Paper - A study of the causes underlying the origin of human monsters 8

Twin Pregnancies

Especially instructive and interesting are those cases in which two pathological ova were obtained from the same woman. Five such sets are found in my collection which I shall describe. The ﬁrst set, Nos. 308 and 325, are from a woman who had born two children during the previous two years, and are especially valuable in this discussion. The ﬁrst ovum (No. 308) appeared to me perfectly normal, and the embryo within it was not changed at all. However, the amnion was found ﬁlled with a jelly-like mass of granular magma, and this aroused my suspicion. Sections were therefore cut from the placenta at the attachment of the cord and a stringy mass rich in leucocytes was found between the villi. They were normal in form and possibly their mesoderm was ﬁbrous in structure. Nine months later a second ovum was obtained from this woman, which was decidedly pathological. Both the chorion and the embryo were much changed, as the ﬁgures and description of the specimen will show. This case, which should be observed further, is to be explained by disease of the uterus, which began after the birth of the second child. This change had not gone far at the time of the ﬁrst abortion, but was more advanced at the time of the second abortion. (Later the woman died of pneumonia. See history of No. 308.)

The second set, Nos. I10 and 141, came from a woman who had had nine children, after which she broke down in health, about ten years ago, when she conceived quite regularly, but aborted each time. The two specimens, which are about a year apart, are much alike, no doubt due to their subjection to the same environment. The chorions are markedly changed and the embryos are macerated and very much deformed.

The third set, No. 330a and b, are twin ova from .3 woman who had aborted once before. These two specimens show practically the same changes in the chorions and in the embryos, as may be seen by the ﬁgures and the description.

The fourth and ﬁfth specimens, Nos. 207 and 341, form two sets of duplicate twins. Unfortunately, no histories accompany either set of specimens. However, in each set the changes within the embryos are about the same degree, but, of course, these sets do not throw any light upon the question whether the primary change was in the germ or in its environment.

The history of the ﬁrst three sets, however, speak decidedly in favor of the hypothesis that the ova were normal to begin with, and the pathological changes within them are due to the diseased condition of the mucous membrane which surrounded them. The implantation was faulty and a variety of other complications was present to interfere with the nutrition and growth of the embryo, which consequently became deformed.

Very recently Dr. West sent me two ova (Nos. 384 and 419) from a woman with an undeveloped uterus of infantile type. She had been married three years, became pregnant twice and aborted on the ﬁfty-fourth and on the ﬁfty-ninth days. The chorions are covered with degenerated villi, which are imbedded in and encircled by much blood. Both are mark edly pathological and each contains a deformed embryo about 3 mm. long.