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Eclampsia in the Real Organism: A Paradigm of General Distress Applicable in Infants, Adults, Etc.
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<h1>
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Eclampsia in the Real Organism: A Paradigm of General Distress Applicable in Infants, Adults, Etc.
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<article class="posted">
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<p>
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To prevent the appropriation and abuse of our language by academic and professional cliques, I like to
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recall my grandparents' speech. When my grandmother spoke of eclampsia, the word was still normal
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English, that reflected the Greek root meaning, "shining out," referring to the visual effects that are
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often prodromal to seizures. The word was most often used in relation to pregnancy, but it could also be
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applied to similar seizures in young children. The word is the sort that might have been coined by a
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person who had experienced the condition, but the experience of seeing hallucinatory lights is seldom
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mentioned in the professional discussion of "eclampsia and preeclampsia."
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</p>
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<p>
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Metaphoric thinking--using comparisons, models, or examples--is our natural way of gaining new
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understanding. Ordinary language, and culture, grow when insightful comparisons are generally adopted,
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extending the meaning of old categories. Although the free growth of insight and understanding might be
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the basic law of language and culture, we have no institutions that are amenable to that principle of
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free development of understanding. Institutions devoted to power and control are naturally hostile to
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the free development of ideas.
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</p>
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<p>
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Among physicians, toxemia (meaning poisons in the blood) has been used synonymously with preeclampsia,
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to refer to the syndrome in pregnant women of high blood pressure, albumin in the urine, and edema,
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sometimes ending in convulsions. Eclampsia is reserved for the convulsions themselves, and is restricted
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to the convulsions which follow preeclampsia, when there is "no other reason" for the seizure such as
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"epilepsy" or cerebral hemorrhage. Sometimes it is momentarily convenient to use medical terms, but we
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should never forget the quantity of outrageous ignorance that is attached to so many technical words
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when they suggest the identity of unlike things, and when they partition and isolate things which have
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meaning only as part of a process. Misleading terminology has certainly played an important role in
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retarding the understanding of the problems of pregnancy.
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</p>
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<p>
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In 1974, when I decided to write Nutrition for Women, I was motivated by the awful treatment I saw women
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receiving, especially during pregnancy, from physicians and dietitians. Despite the research of people
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like the Shutes and the Biskinds, there were still "educated" and influential people who said that the
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mother's diet had no influence on the baby. (That strange attitude affects many aspects of behavior and
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opinion.)
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</p>
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<p>
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How can people believe that the mother's diet has no effect on the baby's health? Textbooks used to talk
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about the "insulated" fetus, which would get sufficient nutrients from the mother's body even if she
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were starving. To "prove" the doctrine, it was pointed out that the fetus gets enough iron to make blood
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even when the mother is anemic. In the last few years, the recognition that smoking, drinking, and using
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other drugs can harm the baby has helped to break down the doctrine of "insulation," but there is still
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not a medical culture in which the effects of diet on the physiology of pregnancy are appreciated. This
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is because of a mistaken idea about the nature of the organism and its development. "Genes make the
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organism," according to this doctrine, and if there are congenital defects in the baby, the genes are
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responsible. A simple sort of causality flows from the genes to the finished organism, according to that
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idea. <strong>It was taught that if "the genes" are really bad, the defective baby can make the mother
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sick, and she contributed to the baby's bad genes.</strong> The idea isn't completely illogical, but
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it isn't based on reality, and it is demonstrably false. (Race, age and parity have no effect on
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incidence of cerebral palsy<strong>;</strong> low birth weight and complications of pregnancy are
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associated with it<strong>: </strong>J. F. Eastman, "Obstetrical background of 753 cases of cerebral
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palsy," Obstet. Gynecol. Surv. 17, 459-497, 1962.)
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</p>
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<p>
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Although Sigmund Freud sensibly argued in 1897 that it was more reasonable to think that an infant's
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cerebral palsy was caused by the same factors that caused the mother's sickness, than to think that the
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baby's cerebral palsy <em>caused</em> maternal sickness and premature labor, <strong>more than 50 years
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later people were still taking seriously the idea that cerebral palsy might cause maternal
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complications and prematurity.</strong> (A.M. Lilienfield and E. Parkhurst, "A study of the
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association of factors of pregnancy and parturition with the development of cerebral palsy," <em>Am. J.
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Hyg. 53,</em> 262-282, 1951.)
