PATHOLOGICAL METABOLISM IN PREGNANCY 841 



TABLE II 

 NITROGEN IN URINE. ECLAMPSIA FATAL. (From Ewing and Wolf) 



TOXEMIA CHARACTERIZED CHIEFLY BY VOMITING 



Vomiting ceased; patient recovered. 



FATAL CASE OF PERNICIOUS VOMITING 



Author's comment: Note the same general changes in the nitrogen excretion in 

 the fatal eclamptic cases, Nos. 28 and 29 and the pernicious vomiting case, No. 7, as in 

 the acute atrophy cases of Table I. In case No. 12 the figures represent the endogenous 

 metabolism and suggest that deamination may take place outside of the liver. The unde- 

 termined nitrogen is high and may show the presence of a metabolite such as an amino 

 body or oxyproteic acid. 



factor in the rise of the ammonia, do not believe that the toxemia with 

 the resultant symptoms have either acid intoxication or acidosis as a 

 basis. One of them, Wolf, criticises Williams for failing to recognize that 

 low total nitrogen with low urea and high ammonia in some of his cases 

 may be explained in part by starvation. 



