Further Contributions to Our Knowledge of the Pernicious Vomiting of Pregnancy. *

I cL4x perhaps intercst the members of this Society by bringing to their attention the results of my investigations concerning the nature and treatment of pernicious vomiting of pregnancy. Some of you may recollect my monograph upon the subject which appeared in 1905, in which I reviewed the literature and reported my observations concerning certain pathological and metabolic changes occurring in the disease. The following year I still further claborated my views in an article entitled “ Tox;eniic Vomiting of Pregnancy.” Since that time I have written nothing further upon the subject, but I have had an opportunity to observe a considerable number of cases, which I have studied as thoroughly as possible. This increased experience has served to confirm in grcat part my original views, but a t the same time it has forced me to recognize that some of my conclusions were too far-reaching, and consequently are in need of revision. It i s my purpose upon this occasion to discuss with you, frankly and informally, various aspects of the subject, and then to indicate to what extcnt my original conclusions must be modified. I n niy original articles I held that the evidence then available justified the classification of cases of pernicious vomiting into three groups-reflex, neurotic and toxemic. I made no contribution to our knowledge of the first two varieties, but I pointed out that the toxzmic form should be sharply differentiated from others, as it is associated with profound degenerative lesions in the liver and kidneys, as well as with striking changes in metabolism, which are characterized by a marked distortion in the nitrogenous partition, more