon 

 it; at one point it is thin and nearly perforated, being in- 

 vaded by leucocytes. 



