Talk:Embryology History - Arthur Hertig

Format image Extent 1 photograph Type still image Identifier DigID0002384 Provenance Part of the Harvard Medical Library collection

Subject Hertig, Arthur Tremain, 1904- Photographs Abstract Photograph of Arthur T. Hertig Creator Unknown Date Created 1967 Rights The Harvard Medical Library does not hold copyright on all materials in this collection. For use information, consult Public Services at chm@hms.harvard.edu Access Rights Access to the original work depicted requires advance notice. Contact Public Services at chm@hms.harvard.edu for additional information Is Part Of Arthur T. Hertig papers, 1918-1986 (inclusive), 1922-1976 (bulk). H MS c11. Box 55, folder 1.

New England’s First Recorded Hydatidiform Mole

NEMJ Mar 12 1959

A Historical Note

MARGARET V. RICHARDSON, B.A., M.T.,'l‘ AND ARTHUR T. HERTIG, M.D.1:

BOSTON

HYDATIDIFORM moles have been known for many centuries and have had their existence explained in various, sometimes unique, ways. Diocles of Carystos supposedly had a knowledge of moles in the third century B.C., and Erotianus, in the time of Nero (54--68 A.D.), made suggestions concerning the degenerative nature of the molar villi? In 1564 Christopher de Vigo described the expulsion of a 12-pound mole,‘ and in 1565 Schenk von Grafensberg has been credited with classic descriptions,” calling it mola aquea. F. Balleriola believed hydatids developed from ova that had not been impregnated (1573), and F. Mauriceau, in 1664, considered the main factor responsible for molar formation to be too

• “From the Department of Pathology, Harvard Medical School.

Aided by Grant C-2451 from the United States Public Health Service.

'l*Senior research assistant, Department of Pathology, Harvard Medical School.

ishattuck Professor of Pathological Anatomy and head, Department of Pathology, Harvard Medical School.

The New England Journal oi Medicine Downloaded from nejm.org at UNIVERSITY OF NEW SOUTH WALES on February 21, 2017. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved. Vol. 260 No. 11

frequent coitus} In 1690 A. Vellesnieri wrote to M. Malpighi suggesting that moles developed from placental tissue, an idea that Malpighi enlarged upon to include chorion degeneration.

As late as the nineteenth century the theory that moles were due to parasites rather than pregnancy had some acceptance (Percy, 1811, Cloquet, 1822, and Brachet and G. Gluge, 1843) . At other times it was believed that these were multiple pregnancies, as in the legendary case of the Countess Hagenau, who was said to have delivered 365 pregnancies simultaneously, the midwife baptizing each vesicle separately and alternately male and female? J. B. Bremser introduced the term hydatidiform because of the close resemblance to ecchinococcal cysts in 1819, and Madame Boivin, in 1827, was the first to recognize the chorionic origin of the growth referred to by Malpighi.

J. F. Heller first analyzed the contents of hydatid cysts, in 184-7, the same year as R. Gscheidlen analyzed hydatids chemically. In modern times the genesis of the condition has been studied by Myer and Mall in 1921 and Hertig and Edmonds3 in 1940 and Hertig and Mansell‘ in 1956.

The present case, that of Anne Hutchinson, was mentioned in the book The Winthrop Woman by Anya Setons" It is our belief that this was the first hydatidiform mole to be recorded in New England.

Mrs. Hutchinson was a controversial member of the original Colony of the Massachusetts Bay. She had incurred the wrath of the elders of the colony at Boston and had been expelled from the church and from the town. She moved, with her family, to the Isle of Aquiday in Narragansett Bay; it was here that she was delivered of the mole. Word was sent back to Boston of the “monstrous birth,” and at a “lecture day” Mr. Cotton, the minister of the church, preached to the entire populace of this proof of Mrs. Hutchinson’s heresy. It was Mr. Cotton’s belief that a mole was “several lumps of man’s seed, without any alteration, or mixture of any thing from the woman.”“ Governor Winthrop seemingly was not completely satisfied with this explanation and therefore wrote to Mr. Clarke, “a physician and preacher to those of the island,” for a complete account of the delivery, which is quoted as follows from Governor Winthrop’s journal of 1638“:

“Mrs. Hutchinson, six weeks before her delivery, perceived her body to be greatly distempered, and her spirits failing, and in that regard doubtful of life, she sent to me, etc. and not long after (in immoderato fluore uterino) it was brought to light, and I was called to see it, where I beheld, first unwashed, (and afterwards in warm water,) several lumps, every one of them greatly confused, and if you consider each of them according to the representation of the whole, they were altogether without form; but if they were considered in respect of the parts of each lump of flesh, then there was a representation” of innumerable distinct bodies in the form of a globe, not much unlike the swims of some fish, so confusedly knit together by so many several strings, (which I conceived were the beginnings of veins and nerves,) so that it was impossible either to number the small round pieces in every lump, much less to discern from whence every string did fetch its original, they were so snarled one within another. The small globes I likewise opened, and perceived the matter of them (setting aside the membrane in which it was involved,) to be partly wind and partly water. Of these several lumps there were about twenty-six, according to the relation of those, who more narrowly searched into the number of them. I took notice of six or seven of some bigness; the rest both in matter and form; and the whole was like the (blank) of the liver; being similar and every where like itself. When I had opened it, the matter seemed to be blood congealed.” The governour, not satisfied with this relation, spoke after with the said Mr. Clarke, who thus cleared all the doubts: The lumps were twenty—six or twenty-seven, distinct and not joined together; there were no secundine after them; six of them were as great as his fist, and one as great as two fists; the rest each less than the other, and the smallest about the bigness of the top of his thumb. The globes were round things, included in the lumps, about the bigness of a small Indian bean, and like the pearl in a man’s eye. The two lumps, which differed from the rest, were like liver or congealed blood, and had no small globes in them, as the rest had.

REFERENCES

I. Ricci, J. V. One Hundred Years of Gynaecology, 1800-1900: A

comprehensive review of the specialty during its greatest century

with summaries and case reports of all diseases pertaining to

women. 651 pp. Philadelphia: Blakiston, 1945. Pp. 491-493.

Bardawil, W. A., Hertig, A. T., and Velardo, J. T. Regression of trophoblast. I. Hydatidiiorm mole: case of unusual features, pos sibly metastasis and regression: review of literature. Obst. C-l Gynec. lll:6l4-625, 1957.

3. Hertig, A. T., and Edmonds, H. W. Genesis of hydatidiform mole. Arch. Path. 302260-291, 1940.

4. Hertig, A. T., and Mansell, H. Tumors of female sex organs. Part I. Hydatidiform mole and choriocarcinoma. In Atlas of Tumor Pathology. (Section IX -— Fascicle 33.) Washington, D. C.: Armed Forces Institute of Pathology, 1956. Pp. 1-63.

5. Seton, A. The Winthrop Woman. 586 pp. Boston: I-Ioughton, Mifflin Com any, 1958. P. 323.

6. Savage, The History of New England from 1630 to 1649: by John Winthrop, Esquire: first Governoar of the Colony of the Massachusetts Boy: From his original manuscripts: With notes to illustrate the civil and ecclesiastical concerns, the geography, settlement and institutions of the country, and the lives and manners ol the principal planters. 2 vols. Vol. 1. Boston: Phelps & Farnham, 1825. P. 271 et seq.