Clinical Hemodynamics and Pharmacodynamics of Toxemia.

For many years toxemia has served as a wastebasket for a variety of disease states characterized by an elevated arterial pressure, edema, and albuminuria. Whereas this triad is consistent with the diagnosis of toxemia, it is not diagnostic. Besides toxemia, these abnormalities may be found in pregnant patients with hypertensive vascular disease, pyelonephritis, glomerulonephritis, or any combination of these (fig. 1). Data derived from studies performed on patients with such a variety of disease entities have obviously been confusing. It makes a lot of difference, for example, whether the subjects studied had chronic pyelonephritis or acute vasospastic toxemia. During the past 13 years, our group has attempted to cut the pie of elevated arterial pressure, albuminuria, and edema into separate and distinct diagnostic pieces. Ophthalmoscopic examination and urinalysis have been of great help in this regard (Finnerty, 1954, 1956 and 1965; Finnerty et al. , 1960).