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REPRINTED KROIVT 
UNIVERSITY 
Medical Magazine. 
EDITED UNDER THE AUSPICES OT THE 'ALUMNI AND FACULTY OF MEDICINE 
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Si^£'~:r—• ':■■ 5 
MAY, 1896 
CYSTIC DISEASE OF THE CHORION : WITH A 
TABULATION OF ONE HUNDRED CASES. 
BY W. A. NEWMAN DORLAND, M.D., 
Assistant Demonstrator of Obstetrics, University of Pennsylvania ; Instructor in Gynecology, 
Philadelphia Polyclinic, 
AND 
T. PERCEVAL GERSON, M.D., 
Of Johns Hopkins University, Baltimore, Md. CYSTIC DISEASE OF THE CHORION: WITH A TABU- 
LATION OF ONE HUNDRED CASES.1 
By W. A. Newman Dori*4nd, M.D., 
Assistant Demonstrator of Obstetrics, University of Pennsylvania; Instructor in Gynecology, 
Philadelphia Polyclinic. 
AND 
T. Perceval Gerson, M.D., 
Of Johns Hopkins University, Baltimore, Md. 
On the morning of July 20, 1895? there appeared at the Gyneco- 
logic Dispensary of the Pennsylvania Hospital D. C., a tall, well-devel- 
oped Russian Jewess, who intellectually was much superior to others 
of her class, and who gave the following history : She was 25 years of 
age, and was at that time three and a half months advanced in her 
fifth pregnancy. She had given birth to three children at term and 
one miscarriage; her youngest child was years of age. Her 
labors had been of ordinary severity. She stated that she was averse 
to having more children, and that for the past two years she had been 
adopting measures to prevent conception, including the practice of 
onanism, and the use of vaginal injections. She was exceedingly 
weak and emaciated, and markedly anemic at the time of her visit, 
but had formerly enjoyed excellent health. Her menstrual periods 
had been regular. Notwithstanding her efforts at enforced sterility 
she had conceived, and gestation had to all appearances advanced in 
a perfectly normal manner until the ninth week. At this time she 
began to have a slight bleeding, which persisted as an almost daily 
show until the date of her visit to the hospital, five weeks later. The 
constant flowing was unattended with pain at first, but later she had 
1 Read before the Barton Cooke Hirst Obstetrical Society, of the University of Pennsylvania. 2 
IV. A. Newman Borland and T. Perceval Gerson. 
suffered with slight colicky pains in the lower abdomen, of sufficient 
intensity, however, to excite considerable apprehension,—hence her 
application for relief. 
An examination made at this time elicited all the signs of 
early gestation, including a very soft cervix and a moderate degree of 
uterine enlargement, about corresponding to, or perhaps, a little over 
that of the supposed period of pregnancy. The cervix was somewhat 
patulous and there was a moderate flow of red blood. The diagnosis 
of a threatened abortion was made, and the patient was given one 
dram doses of the fluid extract of viburnum prunifolium three times 
daily, and ordered to confine herself to bed until the flow had ceased. 
Three days later, the bleeding having persisted, but without any 
appreciable increase in the amount, she was given a suppository of 
the aqueous extract of opium night and morning. In two days’ time 
she reported that there had been no amelioration of her symptoms. 
The treatment was continued, and after an absence of nine days she 
returned on the morning of August 3, reporting that there was at 
that time but a slight flow, and that she was feeling considerably im- 
proved. It was noted, however, that there was a progressive emacia- 
tion with marked sallowness of the skin. 
Eleven days passed when she again appeared in a decidedly 
worse condition, with a return of the bleeding, and the addition of 
severe abdominal pain. She stated that she had been discharging small 
clots for the past two or three days. She was also suffering exceed- 
ingly from hemorrhoids. An examination made at this time revealed 
a still more patulous condition of the external os, and the finger, 
gently introduced, detected dilatation of the internal os, and the 
presence of a spongy material feeling very much like placental tis- 
sue. It was also noted that the fundus of the uterus was much 
enlarged, reaching well up to the umbilicus. The amount of abdomi- 
nal resistance did not permit a close study of the degree of consistence 
of the uterine tumor. A diagnosis of placenta previa was made, and 
the patient was given my address and commanded to send for me at 
once should there appear any considerable increase in the amount of 
hemorrhage. This was the morning of August 14. 
Four days later, at 5.30 a.m,—the patient now being four and a 
half months pregnant,—I was hastily summoned by note which stated 
that the woman was bleeding to death. When I reached her the 
hemorrhage had ceased, but the bed, bedclothing, and floor were 
drenched with blood, and her mother showed me a chamber-pot half 
filled with clotted blood, but containing no membranes or other por- 
tion of an ovum. A glance was sufficient to show that the patient 
was almost exsanguinated. A careful examination revealed the os Cystic Disease of the Chorion. 
3 
dilated to the size of a quarter of a dollar, but filled with a protruding 
mass of spongy material which I judged to be placental tissue. The 
patient informed me that on the previous morning she had suffered 
from a smart hemorrhage, and had passed a fragment of meat-like 
substance that had contained one or two bladder-like structures. 
Fearing a renewal of the hemorrhage if I should displace this 
plug, I sent for Dr. Alfred C. Wood, who etherized the patient. When 
completely anesthetized I dilated the os and removed with the fingers 
a large mass—over two quarts—of a substance very closely resembling 
boiled tapioca, and which I at once recognized as cystic degeneration 
of the chorion. But very little bleeding attended the evacuation of 
the mass, and the uterus contracted firmly as the cavity was emptied. 
After giving a hypodermatic injection of ergotin and an intrauterine 
douche of mercuric-chloride solution (1:3000), a strip of iodoform 
gauze was introduced and the patient placed in bed. An examination 
of the removed uterine contents revealed no trace of a fetus, and but 
a small portion of placental tissue—about two by two inches in size— 
was found. The cysts, which varied in size from a very minute vesicle 
to one as large as a small-sized grape, were white or pinkish-white in 
color, and translucent. They were not pedunculated, but seemed to 
be loosely grouped together without any special relationship to one 
another. 
The progress of the case was very satisfactory. The evening 
temperature on the day of delivery was ioi° F., and the next morning 
ioo° F., with a pulse of 102. The following morning the lochia be- 
came exceedingly offensive, although there was no elevation of tem- 
perature over ioo° F,, and the pulse remained but moderately accel- 
erated. Under the use of mercuric-chloride douches of 1:2000 
strength, the fetor was destroyed and the patient steadily regained 
her strength and color. She remained in bed for two weeks, at the 
expiration of which time she was practically well, the uterus being 
well advanced in involution and sunk beneath the pelvic brim. Two 
weeks later she again visited the hospital to report progress, and even 
at that early period had regained considerable flesh and color. 
Shortly before this time, Kehrer,1 of Heidelberg, had published a 
paper containing the reports of fifty hitherto unpublished cases of 
cystic disease of the chorion, which he had gathered in two years’ 
time, from forty-eight midwives and physicians in the lowlands of 
Baden. It was the opinion of all with whom he had corresponded 
that the disease was one of considerable rarity. His object in gather- 
ing unreported cases was to arrive, if possible, at a more accurate 
knowledge of the peculiarities of the disease, for he believed that the 
1 Archiv fiir Gynakologie, 1894, Band xlv, Heft 3. 4 
W. A. Newman Norland and T. Perceval Gerson. 
cases that found their way into the medical journals were more prob- 
ably those that had terminated favorably, and would not, therefore, 
present a true picture of the gravity of the disease. 
Admitting that there was much truth in Kehrer’s arguments, it 
being deplorably true that medical men are not apt to report their 
failures, I was stimulated, however, by this interesting case in my 
own practice, and by my perusal of Kehrer’s paper, to put the matter 
to the test. At the expense of much time and trouble, therefore, and 
with the kind assistance of Dr. T. Perceval Gerson, of Johns Hop- 
kins Hospital, and Dr. George C. Kiisel, of this city, I have collected 
from current medical literature 100 reported cases of the disease, 
which I have tabulated, and from which I have formulated conclu- 
sions. These I have compared with the studies of Kehrer with the 
following results : 
In the first place, as regards the age af the time of the molar 
birth. In 15 per cent, of the cases the age of the woman is not stated, 
but from the histories of the cases in eight instances in which the 
patients were described as “young” married women, it is fair to pre- 
sume that they were under 30 years of age. In 8 per cent, the 
patient was under 20 years, the youngest being a single girl of 13. 
The larger percentages occurred between 20 and 40 years of age; 
thus, between 20 and 30 years one-third of the cases (33 per cent.) are 
noted, or, if we include here the eight women whose ages are not 
given, but who were presumably under 30, we have a percentage of 
41 occurring in the third decade of life. Twenty-seven per cent, of 
the women were between 30 and 40 years of age, and n per cent, 
between 40 and 50 years, while but 5 per cent, were over 50; the two 
oldest women having each attained the age of 53. It will thus be 
noted that 68 per cent, of the cases occurred between 20 and 40 years 
of age, while only 8 per cent, were under, and 16 per cent, over, this 
period, leaving 7 per cent, undetermined. Two per cent, of the cases 
occurred in colored women, one 29 years of age, and the other a 
mulatto of 42, and 5 per cent, occurred in single women, four of these 
being under 20 years (13, 16, 17, and 17), and one 24 years of age. 
These figures very closely approximate those of Kehrer, who found 
in his fifty cases that 4 per cent, happened before the twentieth year, 
38 per cent, between 20 and 30 years, 36 per cent, between 30 and 40 
years, 18 per cent, between 40 and 50, and 4 per cent, over 50 years 
of age. It will be noted that 74 per cent, of Kehrer’s cases occurred 
between the twentieth and fortieth year as compared with 68 per cent, 
of my own table. Sixteen per cent, of my cases occurred in advanced 
years,—that is, after 40 years of age,—while 22 per cent, of Kehrer’s 
cases occurred during the same period. This goes to prove the rela- Cystic Disease of the Chorion. 
5 
tive frequency of the molar births late in life as compared to normal 
childbirth. 
Number of Previous Pregnancies.—ln 9 per cent, of my cases it 
is not stated whether the patient had previously given birth to chil- 
dren. In 24 per cent, the molar birth occurred in primiparas, as com- 
pared with 10 per cent, of Kehrer’s table. Of the remainder, 8 per cent, 
were multiparse, the number of previous children not being noted; 
14 per cent, had given birth to one child ; 7 per cent, to two children; 
6 per cent, to three children ; 5 per cent, to four children ; 2 per cent, 
to five children; 4 per cent, to six children; 4 per cent, to seven 
children; 2 per cent, to eight children; 3 per cent, to nine children ] 
3 per cent, to ten children; 1 per cent, to eleven children; 2 per 
cent, to twelve children ; 2 per cent, to thirteen children ; 2 per cent, 
to fourteen children; and 1 per cent, to fifteen children. Eighteen 
per cent, of the women, or per cent, of the multiparas, had 
aborted one or more times. 
Previous Health.—ln 36 per cent, of the cases no mention is 
made as to the previous condition of health. Forty per cent, of the 
women had always enjoyed excellent health and presented normal 
menstrual histories, while in 25 per cent, of the cases the record is 
that of poor health. Most of these delicate women suffered from 
anemia and irregular menstruation, with periods of suppression or a 
history of too profuse flow. One was of the scrofulous diathesis; one 
had suffered from an attack of typhus fever one year before ; one had 
had a gastric ulcer; one was insane, believing herself to have hydro- 
phobia ; one was melancholic and attempted suicide by cutting her 
throat; and one was suffering from a chronic cardiac disease. It 
would appear from these statistics that the previous condition of 
health exerted little, if any, influence upon the development of the 
chorionic disease. 