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</p>
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<p>
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Medical textbooks and articles still commonly list the conditions that are associated with
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eclampsia<strong>: </strong> Very young and very old mothers, a first pregnancy or a great number of
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previous pregnancies, diabetes, twins, obesity, excessive weight gain, and kidney disease. Some authors,
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observing the high incidence of eclampsia in the deep South, among Blacks and on American Indian
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reservations, have suggested that it is a genetic disease because it "runs in families." If poverty and
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malnutrition are also seen to "run in families," some of these authors have argued that the bad genes
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which cause birth defects also cause eclampsia and poverty. (L. C. Chesley, et al., "The familial factor
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in toxemia of pregnancy," Obstet. Gynec. 32, 303-311, 1968, reported that women whose mothers suffered
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eclampsia during their gestation were likely to have eclampsia themselves. Some "researchers" have
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concluded that eclampsia is good, because many of the babies die, eliminating the "genes" for eclampsia
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and poverty.)<strong>*</strong> Any sensible farmer knows that pregnant animals must have good food if
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they are to successfully bear healthy young, but of course those farmers don't have a sophisticated
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knowledge of genetics.
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</p>
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<p>
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The inclusion of obesity and "excessive weight gain" among the conditions associated with eclampsia has
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distracted most physicians from the fact that malnutrition is the basic cause of eclampsia. The
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pathologist who, knowing nothing about a woman's diet, writes in his autopsy report that the subject is
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"a well nourished" pregnant woman, reflects a medical culture which chooses to reduce "nutritional
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adequacy" to a matter of gross body weight. The attempt to restrict weight gain in pregnancy has
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expanded the problem of eclampsia beyond its association with poverty, into the more affluent classes.
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</p>
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<p>
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Freud wasn't the first physician who grasped the idea that the baby's health depends on the mother's,
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and that her health depends on good nutrition. Between 1834 and 1843, John C. W. Lever, M.D., discovered
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that 9 out of 10 eclamptic women had protein in their urine. He described an eclamptic woman who bore a
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premature, low-weight baby, as having "...been living in a state of most abject penury for two or three
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months, subsisting for days on a single meal of bread and tea. Her face and body were covered with
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cachectic sores." ("Cases of puerperal convulsions," <em>Guy's Hospital Reports, Volume 1, series 2,</em
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> 495-517, 1843.) S. S. Rosenstein observed that eclampsia was preceded by changes in the serum (<em
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>Traite Pratique des Maladies des Reins,</em> Paris, 1874). L. A. A. Charpentier specifically documented
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low serum albumin as a cause of eclampsia (<em>A Practical Treatise on Obstetrics, Volume 2,</em>
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William Wood & Co., 1887). Robert Ross, M.D., documented the role of malnutrition as the cause of
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proteinuria and eclampsia (<em>Southern Medical Journal 28,</em> 120, 1935).
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</p>
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<p>
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In outline, we can visualize a chain of causality beginning with a diet deficient in protein, impairing
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liver function, producing inability to store glycogen, to inactivate estrogen and insulin, and to
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activate thyroid. Low protein and high estrogen cause increased tendency of the blood to clot. High
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estrogen destroys the liver's ability to produce albumin (G. Belasco and G. Braverman, <em>Control of
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Messenger RNA Stability,</em> Academic Press, 1994). Low thyroid causes sodium to be lost. The loss
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of sodium albuminate causes tissue edema, while the blood volume is decreased. Decreased blood volume
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and hemoconcentration (red cells form a larger fraction of the blood) impair the circulation. Blood
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pressure increases. Blood sugar becomes unstable, cortisol rises, increasing the likelihood of premature
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labor. High estrogen, hypoglycemia, viscous blood, increased tendency of the blood to clot cause
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seizures. Women who die from eclampsia often have extensive intravascular clotting, and sometimes the
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brain and liver show evidence of earlier damage, probably from clots that have been cleared. (Sometimes
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prolonged clotting consumes fibrinogen, causing inability to clot, and a tendency to hemorrhage.) <em>M.
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M. Singh, "Carbohydrate metabolism in pre-eclampsia," Br. J. Obstet. Gynaecol. 83, 124-131. 1976.
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Sodium decrease, R. L. Searcy, Diagnostic Biochemistry, McGraw-Hill, 1969. Viscosity, L. C. Chesley,
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'Hypertensive Disorders in Pregnancy, Appleton-Century-Crofts, 1978. Clotting, T. Chatterjee, et
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al., "Studies on plasma fibrinogen level in preeclampsia and eclampsia, Experientia 34, 562-3,
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1978<strong>;</strong> D. M. Haynes, "Medical Complications During Pregnancy, McGraw-Hill Co.
