ECLAMPSIA 441 



of the uterus, almost compels us to admit that the causative 

 agent is produced by the fetus or the placenta. Some investi- 

 gators (Politi, Liepmann) believe that they have found a greater 

 degree of toxicity in extracts from the placentas from eclamptic 

 than from normal women. We have no approximate ideas 

 as to the nature of the supposed toxic substances, except that 

 Zweifel, 1 who is the leading exponent of the idea that eclampsia 

 is an acid intoxication, believes that the fetus produces abnormal 

 quantities of lactic acid which is the cause of the maternal 

 intoxication. In support of this view he reports the finding in 

 eclampsia of lactic acid in blood from the umbilical vein in much 

 greater quantities than in the maternal blood, and in still greater 

 quantities in the placenta. It seems improbable, however, that 

 the severe anatomical changes and the convulsive manifestations, 

 so different from the conditions observed in ordinary acid intox- 

 ications, can be due to sarcolactic acid alone, especially when in 

 such minute quantities as it is found in the blood of eclamptics. 



The Placenta as a Source of Intoxication. Histologists 

 having frequently observed placental cells in the blood and 

 vessels of eclamptic patients, it has been suggested that multi- 

 ple capillary emboli of placental cells, detached from the chorionic 

 villi and forced into the placental circulation, cause the manifes- 

 tations of the disease ; this theory is entirely inadequate, how- 

 ever, to explain all the features of eclampsia. Related to this 

 hypothesis is the idea that the placental tissues, being foreign to 

 the maternal organism in so far as they are derived from the 

 ovum, give rise to the production of antibodies (syncytiolysins) 

 by the mother, which are toxic for pregnant animals (Ascoli), 

 and which may have to do with eclampsia in some unknown 

 way. In any case, antiserum for placental tissue has been 

 repeatedly prepared (Weichardt, Scholten and Veit, 2 Opitz 3 ). 

 Possibly the foreign tissues are toxic to the maternal organism, 

 or form toxic substances during their solution (Weichardt), and 

 a failure to develop such antibodies as have been obtained 

 experimentally leaves the mother unprotected from these toxic 

 substances. Up to the present time, however, this phase of 

 the study of the pathogenesis of eclampsia has yielded little 

 besides interesting but contradictory hypotheses. 4 



Liepmann 5 has reported the finding of a considerable degree 

 of toxicity in eclamptic placentas ; the poisonous substance, 



1 Loc. eit. 



2 Zeit f. Geb. u. Gyn., 1903 (49), 210. 



3 Deut. med. Woch., 1903 (29), 597. 



4 See review by Wormser, Munch, med. Woch., 1904 (51), 7 and 2285. 



6 Munch, med. Woch., 1905 (52), 687 and 2484. 