Symptoms during the Pregnancy.—Fifty per cent, of the women 
suffered from nausea and vomiting during the molar pregnancy, in 
many the symptoms being more or less constant and severe. Gen- 
erally it became more marked towards the close of the gestation. 
Eight per cent, of the women did not present this symptom, and in 
42 per cent, no statement is given. This cannot, therefore, be regarded 
as an especially characteristic clinical manifestation of cystic degen- 
eration of the chorion. One woman presented the symptom of pica 
in an aggravated form. 
Fully half of the women suffered from anemia and debility to a 
marked degree, and a number of these were prostrated to such an 
extent as to necessitate their confinement to bed for a portion of the 
pregnancy. It would seem very evident, therefore, that women with 6 
W. A. Newman Borland and T. Perceval Gerson. 
this abnormal condition in the uterine cavity are especially prone to 
suffer from an undue debility which is probably largely dependent 
upon the hemorrhages from which they suffer. 
Albuminuria and edema of the lower extremities or general 
anasarca were noted in 19 per cent, of the cases, a frequency sufficient 
to attract attention and to call for a closer study as to the coexistence 
of renal derangement and cystic disease of the ovum. It would be 
fair to state that renal insufficiency, or the kidney of pregnancy, is at 
least three times as frequent in this condition as in normal gestation. 
Abdominal pain was a marked symptom in 38 per cent, of the 
women, and when present was usually first noted towards the close 
of the gestation. It partook of the character of labor pains, and 
in some instances was exceptionally severe. Thirteen per cent, of 
the women had absolutely no pain before the onset of labor, while in 
almost half of the cases no mention of this symptom is made. It is 
probable that the origin of this pain is the extreme and rapid develop- 
ment of the uterine tumor which was noted in 85 per cent, of the 
cases. By the time of the third or fourth month in the vast majority 
of the cases the abdominal distention and uterine growth were equal 
to that of the sixth or seventh month of normal gestation, the fundus 
uteri reaching to or extending slightly above the umbilicus. On pal- 
pation the tumor was generally noted to be of a greater consistence 
than the cystic tumor of pregnancy, non-fluctuating, but of a peculiar 
doughy or mushy feel. Absence of the uterine souffle is the rule. A 
number of the women claimed to have felt fetal movements. 
Uterine hemorrhage is a constant symptom, in many instances 
occurring as an excessive flow at irregular intervals, or, as in my own 
case, persisting as a daily stillicidium until the final profuse hemor- 
rhage ushering in the expulsion of the mole. Generally the bleeding 
does not commence before the second or third month, and at times it 
partakes rather of the nature of a watery or sanguineous discharge 
than of a true hemorrhage. Once established, the flowing persists in 
increasing amounts at irregular intervals. Kehrer believes that the 
hemorrhage results from imperfect attachment of the diseased chori- 
onic villi to the decidual tissue. 
Time of Birth.—The month of pregnancy in which the expulsion 
of the mass occurs varies. In my own table in 6 per cent, of the 
cases the time is not given. In 6 per cent, it occurred during the 
second month; in 20 per cent, during the third month; in 31 per 
cent, during the fourth month; in 12 per cent, during the fifth 
month; in 15 per cent, during the sixth month; in 2 per cent, during 
the seventh month; in 4 per cent, during the eighth month; and in 
3 per cent, at term. Sixty-three per cent, of the cases, therefore, Cystic Disease of the Choi'ion. 
7 
occurred from the third to the fifth months inclusive, as compared 
to 74 per cent, in Kehrer’s table. But 3 per cent, of my cases arrived 
at term, while Kehrer showed a percentage of 4. The time required 
for the expulsion of the mass was usually short, not exceeding four to 
six hours in most of the cases. The labors, however, as far as suffering 
was concerned, closely resembled the normal. The pains were inter- 
mittent, colicky, and often severe, and attended with profuse bleeding 
in most of the cases. 
Size and Nature of the Mole.—Almost without exception the 
mass discharged was of considerable bulk, varying from a pint to over 
a gallon. The description of the size varies. In one instance it filled 
a dinner-plate; in others it is described as immense or enormous; 
repeatedly it was said to half fill or to fill completely an ordinary 
chamber-pot or hand basin. In one case it was said to weigh six or 
seven pounds ; again, four pounds, and again, between two and three 
pounds. In one case it was described as one and a half times as large 
as a fetal head at term. 
Generally the mole consisted of the usual clear or translucent 
vesicles of a whitish or pinkish-white color, and varying in size from a 
pin’s head to a walnut. These cysts contained the characteristic 
watery fluid. In 1 per cent, of the cases the disease had occurred at 
a preceding pregnancy. In 21 per cent, of the cases fragments of 
placental tissue and fetal membranes were discovered, and in 6 per 
cent, of the cases an embryo or fetus either preceded or followed the 
discharge of the mass. 
The mole was expelled spontaneously in 39 per cent, of the cases, 
and in the remainder of the patients was driven out either /by strong 
uterine contractions induced by the action of ergot, or was removed 
by the hand or curette. 
Sepsis.—There is a great tendency to the manifestation of septic 
intoxication after the delivery of an hydatidiform mole. In my table 
31 per cent, of the women, or nearly one-third of the cases, developed 
a certain degree of sepsis, as shown by an elevation of temperature, 
rigors, and fetid lochia. Five of the cases resulted fatally. 
Mortality.—The mortality as shown by my table is probably a 
little under the usual percentage, thus proving the truth of Kehrer’s 
statement that fatal cases, as a rule, are not reported. The table 
shows a mortality of 10 per cent., 3 per cent, perishing from hemor- 
rhage at the time of delivery; 2 per cent, succumbing shortly after 
.delivery to the effects of perforation of the uterine wall; and 5 per 
cent, dying at varying periods during the puerperium of septic infec- 
tion. 
A tabular arrangement of the cases is appended. 8 
W. A. Newman Borland a7id T. Perceval Gerson. 
Number. 
Reporter. 
Reference. 
Name. 
Social State. 
6 
00 
< 
Previous Pregnan- 
cies. 
Abortions. 
Previous Health. 
Gastric Symptoms. 
General Symptoms. 
Pain. 
Hemorrhage. 
AbdominalEnlarge- 
ment. 
I 
Ander- 
son, W. 
Lond Med. 
Reposit., 
1827, 
XXVIII, 
4°3 • 
Mrs. 
E. 
M. 
22 
2 
0 
Sparehabit 
a fright 
when 2 
mos.preg- 
nant. 
Felt quicken- 
ing 
Some 
bear- 
ing 
down. 
First at 7th 
mo.; slight 
in amount. 
Great. 
2 
Andrew, 
John. 
Glasgow 
Med. 
Journ., 
1832,v, 68- 
74- 
M.R. 
S. 
16 
0 
0 
Poor for 6 
mos-,spit- 
ting of 
blood; 
mental 
depres- 
sion. 
Weak; ane- 
mic ; at- 
tempted 
suicide at 
6th month 
by cutting 
throat. 
Irregu- 
lar 
bear- 
ing 
down. 
None. 
Rapid; size 
of eighth 
month of 
gestation. 
3 
Ibid. 
Ibid. 
Mrs 
F. 
M. 
22 
mos. 
1 
1, at 
three 
mos. 
Nau- 
sea. 
Slight spit- 
ting of 
blood. 
Slight. 
None. 
Greater 
than at 
the sixth 
month of 
pregnan- 
4 
Ibid. 
Ibid. 
Mrs. 
S. 
M. 
6 
mos. 
0 
0 
Poor. 
Nau- 
sea. 
Violent 
cough; 
slight spit- 
ting of 
blood. 
None. 
cy • 
Marked; 
firm to the 
touch. 
5 
Ibid. 
Ibid. 
S. H. 
S. 
17 
0 
0 
Good. 
Nau- 
sea ; 
occa- 
sional 
vom- 
iting. 
None. 
Size of 7th 
month of 
gestation; 
hymen in- 
tact. 
6 
Arm- 
strong, 
J. 
Liverpool 
and Man- 
chester M. 
& S. Re- 
porter, 
1874, 53- 
Mrs. 
X. 
M. 
1 
0 
Good con- 
stitution ; 
inclined 
to obesity; 
menstru- 
ation pro- 
fuse ; se- 
vere uter- 
ine hem- 
orrhage 
after birth 
of fifth 
and suc- 
ceeding 
children. 
Fluid dis- 
charges of a 
dirty white 
color, at 
times offen- 
sive. 
Rapid in- 
crease. 
7 
Ashley, 
W. H. 
London 
Lancet, 
1850,11,319 
-321. 
Mrs. 
F. 
M. 
18 
years. 
36 
15 
6 
Nausea 
and 
vom- 
iting, 
at 
times 
se- 
vere. 
Anemia; hys- 
teria ; ex- 
treme debil- 
ity; dyspep- 
sia; moder- 
ate emacia- 
tion ; vision 
impaired; 
bedridden 
forovertwo 
years. 
Severe. 
Considera- 
ble. 
8 
Atthill, 
L. 
Brit. Med. 
Journ., 
1878.1,334- 
Very deli- 
cate ; suf- 
fering 
with ulcer 
of stom- 
ach. 
First at 12th 
week; re- 
peated and 
profuse af- 
ter that 
date. 
Size of 7th 
month of 
gestation. 
9 
B., J. 
Prov. M. & 
S. J., Lon- 
don, 1842, 
Mrs. 
X. 
M. 
52 
Large 
family. 
Repeat- 
ed 
vom- 
Much weak- 
ened. 
%o 
Barnes, 
Robert. 
v, 328. 
Irans.Obst. 
Soc., Lon- 
don, 1865, 
vn, 117- 
120. 
A.W. 
M. 
42 
II 
3, 
last at 
third 
mo., 
one 
year 
pre- 
vious- 
ly. 
Ring. 
Consid- 
erable 
nau- 
sea 
and 
vom- 
iting. 
Edema of 
legs; ane- 
mic ; urine 
scanty, 
highly-col- 
ored ; felt 
quickening. 
Abdomen 
promi- 
nent; tu- 
mor more 
to right 
side, and 
reaching 
to umbili- 
cus ; firm, 
elastic, 
tender. 
History of the Pregnancy. Cystic Disease of the Chorion, 
9 
History of Molar Birth. 
c 
o 
Puerperium. 
"rt 
m 
€ 
o 
o3 
bo 
cd 
Description of Mole. 
Treatment. 
nd 
0) 
tt 
V 
bo 
Result. 
o 
,g 
c 
o 
§ 
.s 
c3 
a* 
u 
u 
O 
B 
V 
X 
.2 
CO 
rt 
Q 
u 
u 
o 
B 
a> 
X 
U 
> 
V 
ptH 
Term. 
Sixth. 
Slight- 
Slight. 
Consider- 
able. 
Weight of mass upward of five 
pounds; great quantity of fluid; 
vesicles size of hazel nuts; piece 
of placental tissue size of wal- 
nut. 
Discharged a sac the size of a new- 
born child’s head, containing 
clear fluid; one hour later a 
large mass of hydatids; two 
hours later another mass. 
