544 ABNORMALITIES IN METABOLISM 



Zweifel that lactic acid is responsible seems untenable, and the de- 

 gree of acidosis present is not sufficient to account for the intoxication 

 (Losee and Van Slyke) . 



The Placenta as a Source of Intoxication.^ — Histologists having fre- 

 quently observed placental cells in the blood and vessels of eclamptic 

 patients, it was once suggested that multiple capillary emholi of pla- 

 cental cells, detached from chorionic villi and forced into the pla- 

 cental circulation, cause the manifestations of the disease; this theory 

 is entirely inadequate, however, to explain all the features of eclamp- 

 sia. Related to this hypothesis is the idea that the placental tissues, 

 being foreign to the maternal organism in so far as they are derived 

 from the ovum, give rise to the production of antibodies (synajtioly- 

 sins) by the mother, which are toxic for pregnant animals (Ascoli), 

 and which may have to do with eclampsia in some unknown way. 

 Rosenau and Anderson found that guinea pigs could be made anaphy- 

 lactic to guinea-pig placenta, showing conclusively that the placenta 

 contains proteins foreign to the mother. Attempts to establish the 

 anaphylactic nature of eclampsia have, like so many other theories, 

 foundered on the fact of the characteristic anatomy of this disease, 

 which is never seen in anaphylaxis.'^* The studies of Abderhalden 

 have shown that the blood of every pregnant female animal contains 

 enzymes which have a specific proteolytic action, and so the possibility 

 exists that abnormal or excessive products of such proteolysis, or a 

 lack of adequate defensive digestive action, may be responsible for 

 the toxemias of pregnancy. Esch'^^ and Franz^^ have, indeed, found 

 evidence of the presence in the serum and urine of eclamptics, of sub- 

 stances resembling anaphylactic poisons in their action, and presum- 

 ably derived from proteolysis somewhere in the body. Franz found 

 that if the poison injures the kidneys seriously it is retained in the 

 body, the urine ceasing to be toxic, which has, presumably a relation 

 to the toxicosis of eclampsia. '''' 



Liepmann^* and others have reported the finding of a considerable 

 degree of toxicity in eclamptic placentas, but this is probably related 

 to the increased autolysis observed in eclamptic placentas by Dr}'- 

 fuss.'^^ Obata^° found no great difference in the toxicity of eclamptic 



^*See Fellander, Zeit. Geb. u. Gyn., 1911 (68), 26; Mosbacher, Deut. med. 

 Woch., 1911 (37), 1021. Vertes (Monat. Geb. u. Gyn., 1914 (40), 361, 466) 

 states that animals dying from anaphylaxis may show typical eclamptic tissue 

 changes, which is not in accordance with the observations of many others. 



" Mlinch. med. Woch., 1912 (59), 461. 



" Ibid., page 1702. 



" Hull and Rhodenburg (Amer. Jour. Obst., 1914 (70), 919) ascribe impor- 

 tance to leucine derived from proteolysis of the placental elements, while Kiutsi 

 (Zeit. Geb. u. Gyn., 1912 (72), 576) considers the nucleins of the placenta the 

 toxic agents, both statements being unconfirmed and imjjrobable. 



'« Munch, med. Woch., 1905 (52), 687 and 2484; Boos, Boston Med. and Surg. 

 Jour., 1908 (158), 612. 



" Biochem. Zeit., 1908 (7), 493. 



*" Jour, lumiuiiol., 1919 (4), 111; bibliography on etiology of eclampsia. 



