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            Eclampsia in the Real Organism: A Paradigm of General Distress Applicable in Infants, Adults, Etc.
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        <h1>
            Eclampsia in the Real Organism: A Paradigm of General Distress Applicable in Infants, Adults, Etc.
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        <article class="posted">
            <p>
                To prevent the appropriation and abuse of our language by academic and professional cliques, I like to
                recall my grandparents' speech. When my grandmother spoke of eclampsia, the word was still normal
                English, that reflected the Greek root meaning, "shining out," referring to the visual effects that are
                often prodromal to seizures. The word was most often used in relation to pregnancy, but it could also be
                applied to similar seizures in young children. The word is the sort that might have been coined by a
                person who had experienced the condition, but the experience of seeing hallucinatory lights is seldom
                mentioned in the professional discussion of "eclampsia and preeclampsia."
            </p>
            <p>
                Metaphoric thinking--using comparisons, models, or examples--is our natural way of gaining new
                understanding. Ordinary language, and culture, grow when insightful comparisons are generally adopted,
                extending the meaning of old categories. Although the free growth of insight and understanding might be
                the basic law of language and culture, we have no institutions that are amenable to that principle of
                free development of understanding. Institutions devoted to power and control are naturally hostile to
                the free development of ideas.
            </p>
            <p>
                Among physicians, toxemia (meaning poisons in the blood) has been used synonymously with preeclampsia,
                to refer to the syndrome in pregnant women of high blood pressure, albumin in the urine, and edema,
                sometimes ending in convulsions. Eclampsia is reserved for the convulsions themselves, and is restricted
                to the convulsions which follow preeclampsia, when there is "no other reason" for the seizure such as
                "epilepsy" or cerebral hemorrhage. Sometimes it is momentarily convenient to use medical terms, but we
                should never forget the quantity of outrageous ignorance that is attached to so many technical words
                when they suggest the identity of unlike things, and when they partition and isolate things which have
                meaning only as part of a process. Misleading terminology has certainly played an important role in
                retarding the understanding of the problems of pregnancy.
            </p>
            <p>
                In 1974, when I decided to write Nutrition for Women, I was motivated by the awful treatment I saw women
                receiving, especially during pregnancy, from physicians and dietitians. Despite the research of people
                like the Shutes and the Biskinds, there were still "educated" and influential people who said that the
                mother's diet had no influence on the baby. (That strange attitude affects many aspects of behavior and
                opinion.)
            </p>
            <p>
                How can people believe that the mother's diet has no effect on the baby's health? Textbooks used to talk
                about the "insulated" fetus, which would get sufficient nutrients from the mother's body even if she
                were starving. To "prove" the doctrine, it was pointed out that the fetus gets enough iron to make blood
                even when the mother is anemic. In the last few years, the recognition that smoking, drinking, and using
                other drugs can harm the baby has helped to break down the doctrine of "insulation," but there is still
                not a medical culture in which the effects of diet on the physiology of pregnancy are appreciated. This
                is because of a mistaken idea about the nature of the organism and its development. "Genes make the
                organism," according to this doctrine, and if there are congenital defects in the baby, the genes are
                responsible. A simple sort of causality flows from the genes to the finished organism, according to that
                idea. <strong>It was taught that if "the genes" are really bad, the defective baby can make the mother
                    sick, and she contributed to the baby's bad genes.</strong> The idea isn't completely illogical, but
