above the uterine glands. These proliferated cells are called "decidual cells." The ovum, lying in the folds of the hypertrophied mucosa, finally is completely surrounded. That portion of the mucous membrane reflected over the ovum is the decidua reflexa. The portion under the ovum, the decidua serotina, and the uterine mucous membrane elsewhere, the decidua vera. The decidua serotina helps to form the placenta; the decidua vera undergoes a partial atrophy in the latter months of pregnancy and is cast off in part with the ovum in labor, in part by disintegration in the lochial discharge; the decidua reflexa begins to undergo degeneration at the second month and by the seventh month has disappeared. DISEASES. 1. Apoplexies.-These are a common cause of early abortions, and are apt to occur prior to the second or third month. Causes.-Bright's disease, repeated congestions from frequent coitus, injuries, blows, etc. 2. Inflammations, Chronic. (a) Hyperplastic endometritis gravidarum. The hypertrophy of the mucous membrane is exaggerated, deflects nourishment to itself and gives rise to apoplexy and early abortion of a fleshy mass. It is usually the result of chronic endometritis prior to pregnancy. The decidual apoplexies may be multiple and distributed all over the surface of the ovum, projecting into its cavity, producing the socalled "subchorial tuberous hæmatomata of the decidua." (b) Polypoid endometritis gravidarum. The hypertrophy confined to certain areas. Is very rare. Leads to abortion, second to fourth month. (c) Catarrhal endometritis gravidarum. There is an abnormal hypertrophy of the uterine glands, giving rise to the secretion of a few ounces to a pint or more, with periodic discharges, of thin mucus, called hydrorrhoea gravidarum. (d) Cystic endometritis gravidarum occurs very early. The glands hypertrophy. May be cured by subsequent growth of the deciduæ or may continue to produce hydrorrhoea gravid arum. 3. Inflammations, Acute.-(a) Hemorrhagic endometritis, as Classes.-Acute. Rare. There is a sudden transudation of fluid from some traumatism. Symptoms.-Pain, difficulty in respiration, at times orthopnoea, fever. Chronic.-Begins at the third or fourth month and steadily increases, usually causing but little trouble. Treatment.-Immediate evacuation in the acute_variety; in the chronic this is, as a rule, not required. If necessary, the life of the fœtus is not to be considered, as it will usually be diseased. Aspiration through uterine wall condemned. The membranes are to be punctured at the os, using the hand as a plug to prevent sudden escape of fluid. (B) Abnormalities of Color and Consistency.-Normally slightly opaque in the latter months of pregnancy, the liquor amnii may be green or brown from the presence of meconium, or tinged with red if the foetus is macerated. (C) Putrefaction of the Liquor Amnii.-Most likely to be associated with death and decomposition of the foetus, but occasionally there is an intensely putrid odor to the liquor amnii, with physometra, and yet the child is born alive. (D) Plastic Exudation.-Usually occurs early when amnion and foetus are near each other, and thus forms bands of adhesion between them, and even causes amputations of fœtal extremities and premature detachment of the placenta. (E) Abnormal Tenuity.-Rare. The amnion may rupture and become separated from the chorion, which remains intact, forming bands or strings by being rolled upon itself. The strings thus formed may encircle the fœtus. (F) Cysts. Of no clinical importance. (G) Rupture.-Abortion may result. Occasionally the amnion and chorion are perforated at a situation remote from the internal os, and the liquor amnii dribbles away for some weeks, or even months, before delivery. This is called an amniotic hydrorrhoea. The Chorion. Definition.-The chorion is the outermost of the foetal membranes, and is formed from the external layer of the non-germi оти |