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July 24, 1926


JAMA. 1926;87(4):226-228. doi:10.1001/jama.1926.02680040014005

The types of toxemia to be considered in this discussion are hyperemesis, the preeclamptic toxemias and eclampsia.

Until recently, the etiology of the excessive vomiting of pregnancy has been a question of great dispute. At present all clinical evidence tends to substantiate the theory that hyperemesis is the result of a vicious cycle beginning with a carbohydrate deficiency, as suggested by Duncan, Harding and Titus, and that the pathologic changes found in the liver, kidneys and blood are the result of starvation and dehydration. That pernicious vomiting is a serious complication of pregnancy is evidenced by the fact that it has a mortality of more than 20 per cent.

These investigators (Watson, Harding and Titus) group the underlying factors under three headings:

1. The metabolic factor with its carbohydrate deficiency during pregnancy. This is shown in the glycogenic disturbance in the maternal liver, and, according to Harding, expresses itself in

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