                it isn't based on reality, and it is demonstrably false. (Race, age and parity have no effect on
                incidence of cerebral palsy<strong>;</strong> low birth weight and complications of pregnancy are
                associated with it<strong>: </strong>J. F. Eastman, "Obstetrical background of 753 cases of cerebral
                palsy," Obstet. Gynecol. Surv. 17, 459-497, 1962.)
            </p>
            <p>
                Although Sigmund Freud sensibly argued in 1897 that it was more reasonable to think that an infant's
                cerebral palsy was caused by the same factors that caused the mother's sickness, than to think that the
                baby's cerebral palsy <em>caused</em> maternal sickness and premature labor, <strong>more than 50 years
                    later people were still taking seriously the idea that cerebral palsy might cause maternal
                    complications and prematurity.</strong> (A.M. Lilienfield and E. Parkhurst, "A study of the
                association of factors of pregnancy and parturition with the development of cerebral palsy," <em>Am. J.
                    Hyg. 53,</em> 262-282, 1951.)
            </p>
            <p>
                Medical textbooks and articles still commonly list the conditions that are associated with
                eclampsia<strong>: </strong> Very young and very old mothers, a first pregnancy or a great number of
                previous pregnancies, diabetes, twins, obesity, excessive weight gain, and kidney disease. Some authors,
                observing the high incidence of eclampsia in the deep South, among Blacks and on American Indian
                reservations, have suggested that it is a genetic disease because it "runs in families." If poverty and
                malnutrition are also seen to "run in families," some of these authors have argued that the bad genes
                which cause birth defects also cause eclampsia and poverty. (L. C. Chesley, et al., "The familial factor
                in toxemia of pregnancy," Obstet. Gynec. 32, 303-311, 1968, reported that women whose mothers suffered
                eclampsia during their gestation were likely to have eclampsia themselves. Some "researchers" have
                concluded that eclampsia is good, because many of the babies die, eliminating the "genes" for eclampsia
                and poverty.)<strong>*</strong> Any sensible farmer knows that pregnant animals must have good food if
                they are to successfully bear healthy young, but of course those farmers don't have a sophisticated
                knowledge of genetics.
            </p>
            <p>
                The inclusion of obesity and "excessive weight gain" among the conditions associated with eclampsia has
                distracted most physicians from the fact that malnutrition is the basic cause of eclampsia. The
                pathologist who, knowing nothing about a woman's diet, writes in his autopsy report that the subject is
                "a well nourished" pregnant woman, reflects a medical culture which chooses to reduce "nutritional
                adequacy" to a matter of gross body weight. The attempt to restrict weight gain in pregnancy has
                expanded the problem of eclampsia beyond its association with poverty, into the more affluent classes.
            </p>
            <p>
                Freud wasn't the first physician who grasped the idea that the baby's health depends on the mother's,
                and that her health depends on good nutrition. Between 1834 and 1843, John C. W. Lever, M.D., discovered
                that 9 out of 10 eclamptic women had protein in their urine. He described an eclamptic woman who bore a
                premature, low-weight baby, as having "...been living in a state of most abject penury for two or three
                months, subsisting for days on a single meal of bread and tea. Her face and body were covered with
                cachectic sores." ("Cases of puerperal convulsions," <em>Guy's Hospital Reports, Volume 1, series 2,</em
                > 495-517, 1843.) S. S. Rosenstein observed that eclampsia was preceded by changes in the serum (<em
                >Traite Pratique des Maladies des Reins,</em> Paris, 1874). L. A. A. Charpentier specifically documented
                low serum albumin as a cause of eclampsia (<em>A Practical Treatise on Obstetrics, Volume 2,</em>
                William Wood &amp; Co., 1887). Robert Ross, M.D., documented the role of malnutrition as the cause of
                proteinuria and eclampsia (<em>Southern Medical Journal 28,</em> 120, 1935).
            </p>

