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Magnesium sulfate's reputation waxed as eclampsia's perniciousness waned. Since 1906, when eclampsia was first described, earlier diagnoses, better antihypertensive treatment, and improved intensive care have assured increasingly better results. The omission of control subjects assured that credit would accrue to magnesium sulfate, the treatment of choice. Moreover, because of its wide-spread use, physicians gained extensive experience with use of the drug, decreasing its complications and improving further its apparent beneficial effects. Dinsdale makes a gallant case for the use of magnesium sulfate in eclampsia, based in part on his own considerable knowledge and contributions to the understanding of other types of hypertensive encephalopathy, but he acknowledges that magnesium sulfate's usefulness has never been demonstrated in a controlled clinical trial. Kaplan and colleagues argue convincingly that there are better methods of treating both the hypertension and the seizures commonly associated with eclampsia.
Until such time as we have a better grasp