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Blakiston Div., 1969. Progesterone decrease, G. V. Smith, et al., "Estrogen and progestin metabolism
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in pregnant women, with especial reference to pre-eclamptic toxemia and the effect of hormone
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administration," Am. J. Obstet. Gynecol. 39, 405, 1940; R. L. Searcy, Diagnostic Biochemistry,
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McGraw-Hill, 1969.</em>
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</p>
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<p>
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But the simple chain of causality has many lines of feedback, exacerbating the problem, and the
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nutritional problem is usually worse than a simple protein deficiency. B vitamin deficiencies alone are
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enough to cause the liver's underactivity, and to cause estrogen dominance, and a simple vitamin A
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deficiency causes an inability to use protein efficiently or to make progesterone, and in itself mimics
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some of the effects of estrogen.
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</p>
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<p>
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Anything that causes a thyroid deficiency will make the problem worse. Thyroid therapy alone has had
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spectacular success in treating and preventing eclampsia. (H. O. Nicholson, 1904, cited in Dieckman's
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<em>Toxemias of Pregnancy,</em> 1952; 1929, Barczi, of Budapest; Broda Barnes, who prescribed thyroid as
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needed, delivered more than 2,000 babies and never had a case of pre-eclampsia, though statistically 100
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would have been expected.)
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</p>
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<p>
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The clotting which sometimes kills women, can, if it is not so extensive, cause spotty brain damage,
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similar to that seen in "multiple sclerosis," or it can occur in the liver, or other organ, or in the
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placenta, or in the fetus, especially in its brain and liver. Some cases of supposed "post-partum
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psychosis" have been the result of multiple strokes. When large clots occur in the liver or placenta,
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the fibrinogen which has been providing the fibrin for disseminated intravascular coagulation can appear
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to be consumed faster than it is produced by the liver. I think its disappearance may sometimes be the
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result of the liver's diminished blood supply, rather than the "consumption" which is the way this
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situation is usually explained. It is at this point that hemorrhages, rather than clots, become the
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problem. The undernourished liver can produce seizures in a variety of ways--clots, hemorrhages,
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hypoglycemia, and brain edema, for example, so eclampsia needn't be so carefully discriminated from "the
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other causes of seizures."
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</p>
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<p>
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Because I had migraines as a child, I was interested in their cause. Eating certain foods, or skipping
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meals, seemed to be involved, but I noticed that women often had migraines premenstrually. Epilepsy too,
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I learned, often occurred premenstrually.
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</p>
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<p>
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In my experience of migraine, nausea and pain followed the visual signs, which consisted of a variable
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progression of blind spots and lights. When I eventually learned that I could stop the progression of
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symptoms by quickly eating a quart of ice cream, I saw that my insight could be applied to other
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situations in which similar visual events played a role, especially "eclampsia" and "epilepsy." For
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example, a woman who was 6 months pregnant called me around 10 o'clock one morning, to say that she had
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gone blind, and was alone in her country house. She said she had just eaten breakfast around 9 AM, and
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wasn't hungry, but I knew that the 6 month fetus has a great need for glucose, so I urged her to eat
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some fruit. She called me 15 minutes later to report that she had eaten a banana, and her vision had
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returned.
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</p>
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<p>
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Early in pregnancy, "morning sickness" is a common problem, and it is seldom thought to have anything to
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do with eclampsia, because of the traditional medical idea that the fetus "causes" eclampsia, and in the
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first couple of months of pregnancy the conceptus is very small. But salty carbohydrate (soda crackers,
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typically) is the standard remedy for morning sickness. Some women have "morning sickness"
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premenstrually, and it (like the nausea of migraine) is eased by salt and carbohydrate. X-ray studies
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have demonstrated that there are spasms of the small intestine (near the bile duct) associated with
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estrogen-induced nausea.
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</p>
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<p>
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Hypoglycemia is just one of the problems that develops when the liver malfunctions, but it is so
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important that orange juice or Coca Cola or ice cream can provide tremendous relief from symptoms.
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Sodium (orange juice and Pepsi provide some) helps to absorb the sugar, and--more basically--is
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essential for helping to restore the blood volume. Pepsi has been recommened by the World Health
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Organization for the rehydration of babies with diarrhea, in whom hypovolemia (thickening of the blood
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from loss of water) is also a problem.
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</p>
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<p>
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The problem of refeeding starving people has many features in common with the problem of correcting the
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liver malfunction and hormone imbalances which follow prolonged malnutrition of a milder sort. The use
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of the highest quality protein (egg yolk or potato juice, or at least milk or meat) is important, but
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the supplementation of thyroid containing T 3 is often necessary. Intravenous albumin, hypertonic
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solutions of glucose and sodium, and magnesium in an effective form should be helpful (magnesium sulfate
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injected intramuscularly is the traditional treatment for eclampsia, since it is quickly effective in
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stopping convulsions). While the sodium helps to restore blood volume and to regulate glucose, under
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some circumstances (high aldosterone) it helps to retain magnesium<strong>;</strong> aldosterone is not
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necessarily high during eclampsia.. Triiodothyronine directly promotes cellular absorption of magnesium.