Expelled spon- 
taneously. 
Expelled spon- 
taneously. 
Usual 
time. 
Thirteen 
days. 
No. 
No. 
Recovery. 
Recovery. 
Fourth. 
Fourth. 
Five and 
a half. 
Severe. 
Severe; 
labor- 
like. 
Severe; 
irregu- 
lar. 
Slight. 
Consider- 
able. 
Consider- 
able 
flood- 
ing. 
Discharged a large sac containing 
clear fluid, and soon after a large 
mass of vesicles, weighing about 
seven pounds; vesicles con- 
tained a glairy fluid; no fetus 
nor placenta. 
Discharged a fleshy mass resem- 
bling placen ta,with a number of 
small vesicles on its surface; no 
cord or fetus; shortly after ex- 
pelled a bag containing fluid ; a 
little later passed a hand basin- 
ful of vesicles, size of a pea to a 
large hen’s egg, containing a 
glairy fluid; the next day nearly 
as much more was discharged. 
Discharged a large bag containing 
a glairy fluid, and shortly after 
a mass of vesicles. 
Expelled spon- 
taneously. 
Partially spon- 
taneous ; 
manual ex- 
traction. 
Partially spon- 
taneous ; 
manual ex- 
traction. 
Two 
weeks. 
Twelve 
days. 
Usual 
time. 
Slight. 
No. 
Slight for 
two 
days. 
Recovery. 
Recovery. 
Recovery. 
Not 
given. 
Severe. 
Profuse. 
Mass of hydatids containing a 
watery fluid. 
Manual extrac- 
tion. 
Death at time 
of delivery, of 
hemorrhage. 
Not 
known. 
Severe; 
bearing- 
down. 
Consider- 
able. 
Discharge of solid masses looking 
like lard, with cysts, at intervals 
for a month ; about four ounces 
of solid matter and a large 
amount of fluid. 
Expelled spon- 
taneously. 
Four or 
five 
months. 
No. 
No. 
Gradual recov- 
ery. 
Fourth. 
Some. 
Size of mass not given. 
Ergot, tarn- 
Usual 
Rapid recov- 
penning, and 
hot-water in- 
jections. 
time. 
ery. 
Profuse. 
i 
Mass of hydatids of sufficient size 
to fill a wash hand-basin. 
Considerable mass of cysts, some 
as large as a walnut; discharged 
in several sections. 
Expelled under 
„ 
Slight. 
Yes. 
Recovery good. 
a half. 
Six and a 
half. 
Labor- 
like. 
Some. 
actionof large 
doses of er- 
got. 
Galvanism; 
tampon; 
finally spon- 
taneous ex- 
pulsion. 
Death evening 
of delivery, of 
sepsis(stupor, 
retching, vom- 
iting); uterus 
contained 
fibroid tumor 
size of large 
orange. 10 
W. A. Newman Norland and T. Perceval Gerson 
History of the Pregnancy—Continued. 
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Mrs. 
M. 
37 
2, 
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Some 
Some edema 
Severe. 
Slight at the 
Size of 6th 
Ezra. 
S. J., 1846, 
A. 
young- 
nau- 
of feet; con- 
sixth week. 
month by 
xxxiv, 95 
est six 
sea 
siderable 
the 12th 
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mos. 
and 
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debility; 
bedridden. 
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fluctua- 
12 
Bass, 
J. D. 
Tr. Texas 
Med. Ass., 
Mrs. 
D. 
M. 
4 
24 
0 
0 
Very deli- 
cate ; at 
end of 1st 
iting. 
Anemic, 
Slight. 
Slight from 
one and a 
tion. 
Size of 7th 
month at 
1885, XVII, 
mos. 
half mos. 
four mos. 
382-386. 
month of 
pregnan- 
cy felland 
struck ab- 
domen on 
13 
Bennett, 
Thomas 
J- 
Richmond 
andLouis- 
ville M. J., 
Mrs. 
E. 
M. 
25 
0 
0 
chairpost. 
Never en- 
joyed 
good 
N ausea 
and 
vom- 
Anemic; 
dropsical 
for three 
Consider- 
able. 
1872, XIII, 
health; 
iting. 
months. 
337- 
amenor- 
rhea. 
Good. 
14 
Bernar- 
Unreported. 
Mrs. 
M. 
30 
0 
0 
Slight from 
Great dis- 
|Y’P. 
G. S. 
5 
the fifth 
tention; 
years. 
month. 
tumor 
soft, but 
harden- 
ing under 
contrac- 
15 
Bethune, 
Canada 
Mrs. 
M. 
41 
last 
7, 
Delicate; 
N ausea 
Anemic; very 
Severe 
Slight after 
tions. 
Nor- 
Lancet, 
X. 
4 be- 
highly 
from 
weak; bed- 
for i 
one and a 
reached 
man. 
1876, VIII, 
three 
tween 
nervous 
date 
ridden. 
week 
half mos.; 
midway 
161. 
abor- 
tions. 
4th & 
6th 
mo. & 
3 at 2d 
mo. 
tempera- 
ment ; 
poor 
health for 
11 years. 
of first 
hem., 
day 
and 
night; 
before 
deliv- 
ery. 
severe for 1 
week before 
delivery of 
mole. 
between 
pubes and 
umbili- 
cus. 
l6 
Boislin- 
iire. 
St. Louis 
Courier of 
Med., 1879, 
1, 104-107. 
pica. 
Slight. 
For one week 
previous to 
expulsionof 
mass, wa- 
tery and 
sanguine- 
ous dis- 
charges, fol- 
lowed by 
alarming 
Great dis- 
tention. 
17 
Bookless, 
John. 
Boston M. 
and S. J., 
Mrs. 
A. 
M. 
49 
12 
(all liV") 
0 
Good. 
None. 
Slight. 
hemorrh’es. 
None. 
Consider- 
able. 
1852, XLV, 
ing), la- 
80. 
borsdif- 
ficult. 
7. 
18 
Borden, 
Med. News, 
Mrs. 
M. 
36 
0 
Always re- 
None. 
Comfortable. 
None. 
Appeared at 
Moderate. 
F. W. 
1884, XLV, 
703- 
P. 
l8 
years. 
young- 
est four 
years. 
markably 
healthy; 
menstru- 
ation reg- 
Sth week; 
excessive 
with piece 
of mem- 
19 
Browne, 
G. Hen- 
ry. 
Lancet, 1886, 
August 7, 
249. 
Mrs. 
X. 
M. 
32 
Multip- 
ara. 
0 
ular. 
brane. 
Flooding be- 
gan at sixth 
week, and 
continued 
Abdomenat 
3 Vz mos. 
size of 7 
mos. of 
20 
Bryan, 
Brit. Med. 
Mrs. 
M. 
38 
4. 
I 
Healthy. 
Con- 
Considerably 
at intervals. 
Slight at 2d 
gestation. 
At 4 months 
John 
Journ., 
X. 
young- 
stant 
emaciated. 
mo., and for 
uterus ex- 
M. 
1872, 11, 
464. 
est 17 
years. 
nau- 
sea 
and 
vom- 
iting 
after 
2^ 
mos. 
6 weeks af- 
ter there 
was an in- 
odorous 
sanguineo- 
aqueous 
discharge. 
tended 
quite 
across ab- 
domen, 
and 
reached 
the umbil- 
icus. Cystic Disease of the Chorion, 
11 
History of Molar Birth—Continued 
Continued. 
c 
o 
Puerperium. 
© 
O 
O 
X 
c 
o 
s 
.s 
Ph 
<i3 
bfl 
ci 
X 
u 
u 
O 
a 
© 
a 
Description of Mole. 
Treatment. 
© 
m 
.S 
CO 
Q 
© 
SP 
X 
u 
u 
o 
s 
0) 
a 
>-4 
> 
© 
Result. 
Fourth. 
Severe. 
Profuse, 
causing 
col- 
lapse. 
Mass of hydatids filling a cham- 
ber-pot. 
Expelled under 
the action of 
ergot. 
Seven to 
eight 
weeks. 
No. 
No, 
Recovery pro- 
tracted. 
Fourth. 
Labor- 
like. 
Consider- 
able. 
Size of mass not given. 
Manual extrac- 
tion. 
Death early the 
following 
morning from 
hemorrhage. 
Eighth. 
Moder- 
ate. 
Slight. 
Delivered of a dead fetus; next 
day hydatid mass, weighing 
about four pounds; fetus had 
been dead for probably three 
months. 
Expelled spon- 
taneously. 
Usual 
time. 
No. 
No. 
Good recovery. 
Term. 
Labor- 
like. 
Profuse. 
Mass of cysts and degenerated 
fetal membranes filling a quart 
measure. 
Manual extrac- 
tion. 
Usual 
time. 
Good recovery. 
Four and 
a half. 
Severe; 
labor- 
like. 
Consider- 
able. 
Mass of hydatids weighing two 
pounds ; size of vesicles pin’s 
head to cherry stone; many 
showed opaque whitish dots. 
Expelled spon- 
taneously. 
“ 
Slight. 
Recovery grad- 
ual, but per- 
fect. 
Third. 
Labor- 
like. 
Consider- 
able. 
Considerable mass of hydatids, 
resembling grapes ; no trace of 
fetus. 
Expelled spon- 
taneously, 
Usual 
time. 
“ 
No. 
Good recovery. 
Not 
given. 
Labor- 
like 
Profuse. 
Considerable cluster of hydatids 
interspersed with clots. 
Expelled spon- 
taneously. 
Consider- 
able for 
some 
hours. 
“ 
Recovery. 
Two and 
a half. 
None. 
Exces- 
sive. 
Small mass containing but four 
cysts. 
Manual etrac- 
tion. 
Usual 
time. 
No. 
Recovery. 
Three 
and a 
half. 
Severe. 
Consider- 
able. 
Expelled a “large quantity” of 
vesicles. 
Expelled under 
action of ergot 
and Barnes’s 
bag. 
Usual 
time. 
“ 
“ 
Recovery. 
Four and 
a half. 
Labor- 
like. 
Free. 
Expelled a large mass of hydatids 
(about two pints), and six or 
eight hours afterwards asmailer 
mass. 
Manual extrac- 
tion. 
Slight. 
Offensive 
lochia 
on sec- 
ondday. 
Gradual recov- 
ery. 12 
W. A. Newman Borland and T. Perceval Gerson 
History of the Pregnancy—Continued. 
6 
3 
3 
3 
bo 
0) 
£ 
cn 
a 
0 
p. 
a 
0 
a 
0) 
So 
u 
'S 
Pl, 
<D 
s 
a 
6 
w 
i Number. 
<D 
u 
0 
a 
D 
04 
6 
3 
<D 
u 
4) 
cu 
X 
6 
s 
d 
£ 
d 
-*-» 
in 
[cl 
'u 
O 
in 
<D 
< 
CO 
3 
O • 
£0 
Ph 
to 
3 
.2 
u 
0 
rQ 
X 
CO 
3 
O 
’> 
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u 
PH 
in 
0 
M 
d 
O 
in 
'd 
u 
4> 
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Ph 
d 
'S 
O 
B 
O) 
a 
*3 
3 
a-a 
0 g 
2s 
Of 
21 
Camp- 
bell, J. 
Mich. Med- 
News., 
1880, in, 
60. 
Mrs. 
C. 
M. 
