The practice of obstetrics, designed for the use of students and practitioners of medicine . us, arsenic andantimony, alcohol when taken habitually, and perhaps other substances of asimilar nature. Bacterial toxins must also be borne in mind as chance factors. Pathogeny.—Pregnancy itself is doubtless the efficient cause of the hepaticoverwork, for the liver presides over anabolism and must be largely concernedin the upbuilding of the fetus. The importance of the hepatic tissue to thegrowing organism is best seen in the disproportionally large size of the liver inthe fetus and infant. It is oft


The practice of obstetrics, designed for the use of students and practitioners of medicine . us, arsenic andantimony, alcohol when taken habitually, and perhaps other substances of asimilar nature. Bacterial toxins must also be borne in mind as chance factors. Pathogeny.—Pregnancy itself is doubtless the efficient cause of the hepaticoverwork, for the liver presides over anabolism and must be largely concernedin the upbuilding of the fetus. The importance of the hepatic tissue to thegrowing organism is best seen in the disproportionally large size of the liver inthe fetus and infant. It is often stated that the maternal liver should not beovertaxed in the early months of pregnancy; and this may be true in the sensethat the products of embryonal katabolism must be insignificant; we mustbear in mind, however, that during the embryonal period a rapid organogenesisoccurs; and that the various tissues and organs are all rapidly evolved from arelatively undifferentiated matrix. It is commonly affirmed that this rapid &^i)^^ / &k^^ ^y; Per i p Ii era Irow of in-tact Narrozv zoneof very fat-tv cells. Edge of areaof necroticand in-}i c r t tv 0-th irds oflobue. Fig. 469.—Toxemia of Pregnancy. Portion of an hepatic lobnlo from a case of pornicimisvomiting of pregnancy. Specimen siiows fatty degeneration and necmsis.—(/?;•<»//; aspccniini iu flic Pathological Laboratorv of ihc Cornell University Medical Collate.) TOXEMIA OF PREGNANCY. 295 differentiation is accomplished by the aid of enzyme-like bodies, which aregenerated, do their work, and g-ive way to others. While it is often said thatthe maternal blood contains all these potentialities for fetal development,it would be more nearly correct to state that this responsibility is invested inthe chief hematopoietic organ—the liver. To this drain upon the liver must be added the influence of suppressed men-struation in the gravida, which is said to entail congestion of the


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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1