File:A treatise on the science and practice of midwifery (1878) (14780003461).jpg

Identifier: treatiseon00play (find matches)
Title: A treatise on the science and practice of midwifery
Year: 1878 (1870s)
Authors: Playfair, W. S. (William Smoult), 1836-1903 Harris, Robert P., (from old catalog) ed
Subjects: Obstetrics
Publisher: Philadelphia, H. C. Lea
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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millet-seed toan acorn, are often described as resem-bling a bunch of grapes or currants. Onmore minute examination, they are foundnot to be each attached to independentpedicles, as is the case in a bunch ofgrapes, bat some of them grow fromother vesicles, while others have distinctpedicles attached to the chorion, the pedi-cles themselves sometimes being dis-tended by fluid (Fig. 84). This peculiararrangement of the vesicles is explainedby their mode of growth. Causes of Cystic Degeneration.—Therehas been considerable discussion as tothe etiology of this disease. By some itis supposed always to follow death ofthe foetus; and the whole developmentalenergy being expended on the chorion, which retains its attachmentto the decidua, the result is its abnormal growth and cystic degenera-tion. This is the view maintained by Gierse and Graily Hewitt, andit is favored by the undoubted fact that in almost all cases the foetushas entirely disappeared; and by the occasional occurrence of cases
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Hydatiform Degeneration of thtChorion. 216 PREGNANCY. of twin conceptions in which one chorion has degenerated, the otherremaining healthy until term. On the other hand, it is maintainedthat the starting-point is connected with the maternal organism.Virchow thinks it originates in a morbid state of the decidua ; whileothers have attributed it to some blood dyscrasia on the part of themother, such as syphilis. There are many reasons for believing thatcanses of this nature may originate the affection. Th us it is often foundto occur more than once in the same person; and alterations of a simi-lar kind, although limited in extent, are not unfrequentiy found inconnection with the placenta and membranes of living children. Onthis theory the death of the foetus is secondary, the consequence ofimpaired nutrition from the morbid state of the chorion. The prob-ability is that both views may be right, the disease sometim.es fol-lowing the death of the embryo, and at others being the result ofob

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