&58 HAROLD BAILEY 



Following this test Reichenstein found sugar in the urine of 37.5 per cent 

 of the cases and his results have been thoroughly verified by others. Widen 

 in an examination of the blood in eight cases of eclampsia found the 

 hyperglycemia to be variable and its absence denoted a serious prognosis. 

 He stated that the sugar content was also increased in pernicious vomiting. 

 Morriss found values of 0.098 to 0.116 per cent for normal preg- 

 nancy and no increase in the sugar in pre-eclampsia. In 5 eclamptics 

 the figures were 0.097 per cent, 0.128 per cent, 0.136 per cent, 0.151 per 

 cent and 0.256 per cent. The blood specimens were all obtained directly 

 after a convulsion. Killian found a moderate hyperglycemia in all of his 

 eclamptic cases. 



These figures are in contrast to those obtained in uremia and chronic 

 nephritis, which are invariably higher and this fact may be made use of in 

 differentiating between the two diseases. 



Falco experimenting with pregnant rabbits and guinea pigs found 

 histological evidence in the islands of Langerhans of pancreatic insuffi- 

 ciency. He suggested that the placenta takes some part in the carbohydrate 

 metabolism. 



Increase in the cholesterol content of the blood in normal pregnancy 

 and a considerable increase in eclampsia have been noted by Autenreith 

 and Funk, Siemens, and Pisani and Savare. It has long been known that 

 there is an increase in the cholesterol of the pregnant and its deposition 

 in the liver has been accepted as an explanation of the frequency of gall- 

 stones in women. It has been suggested that the cholesterol determina- 

 tions may prove of value in separating the eclamptic from the nephritic 

 toxemias. 



J. C. Litzenberg in a study of 271 cases of pregnancy found 

 urobilinogen or urobilin in the urine in 25 per cent and points out, that 

 in the absence of blood destruction it indicates an insufficiency of the 

 liver. 



Summary 



Experimental studies in animals whose livers were removed or side- 

 tracked by means of the Eck fistula showed high ammonia in the urine 

 Avhen protein was fed to them. Animals with liver degeneration follow- 

 ing the administration of various toxic substances showed little or no in- 

 crease in the ammonia in the urine ; and it has been suggested that under 

 such conditions there is a safety mechanism operable, whereby the un- 

 damaged cells take on an increase in activity. 



Pernicious vomiting and acute yellow atrophy cases markedly resemble, 

 as regards the nitrogen excretion in the urine, the animals in the experi- 

 mental studies. There are instances in which the changes are so slight 

 as to suggest that the liver degeneration was not extensive. In other cases 



