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August 11, 1945


JAMA. 1945;128(15):1123. doi:10.1001/jama.1945.02860320065026

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To the Editor:—  The employment of neostigmine in the treatment of preeclampsia as suggested by Woodbury and his associates in The Journal, June 23, is based on principles underlying recent orientation on the etiology of the late toxemia of pregnancy (Hofbauer, J. I.: West. J. Surg.49:615 [Nov.] 1941; Cincinnati J. Med.23:107 [May] 1942; Am. J. Surg.45:361 [Sept.] 1944). The many theories advanced during past decades have failed to receive obstetric approval elucidating the true nature of the disorder.While in the past the placenta was generally considered the chief characteristic of the pregnant state and, in toxemia, the principal factor responsible for the elaboration of "toxins," the new tenet inclines to the view that the pregnant state is essentially conditioned by the altered basic endocrine pattern. Notable among the hyperplastic changes occurring in the ductless glands during pregnancy are the phenomena in the adrenal

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