154 



(abdominal preg'iianey). In all siioh cases there is an increase and 

 enlargement of the capillar}^ blood-vessels at the i)oint to Avhich the 

 cmbrj^o has attached itself so as to furnish the needful nutriment for 

 the grov/ing offspring. 



All appreciable symptoms are absent, imless from tlie death of the 

 fcEtus, or its interference with normal functions, general disorder and 

 indications of parturition supervene. If these occur later than the 

 natui'al time for i^arturition the}' are the more significant. There may 

 be general malaise, loss of appetite, elevated temperature, accelerated 

 15ulse, "with or without distinct lal)or pains. Examination with the 

 oiled hand in the rectum will reveal the womb of the natural unim- 

 pregnated size and shape and with both horns of one size. Further 

 exploration may detect an elastic mass apart from the womb and in 

 the interior of wiiich may be felt the characteristic solid body of the 

 foetus. If the latter is still alive and can be stimulated to move 

 the evidence is even more perfect. The foetus may die and be carried 

 for j^ears, its soft structures becoming absorbed so as to leave only the 

 bones, or by pressure it maj^ form a fistulous ox^ening through the ab- 

 dominal walls, or less frequently through the vagina or rectum. In 

 the latter cases the best course is to favor the expulsion of the foal 

 and to wash out the resulting cavity with a solution of carbolic acid 1 

 part to water 50 ]3arts. This may be repeated dail}^ Where there is 

 no spontaneous opening it is injudicious to interfere, as tlie danger 

 from the retention of the foetus is less than that from septic fermenta- 

 tions in the enormous foetal sack when tliat has been opened to the air. 



MOLES — ANIDIAX MONSTERS. 



These are evidently i^roduets of conception, in Avhich the impreg- 

 nated ovum has failed to develop naturally, and presents only a cha- 

 otic mass of skin, hair, bones, muscles, etc. , attached to the inner 

 surface of the womb by an umbilical cord, which is itself often shriv- 

 eled and wasted. They are usually accompanied hyn, well-developed 

 foetus, so that the mole may be looked upon as a twin which has under- 

 gone arrest and vitiation of development. They are expelled by the 

 ordinar}' iirocess of parturition, and usually, at the same time, with 

 the normally developed offspring. 



CYSTIC DISEASE OF THE WALLS OF THE AVOMB — VESICULAR MOLE. 



This condition apiiears to be due to hypertrophy (enlargement) of 

 the villi on tlie inner surface of the womb, which become greatly 

 increased in number and hollowed out internally into a series of cysts 

 or x^ouches containing liquid. Unlike the true mole, therefore, they 

 appear to be disease of the maternal structure of the womb rather 

 than of the product of conception. Rodet, in a case of this kind, 

 which luid x)roduced active labor x^ains, quieted the disorder witli ano- 

 dynes and secured a recovery. Where this is not available attempts 