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Hypertonic glucose with minerals is known to decrease the destruction of protein during stress<strong
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>:</strong> M. Jeevanandam, et al., <em>Metabolism 40,</em> 1199-1206, 1991.
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</p>
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<p>
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Katherina Dalton observed that her patients who suffered from PMS (and were benefitted by progesterone
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treatment) were likely to develop "toxemia" when they became pregnant, and to have problems at the time
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of menopause. In these women, it is common for "menstruation" to continue on the normal cycle during the
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first several months of pregnancy. This cyclic bleeding seems to represent times of an increased ratio
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of estrogen to progesterone, and during such periods of cyclic bleeding the risk of miscarriage is high.
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Researchers found that a single injection of progesterone could sometimes eliminate the signs of toxemia
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for the remainder of the pregnancy. Katherina Dalton, who continued to give her patients progesterone
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throughout pregnancy, later learned that the babies treated in this way were remarkably healthy and
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bright, while the average baby delivered after a "toxemic" pregnancy has an IQ of only 85.
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</p>
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<p>
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Marian Diamond's work with rats clearly showed that increased exposure to estrogen during pregnancy
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reduced the size of the cerebral cortex and the animals' ability to learn, while progesterone increased
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the brain size and intelligence. Zamenhof's studies suggested that these hormones probably have their
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effects largely through their actions on glucose, though they also affect the availability of oxygen in
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the same way, and have a variety of direct effects on brain cells that would operate toward the same
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end.
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</p>
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<p>
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If Katherina Dalton's patients' IQs averaged 130, instead of the expected 85, the potential social
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effects of proper health care during pregnancy are enormous.
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</p>
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<p>
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But there is evidence that healthy gestation affects more than just the IQ. Strength of character,
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ability to reason abstractly, and the absence of physical defects, for example, are strongly associated
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with weight at birth.
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</p>
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<p>
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Government studies and Social Security statistics suggest the size of the problem. The National
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Institute of Neurological Diseases and Stroke found that birth weight was directly related to IQ at age
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four, and that up to half of all children who were underweight at birth have an IQ under 70.(Chase.)
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According to standard definitions, about 8% of babies in the U.S. have low birth weight.
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</p>
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<p>
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Among people receiving Social Security income because of disability that existed at the age of 18, 75%
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were disabled before birth. In 94% of these cases, the abnormality was neurological. (HEW.)
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</p>
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<p>
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A study of 8 to 10-year-old children found that abstract verbal reasoning and perceptual/motor
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integration are more closely related to birth weight than they are to IQ. (Wiener.)
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</p>
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<p>
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National nutritional data show that in the U.S. <strong>the development of at least a million babies a
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year is "substantially compromised" by prenatal malnutrition.</strong> Miscarriages, which are also
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causally related to poor nutrition, occur at a rate of a few hundred thousand per year. (Williams.)
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</p>
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<p>
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When a muscle is fatigued, it swells, taking up sodium and water, and it is likely to become sore.
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Energy depletion causes any cell to take up water and sodium, and to lose potassium. An abnormal excess
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of potassium in the blood, especially when sodium is low, affects nerve, muscle, and secretory
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cells<strong>;</strong> a high level of potassium can stop the heart, for example. Cellular energy can
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be depleted by a combination of work, insufficient food or oxygen, or a deficiency of the hormones
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needed for energy production. When the swelling happens suddenly, the movement of water and sodium from
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the blood plasma into cells decreases the volume of blood, while the quantity of red cells remains the
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same, making the blood more viscous.
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</p>
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<p>
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During the night, as adrenalin, cortisol, and other stress hormones rise, our blood becomes more viscous
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and clots more easily. In rats, it has been found that the concentration of serum proteins increases
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significantly during the night, presumably because water is moving out of the circulatory system. Even
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moderate stress causes some loss of water from the blood.
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</p>
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<p>
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If a person is malnourished, a moderate stress can overcome the body's regulatory capacity. If tissue
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damage is extreme, or blood loss is great, even a healthy person experiences hypovolemia and shock.
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</p>
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<p>
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C.A. Crenshaw, who was a member of the trauma team at Parkland Hospital in Dallas that worked on Kennedy
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and Oswald, had been involved in research with G. T. Shires on traumatic shock. In his words, "we made
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medical history by discovering that death from hemorrhagic shock (blood loss) can be due primarily to
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the body's adjunctive depletion of internal salt water into the cells." (Shires' work involved isotopes
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of sodium to show that sodium seems to be taken up by cells during shock.)