            <p>
                In outline, we can visualize a chain of causality beginning with a diet deficient in protein, impairing
                liver function, producing inability to store glycogen, to inactivate estrogen and insulin, and to
                activate thyroid. Low protein and high estrogen cause increased tendency of the blood to clot. High
                estrogen destroys the liver's ability to produce albumin (G. Belasco and G. Braverman, <em>Control of
                    Messenger RNA Stability,</em> Academic Press, 1994). Low thyroid causes sodium to be lost. The loss
                of sodium albuminate causes tissue edema, while the blood volume is decreased. Decreased blood volume
                and hemoconcentration (red cells form a larger fraction of the blood) impair the circulation. Blood
                pressure increases. Blood sugar becomes unstable, cortisol rises, increasing the likelihood of premature
                labor. High estrogen, hypoglycemia, viscous blood, increased tendency of the blood to clot cause
                seizures. Women who die from eclampsia often have extensive intravascular clotting, and sometimes the
                brain and liver show evidence of earlier damage, probably from clots that have been cleared. (Sometimes
                prolonged clotting consumes fibrinogen, causing inability to clot, and a tendency to hemorrhage.) <em>M.
                    M. Singh, "Carbohydrate metabolism in pre-eclampsia," Br. J. Obstet. Gynaecol. 83, 124-131. 1976.
                    Sodium decrease, R. L. Searcy, Diagnostic Biochemistry, McGraw-Hill, 1969. Viscosity, L. C. Chesley,
                    'Hypertensive Disorders in Pregnancy, Appleton-Century-Crofts, 1978. Clotting, T. Chatterjee, et
                    al., "Studies on plasma fibrinogen level in preeclampsia and eclampsia, Experientia 34, 562-3,
                    1978<strong>;</strong> D. M. Haynes, "Medical Complications During Pregnancy, McGraw-Hill Co.
                    Blakiston Div., 1969. Progesterone decrease, G. V. Smith, et al., "Estrogen and progestin metabolism
                    in pregnant women, with especial reference to pre-eclamptic toxemia and the effect of hormone
                    administration," Am. J. Obstet. Gynecol. 39, 405, 1940; R. L. Searcy, Diagnostic Biochemistry,
                    McGraw-Hill, 1969.</em>
            </p>
            <p>
                But the simple chain of causality has many lines of feedback, exacerbating the problem, and the
                nutritional problem is usually worse than a simple protein deficiency. B vitamin deficiencies alone are
                enough to cause the liver's underactivity, and to cause estrogen dominance, and a simple vitamin A
                deficiency causes an inability to use protein efficiently or to make progesterone, and in itself mimics
                some of the effects of estrogen.
            </p>
            <p>
                Anything that causes a thyroid deficiency will make the problem worse. Thyroid therapy alone has had
                spectacular success in treating and preventing eclampsia. (H. O. Nicholson, 1904, cited in Dieckman's
                <em>Toxemias of Pregnancy,</em> 1952; 1929, Barczi, of Budapest; Broda Barnes, who prescribed thyroid as
                needed, delivered more than 2,000 babies and never had a case of pre-eclampsia, though statistically 100
                would have been expected.)
            </p>
            <p>
                The clotting which sometimes kills women, can, if it is not so extensive, cause spotty brain damage,
                similar to that seen in "multiple sclerosis," or it can occur in the liver, or other organ, or in the
                placenta, or in the fetus, especially in its brain and liver. Some cases of supposed "post-partum
                psychosis" have been the result of multiple strokes. When large clots occur in the liver or placenta,
                the fibrinogen which has been providing the fibrin for disseminated intravascular coagulation can appear
                to be consumed faster than it is produced by the liver. I think its disappearance may sometimes be the
                result of the liver's diminished blood supply, rather than the "consumption" which is the way this
                situation is usually explained. It is at this point that hemorrhages, rather than clots, become the
                problem. The undernourished liver can produce seizures in a variety of ways--clots, hemorrhages,
                hypoglycemia, and brain edema, for example, so eclampsia needn't be so carefully discriminated from "the
                other causes of seizures."
            </p>
            <p>
                Because I had migraines as a child, I was interested in their cause. Eating certain foods, or skipping
                meals, seemed to be involved, but I noticed that women often had migraines premenstrually. Epilepsy too,
                I learned, often occurred premenstrually.
            </p>
            <p>
                In my experience of migraine, nausea and pain followed the visual signs, which consisted of a variable
                progression of blind spots and lights. When I eventually learned that I could stop the progression of
                symptoms by quickly eating a quart of ice cream, I saw that my insight could be applied to other
                situations in which similar visual events played a role, especially "eclampsia" and "epilepsy." For
                example, a woman who was 6 months pregnant called me around 10 o'clock one morning, to say that she had
                gone blind, and was alone in her country house. She said she had just eaten breakfast around 9 AM, and
