440 METABOLIC ABNORMALITIES, AUTOINTOXICATION 



other organic acids in the body, which are combined with 

 ammonia in the blood and eliminated in the urine. 1 This fact 

 has led many to look with favor upon the idea that eclampsia is 

 due to an acid intoxication. Other nitrogenous urinary constit- 

 uents may also be increased, so that the relative proportion of 

 nitrogen eliminated as urea is often greatly reduced. The 

 proportion of sulphur eliminated in an unoxidized form, as 

 compared with that eliminated as SO 4 , is much greater than 

 normal. These findings all indicate that oxidation within the 

 body is impaired. 



Numerous writers have studied the toxicity of the urine in 

 eclampsia, but the earlier investigations were conducted in such 

 a manner that the results are practically worthless. More recent 

 studies by Volhardt, Schumacher, and Van der Bergh yield no 

 evidence that the urine shows any actual differences in toxicity 

 whether from normal, pregnant, or eclamptic women. . 



Analyses of the blood have given widely differing results, 

 some finding an increase in urea, while others have failed to 

 observe such increase (the latter including the more recent 

 observations). Likewise the statements concerning the quantity 

 of ammonia in the blood are at variance, Zweifel holding that 

 neither urea nor ammonia is increased. The decrease in the 

 alkalinity of the blood observed by Zangemeister and others 

 has been ascribed to the formation of sarcolactic acid by Zweifel, 2 

 who failed, however, to find an excess of CO 2 , or to detect 

 oxy butyric acid or oxalic acid in the blood. As to the blood 

 proteids, fibrin has been found increased by Kolman and by 

 Dienst, while Schmidt found a relative increase in the globulin. 

 Sikes concludes that the statements to be found in the literature 

 concerning the toxicity of the blood in eclampsia leave nothing 

 proved concerning this point. 



Theories as to Etiology. The anatomical changes of 

 eclampsia are such as to leave little or no room for doubt that 

 there is a severe intoxication with poisons that have a markedly 

 toxic effect upon all the organs of the body, thus differing from 

 the toxic materials at work in uremia, which seem to affect 

 chiefly the central nervous system. Repeated bacteriological 

 and histological studies have failed to demonstrate that infection 

 with either vegetable or animal parasites is the cause, and 

 clinical observations do not support such a hypothesis. The 

 association of the condition with pregnancy, and particularly 

 the rapid improvement that follows the removal of the contents 



1 See Zweifel and Lockmann, Munch, med. Woch., 1906 (53), 297. 



2 Arch. f. Gyn.,1905 (76), 537. 



