2«) 



THE AMERICAN NATURALIST [Vol. LIV 



stricture, which in turn, except for an insignificant num- 

 ber of traumatic cases, is gonorrheal in origin. 



Eegarding the wisdom of bringing together under one 

 rubric the causes of death listed in Table IV on a biolog- 



TABLE IV 



ical basis, there would seem to be little doubt with a single 

 exception. This does present a very difficult problem. 

 Item 138, Puerperal albuminuria, is included here rather 

 than with other puerperal diseases under the sex organs, 

 or elsewhere, on the reasoning that the cause of death is 

 finally the organic breakdown of the kidneys and not of 

 the reproductive system, and bespeaks a fundamental 

 organic weakness of the excretory system, which weak- 

 ness is made to flare up into clinical nephritic trouble 

 under the strain of pregnancy. Basically these toxemias 

 are due to faulty maternal metabolism, of unknown 

 origin, which can not in the present state of ignorance be 

 properly charged against any particular organ or organ 

 system. It, however, remains a fact that many women 

 having organically sound excretory organs are able to 

 weather even very severe metabolic storms of this sort 

 near the end of pregnancy and survive. Others with 

 organically weak excretory systems go down. In view of 

 these facts it seems on the whole fairer to put these 

 deaths here than against any other organ system. 



The "rheumatisms" present another difficult ques- 