                wasn't hungry, but I knew that the 6 month fetus has a great need for glucose, so I urged her to eat
                some fruit. She called me 15 minutes later to report that she had eaten a banana, and her vision had
                returned.
            </p>
            <p>
                Early in pregnancy, "morning sickness" is a common problem, and it is seldom thought to have anything to
                do with eclampsia, because of the traditional medical idea that the fetus "causes" eclampsia, and in the
                first couple of months of pregnancy the conceptus is very small. But salty carbohydrate (soda crackers,
                typically) is the standard remedy for morning sickness. Some women have "morning sickness"
                premenstrually, and it (like the nausea of migraine) is eased by salt and carbohydrate. X-ray studies
                have demonstrated that there are spasms of the small intestine (near the bile duct) associated with
                estrogen-induced nausea.
            </p>
            <p>
                Hypoglycemia is just one of the problems that develops when the liver malfunctions, but it is so
                important that orange juice or Coca Cola or ice cream can provide tremendous relief from symptoms.
                Sodium (orange juice and Pepsi provide some) helps to absorb the sugar, and--more basically--is
                essential for helping to restore the blood volume. Pepsi has been recommened by the World Health
                Organization for the rehydration of babies with diarrhea, in whom hypovolemia (thickening of the blood
                from loss of water) is also a problem.
            </p>
            <p>
                The problem of refeeding starving people has many features in common with the problem of correcting the
                liver malfunction and hormone imbalances which follow prolonged malnutrition of a milder sort. The use
                of the highest quality protein (egg yolk or potato juice, or at least milk or meat) is important, but
                the supplementation of thyroid containing T 3 is often necessary. Intravenous albumin, hypertonic
                solutions of glucose and sodium, and magnesium in an effective form should be helpful (magnesium sulfate
                injected intramuscularly is the traditional treatment for eclampsia, since it is quickly effective in
                stopping convulsions). While the sodium helps to restore blood volume and to regulate glucose, under
                some circumstances (high aldosterone) it helps to retain magnesium<strong>;</strong> aldosterone is not
                necessarily high during eclampsia.. Triiodothyronine directly promotes cellular absorption of magnesium.
                Hypertonic glucose with minerals is known to decrease the destruction of protein during stress<strong
                >:</strong> M. Jeevanandam, et al., <em>Metabolism 40,</em> 1199-1206, 1991.
            </p>
            <p>
                Katherina Dalton observed that her patients who suffered from PMS (and were benefitted by progesterone
                treatment) were likely to develop "toxemia" when they became pregnant, and to have problems at the time
                of menopause. In these women, it is common for "menstruation" to continue on the normal cycle during the
                first several months of pregnancy. This cyclic bleeding seems to represent times of an increased ratio
                of estrogen to progesterone, and during such periods of cyclic bleeding the risk of miscarriage is high.
                Researchers found that a single injection of progesterone could sometimes eliminate the signs of toxemia
                for the remainder of the pregnancy. Katherina Dalton, who continued to give her patients progesterone
                throughout pregnancy, later learned that the babies treated in this way were remarkably healthy and
                bright, while the average baby delivered after a "toxemic" pregnancy has an IQ of only 85.
            </p>
            <p>
                Marian Diamond's work with rats clearly showed that increased exposure to estrogen during pregnancy
                reduced the size of the cerebral cortex and the animals' ability to learn, while progesterone increased
                the brain size and intelligence. Zamenhof's studies suggested that these hormones probably have their
                effects largely through their actions on glucose, though they also affect the availability of oxygen in
                the same way, and have a variety of direct effects on brain cells that would operate toward the same
                end.
            </p>
            <p>
                If Katherina Dalton's patients' IQs averaged 130, instead of the expected 85, the potential social
                effects of proper health care during pregnancy are enormous.
            </p>
            <p>
                But there is evidence that healthy gestation affects more than just the IQ. Strength of character,
                ability to reason abstractly, and the absence of physical defects, for example, are strongly associated
                with weight at birth.
            </p>
            <p>
                Government studies and Social Security statistics suggest the size of the problem. The National
                Institute of Neurological Diseases and Stroke found that birth weight was directly related to IQ at age
                four, and that up to half of all children who were underweight at birth have an IQ under 70.(Chase.)
                According to standard definitions, about 8% of babies in the U.S. have low birth weight.
            </p>
            <p>