47 
12 
0 
Not noted. 
Some. 
Considerable. 
Abdomen 
Size of 6th 
month of 
gestation. 
22 
Chad- 
wick, 
James 
Boston M. 
and S. J., 
1887,CXVI, 
258. 
Mrs. 
X. 
M. 
1, 
18 mos. 
before. 
0 
Good. 
Fre- 
quent 
and 
At 1 month 
small quan- 
tity of wa- 
At 11 weeks 
uterus 
reached 
severe 
from 
tery fluid 
which re- 
one inch 
above um- 
first 
curred in 
bilicus. 
bleed- 
the subse- 
mg. 
quent four 
23 
Champ- 
lin, A. 
P. 
N. Orl. M. & 
S. J., 1885, 
Mrs. 
X. 
M. 
17 
33 
9 
I, 
at 2 
Not given. 
weeks. 
Considerable 
during last 
n.s., 273- 
years. 
mos. 
5 months. 
277. 
24 
Chowne. 
Lancet, No- 
vember 11, 
1843- 
Not given. 
Not given. 
Not given. 
25 
Chunn, 
Maryland 
Mrs. 
M. 
35 
9, 
0 
Heart-dis- 
Nausea 
Ankles ede- 
Severe. 
None until 
Attwomos. 
W. P. 
M. J.,1882, 
B. 
young:- 
ease for 
and 
matous; in 
final attack. 
-3, ix, 550- 
est four 
sometime; 
vom- 
bed for four 
552. 
years. 
menstrua- 
iting 
or five days. 
of gesta- 
tion regu- 
at 
lar and 
without 
short 
inter- 
reaching 
to umbili- 
pain. 
vals. 
cus; elas- 
tic, 
26 
Cleeman, 
Am. Journ. 
Mrs. 
M. 
i6J^ 
1, 
0 
Small, deli- 
None. 
Anemic; 
doughy. 
R A. 
Obst.,1875, 
X. 
21 
10 mos. 
cateframe; 
drowsy 
profuse,and 
size of 7th 
viii, 172- 
mos. 
before. 
good 
afterwardat 
month of 
27 
Cremen, 
J- 
T73- 
health af- 
ter birth of 
child; hard 
frequent in- 
tervals. 
gestation; 
very sen- 
sitive. 
Dublin J.M. 
Sc.,. 1858, 
Mrs. 
E. M. 
M. 
40 
13 
1, 
at 7 
Slight, deli- 
cate, ca- 
Slight 
at in- 
About nor- 
mal. 
xxv, 473. 
mos. 
chectic- 
looking; 
fell at 3d 
ter- 
vals 
since 
mo. and 
fall. 
struck ab- 
28 
Cross- 
man, 
Ed- 
ward. 
British Med. 
Journ., 
1867, 11,24. 
Mrs. 
X. 
M. 
28 
I 
0 
Not stated. 
None. 
Slight 
at in- 
ter- 
vals. 
Commenced 
at 4th mo. ; 
slight in 
amount. 
Consider- 
able. 
29 
Curtin, 
R. G. 
Am.J.Obst., 
Mrs. 
M. 
23 
0 
0 
Small, deli- 
Nausea 
Rapid and ex- 
Inter- 
Commenced 
At 4th mo. 
1871-2, IV, 
73I-736- 
JL. Cj. 
2 
cate, but 
and 
treme ema- 
mit- 
at end of 1st 
tumor ex- 
years. 
always 
healthy; 
menstru- 
vom- 
elation; ede- 
tent 
month; yel- 
tended 
rtrng 
ma of feet 
be- 
lowish dis- 
above 
from 
a nd legs 
tween 
charge, at 
umbili- 
ation reg- 
2d 
anemic ; 
no albumen 
hem- 
times gru- 
cus; firm 
ular. 
mo. 
orrha- 
mous. 
to the 
30 
David- 
son, Al- 
exan- 
der. 
Canada 
Pract.,To- 
ronto,1885, 
x, 161. 
Mrs. 
W. 
M. 
45 
Sev- 
eral ; 
young- 
est five 
Menstrua- 
tion regu- 
lar. 
Con- 
stant, 
severe 
nau- 
in urine. 
„ ga- 
slight. 
During last 
month con- 
stant wa- 
tery dis- 
touch. 
Tumor 
reached 
one inch 
aboveum- 
31 
Davis, 
c. w. 
Cin. Lancet- 
Clinic, 
Mrs. 
M. 
M. 
23 
years. 
0 
0 
Good; men- 
struation 
sea. 
charge. 
Flow for last 
bilicus. 
Not stated. 
1887, n s., 
xvin, 695, 
regular. 
erate in 
amount. Cystic Disease of the Chorion. 
History of Molar Birth— 
Continued. 
d 
o 
Puerperium. 
Month of Gestati 
.s 
’cs 
Ph 
6 
bn 
ctf 
rG 
u 
O 
a 
<D 
a 
Description of Mole. 
Treatment. 
*6 
to 
pq 
.S 
in 
c? 
Q 
0) 
bO 
•s 
u 
O 
S 
<D 
w 
U 
<D 
> 
& 
Result. 
Fifth. 
Third. 
Severe 
labor- 
pains. 
Severe 
flood- 
ing. 
Free. 
Expelled a mass filling a great 
bowl, resembling small grapes ; 
size of vesicles snot to large pea; 
vesicles filled with yellow viscid 
water ; pieces of membrane re- 
sembling placental tissue. I 
Expelled a basinful of cysts, blood1 
clots, and chorionic membranes. 
Expelled under 
action of er- 
got. 
Manual extrac- 
tion. 
No. 
Slow, 
but 
contin- 
uous 
oozing 
of 
dark 
fluid. 
No. 
Slight for 
few 
days; 
celluli- 
tis one 
week af- 
ter 
birth. 
Recovery. 
Recovery slow, 
but good. 
Six and a 
half. 
Labor- 
like. 
Consider- 
able. 
Weight of mass four and a half 
pounds; vesicles clear, grape- 
like ; size, pin’s head to grape ; 
of pearly clearness ; mixed with 
coagula; piece of placental tis- 
sue four inches in diameter; no 
cord- 
Manual extrac- 
tion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Fifth. 
Severe, 
labor- 
like. 
Some. 
Expelled large quantity of hy- 
datid cysts, partly enveloped in 
pieces of membrane resembling 
decidua. 
Expelled spon- 
taneously. 
Usual 
time. 
Slight. 
Recovery. 
Two and 
a half. 
Bearing- 
down. 
Terrific. 
Expelled a quart of currant-like 
cystic bodies. 
Expelled after 
passage of 
soundand use 
of ergot. 
Died of hemor- 
rhage at time 
of birth. 
Fourth. 
Labor- 
like. 
Consider- 
able. 
Expelled mass larger than full- 
sized placenta, followed by 
smaller mass and blood clots- 
Manual extrac- 
tion. 
Two 
weeks. 
Slight. 
Slight; 
lochia 
fetid. 
Rapid recov- 
ery 
Four and 
a half. 
Labor- 
like. 
Moder- 
ate. 
Expelled small mass containing 
considerable placental tissue. 
Manual extrac- 
tion. 
“ 
Slight. 
Gradual recov- 
ery. 
Seven 
and a 
half, 
Slight: 
labor- 
like. 
Severe. 
Two large masses of hydatids 
filling a chamber-pot; a half 
hour later another mass half 
filling the vessel; no fetus or 
placenta; some pieces of tough 
white membrane; vesicles trans- 
parent in clusters. 
Expelled spon- 
taneously. 
Usual 
time. 
No. 
No. 
Good recovery. 
Four and 
a half. 
Strong; 
labor- 
like. 
Profuse. 
Expelled large mass of vesicles; 
on second day removed piece ol 
decidua the size of an orange. 
Ergot and com- 
pression ol 
uterus above. 
Two 
weeks. 
Some. 
Slight; 
very of- 
fensive 
lochia. 
Good recovery 
Third. 
Labor- 
like. 
Consider- 
able. 
Expelled large mass of hydatids 
size of mass not given. 
! Expelled spon- 
taneously. 
Usual 
time. 
[No. 
No. 
Good recovery 
Six and a 
half. 
Labor- 
like. 
Some. 
Expelled large mass of vesicles. 
Expelled spon- 
taneously. 
i Usual 
time. 
“ 
(1 
Speedy recov 
ery. 14 
W. A. Newman Borland and T. Perceval Cerson. 
History of the Pregnancy—Continued. 
Number. 
Reporter. 
Reference. 
Name. 
J 
Social State. 
o3 
< 
Previous Pregnan- 
cies. 
Abortions. 
Previous Health. 
Gastric Symptoms. 
General Symptoms. 
Pain. 
Hemorrhage- 
AbdominalEnlarge- 
ment. 
32 
Davis, 
J. Hall. 
Tr. Ob.Soc., 
Lond.,1861, 
Vol.iix,i77- 
Mrs. 
X. 
M. 
33 
4 
I, 
at 2d 
mos. 
Not stated. 
Severe flood- 
ing for last 
3 weeks. 
Not stated. 
33 
Doering, 
E. J. 
Am.J.Obst., 
1886, XIX, 
512-515. 
Mrs. 
P. 
M. 
21 
1, 
fifteen 
mos. 
before. 
0 
Slender; 
general 
health 
good; in- 
strumen- 
tal labor; 
child ten 
pounds. 
None- 
None. 
Slight hemor- 
rhage atend 
of 2d mo., 
soon fol- 
lowed by 
profuse 
flow. 
Uterus size 
of four 
and a half 
months. 
34 
Dorland, 
W.A.N. 
Univ.Med. 
Mag., 
May, 1896. 
Mrs. 
D. C. 
M. 
25 
4, 
young- 
est 2% 
years. 
1 
Excellent ; 
menstru- 
ation reg- 
ular. 
Very weak; 
emaciated; 
anemic. 
Slight; 
col- 
icky 
dur- 
ing 
last 
few 
wks. 
Slight bleed- 
ing at the 
ninth week; 
persisting 
daily until 
birth of 
mole. 
Fundus of 
uterus 
reached 
up to the 
umbili- 
cus. 
35 
Dulac, L. 
Gaz.Heb- 
dom.,1884. 
Mrs. 
X. 
M. 
18 
years. 
37 
0 
0 
Good; men- 
struation 
regular. 
Daily 
nau- 
sea 
and 
vom- 
iting 
after 
three 
and a 
half 
mos. 
Edema of face 
and ankles; 
urineloaded 
with albu- 
men; head- 
ache ; dys- 
pepsia. 
Flooding 
commenced 
in 2d mo., 
and re- 
curred fre- 
quently. 
Not stated. 
36 
Dunn, 
W. A. 
Boston. M. 
and S. J., 
1885, 
cxiii, 612. 
Mrs. 
M. 
M. 
None. 
Uterus size 
of full 
term. 
37 
Edis, 
A. W. 
British Med. 
Journ., 
1871, H, 
353- 
Miss 
C. T. 
S. 
17 
0 
0 
Good. 
Con- 
stant 
nau- 
sea 
and 
vom- 
iting 
after 
sim- 
ple 
food. 
None- 
First at 
months. 
Uterus one 
and a 
half 
inches 
above um- 
bilicus ; 
no move- 
ments nor 
heart- 
sounds : 
soft, 
doughy. 
38 
Edwards, 
Charles. 