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</p>
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<p>
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According to Crenshaw, "Oswald did not die from damaged internal organs. He died from the chemical
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imbalances of hemorrhagic shock. From the time he was shot<strong>...</strong>until the moment fluids
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were introduced into the body<strong>...</strong>" [19 minutes] "there was very little blood circulating
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in Oswald's body. As a result, he was not getting oxygen, and waste built up in his cells. Then, when
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the fluids were started, the collection of waste from the cells was dumped into the bloodstream,
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suddenly increasing the acid level, and delivering these impurities to his heart. When the contaminated
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blood reached the heart, it went into arrest<strong>....</strong>" The "waste" he refers to includes
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potassium and lactic acid. Crenshaw advocates the use of Ringer's lactate to replace some of the lost
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fluid. Since the blood already contains a large amount of lactate because the body is unable to consume
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it, this doesn't seem reasonable. I think a hypertonic version of Locke's solution, containing glucose
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and sodium bicarbonate as well as sodium chloride, would be better, though I think the potassium should
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be omitted too, and extra magnesium would seem desirable. Triiodothyronine, I suspect, would help
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tremendously to deal with the problems of shock, causing potassium, magnesium, and phosphate to move
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back into cells, and sodium to move out, helping to restore blood volume and reduce the wasteful
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conversion of glucose to lactic acid..
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</p>
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<p>
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Albumin has been used therapeutically in preeclampsia (Kelman), to restore blood volume. Synthetic
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polymers with similar osmotic properties are sometimes used in shock, and might also be useful in
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eclampsia, but simply eating extra protein quickly restores blood albumin. For example, in a group of
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women who were in their seventh month of pregnancy, the normal women's serum osmotic pressure was 247
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mm. of water, that of the women with nonconvulsive toxemia was 215 mm., and in the women with eclampsia,
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the albumin and osmotic pressure were lowest, with a pressure of 175 mm. In the eighth month, the
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toxemic women who ate 260 grams of protein daily had a 7% increase in osmotic pressure, and a group who
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ate 20 grams had a decline of 9%.(Strauss) In a group of preeclamptics, plasma volume was 39% below that
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of normal pregnant women.
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</p>
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<p>
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If the physiology of shock has some relevance for eclampsia, so does the physiology of heart failure,
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since Meerson has shown that it is a consequence of uncompensated stress. The failing heart shifts from
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mainly glucose oxidation to the inefficient use of fatty acids, which are mobilized during stress, and
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with its decreased energy supply, it is unable to beat efficiently, since it remains in a partly
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contracted state. Estrogen (which is increased in men who have had heart attacks) is another factor
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which decreases the heart's stroke volume, and estrogen is closely associated with the physiology of the
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free unsaturated fatty acids. The partly contracted state of the heart is effectively a continuation of
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the partly contracted state of the blood vessels that causes the hypertension, and reduced tissue
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perfusion seen in shock and eclampsia. Since shock can be seen as a generalized inflammatory state, and
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since aspirin has been helpful in protecting against heart disease, it's reasonable that aspirin has
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been tried as a treatment in pre-eclampsia. It seems to protect the fetus against intrauterine growth
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retardation, an effect that I think relates to aspirin's ability to protect in several ways against
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excesses of uunsaturated fatty acids and of estrogen. But, since aspirin can interfere with blood
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clotting, its use around the time of childbirth can be risky, and it is best to correct the problem
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early enough that aspirin isn't needed.
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</p>
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<p>
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Besides protein deficiency and other nutritional deficiencies, excess estrogen and low thyroid can also
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limit the liver's ability to produce albumin. Hypovolemia reduces liver function, and (like hepatic
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infarcts) will reduce its ability to maintain albumin production..
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</p>
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<p>
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The studies which have found that hospitalized patients with the lowest albumin are the least likely to
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survive suggest that the hypovolemia resulting from hepatic inefficiency is a problem of general
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importance, and that it probably relates to the multiple organ failure which is an extremely common form
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of death among hospitalized patients. A diet low in sodium and protein probably kills many more people
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than has been documented. If old age is commonly a hypovolemic condition, then the common salt
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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.
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</p>
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<p><strong> </strong></p>
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<p>
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<strong>*Note:</strong> Although Konrad Lorenz (who later received the Nobel Prize) was the architect of
|
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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>
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</p>
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<p><strong> </strong></p>
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<p><strong><h3>ADDITIONAL REFERENCES</h3></strong></p>
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|
|
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<p>
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|
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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