                Among people receiving Social Security income because of disability that existed at the age of 18, 75%
                were disabled before birth. In 94% of these cases, the abnormality was neurological. (HEW.)
            </p>
            <p>
                A study of 8 to 10-year-old children found that abstract verbal reasoning and perceptual/motor
                integration are more closely related to birth weight than they are to IQ. (Wiener.)
            </p>
            <p>
                National nutritional data show that in the U.S. <strong>the development of at least a million babies a
                    year is "substantially compromised" by prenatal malnutrition.</strong> Miscarriages, which are also
                causally related to poor nutrition, occur at a rate of a few hundred thousand per year. (Williams.)
            </p>
            <p>
                When a muscle is fatigued, it swells, taking up sodium and water, and it is likely to become sore.
                Energy depletion causes any cell to take up water and sodium, and to lose potassium. An abnormal excess
                of potassium in the blood, especially when sodium is low, affects nerve, muscle, and secretory
                cells<strong>;</strong> a high level of potassium can stop the heart, for example. Cellular energy can
                be depleted by a combination of work, insufficient food or oxygen, or a deficiency of the hormones
                needed for energy production. When the swelling happens suddenly, the movement of water and sodium from
                the blood plasma into cells decreases the volume of blood, while the quantity of red cells remains the
                same, making the blood more viscous.
            </p>
            <p>
                During the night, as adrenalin, cortisol, and other stress hormones rise, our blood becomes more viscous
                and clots more easily. In rats, it has been found that the concentration of serum proteins increases
                significantly during the night, presumably because water is moving out of the circulatory system. Even
                moderate stress causes some loss of water from the blood.
            </p>
            <p>
                If a person is malnourished, a moderate stress can overcome the body's regulatory capacity. If tissue
                damage is extreme, or blood loss is great, even a healthy person experiences hypovolemia and shock.
            </p>
            <p>
                C.A. Crenshaw, who was a member of the trauma team at Parkland Hospital in Dallas that worked on Kennedy
                and Oswald, had been involved in research with G. T. Shires on traumatic shock. In his words, "we made
                medical history by discovering that death from hemorrhagic shock (blood loss) can be due primarily to
                the body's adjunctive depletion of internal salt water into the cells." (Shires' work involved isotopes
                of sodium to show that sodium seems to be taken up by cells during shock.)
            </p>
            <p>
                According to Crenshaw, "Oswald did not die from damaged internal organs. He died from the chemical
                imbalances of hemorrhagic shock. From the time he was shot<strong>...</strong>until the moment fluids
                were introduced into the body<strong>...</strong>" [19 minutes] "there was very little blood circulating
                in Oswald's body. As a result, he was not getting oxygen, and waste built up in his cells. Then, when
                the fluids were started, the collection of waste from the cells was dumped into the bloodstream,
                suddenly increasing the acid level, and delivering these impurities to his heart. When the contaminated
                blood reached the heart, it went into arrest<strong>....</strong>" The "waste" he refers to includes
                potassium and lactic acid. Crenshaw advocates the use of Ringer's lactate to replace some of the lost
                fluid. Since the blood already contains a large amount of lactate because the body is unable to consume
                it, this doesn't seem reasonable. I think a hypertonic version of Locke's solution, containing glucose
                and sodium bicarbonate as well as sodium chloride, would be better, though I think the potassium should
                be omitted too, and extra magnesium would seem desirable. Triiodothyronine, I suspect, would help
                tremendously to deal with the problems of shock, causing potassium, magnesium, and phosphate to move
                back into cells, and sodium to move out, helping to restore blood volume and reduce the wasteful
                conversion of glucose to lactic acid..
            </p>
            <p>
                Albumin has been used therapeutically in preeclampsia (Kelman), to restore blood volume. Synthetic
                polymers with similar osmotic properties are sometimes used in shock, and might also be useful in
                eclampsia, but simply eating extra protein quickly restores blood albumin. For example, in a group of
                women who were in their seventh month of pregnancy, the normal women's serum osmotic pressure was 247
                mm. of water, that of the women with nonconvulsive toxemia was 215 mm., and in the women with eclampsia,
                the albumin and osmotic pressure were lowest, with a pressure of 175 mm. In the eighth month, the
                toxemic women who ate 260 grams of protein daily had a 7% increase in osmotic pressure, and a group who
                ate 20 grams had a decline of 9%.(Strauss) In a group of preeclamptics, plasma volume was 39% below that
                of normal pregnant women.
            </p>

