CHANGES DURING PREGNANCY 549 



According to Veit and Scholten, 1 the villi can dissolve intact red 

 cells of the circulating blood, just as tin- solution of erythrocytes can 

 be produced by placental extracts. As a result of this, lueiuo- 

 globimemia may occur in pregnancy. Wychgel 2 observed it in eight 

 out of twenty-three pregnancies, and the condition occurs more 

 frequently still in eclampsia. At present, however, it is not yet 

 generally accepted that an erythrotoxin is formed by the syncytiura, 

 though Bonnet 3 has shown historically that a destruction of red 

 cells probably takes place during life. He noticed on the surface of 

 the villi " perfect and damaged erythrocytes in all stages of degenera- 

 tion, clumping and solution." So Hofbauer found, by adding neutral- 

 red to the chorionic villi of two fresh two-months' placentae teased in 

 saline, that many of the blood corpuscles showed red dots indicating 

 degeneration. 



(b.) Calcium. The great demand for calcium by the developing 

 embryo, especially during the last three months of pregnancy, would 

 lead one to suppose that pregnancy involves a loss of calcium on the 

 part of the mother. It has, in fact, been stated that teeth are apt to 

 become brittle in pregnancy from a decrease in calcium fluoride 

 and a deficiency in enamel formation. 4 Evidence of a special 

 drain on calcium is also found in puerperal osteomalacia, which 

 occurs in poor people who presumably live on an ill-constructed 

 diet, and which has been produced experimentally as the result 

 of such a diet in animals. 5 The effect on the teeth is not admitted 

 as a general occurrence in pregnancy by some authorities, 6 if it 

 occurs at all, and is probably the result of a diet deficient in calcium. 

 The exact observations of Hoffstrom have shown clearly that on a 

 suitable calcium-rich diet the mother actually gains in calcium. On 

 such a diet Hoffstrom's patient retained 34'3 gm. < 'a during the whole 

 pregnancy, of which 30'1 gin. were required by the foetus, so that the 

 mother ended her pregnancy with a net gain of 4'2 gm. Ca. As has 

 been stated, the requirements of the fc^tus are particularly high 

 iliuing the last three months of pregnancy, and the mother rcsjionds 

 to this increased call for calcium by diminishing the excretion of 

 calcium in the urine and to a lesser extent by the intestine. Even 

 on this diet and with a total positive balance there are short periods of 



1 Veit and Scholten, " Synzytiolyse und Hamolyse," '/..It.-,, I,. (. <;,l,,i,-t.<l>. . 

 <!tln(ik., vol. xlix. 



-' Wychgel, " Untersuchungen iiber das Pigment der Haut und der Urin* 

 wiihrend der Schwangerschaft," Zntsch. f. <!>'l>"i-uli. >i. '//////., vol. xlvii. 



3 Bonnet, quoted by Hofbauer (/ii<>/< ></>'<' </'> //'/(.</</////. // /'/,/;, Wcr, Wien und 

 Leipzig, 1905). 



4 Terrier, " De 1'influence de la grossesse sur les dents," TV/ Ax.- ,!<< /%//.. 1899. 



5 StillinMwid Mering, "Ueber experimentelle Erzeugung von Osteomalacie," 

 Z<>nt,-it!bl.f. med. Wistenschaft, 1889. 



" Dr. Sim Wallace, Private communication. 



