CHANGES DURING PREGNANCY 541 



glycolysis (Brocard) and to hepatic insufficiency (Cristalli)/ without 

 sufficient evidence: The greater tendency to alimentary glycosuria 

 in pregnancy was upheld by Lanz,^ who observed it after the 

 administration of 100 gm. of glucose. It was confirmed by 

 Payer,* Eeichtostein,* and Bergsma.^ In his observations on 

 partially pancreatectomised dogs Allen "^ found a slight lowering of 

 the limit of carbohydrate assimilation during pregnancy. These 

 observations are difficult to interpret, because, as we shall see in 

 dealing with the fat metabolism, the pregnant organism requires 

 .a larger amount of carbohydrate than the non-pregnant organism 

 to keep the metabolism normal as judged by the tendency to the 

 excretion of the acetone bodies. 



E. The Metabolism of Feds in Pregnancy 



{a.) The Absor2Mo7i of Fats hy'^lie Mother. — The absorption of fats 

 from the intestine is increased during pregnancy (Ferroni^), the 

 neutral fats, fatty acids, cholesterin, and soaps contained in the fteces 

 •being all decreased towards the end of the gestation period. This 

 is the time when the subcutaneous tissues of the fcetus receive an 

 abundant supply. They rapidly reach the normal level in the 

 puerperium. There is a corresponding increase of fat in the maternal 

 blood in the dog and guinea-pig, and the excess disappears after 

 parturition (Gapaldi).* 



(6.) Fats of the Maternal Organism. — According to Miotti,^ the liver 

 cells contain a continuously increasing amount of fat, first in the 

 central parts of the lobule and later throughout. He looks on it as 

 a fatty infiltration, and concludes that an increased fat formation 

 takes places during pregnancy. This observation has been confirmed 

 by Mottramji" who compares it to the fatty infiltration of the liver 



'' Cristalli, Ricerche sulla presenza dello 2,uckero nelle orine delle donne gravida 

 e puerpere, Naples, 1 900. 



2 Lanz, "Ueber alimentare Glykosurie bei Graviden," ^Y^en. 'rued. Presse, 1895. 



^ Payer, "Binfluss des Zuokers auf den StofFweohsel der Schwangeren," 

 Monatsschf. f. Geburtsh. u. Ot/tiak., vol. x., 1899. 



■* .Reichenstein, " Glycosurie und Schwangerschaft," Wiener Hiii. Wocheiisclir., 

 1909 ; ibid., 1911. 



^ Bergsma, loc. cit. 



" Allen, "The Influence of Pregnancy upon Experimental Diabetes," Amer. 

 Jour. Physiol., vol. liv., 1920. 



^ Ferroni, " I grassi neutri . . . delle gravide e delle puerpere sane," Ann. 

 di Ost. e Ginec, 1905. 



" Capaldi, "Sul contenuto di grasso del sangue nella gravidanza e nel 

 puerperio," di Ann. Ost. e Ginec, 1905. 



" Miotti, " Contributo alio studio istologico de f egato durante la gravidanza,'' 

 Ann. di Ost. e Ginec , 1900. 



'<• Mottram and Coope, "Fatty Acid Infiltration of the Liver during 

 Pregnancy and Lactation," Jour. Physiol., vol. xlix., 1914. 



