Toxaemia of pregnancy is that condi tion which occurs as the result of pres ence in excess of toxic material; so far as is known, the poison is of the nature of an alkaloid or alkaloids. The excre tion of waste-material is mainly effected through the kidneys, and this may ac count for the albuminitria of pregnancy, rather than mechanical pressure or reflex spasm. Kynoch (Brit. Med. Jour., May 21, '93).
Conclusions of previous researches on subject of albuminuria during preg nancy: 1. In most pregnant women there is a certain degree of autointoxication; this is the normal toxemia of pregnancy. 2. In lesions or disease of the kidney or liver the toxic condition becomes aggra vated and may lead to grave complica tions. notably uremia. 3. Toxaemia of renal origin is the most common, asso ciated with albuminuria and oedema. 4. Albuminuria is not the cause of eclamp sin, but a symptom owning a common origin. 5. Grave complications—such as coma, dyspncea, and paralysis — may prove fatal in the absence of eclampsia. 6. In most cases toxic eclampsia breaks out in albuminuric women; albuminuria is therefore an important precursory sign which should not be neglected. 7. Per sonal statistics show that 1 pregnant woman in 40 is albuminuric. and that, of 4 albuminurics, 1 develops eclampsia; eclampsia without albuminuria is rare 1 case in 0—and is less serious. 8. Al buminuria alone without eelampsia has often serious or fatal consequences—in 110 eases, S women and 20 children died; there were 61 premature labors, S post-partum hemorrhages, and 3 cases of threatened convulsions. 9. Al buminuria should be looked for in all pregnant women. 10. Every albuminurie pregnant woman should be actively treated, a milk diet being the best. II. In case of threatened danger premature labor is indicated, and gives excellent results. Charles (Jour. d'Accouche ments, Apr. 3, '93).
By many the malarial poison is re garded as an efficient cause of chronic nephritis. Out of a series of 712 cases of malaria studied personally, only 3 were found suffering from chronic nephritis; and in 2 out of these it was probable that the renal affection was due to causes other than malaria. It would thus seem that malarial fever cannot be regarded as a cause of nephritis in the sense that scarlatina. diphtheria, etc.. are. J. H. Brownlow (Amer. Med. Times, Mar., 1900).
Case in a man, aged 41, suffering from an acute articular rheumatism, with a mitral systolic murmur, the urine con taining albumin and casts. Ender the
usual treatment he recovered in three weeks. Four recurrences were attended by albuminuria. the amount of the albu min decreasing with the decline of the rheumatic symptoms. The heart com plication only temporary. The articular symptoms, the pyrexia, and the renal attack thus constituted a rheumatic symptom-complex. The renal cells had probably been affected by rheu matic- toxins. Parkes Weber (Ed. Med. Jour., Jan., p. 48, 1900).
The alterations in the blood which produce the albuminuria and the aseites are due to the presence of toxins which are derived from the gastro-intestinat tract. This fact has been demonstrated beyond all doubt experimentally by Do minic•is. In man intestinal antiseptics will cure such cases. and cause the albu minuria and the aseites to disappear. if the treatment is suspended for a time. and the patient allowed to eat beyond his digestive powers. these phenomena soon reappear. Three eases in which the above conditions were noted. G. R. Filocamo (Gaz. Inter. di Med. Pratica. Mar. 31. 1900).
3. When the composition of the blood is altered the urine, very often, will be albuminous. This can be proved ex perimentally by injecting egg-albumin, soluble casein, lil'emoglobin, etc., into the veins of animals, for generally the quantity of albumin excreted after the injection will exceed the injected quan tity. Similar results may be obtained by the injection of pepton and propepton, whereas the albuminates are generally inoffensive. Ingestion of a very large quantity of egg-albumin is liable to provoke albuminuria.
Fifty-five cases of nephritis. either chronic or subacute, with albuminuria. in which the haemoglobin and specific gravity of blood and amount of albumin excreted in urine per day were esti mated. There is more or less constant relation between the degree of hydreemia and the amount of albumin excreted. The blood of women is, on an average. about 2.12 lower in specific gravity than the blood of men. The hydreemia bears no relation to the heemoglobin. but varies inversely as the specific gravity of the blood. No definite relation ap pears to exist between the hydrannia and the dropsy; but it seems as if there must be some etiological relation be tween the albuminuria and the hydrie mia. Geza Dieballa and Ladislaus V011 Ketly (Dent. Arrhiv f. klin. Med., Sept. 6. 'US).