Lancet, 1847, 
Vol. 1. 
Mrs. 
S. A. 
M. 
42 
7 
1, 
I2yrs. 
be- 
fore. 
Bilioustem- 
perament; 
healthy; 
menstrua- 
tion regu- 
lar. 
Great ema- 
ciation ; 
paininscro- 
biculus cor- 
dis, and in 
bowels. 
Labor- 
like. 
Began at 3d 
month; a 
daily stilli- 
cidium of 
blackblood. 
Large size. 
39 
Fifield. 
Boston M. 
and S. J., 
1857-8, 
LVII, 197. 
Mrs. 
B. M. 
G. 
M. 
36 
6 
Occa- 
sional 
vom- 
|tinS- 
finally 
be- 
com- 
ing 
exces- 
sive. 
Began at 2j£ 
mos.; recur- 
ring almost 
daily; pro- 
fuse at third 
month. 
Uterus size 
of 5th mo. 
of gesta- 
tion. Cystic Disease of the Chorion. 
15 
History of Molar Birth—Continued. 
c 
o 
Puerperium. 
"S 
8 
o 
c3 
bu 
d 
Description of Mole. 
Treatment. 
T3 
<D 
o3 
bfl 
d 
Result. 
c 
o 
s 
.s 
’d 
Of 
J-t 
o 
a 
<U 
W 
.S 
to 
c3 
Q 
u 
u 
O 
a 
V 
K 
U 
0) 
> 
V 
Sixth. 
Second. 
Labor- 
like, 
Labor- 
like. 
Consider- 
able. 
Consider- 
able. 
Expelled a fetus ; placenta entire 
and appearance healthy; subse- 
quently a mass of hydatids, 
about one and a half pints; ves- 
icles size of millet seed to a 
grape; fetus died in a few mo- 
ments. 
Entire mass about the size of a 
large orange; small vesicles. 
Manual extrac- 
tion. 
Tampon and 
ergot. 
Usual 
time. 
Fifteen 
days. 
No. 
Some. 
Slight; 
lochia 
offen- 
sive. 
Consider- 
able. 
Recovery good. 
Good recovery. 
Four and 
a half- 
Labor- 
like. 
Profuse. 
Mass of hydatids,'—over two 
quarts; no trace of a fetus ; one 
small piece of placental tissue, 
two inches by two inches , vesi- 
cles size from pin headto grape. 
Manual extrac- 
tion. 
Two 
weeks. 
No. 
Slight for 
two 
days ; 
lochia 
fetid. 
Good recovery. 
Fifth. 
Labor- 
like. 
Severe 
flood- 
ing. 
Expelled a mass of hydatids of 
considerable size, containing a 
small portion of placental tis- 
sue. 
Expelled spon- 
taneously. 
One 
month. 
Slight. 
Seventeen days 
after delivery 
had an 
eclamptic 
seizure with 
hemiplegia, 
but made a 
fair recovery. 
Sixth. 
Labor- 
like. 
Profuse. 
Expelled a large basinful of cysts. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
No. 
Good recovery. 
Eighth. 
Labor- 
like. 
Consider- 
able. 
Expelled a mass of hydatids 
nearly filling an ordinary hand- 
basin. 
Manual extrac- 
tion. 
Three 
weeks. 
Good recovery. 
Four and 
a half. 
Labor- 
like. 
Consider- 
able. 
Expelled two quarts of hydatids 
without investing membrane or 
fetus. 
Expelled spon- 
taneously. 
Usual 
time. 
“ 
“ 
Good recovery. 
Fifth. 
Labor- 
like. 
Profuse. 
Expelled between two and three 
quarts of cysts. 
Tampon. 
Two 
weeks. 
Consider- 
able. 
(1 
Good recovery. W. A. Newman Borland and T. Perceval Gerson. 
History of the Pregnancy.—Continued. 
fl 
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d 
a 
a 
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< 
£ 
0 
0 
Ph 
W 
'< 
40 
Fischel. 
St. Louis M. 
Mrs. 
M. 
22 
0 
0 
Very deli- 
Nausea 
During last 3 
Very 
and S. J., 
X. 
i yr. 
cate. 
and 
months at 
marked 
1881, XLI, 
vom- 
intervals of 
and of 
196. 
iting 
dur- 
ing 
last 3 
two weeks; 
at times 
flooding. 
rapid de- 
velop- 
ment. 
M. and S. 
mos. 
41 
Foote, 
25 
Labor- 
Profuse dur- 
Uterus en- 
John. 
Reporter, 
like 
ing last few 
larged; 
1860-61, V, 
349- 
for 2 
days 
days. 
had felt 
move- 
only. 
ments. 
42 
Ford, C. 
Am J. Med. 
Mrs. 
M. 
42 
13 
Weight 200 
Con- 
Greatexhaus- 
Serum and 
At third 
M. 
Sc., n. s., 
Vol. LVI, 
S. A., 
mu- 
pounds; 
plethoric; 
stant 
nau- 
tion; faint- 
ness. 
blood dis- 
charge for 
month 
uterus 
1868, 
latto. 
menstru- 
sea. 
2% mos. 
size of 
ation reg- 
fifth 
ular. 
month of 
Boston M. 
gestation. 
43 
Gay, 
Mrs. 
M. 
30 
2 
0 
Menstrua- 
Severe 
Flowing from 
Considera- 
Geo. H. 
and S. J., 
Vol LXX, 
1864, 138. 
X. 
tion regu- 
lar. 
vom- 
iting 
th’gJi- 
out. 
sixth week. 
ble. 
44 
Githens, 
Peoria Med. 
B.S. 
19 
0 
0 
Anemic; 
Severe. 
Great pros- 
Labor- 
Repeated 
Marked. 
W. H. 
Monthly, 
1880-81, 1, 
136-38. 
dysmen- 
orrhea. 
tration; 
partially 
bedridden. 
like. 
after eighth 
week; pro- 
fuse. 
45 
Haines. 
Dublin J. 
Mrs. 
M. 
33 
5 
0 
None. 
None. 
Occasional. 
Uterus well 
Med. Sc., 
1850, X, 
201. 
X. 
above pel- 
vic brim. 
46 
Hehle. 
Wien. med. 
Mrs. 
M. 
32 
Sev- 
Poor. 
No debility. 
None. 
Slight: easily 
Presse, 
M. C. 
eral. 
arrested 
1871. 
47 
Hewitt, 
Trans. Ob. 
Mrs. 
M. 
24 
I, 
0 
None. 
Slight at 6th 
Not 
Graily. 
Soc., Lon- 
X. 
seven 
week; pro- 
marked. 
don, 1859, 
Vol. I, 251. 
mos. 
before. 
fuse later. 
48 
Hilde- 
Monatsch.f. 
Mrs. 
M. 
34 
3 
I 
Typhus 
Severe; 
Profuse. 
Uterine 
brande. 
Geburts. 
u. Frauen- 
krankh’n, 
X. 
fever one 
year be- 
fore 
cramp- 
like. 
tumor 
reached 
umbili- 
i860. 
Never good 
cus. 
49 
Hooker, 
Boston M. 
Mrs. 
M. 
26 
1, 
0 
Nausea 
Flooding at 
Consider- 
Charles. 
and S. L, 
C. 
2 years 
since 
and 
3d mo. 
able. 
Vol. xvi, 
before. 
birth of 
vorn- 
1837- 9i. 
child; 
iting. 
menstru- 
ation ir- 
regular; 
serous 
dis- 
charges 
from va- 
gina. 
So 
Hunter, 
Lancet,1846, 
Mrs. 
M. 
23 
I 
0 
None. 
None. 
Much be- 
Geo. Y. 
Vol. 1, 430. 
B. 
yond 
term. 
51 
Hutchin- 
Lancet, 
Mrs. 
M. 
25 
2, 
0 
Good until 
Some; 
Began at 2Yi 
Sudden en- 
son. 
April,1851. 
H. 
3 yrs. 
young- 
beginning 
labor- 
mos.; re- 
curred at 
short inter- 
large- 
est 5 
mos. 
of preg- 
nancy 
like. 
ment; 
more on 
(molar). 
vals; atone 
right side. 
time lost 1 
quart of 
(Hotted 
blood. Cystic Disease of the Chorion. 
17 
c 
3 
Puerperium. 
"d 
c/i 
<D 
o 
o 
C 
o 
s 
.5 
Ph 
CD 
b/) 
€0 
A 
Ut 
5-h 
O 
a 
<D 
x 
Description of Mole. 
Treatment. 
T3 
<D 
X 
.S 
cn 
>> 
d 
Q 
o3 
bo 
d 
Xi 
u 
u 
o 
s 
CD 
X 
U 
CD 
> 
X 
Result. 
Sixth. 
Labor- 
like. 
Consider- 
able. 
Expelled an immense mass of 
hydatids. 
Manual extrac- 
tion. 
Usual 
time. 
No- 
No. 
Good recovery. 
Sixth. 
Violent; 
Labor- 
like. 
Profuse. 
Expelled a gallon of transparent 
cysts; size of cysts, hempseed 
to walnut. 
Manual extrac- 
tion. 
Ten days. 
“ 
Good recovery. 
Four and 
a half. 
Labor- 
like. 
Flooding. 
Expelled one quart of hydatids ; 
three days later expelled three 
pints more ; and twelve days 
later a piece of decidua. 
Tent; sponta- 
neous expul- 
sion. 
Some. 
“ 
Good recovery. 
Third. 
Labor- 
like. 
Some. 
Expelled two quarts of cysts and 
a well-developed fetus of three 
months; cord normal. 
Spontaneous 
expulsion. 
U sual 
time. 
No. 
“ 
Good recovery. 
Fourth. 
Three 
and a 
half. 
Not 
given. 
Labor- 
like. 
Labor- 
like. 
Labor- 
like. 
Profuse. 
Consider- 
able. 
Some. 
Expelled immense mass (thou- 
sands of vesicles); no trace of 
fetus or placenta. 
Expelled a mass of hydatids, 
filling a dinner-plate ; large 
fragment of decidua. 
No description given. 
Manual extrac- 
tion. 
Spontaneous 
expulsion. 
Manual extrac- 
tion. 
Two 
weeks. 
Usual 
time. 
Fourteen 
days. 
“ 
Slight for 
2 days; 
offensive 
lochia. 
No. 
Perfect recov- 
ery ; again 
pregnant in 4 
months. 
Good recovery; 
12 mos. later 
gave birth to 
living child, 
but died on 
10th or nth 
day (cause un- 
known.) 
Good recovery. 
Two and 
a half. 
Labor- 
like. 
Consider- 
able. 
Expelled small mass of small 
transparent cysts. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
“ 
Good recovery; 
12 mos. later 
another child. 
Six and a 
half. 
Labor- 
like. 
Some. 
Expelled mass of hydatids ; also 
a fetus ; description not given. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
Some. 
Good recovery. 
Third. 
Labor- 
like. 
Profuse. 
Expelled six or seven pounds of 
cysts. 
Spontaneous 
expulsion. 
Three 
months. 
Died in 3 mos. 
of septic pel- 
vic abscess; 
uterine walls 
infiltrated 
with fungous 
growths. 
Term. 
Three 
and a 
half. 
Labor- 
like. 
Labor- 
like. 
Some. 
Child born after two hours’ labor, 
followed by three pints of hy- 
datids, which were attached to 
placenta as well as to uterus. 
