PATHOLOGICAL METABOLISM IN PREGNANCY 843 



allied to autolysis. In .these animals there was a marked increase in 

 the total nitrogen, one case showing a rise from two to nine grams. 

 While the ammonia was increased in actual amount, the percentage rela- 

 tionship was somewhat lower. Both the creatinin and creatin were in- 

 creased and the authors concluded that the ratio of creatin excretion to 

 total nitrogen steadily rises during the poisoning. 



Perhaps chloroform poisoning presents in its pathological changes in 

 the liver the closest resemblance to the liver of pernicious vomiting. 

 Here again, the changes are in the cells about the center of the lobule. 



Howland and Richards studied the nitrogen excretion in delayed 

 chloroform poisoning in dogs and came to the conclusion that "it is a 

 striking fact and worthy of especial emphasis that the distribution of 

 nitrogen as urea, ammonia and undetermined, so closely approximated 

 the normal." However, while the proportions remained the same, there 

 was a decided increase in the amount of total nitrogen and the other 

 fractions. In two of the dogs that died there was a marked increase 

 in the creatin nitrogen but not proportional to the severity of the poison- 

 ing. They state that a rough index of the severity of the acute effects 

 is given by the total nitrogen and sulphur figures and the changes in 

 creatin. 



In all of these types of artificial liver degeneration the animal is 

 in a condition of starvation and the nitrogen represents the endogenous 

 metabolism. The marked increase in the total nitrogen must be due to 

 either a general stimulation of the protein metabolism by these poisons 

 or to an increase in the nitrogen by autolysis of the cells in the injured 

 liver. The disturbances in the creatin and the rise of the undetermined 

 nitrogen would indicate that the latter condition exists. 



Even though the injury to the liver is extreme these investigations 

 suggest that the intermediary metabolic processes are carried on to a 

 large extent by the remaining uninjured cells. 



The nitrogen figures from these cases of experimental liver degenera- 

 tion are comparable to those of the fatal case of pernicious vomiting in 

 Ewing and Wolf's tables. 



Further Studies of the Urine in Toxemia 



Murlin and Bailey (a) in an effort to ascertain if there is evidence 

 of defective deamination in pregnant women made a study of the 

 nitrogen partitions of 100 urines. The ammo-acid nitrogen was deter- 

 mined by the formal titration method or by the new method of Benedict 

 and Murlin and the purin nitrogen was also separated, leaving for the 

 undetermined fraction only polypeptid bodies or oxyproteic acids. The 

 average of 33 normal urines showed urea of 77.7 per cent, ammonia of 6.7 