            <p>
                If the physiology of shock has some relevance for eclampsia, so does the physiology of heart failure,
                since Meerson has shown that it is a consequence of uncompensated stress. The failing heart shifts from
                mainly glucose oxidation to the inefficient use of fatty acids, which are mobilized during stress, and
                with its decreased energy supply, it is unable to beat efficiently, since it remains in a partly
                contracted state. Estrogen (which is increased in men who have had heart attacks) is another factor
                which decreases the heart's stroke volume, and estrogen is closely associated with the physiology of the
                free unsaturated fatty acids. The partly contracted state of the heart is effectively a continuation of
                the partly contracted state of the blood vessels that causes the hypertension, and reduced tissue
                perfusion seen in shock and eclampsia. Since shock can be seen as a generalized inflammatory state, and
                since aspirin has been helpful in protecting against heart disease, it's reasonable that aspirin has
                been tried as a treatment in pre-eclampsia. It seems to protect the fetus against intrauterine growth
                retardation, an effect that I think relates to aspirin's ability to protect in several ways against
                excesses of uunsaturated fatty acids and of estrogen. But, since aspirin can interfere with blood
                clotting, its use around the time of childbirth can be risky, and it is best to correct the problem
                early enough that aspirin isn't needed.
            </p>

            <p>
                Besides protein deficiency and other nutritional deficiencies, excess estrogen and low thyroid can also
                limit the liver's ability to produce albumin. Hypovolemia reduces liver function, and (like hepatic
                infarcts) will reduce its ability to maintain albumin production..
            </p>
            <p>
                The studies which have found that hospitalized patients with the lowest albumin are the least likely to
                survive suggest that the hypovolemia resulting from hepatic inefficiency is a problem of general
                importance, and that it probably relates to the multiple organ failure which is an extremely common form
                of death among hospitalized patients. A diet low in sodium and protein probably kills many more people
                than has been documented. If old age is commonly a hypovolemic condition, then the common salt
                restriction for old-age hypertension is just as irrational as is salt-restriction in pregnancy or in
                shock. Thyroid (T 3), glucose, sodium, magnesium and protein should be considered in any state in which
                weakened homeostatic control of the composition of plasma is evident.
            </p>
            <p><strong> &nbsp;</strong></p>
            <p>
                <strong>*Note:</strong> Although Konrad Lorenz (who later received the Nobel Prize) was the architect of
                the Nazi's policy of "racial hygiene" (extermination of those with unwanted physical, cultural, or
                political traits which were supposedly determined by "genes") he took his ideas from the leading U.S.
                geneticists, whose works were published in the main genetics journals. Following the Nazis' defeat, some
                of these journals were renamed, and the materials on eugenics were often removed from libraries, so that
                a new historical resume could be presented by the profession. <strong></strong>
            </p>
            <p><strong> &nbsp;</strong></p>
            <p><strong><h3>ADDITIONAL REFERENCES</h3></strong></p>