Expelled a large quantity of hy- 
datids resembling bunches of 
grapes ; no trace of fetus. 
Spontaneous 
expulsion. 
Spontaneous 
expulsion. 
Usual 
time. 
Usual 
time. 
Slight. 
No. 
Moder- , 
ate. 
No. 
Good recovery. 
Good recovery. 
History of Molar Birth.—Continued. W. A. Newman Borland and T. Perceval Gerson. 
History of the Pregnancy.—Continued. 
I 
1 
g 
1 
c/5 
CD 
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0 
H 
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CD 
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ft 
a 
ft 
a 
>> 
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52 
Jackson. 
Am. J. Med. 
Mrs. 
M. 
38 
8, 
Sdema of 
Slight bloody 
Uterine tu- 
Sc., n. s., 
X. 
last 
legs. 
discharge 
mor size 
1853, Vol. 
still- 
daily. 
of full 
xxv, 379. 
born 8 
mos. 
term. 
before. 
Colored dis- 
53 
Jamie- 
Lancet, 
Mrs. 
M. 
27 
Last 
Menses reg- 
N ausea 
Legs edema- 
None. 
Uterine 
son, 
Allan. 
August, 
S.E. 
child 
ular. 
and 
tous; urine 
charge for 
tumor 
1867. 
• 
oorn 18 
vom- 
scanty, 
last 2 mos. 
reached 
mos. 
iting.! 
highly col- 
to umbili- 
before. 
ored, highly 
cus; pla- 
cental 
albumin- 
ous: few 
souffle 
hyaline and 
distinct 
♦ 
finely gran- 
to left of 
ular casts ; 
fundus. 
anemic; 
Frail- 
cough. 
54 
Koch. 
Zeitschr. f. 
Mrs. 
M. 
36 
7 
0 
None. 
Small quan- 
Uterine tu- 
Wunds- 
artz u. Ge- 
M. 
tity. 
mor equal 
to fifth 
burtsh. 
Perfect be- 
month. 
55 
Lewis, E. 
N. 0. Med. 
Mrs. 
M. 
20 
I 
1, at 
Fre- 
Anemic; ana- 
Began at 3d 
Uterine tu- 
S. 
and Surg. 
J., 1881-82, 
N. S., ix, 
X. 
six 
mos. 
fore mar- 
riage. 
quent 
nau- 
sea 
sarca. 
mo., follow- 
ing severe 
exertion; 
mor size 
of seventh 
month; 
401-406. 
and 
profuse; no 
movable, 
vom- 
discharge of 
elastic. 
Good. 
iting. 
cysts. 
56 
Macgill, 
Am. J. Med. 
Mrs. 
M. 
40 
Sev- 
Nausea 
Periodic, 
Consider- 
W. D. 
Sc., 1827, 
1, 240. 
W. 
eral. 
and 
vom- 
every 24 
hrs.. usually 
able. 
iting. 
in evening, 
and increas- 
ing in am’t. 
57 
Madden, 
Dublin 
Mrs. 
M. 
22 
2 
0 
fl 
None. 
Weak. 
None. 
For 3 days 
Uterine tu- 
Thos. 
More. 
Quart. J. 
M., 1868, 
K. 
before a 
consider- 
mor nor- 
mal in 
xlvi, 290. 
able am’t 
size. 
of clotted 
blood. 
58 
Ibid. 
Ibid. 
Mrs. 
M. 
53 
14, 
0 
Menses per- 
Labor- 
For 12 mos. a 
Marked. 
E. F. 
last 8 
years 
before. 
sisted 
since 
birth of 
like; 
with 
hem- 
constant 
red dis- 
charge from 
last child. 
or- 
vagina; 
smart hem- 
rhage. 
orrhage 2 
Good. 
w’ks before 
59 
Ibid. 
Med. Press 
Mrs. 
M. 
3° 
1 9 
1, at 
Greatexhaus- 
Persistent 
Consider- 
and Circ., 
1888, n. s.. 
E. G 
I 
seven 
mos., 
tion; ane- 
mia. 
since mis- 
carriage. 
able. 
xlvi,7-io. 
6 mos 
be- 
fore. 
0 
60 
Marsh, 
iMed. News, 
Mrs. 
M. 
24 
i, 
Malarial 
Some. 
Edema of feet 
i Labor- 
Began at end 
Uterine tu- 
F. 0. 
1884, p 
L.J. 
20 mos 
fever 3% 
and legs for 
| like 
of 3d mo. 
mor ex- 
524-528. 
1 old. 
years be- 
2 months 
tended to 
fore men- 
struation 
at 15; dys- 
menor- 
rhea be- 
fore mar- 
urine loaded 
with albu- 
1 men; heart- 
burn; head- 
ache ; giddi- 
! ness. 
umbili- 
cus. 
In. Y. Med 
riage. 
6l 
Marsh. 
Mrs. 
M. 
24 
0 
0 
Puberty at 
Almost 
[Emaciated; 
Intense 
Occasionally 
Rapid; 
Jas P. 
J., 1888 
X. 
4mos 
15 ; men- 
un- 
very weak 
parox- 
slight aftei 
uterus at 
XLV11I, 
ses regu 
con- 
anemic. 
ysmal 
2d month. 
4th mo. 
93-95- 
lar before 
trol- 
reached 
marriage 
general 
lable 
vom- 
umbilicus; 
more on 
health 
iting. 
left side of 
good; fal 
abdomen ; 
at 2d mo 
no heart- 
I of gesta 
sounds. 
1 tion. 
1 Cystic Disease of the Chorion. 
19 
History of Molar Birth.—Continued. 
d 
o 
I 
Puerperium. 
"rt 
0) 
2 
o 
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5 | 
S 
d 
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0-. 
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X 
Description of Mole. 
Treatment. 
O) 
CQ 
.s 
t/5 
Q 
<D 
bo 
pG 
1-4 
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e 
4) 
a 
U 
(D 
> 
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Result. 
Fourth. 
Labor- 
like. 
Profuse. 
Expelled five pints of cysts ; also 
fetus of fourth month, a small 
piece of cord, and an eight-inch 
fragment of healthy chorion. 
Ergot; sponta- 
neous expul- 
sion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Eighth. 
None. i 
Expelled large quantity of cysts ; 
no trace of fetus ; piece of pla- 
cental tissue size of hand. 
Spontaneous 
expulsion. 
Usual 
time. 
Good recovery. 
Third. 
Labor- 
like. 
Some. 
Description not given. 
Manual extrac- 
tion. 
Usual 
time. 
Slight. 
Good recovery. 
Sixth. 
Intense ; 
labor- 
like. 
Consider- 
able. 
Expelled a chamber-potful of 
grape-like masses, and firm, 
dark clots. 
' 
Manual extrac- 
tion. 
Two 
weeks. 
Sharp 
(105 %°)\ 
no uter- 
ine ten- 
derness; 
marked 
fetor. 
Good recovery. 
Three 
and a 
half. 
Labor- 
like. 
Severe. 
Expelled mass of hydatids size of 
fetal head at birth. 
Ergot; sponta- 
neons expul- 
sion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Fifth. 
Labor- 
like. 
Consider- 
able. 
Expelled a large basinful of hy- 
datids and fresh clots ; size of 
vesicles, currant to plum. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
“ 
Good recovery. 
Not 
known. 
Labor- 
like. 
Profuse. 
Excelled a mass of hydatids, and 
two days later a blighted fetus; 
size of vesicles, pea to grape. 
Spontaneous 
expulsion. 
One 
week. 
Good recovery. 
Seventh. 
Labor- 
iike. 
Consider- 
able. 
Expelled mass of hydatids filling 
small hand-basin ; small piece 
of placental tissue. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
Good recovery. 
Fifth. 
Labor- 
like. 
Some. 
Mass of hydatids filled half a 
large wash-basin. 
Digital separa- 
tion of growth; 
spontaneous 
expulsion. 
Slight; in 
form of 
clots. 
Severe, 
com- 
menc- 
ing on 
4th day; 
soon de- 
veloped 
typhoid 
state. 
Died on 12th 
day of sepsis. 
Four and 
a half. 
Labor- 
like. 
Profuse. 
Nearly three pints of cysts of 
various sizes. 
Manual extrac- 
tion and cu- 
reting. 
Two 
weeks. 
No. 
Slight. 
Good recovery 20 
IV. A. Newman Borland and T. Perceval Gerson. 
History of the Pregnancy.—Continued. 
u 
0) 
s 
£ 
Reporter. 
Reference. 
Name. 
Social State. 
<P 
< 
Previous Pregnan- 
cies. 
1 
Abortions. 
Previous Health. 
I 
1 
Gastric Symptoms. 
General Symptoms 
Pain. 
Hemorrhage. 
AbdominalEnlarge- 
ment. 
62 
Maslow- 
sky. 
Centralb. f- 
Gynakol., 
No. 16, 
1882 
21 
0 
0 
Good. 
Anemic. 
Some. 
Slight, at in- 
tervals. 
Consider- 
able ; 
about at 
umbili- 
cus. 
63 
Mellor, 
Thos. 
British Med. 
Journ., 
1865, II, 
282. 
Mrs. 
W. 
M. 
25 
1, 
13 mos. 
old. 
0 
Nausea 
and 
vom- 
iting. 
Irregu- 
lar. 
At 3% mos. 
slight dis- 
charge of 
blood. 
Consider- 
ab e. 
64 
Miller, J. 
P. 
Trans Med. 
Soc., W. 
Va., 
Wheeling, 
1879. 11. 
part 4, pp, 
488-519. 
Mrs. 
B. 
M. 
17 
0 
0 
Menstrua- 
tion regu- 
lar ; dys- 
menor- 
rhea. 
Con- 
stant 
nau- 
sea 
and 
vom- 
iting. 
Edema of 
feet; night- 
sweats ; 
cough; bed- 
ridden. 
Slight. 
At 6th week, 
at first 
slight; in a 
few days 
free; at 10th 
week escape 
of piece of 
decidua (?)■ 
Consider- 
able; cys- 
tic, soft, 
doughy. 
65 
Moore, C. 
F. 
Dublin 
Quart. J. 
Med. Sc., 
1868, XLV, 
473- 
Mrs. 
J. R- 
M. 
So 
10, 
last 10 
years 
before. 
0 
Menses reg- 
ular, 
ceased 2 
years be- 
fore. but 
show 
every 7 to 
8 weeks 
Fre- 
quent 
bil- 
ious 
vom- 
iting 
for 2 
mos. 
Giddiness; 
debibty. 
« 
Some. 
Constant and 
bloody, at 
times offen- 
sive ; dis- 
charge last- 
ing 2 mos. 
Some. 
66 
Moore- 
head, J, 
Lancet, 1863, 
Vol. 1 305. 
Mrs. 
G. 
M. 
So 
7, 
sterile 
for past 
twenty 
years. 
3 
Naturally 
stout; 
menstru- 
ation reg- 
ular up to 
2 mos. be- 
fore first 
visit. 
Nausea 
and 
vom- 
iting. 
Anemic; 
somewhat 
emaciated. 
Some. 
Began after a 
mental 
shock at 1% 
mos.; san- 
guineous 
discharge 
and clots; 
later watery 
and bloody. 
Globular 
tumor 
size of 
child’s 
head, ex- 
tending 
to umbili- 
cus. 
67 
Morris, J. 
M. 
Boston M. 
