534 ABXORMALITIES IX METABOLISM 



there is an accumulation of tlie precursors of urea in the system 

 (Sikes). However, the involution of the uteinis itself results in an 

 increased nitrogen excretion which probably accounts for much if 

 not all of these findings (Slemons).^^^ There is an excessive elimina- 

 tion of nitrogen in the form of ammonia, which is said to be due to 

 the formation of abnormal quantities of sarcolactic and other organic 

 acids in the body, which are combined with ammonia in the blood and 

 eliminated in the urine.^" This fact has led many to look with favor 

 upon the idea that eclampsia is due to an acid intoxication. Other 

 nitrogenous urinary constituents may also be increased, so that the 

 relative proportion of nitrogen eliminated as urea is often greatly 

 reduced. It is said that the toxicity of the urine, which is high in 

 normal pregnancy, is increased if the kidneys are not impaired, but 

 decreased if their permeability is impaired by nephritis, the character 

 of the toxicity being such as to indicate that it is from substances de- 

 rived by disintegration of proteins (Franz). The proportion of sul- 

 phur eliminated in an unoxidized form, as compared with that elimi- 

 nated as SO4, is much greater than normal. These findings all indi- 

 cate that oxidation within the body is impaired. There is more or 

 less retention of chlorides, but there is nothing characteristic in this.'*" 

 In spite of the hepatic lesions of eclampsia the tolerance for levulose 

 was not found impaired by Alsberg.*^ 



The nonprotein nitrogen of the blood is but little increased in 

 eclampsia, and not to the extent usually seen in uremia, and it bears 

 no definite relation to the severity of the symptoms (Farr and Wil- 

 liams)."^ They found from 25 to 72 mg. per 100 c.c. in seven cases. 

 These figures can be reasonably explained as the result of tissue dis- 

 integration rather than renal retention. However, Losee and Van 

 Slyke could find no increase of amino-acids or other intermediates 

 of protein destruction in either blood or urine in pregnancy toxe- 

 mias ; "" their total nonprotein blood nitrogen figures ranging from 

 25 to 46 mg. 



The decrease in the alkalinity of the l)lo()d observed by Zangmeister 

 and others has been ascribed to the formation of sarcolactic acid by 

 Zweifel/- who failed, however, to find an excess of CO.,, or to detect 

 oxybutyric acid or oxalic acid in the blood. As to the blood proteins, 

 fibrin has been found increased by Kolman and by Dieiist,''' while 

 Schmidt found a relative increase in tbo gl()l)ulin. Sikes eoncludes 

 that the statements to be found in the literature eoncei'iiing tlie tox- 



38a Bull. Johns TTopkina ITosp., 1914 (25), iDfi. 



30 See /wcifcl and Lockniann, IMiincli. med. Worli., lOOli dS). ^HT ; Cfut. f. 

 Gvn.. 190!) (:53), 847. 

 ■40 Zinsser, Zeit. f. Gob., 1912 (70), 200. 

 41 Cent. f. C.yn., 1910 (.34), (>. 

 4iaAmer. .Tour. j\Ied. St-i., 1914 (147), or.fi 

 ••lb Amor. Jour. ^Nled. Sci.. 1917 (15.3), 94. 

 4-.iAroh. f. Gyn., 1905 (7(5), 537. 

 43 Arch. f. Gyn., 1912 (96), 43. 



