136 MALL. [VoL. XIX. 
cells, especially in the deformed extremities, where all of the 
structures are involved, forming syndactyly. 
Changes similar to the ones found in No. 124 are seen 
again in No. 316. Unfortunately, I failed to obtain the mem- 
branes or any history of this specimen, so its story must be 
told by its form and structure alone. The feet and one hand 
are club-shaped, and the other hand is spread out and is 
attached to the side of the head. The skin is thickened and 
much of the epidermis has fallen off. At points the epithelial 
cells form mounds without any tendency towards horny 
changes in them. The muscles, blood-vessels and nerves of 
the extremities are converted into one fibrous mass of spindle- 
shaped cells, giving much the appearance of myomatous tissue 
infiltrated with round cells. The cartilages are hyaline, and 
bone has formed in the center of the calcaneum. The hand 
has grown to the side of the head, the epithelial coverings 
having united. The true skin is composed of a mass of round 
cells. 
No. 230 shows about the same changes, with additional 
“records” in the chorion, including the menstrual age. 
Together they show that the pathological process must have 
been under way for at least three months. There are some 
leucocytes in the chorion and the cord is thin and twisted. 
The tissues of the embryo appear normal, but they do not 
stain well, and the changes in the hands and feet appear to 
have been caused by mechanical twisting after the death of 
the embryo. 
No. 286 is a similar specimen. The chorion is hyaline, 
infiltrated with leucocytes, and is attacked by syncytial cell 
masses. However, sections of different portions of the em- 
bryo show that its tissues are practically normal, which indi- 
cates that its death must have been sudden and not gradual. 
The oldest specimen of this group is No. 261, which must 
also have been dead for a considerable time. The villi of 
the placenta have undergone fibrous degeneration and are 
devoid of syncytium. The cord is twisted, is of normal size, 
and at its attachment to the placenta is somewhat fibrous. 