J-. 1845, 
XXXII, 17. 
Mrs. 
c. 
M. 
3 
0 
Sanguine 
tempera- 
ment ■ fine 
constitu- 
tion ; fell 
at 1 Vi 
mos. of 
preg- 
nancy. 
Severe; 
occa- 
sional. 
Began at 4th 
mo-; bloody 
and at times 
brownish 
discharge. 
Consider- 
able ; 
never felt 
move- 
ments. 
68 
Ibid. 
Ibid. 
Mrs. 
W. 
M. 
32 
6 
Delicate 
form. 
Pain in chest; 
signs of tu- 
berculosis. 
69 
Moses, S. 
G. 
St- Louis 
Cour. 
Med., 1879, 
I, 104-107. 
Mrs. 
X. 
M. 
Marked ner- 
vous mani- 
festations. 
Enormous; 
at 6 mos. 
much 
larger 
than 
uterus at 
term. 
70 
Munde, 
Paul F. 
Am Journ 
Obst, 
i874-75- 
vn, 475- 
Mrs. 
G. 
M. 
44 
TO 
0 
Always 
good. 
Severe 
vom- 
iting. 
General ma- 
laise. 
Severe in 2d 
month. 
Uterus 
reached 
above 
umbili- 
cus ; size 
of seventh 
month, 
broad, 
doughy, 
irregular 
contrac- 
tions ; no 
fetal 
move- 
ments. 
71 
Mundell, 
J. H. 
J. Am. Med. 
Associa’n, 
1888, XI, 
592. 
Mrs. 
L. T. 
M. 
19 
0 
0 
Nausea 
and 
vom- 
iting 
after 
ij* 
mos. 
Weak. 
Slight after 
2d month. 
Uterus 
reached 
umbili- 
cus ; hard, 
symmet- 
rical. Cystic Disease of the Chorion. 
21 
History of Molar Birth.—Continued. 
d 
o 
PUERPERIUM. 
"rt 
<D 
O 
<D 
be 
oJ 
pG 
Description of Mole. 
Treatment. 
T3 
<v 
CQ 
P 
be 
as 
Si 
Result. 
si 
o 
§ 
d 
a. 
u 
O 
a 
CD 
M 
(/) 
>> 
aS 
a 
u 
O 
s 
<u 
U 
0) 
> 
Four and 
a half. 
Labor- 
like. 
Some. 
Description not given. 
Spontaneous 
expulsion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Four and 
a half. 
Labor- 
like. 
Consider- 
able. 
Mass of cysts and coagula; vesi- 
cles size of grape and less ; no 
vestige of embryo. 
Spontaneous 
expulsion. 
Usual 
time. 
Slight. 
Good recovery. 
Fourth. 
Consider 
able. 
Terrific. 
Mass of cysts weighed between 
two and three pounds; vesicles 
white ; in size from small cherry 
to large plum; contained a 
watery fluid. 
Manual extrac- 
tion. 
Five 
weeks. 
Consider- 
able at 
inter- 
vals for 
i mo. 
Fetid 
lochia. 
Retarded recov- 
ery. 
Three 
and a 
half. 
Severe. 
Consider- 
able. 
Mass of hydatids size of pin’s 
head to grape, of a beautiful 
pink color: size of mass, one 
and a half fetal head. 
Spontaneous 
expulsion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Two and 
a half. 
Severe; 
labor- 
like. 
Some. 
Vesicular masses nearly filled half 
a wash-basin ; size of vesicles, 
currant a few larger. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
Good recovery 
Sixth. 
Labor- 
like. 
“ 
Weight of hydatids about four 
pounds; size of cysts, pin’s head 
to hazel-nut. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
Slight 
fetid 
lochia. 
Good recovery. 
Eight and 
a half. 
Sixth. 
Labor- 
like. 
Weight of hydatids six or seven 
pounds : size of cysts, mustard 
seed to large filbert. 
Mass of hydatids filled an ordi- 
nary bucket. 
Spontaneous 
expulsion. 
Manual extrac- 
Few 
weeks. 
“ 
Slight. 
Gradual but 
complete re- 
covery. 
Gradual recov- 
ery. 
like. 
able. 
tion. 
Fourth. 
Violent; 
labor- 
like. 
Some. 
Large quantity of vesicles min- 
gled with coagula and shreds of 
membranes and placental tis- 
sue ; size of vesicles, currants ; 
mass expelled, size of two fists. 
Tampon: ergot; 
spontaneous 
expulsion. 
No. 
Slow recovery. 
Third. 
Labor- 
like. 
“ 
Large quantity of cysts. 
Tampon; man- 
ual extrac- 
tion. 
Slight. 
Slow recovery. 22 
IV. A. Newman Borland and T. Perceval Gerson 
History of the Pregnancy.—Continued. 
.«? SP SP ?P S 3 3. S 2 2 2 1 Number. 
Murphy, 
P. J. 
Oliver, 
James. 
Parish, 
W. H. 
Phillips, 
John. 
Poole. 
Ibid. 
Putnam. 
Rooker, 
Jas. I. 
Routh. 
Sackett, 
S. P. 
Schiitz. 
Shattuck, 
Geo. B. 
Reporter. 
Obst. Gaz., 
Cincin., 
1880- 
in, 114- 
116 
Lancet, Sep. 
21,1889, p. 
592. 
Trans. Ob. 
Soc., Phil- 
adelphia, 
Trans. Ob. 
Soc., Lon- 
don, Vol. 
XXXII, 
1890,p. 63 
Dublin J. 
Med. Sc., 
1881, 3 s., 
LXXI, 423- 
426. 
Ibid. 
Am Journ. 
Med. Soc , 
1850, n. s., 
xx, 37. 
Boston M. 
and S. J., 
1868-69, 
LXXIX, 
2l6. 
Lancet,i860, 
1, 597 
Obst. Gaz., 
Cincin., 
1881- IV, 
174-76. 
Zeitschr. f. 
Wunds- 
artzu Ge- 
burtsh. 
Boston M. 
1 and S. J., 
1888, CXIX, 
10. 
Reference. 
Mrs. 
L.N., 
col- 
ored. 
Mrs. 
A. T. 
Mrs 
C. 
Mrs. 
X. 
Mrs. 
X. 
Mrs. 
X. 
Mrs 
X. 
Mrs. 
W. 
Mrs. 
B. 
Mrs. 
B. W. 
Miss 
S. C. 
Name 
g g S S ' g 
8 ■ s»' 
Social State. 
$ £ £ ! -3unoA 8, “ m 0 2 S 
Age. 
in in 
OOSOMO 2 OJ OJ 2 OJ 
p p “to 
Previous Pregnan- 
cies. 
00000*0 0 • 00 
Abortions. 
Never 
strong; 
puberty at 
18. 
Puberty at 
14; men- 
ses always 
lasted 7 
days. 
Generally 
poor. 
Poor. 
Good. 
Menstrua- 
tion regu- 
lar. 
Always 
good; men- 
struation 
regular. 
Good. 
Previous Health. 
Con- 
stant 
nau- 
sea 
and 
vom- 
iting. 
Nausea 
and 
vom- 
iting. 
— 
Con- 
stant 
nau- 
sea 
and 
vom- 
iting. 
Irrita- 
ble 
stom- 
ach. 
Nausea 
and 
1 vom- 
iting. 
Nausea 
and 
vom- 
iting. 
Nausea 
and 
vom- 
iting 
for 6 
w’ks. 
Gastric Symptoms. 
Edema ot 
feet; ane- 
mia. 
Edema of 
legs; ane- 
mic. 
Exhaustion ; 
bedridden. 
Edema of feet 
and legs 
and hands; 
no albumen 
in urine. 
Extreme de- 
bility ; in 
bed 1 mo. 
Emaciated. 
Anemic, 
Exhaustion; 
faintness ; 
emaciation. 
None. 
General Symptoms. 
Col- 
icky. 
None. 
None. 
I 
Some. 
Slight. 
None. 
Pain. 
Severe at ir- 
regular in- 
tervals after 
2d month; 
profuse at 
6th month. 
More or less 
daily for n 
weeks. 
Slight. 
Incessant 
flooding for 
3 weeks. 
Commenced 
at fifteenth 
week. 
Commenced 
at 4th mo.; 
at first cof- 
fee-grounds, 
later free 
blood. 
Began at mid- 
dle of 4th 
mo ; slight 
, at first, 
gradually 
increasing. 
Constant. 
Began at 4th 
mo.; slight 
in amount. 
Profuse. 
Slight in Sth 
week. 
Hemorrhage 
Rapid; at 
2d mo. 
size of 6th 
mo. of 
gestation. 
T umor 
reached 
one inch 
above 
umbili- 
cus. 
T umor 
reached 
above 
umbili- 
cus ; bi- 
lobed 
with verti- 
cal me- 
dian fur- 
row ; reg- 
ular uter- 
ine con- 
tractions. 
Uterus two 
inches 
above 
umbili- 
cus : no 
fetal 
heart- 
sounds. 
At 4th mo. 
tumor 
equal to 
6th mo. of 
gestation; 
resisting. 
Rapid and 
consider- 
able. 
1 
Consider- 
able. 
; Gradual. 
j 
Consider- 
i able. 
Consider- 
able. 
Consider- 
able. 
Tumor 
reached 
umbili- 
cus ; no 
bruit. 
AbdominalEnlarge- 
ment. Cystic Disease of the Chorion. 
23 
History of Molar Birth.—Continued. 
c 
o 
Puerperium. 
"rt 
<G 
O 
o 
c 
o 
s 
a 
P-. 
Hemorrhage. 
Description of Mole. 
Treatment. 
Days in Bed. 
Hemorrhage. 
U 
<D 
> 
Result. 
Sixth. 
Consider- 
able. 
Profuse- 
Large mass of hydatids ; two and 
three-fifths pounds: vesicles 
size of pin’s head to grape. 
Ergot; sponta- 
neous expul- 
sion. 
No. 
Slight for 
3, to 4 
days. 
Good recovery. 
Four and 
a half. 
Some. 
Consider- 
able. 
Weight of mass, two pounds. 
Spontaneous 
expulsion. 
Usual 
time. 
(( 
No. 
Good recovery. 
Three 
and a 
half. 
None. 
Slight. 
Mass removed size of fetal head 
at term ; no placenta ; no fetus. 
Manual extrac- 
tion. 
Some. 
Slow recovery 
Fourth. 
Labor- 
like. 
Some. 
Large mass of vesicles ; no trace 
of fetus. 
Manual extrac- 
tion. 
Usual 
time. 
No. 
“ 
Recovery. 
Fourth. 
Labor- 
like. 
Slight. 
Expelled three pints of vesicles, 
resembling boiled sago, mixed 
with clotted blood; no decidua. 
Spontaneous 
expulsion. 
Two 
weeks. 
“ 
> 
Good recovery. 
Fourth. 
Labor- 
like. 
Some. 
Mass of cysts: vesicles quite 
large, some size of plum; shreds 
of decidua. 
Spontaneous 
expulsion. 
Two 
weeks. 
“ 
“ 
Good recovery. 
Four and 
a half- 
Labor- 
like. 
“ 
Mass more than filled a half-pint 
bowl; size of vesicles, pin’s head 
to half an inch in diameter; no 
fetus; but decidua distinct. 
Spontaneous 
expulsion. 
Some. 
“ 
Slow but good 
recovery. 
