Toxemia of pregnancy with vomiting : its toxic manifestations, its relation to eclamptic toxemia, acute yellow atrophy and experimental necrosis of the liver / by Ellice McDonald.

  • McDonald, Ellice, 1876-1955.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Toxemia of pregnancy with vomiting : its toxic manifestations, its relation to eclamptic toxemia, acute yellow atrophy and experimental necrosis of the liver / by Ellice McDonald. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in excess of the amount needed to counteract the invasion by the fetal elements. Weichardt’s theory is based on the supposition that, in the dis- solution of the wandering placental elements, an albuminous ma- terial is formed, a “syncytiotoxin” which is poisonous to the mother. In normal pregnancies this poison is immediately neutral- ized by an adequate amount of antitoxin ; but in cases in which the formation of this antitoxin is absent or deficient, the poison pre- vails and gives rise to eclamptic toxemia. The results of Leiptman and of Wormser and Lathardt who repeated these experiments, do not support these theories. These writers did not obtain the “syncytiolysis in vitro” described by Viet, Scholer, Weichardt and Opitz. Neither were they able to induce eclampsia in rabbits as Weichardt claims to have done by the direct introduction of placenta cells into the vein. Also, the results of subdural injections failed to confirm Ascoli’s views. Dienst, in a recent article on the causation of eclamptic toxemia, ascribes great importance to the action of the mother’s blood serum upon the red blood corpuscles of the child. He obtained blood both from the umbilical stump and from the placental end of the cord at the time of labor, and determined the action of these in vitro. He also tested the permeability of the expelled placenta by the injection of milk and of the placenta in situ by injecting methylene blue at low pressure. In all 118 women were examined. The maternal blood serum, in twenty-four cases, agglutinated and eventually dissolved the red blood corpuscles of the respective children. Of these twenty- four cases, fifteen had impervious placenta, a normal course and no albuminuria. Of the other nine, with pervious placenta, seven were eclamptic and two had albuminuria. He, therefore, reaches the conclusion that, to this agglutination and hemolysis, is due the condition of eclamptic toxemia, and that this can occur only when there is a free communication between mother and child. Albuminuria occurs when the interchange is slight. He considers this action analogous to that of heterolytic sera; for example, he has seen in the liver of a rabbit after intravenous injection of human or dog’s blood, changes similar to those caused by eclampsia. He states that there is not only a simi- larity, but an exact agreement between the clinical symptoms and the pathological lesions in both these conditions (eclampsia and transfusion with heterolytic sera). The hemoglobinuria is more marked in the experimental lesion.