            <p>
                G. Wiener, et al., "Correlates of low birth weight: Psychological status at eight to ten years of age,"
                Pediatr. Res. 2, 110-118, 1968.
            </p>

            <p>A. Chase, "The great pellagra cover-up," Psychol. Today, pp. 83-86, Feb., 1975.</p>

            <p>Prevention Handbook, Natl. Assoc. for Retarded Citizens, 1974.</p>

            <p>US HEW, The Women and Their Pregnancies, W.B. Saunders Co., 1972.</p>

            <p>
                M. Winick and P. Rosso, "The effect of severe early malnutrition on cellular growth of human brain,"
                Pediatr. Res. 3, 181-184, 1969.
            </p>

            <p>Roger Williams, Nutrition Against Disease, Pitman Publ., 1971.</p>

            <p>H.M. Schmeck, Jr., "Brain harm in US laid to food lack," N.Y. times, Nov. 2, 1975.</p>

            <p>R. Hurley, Poverty and Mental Retardation: A Causal Relationship, Random House, 1970.</p>

            <p>D. Shanklin and J. Hodin, Maternal Nutrition and Child Health, C. C. Thomas, 1978.</p>

            <p>
                H.H. Reese, H. A. Paskind, and E. L. Sevringhaus, 1936 Year Book of Neurology, Psychiatry and
                Endocrinology, Year Book Publishers, Chicago, 1937.
            </p>

            <p>
                M. B. Strauss, "Observations on the etiology of the toxemias of pregnancy: The relationship of
                nutritional deficiency, hypoproteinemia, and elevated venous pressure to water retention in pregnancy,"
                Am. J. Med. Sci. 190, 811-824, 1935.
            </p>

            <p>"Albumin concentration can be used for mild preeclampsia," Obstet. Gynecol. News, October 1, 1974.</p>
            <p>
                L. Kelman, et al., "Effects of dietary protein restriction on albumin synthesis, albumin catabolism, and
                the plasma aminogram," Am. J. Clin. Nutr. 25, 1174-1178, 1972.
            </p>

            <p>
                T. H. Brewer, "Role of malnutrition, hepatic dysfunction, and gastrointestinal bacteria in the
                pathogenesis of acute toxemia of pregnancy," Am. J. Obstet. Gynecol. 84, 1253-1256, 1962.
            </p>

            <p>"Plasma volume 'a clue' to hypertension risks," Obstet. Gynecol. Observer, August/September, 1975.</p>

            <p>C. A. Crenshaw, MD, J. Hansen and J. G. Shaw, JFK: Conspiracy of Silence, Signet, 1992.</p>

            <p>
                T. Backstrom, "Epileptic seizures in women related to plasma estrogen and progesterone during the
                menstrual cycle," Acta Neurol. Scand. 54, 321-347, 1976.
            </p>

            <p>
                C. Muller, et al., "Reversible bilateral cerebral changes on magnetic resonance imaging during
                eclampsia," Deutsche Medizinische Wochenschrift 121(39), 1184-1188, 1996. (Brain edema was
                demonstrated.)
            </p>

            <p>
                Uzan S; Merviel P; Beaufils M; Breart G; Salat-Baroux J. [Aspirin during pregnancy. Indications and
                modalities of prescription after the publication of the later trials]. Presse Medicale, 1996 Jan 6-13,
                25(1):31-6. Aspirin, an inhibitor of cyclo-oxygenase, is prescribed in a number of conditions related to
                abnormal production of prostaglandins including gravidic hypertension. Results of the most recent trials
                demonstrate that in patients with a past history of pre-eclampsia or intra-uterine growth retardation, a
                pathological Doppler examination of the uterus, a pathological angiotensin test or an antiphospholipid
                syndrome, prescription of aspirin at the dose of 100 mg/day can prevent recurrence or development of
                pre-eclampsia or intra-uterine growth retardation. Treatment should begin as soon as possible during
                pregnancy, certainly before development of clinical manifestations. After history taking and
                identification of possible contraindications, bleeding time (Ivy method) is recorded before and after
                prescription and should be lower than 8 minutes. In case bleeding time exceeds 10 minutes 10 to 15 days
                after initiating aspirin, doses may be reduced to 50 mg per day or even 50 mg every two or three days to
                reach the target level. Treatment should generally be continued up to 36 weeks gestation.
            </p>