Five and 
a half. 
Labor- 
like. 
Profuse. 
Mass weighed about five pounds ; 
vesicles size of pin’s head to 
large grape. 
Manual extrac- 
tion. 
Usual 
time. 
No. 
“ 
Slow but good 
recovery. 
Two and 
a half. 
Labor- 
like. 
Consider- 
able. 
Large number of cysts, pinkish 
in color, and containing an 
albuminous fluid, of acid reac- 
tion. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
Good recovery. 
Four and 
a half. 
Labor- 
like. 
Free. 
Considerable quantity of vesicles. 
Manual extrac- 
tion. 
Two 
weeks. 
Slight. 
Slow but steady 
recovery. 
Five and 
a half. 
Labor- 
like. 
Some. 
No description given. 
Spontaneous 
expulsion. 
Three 
weeks. 
“ 
No. 
Good recovery. 
Three 
and a 
half. 
Labor- 
like. 
Slight. 
Mass filled one-third of a pail; 
cysts and clots. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
“ 
Good recovery. 24 
W. A. Newman Borland and T. Perceval Gerson. 
History of the Pregnancy.—Continued. 
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< 
84 
Shewen, 
British Med. 
Mrs. 
M. 
S3 
10 
I 
Nausea 
Great debil- 
Severe. 
For 2 months 
Uterus as 
Alfred. 
Journ., 
X. 
28 
and 
ity; ano- 
gushes of 
large as 
1875, n, 
years. 
vom- 
rexia; pain 
in back and 
pale, foul, 
fetal 
IOI. 
itmg. 
watery 
head. 
85 
limbs. 
fluid 
Smith, 
Thos.C. 
J. Am. Med. 
Associa’n, 
1887, IX, 
Mrs. 
F. 
M. 
20 
0 
0 
N ausea 
and 
vom- 
Anemic. 
Began at 4th 
month. 
U terus 
reached 
to umbili- 
86 
686. 
iting. 
cus; hard. 
Ibid. 
Ibid. 
Mrs. 
X. 
M. 
Kj 
O 
0 
0 
2 
0 
Consider- 
able. 
87 
Smyth, 
British M. 
Miss 
S. 
orq 
13 
0 
Plethoric 
Occa- 
u 
Vio- 
Severe flood- 
Uterus size 
Spencer 
J- 1873. 1. 
61. 
S.G. 
habit; pu- 
sional 
lent. 
ing 1 week 
of third 
T. 
T. 
berty at 
13 ; men- 
ses regu- 
lar. 
nau- 
sea. 
before birth. 
month. 
88 
Thomas, 
British Med. 
Mrs. 
M. 
26 
Marked jaun- 
Some. 
Great. 
Hugh. 
J-, 1883, 
Vol. 1,911. 
X. 
dice. 
89 
Thomp- 
Proc. Con. 
Mrs. 
M. 
30 
3 
0 
Good. 
None. 
Slight blood 
son, B. 
Med. Soc., 
B. F. 
and water 
S. 
1880. n. s., 
after 1st 
11, 60-69 
Am. J. Ob., 
month. 
90 
Under- 
Mrs. 
M. 
24 
2 
Scrofulous 
Anemic; de- 
Began at two 
Greater 
hill. 
1879, XII, 
T. H. 
4 yrs. 
diathesis; 
spondent. 
mos.,slight; 
than 
185. 
nervous. 
later pro- 
term; 
fuse. 
tense, 
Van 
doughy. 
9i 
M. and S. 
Mrs. 
M 
25 
0 
0 
Occa- 
Anemic; 
Some. 
Uterus size 
Dyke, 
Rep., 1S83, 
K. 
sional 
giddy. 
of 6 mos. 
A. 
XLIX, 10. 
vom- 
92 
Verrier, 
Gaz. heb- 
Mrs. 
M. 
21 
0 
0 
Good; sud- 
iting. 
Urine highly 
At 4th month 
Not given. 
E. 
dom ,I)ec. 
X. 
den men- 
albuminous. 
after shock 
7, 1883. 
tal shock. 
and atirreg- 
ular inter- 
vals after. 
93 
Ibid. 
Ibid. 
Mental 
shock at 
N 0 albumen 
in urine. 
Colic 
after 
Began at 4th 
mo., contin- 
Not given. 
4th mo. 
4th 
ued for over 
Ibid. 
mo. 
45 days. 
94 
Ibid 
Mrs. 
M. 
45 
Persist- 
Not given. 
X. 
ent 
nau- 
sea 
and 
vom- 
iting 
Some. 
95 
Wearne, 
Lancet.1893, 
Mrs. 
M. 
36 
0 
0 
Occa- 
Anemic; 
Commenced 
Great tu- 
J. 
Vol. 11, 
M. C. 
sional 
great ex- 
in 3d mo.; 
mor; ine- 
141-42. 
vom- 
haustion; 
free dis- 
lastic. 
iting. 
edema of 
charge. 
96 
feet. 
Wells, 
Boston M. 
Mrs. 
M. 
21 
1, 
Flow for sev- 
Uterus size 
Daniel 
and S. J., 
M. 
is mos. 
eral weeks. 
of seventh 
E. 
1866-67, 
old. 
month; 
7 
LXXV, 321. 
irregular ; 
very hard. 
97 
Wilton, 
Lancet, 
Mrs. 
M. 
37 
4 
I 
Menstrua- 
Nausea 
Con- 
Frequent and 
Great. 
Wm. 
London, 
Vol. 1. 
M. 
tion regu- 
lar; infec- 
and 
vom- 
stant. 
severe, with 
gushes of 
tion of 
iting. 
watery 
bowels 
fluid. 
since last 
98 
child. 
Winn. 
Lancet, 
London, 
1855, Vol. 
1, 214. 
Mrs. 
X. 
M. 
Great. Cystic Disease of the Chorion. 
History of Molar Birth.—Continued. 
d 
o 
PUERPERIUM, 
Month of Gestati 
d 
rt 
Ph 
be 
Oj 
'u 
u 
o 
£ 
(D 
Description of Mole. 
Treatment. 
0) 
PQ 
c 
CO 
rt 
Q 
0) 
be 
'u 
u 
o 
£ 
<D 
X 
U 
<D 
> 
Result. 
Fifth. 
Labor- 
like. 
Slight. 
Chamberful of “bladdery, sea- 
weedy’’ material; vesicles size 
of pea to hazel-nut; no fetus ; 
three years before had dis- 
charged the same. 
Spontaneous 
expulsion. 
Usual 
time. 
No. 
No. 
Good recovery. 
Fourth. 
Severe. 
Profuse. 
About a quart of cysts, size of 
currants and grapes. 
Manual extrac- 
tion. 
Usual 
time. 
Good recovery. 
Three 
and a 
half. 
“ 
“ 
Half a gallon of cystic bodies. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
“ 
Good recovery. 
Third. 
Labor- 
like. 
Some. 
Mass of hydatids, size not given ; 
no embryo. 
Spontaneous 
expulsion. 
Usual 
time. 
Good recovery. 
Not 
given. 
Labor- 
like. 
“ 
Weight of mass of hydatids, three 
and three-quarters pounds. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
“ 
Rapid recov- 
ery. 
Four and 
half. 
Labor- 
lit e. 
Consider- 
able. 
Large basinful of cysts ; no fetus. 
Spontaneous 
expulsion. 
Usual 
time. 
* * 
Good recovery. 
Third. 
Labor- 
like. 
Some. 
Two quarts of vesicles. 
Manual extrac- 
tion. 
Five 
months. 
Free. 
Consider- 
able. 
Tedious conva- 
lescence, but 
good recov- 
ery. 
Fourth. 
Labor- 
like. 
Consider- 
able. 
Three quarts of cysts and clots. 
Ergot; sponta- 
neous expul- 
sion. 
No. 
Some. 
Slow recovery. 
Five and 
a half. 
Labor- 
like. 
Moder- 
ate. 
Mass of cysts; no trace of fetus 
or placenta. 
Spontaneous 
expulsion. 
Yes. 
Died six weeks 
after delivery, 
of sepsis. 
Five and 
a half. 
Labor- 
like. 
Moder- 
ate. 
Mass of cysts ; about one-eighth 
of normal placenta remained. 
Spontaneous 
expulsion. 
Usual 
time. 
Slight. 
No. 
Good recovery. 
Five and 
a half. 
Labor- 
like. 
Some. 
Mass of cysts. 
Spontaneous 
expulsion. 
Usual 
time. 
No. 
Good recovery. 
Third. 
Labor- 
like. 
Four or five quarts of hydatids 
expelled. 
Spontaneous 
expulsion. 
Usual 
time. 
“ 
“ 
Good recovery. 
Fourth. 
Consider- 
able. 
Profuse 
flood- 
ing. 
Chamber-pot two-thirds full; size 
of cysts from large shot to inch 
in diameter; no fetus or pla- 
centa. 
Manual extrac- 
tion. 
Usual 
time. 
“ 
“ 
Good recovery. 
Three 
and a 
half. 
Labor- 
like. 
Consider- 
able. 
Large mass found after death in 
uterine cavity ; mass of cysts 
expelled. 
Spontaneous 
expulsion. 
Died of uterine 
rupture; 
masses of 
cysts embed- 
ded in wall. 
Sixth. 
Labor- 
like. 
Profuse. 
Great mass of hydatids and clots. 
Spontaneous 
expulsion. 
Died of uterine 
rupture; 
ragged ulcer 
size of shilling 
in upper ante- 
rior wall. 26 
W. A. Newman Borland and T. Perceval Gerson. 
History of the Pregnancy.—Concluded. 
99 
100 
Number. 
Wood- 
man, 
W. B. 
Ibid. 
Reporter. 
Trans. Ob. 
Soc., Lon- 
don, 1S65. 
Ibid. 
Reference. 
Miss 
E. II. 
Mrs. 
M.K. 
Name. 
l/l 
Social State. 
CO K) 
ON 
Age. 
0 
Previous Pregnan- 
cies. 
M O 
Abortions. 
Previous Health. 
Gastric Symptoms. 
General ana- 
sarca ; pul- 
monary 
edema: 
urine scan- 
ty ; enor- 
mous am’t 
of albumen; 
few casts. 
General ana- 
sarca; urine 
scanty, al 
buminous ; 
no casts. 
General Symptoms. 
Pain. 
Constant 
flowing 
from \Vi 
months. 
Some for last 
week. 
Hemorrhage. 
Size of tu- 
mor equal 
to seventh 
month of 
gestation. 
Enormous- 
A bdominal Enlarge- 
ment. Cystic Disease of the Chorion 
27 
History of Molar Birth.—Concluded. 
Month of Gestation. 
Pain. 
Hemorrhage. 
Description of Mole. 
Treatment. 
Days in Bed. 
1 hj 
JERPERIU 
6 
bo 
Ut 
u 
O 
6 
0 
X 
g 
Fever. 
Result. 
Flooding. 
Yes. 
and a 
like. 
datids ; size of vesicles, pin’s 
expulsion. 
day, of sepsis. 
half. 
head to grape. 
Six and a 
Labor- 
Profuse. 
Two to three pounds of hydatids; 
Spontaneous 
Usual 
No. 
No. 
Good recovery. 
half. 
like. 
size of vesicles, pin’s head to 
expulsion. 
time. 
gooseberry; some degenerated 
spongy placental tissue.