In 338 women not albuminuric, there were 12 cases of dystocia, or 3.5 per cent.
In 109 women albuminuric, there were 18 cases of dystocia or 16.5 per cent. Albuminuria, in turn, predisposes to hemorrhage. Thus, from Cazin: In 338 women not albuminuric, there were 26 c,ases of hemorrhage.
In 109 women albuminuric, there were 23 cases of hemorrhage.
We note finally, according to 'layer, 131ot, Imbert Goubeyre, Molas, etc., that these hemorrhages, generally uterine, manifest themselves par ticularly at the time of delivery, and may be met with in other organs, the liver, brain, lungs and bladder.
Although we have insisted at length on the frequency of cedema and dropsy, it is not to be believed that there is a constant and absolute rela tion between cedema and alburninuria; because, on the one hand, it may be absolutely absent, when women are albuminuric, according to the re searches of Blot, and the cases we have cited in our thesis of 1872, and, on the other hand, cedema exists often in pregnant women, without a trace of albumin in the urine, and this fact has been demonstrated with out a doubt by Devilliers and Regnault.
The last point to be noted is the relation which exists between albu minuria and eclampsia, and, without encroaching on the following chapters, which are devoted to eclampsia, there is a statement one can make almost absolutely,—we say almost, because there are some exceptions. This is the statement: " If all albuminuric cases are not eclampsic, all eclampsic patients are albuminuric." Peter does not admit this. It follows, however, from these statistics: Depaul has met in his private practice anct in that of his colleagues, by whom he was called in consultation, twenty cases where he did not find albumin, and we can add cases of Trousseau, Leuret, Dubois, Imbert Goubeyre, Mascarel, L'huillier, Schroeder, Trelat, Spiegelberg, Davis, Hartmann, IIicks, Oslx)rn, Van du Meersch, Dohrn, Fabre, etc.
These cases, although exceptional, tend to increase, and they justify our assertion. The frequency of the occurrence of eclampsia and albuminuria has been noted by all authors: Blot in 41, albuminuric 7 times; Stoltz in 7, 1; DevilHers in 20, 11; Mayer in 63, 7; Litzmann in 13, 5; Braun in 35, 6; Imbert G-onbeyre in 159, 94; Hubert du Louvain in 135, 36; Rosen stein in 40, 10; Hoffmeier in 30, 10; Macdonald in 5, 5.
The two tables reported in onr thesis were furnished us by : As albuminuria, so eclampsia is more frequent during labor than during pregnancy, and there is here also a direct relation between eclamp sia and albuminnria. Eclampsia in some cases may appear early, most fre quently, however, during the seventh or ninth month, above all during the few days or hours which precede labor, but it may come also after labor—thus: depend3 on two conditions: lot. To establish the fact of albuminuria. The examination of the urine leaves no doubt; 2d. To find out whether the albnminuria is dependent upon pregnancy, or upon other causes. Here the sign given by Bouchard and Cassin may be of great importance, coagulation of albumin indicating, according to them, a renal lesion; the non-retractile coagulum indicates a transient albumi nuria, such as we observe in severe forms of alcoholism, etc. The im portance of this sign is understood (if further observations confirm it) not only from a diagnostic, but also from a prognostic standpoint.
disease may be always considered grave, because, if a number of women are cured, there are a great many who die, either from the disease itself or from the complications, and we have seen how the albuminuria of pregnancy can become the starting point of a chronic nephritis.
The prognosis will vary according to the natnre, the duration, more or less long, of urinary troubles, their intensity, the existence or not of kid ney lesions and the morbid cause, the severity of the complications.
The prognosis is particularly grave when the albuminuria exists pre vious to pregnancy, although we make an excvtion in case of albumin nria of labor and of eclampsia. Hoffmeier, in 48 cases of chronic nephritis, has noted death 18 times. In 104 cases of eclampsia death has resulted in 39 per cent.; Rosenstein 32.9 per cent.; Devilliers in 11 ont of 20 cases.