            <p>
                Randall, C L; Anton, R F; Becker, H C; Hale, R L; Ekblad, U. Aspirin dose-dependently reduces
                alcohol-induced birth defects and prostaglandin E levels in mice. Teratology, v.44, n.5, (1991):
                521-530. The purpose of the present study was threefold. The first purpose was to determine if aspirin
                (ASA) decreases alcohol-induced birth defects in mice in a dose-dependent fashion. The second purpose
                was to see if the antagonism of alcohol-induced birth defects afforded by ASA pretreatment was related
                to dose-dependent decreases in prostaglandin E (PGE) levels in uterine/embryo tissue. The third purpose
                was to determine if ASA pretreatment altered maternal blood alcohol level.” In experiments 1 and 2,
                pregnant C57BL/6J mice were administered ASA (0, 18.75, 37.5, 75, 150, or 300 mg/kg) on gestation day
                10. One hour following the subcutaneous injection of ASA, mice received alcohol (5.8 g/kg) or an
                isocaloric sucrose solution intragastrically. In experiment 1 the incidence of birth defects was
                assessed in fetuses delivered by caesarean section on gestation day 19. In experiment 2 uterine/embryo
                tissue samples were collected on gestation day 10 1 hr following alcohol intubation for subsequent PGE
                analysis. In experiment 3 blood samples were taken at five time points following alcohol intubation from
                separate groups of alcohol-treated pregnant mice pretreated with 150 mg/kg ASA or vehicle The results
                from the three experiments indicated that ASA dose-dependently reduced the frequency of alcohol-induced
                birth defects in fetuses examined at gestation day 19, ASA decreased the levels of PGE in gestation day
                10 uterine/embryo tissue in a similar dose-dependentfashion, and ASA pretreatment did not significantly
                influence maternalblood alcohol levels. These results provide additional support for the hypothesis that
                PGs may play an important role in mediating the teratogenic actions of alcohol.
            </p>

            <p><hr /></p>

            <p>
                An aspirin a day to prevent prematurity. Sibai BM. Clin Perinatol, 1992 Jun, 19:2, 305-17. Intrauterine
                fetal growth retardation and preeclampsia remain a substantial cause of preterm birth world wide. There
                is evidence to suggest that a functional imbalance between vascular prostacyclin and platelet-derived
                thromboxane A2 production plays a central role in the pathogenesis of these disorders. Low-dose aspirin
                appears to reverse the above functional balance resulting in increased prostacyclin to thromboxane
                ratio. The efficacy and safety of low-dose aspirin in preventing preeclampsia and fetal growth
                retardation were tested in several randomized and uncontrolled trials. The data in the literature
                suggest that low-dose aspirin is effective in reducing preterm birth due to the above complications in
                selected high-risk pregnant women.
            </p>

            <p>
                Rosental, D G; Machiavelli, G A; Chernavsky, A C; Speziale, N S; Burdman, J A. Indomethacin inhibits the
                effects of estrogen in the anterior pituitary gland of the rat. Journal of Endocrinology, v.121, n.3,
                (1989): 513-520. Two inhibitors of prostaglandin synthesis, indomethacin and aspirin, blocked the
                increase of oestrogen-binding sites in the nuclear subcellular fraction, an increase which occurs after
                the administration of oestradiol.
            </p>
            <p>
                Zanagnolo, V; Dharmarajan, A M; Endo, K; Wallach, E E. Effects of acetylsalicylic acid (aspirin) and
                naproxen sodium (naproxen) on ovulation, prostaglandin, and progesterone production in the rabbit.
                Fertility and Sterility, v.65, n.5, (1996): 1036-1043.
            </p>
        </article>
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