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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    affection into two groups, basing the distinction between them simply on the extent and severity of the lesions presented, and so divides them into (a) the less severe and localized forms and (b) severe diffuse forms which may simulate Landry’s paralysis or involve the cerebral nerve areas. He concludes that they usually arise from autointoxication. Nicholson divides the etiological classification as follows: (i) Those cases arising from a toxemia; (2) those cases arising from a septic process; (3) those cases resulting from some me- chanical agent during labor or in the early puerperium. He reports two cases, in one of which there is a vague history of a mild tox- emia in the early months; the other followed a difficult forceps labor with unrepaired complete laceration of the perineum seen two months after childbed. He states that the improvement in severe conditions is slow. Landemann also reports a case of pregnancy with polyneuritis. Necropsy examination showed cloudy swelling and fatty degenera- tion of the liver without necrosis of cells. The spleen and kidney showed coagulation necrosis, which he considers to be an evidence of the toxic cause of the disease. The writer would add the following case of toxemia of preg- nancy wdth vomiting, jaundice and neuritis. Primipara, aged 36; married. Previous History.—Patient was never a strong child and had diseases of childhood. No history of acute rheumatism, but has had scarlet fever. Has had “heart disease” attributed to lifting a heavy weight. History of Present Illness.—Patient had been married five months. Menstruation was present once after marriage. When two months pregnant vomiting began in the mornings, persisting with intervals of relief. At three months, vomiting was so per- sistent as to confine the patient to bed. She, however, looked upon this as the usual course and refused to call a physician. At four months, vomiting was so severe and continuous that a physician was consulted. He treated the patient with rectal feeding, cocaine by the mouth, and after several days curetted her in bed, in the Sims position and without anesthesia. Eight days after this curettage the writer was called to take the case owing to the de- parture from town of the first physician, who assured me that the uterus had been thoroughly curetted. The vomiting, at that time, was persistent and continuous, and there had been no re- tention of food for three days. Vomitus was dark and blood-