Before beginning our discussion today, I should like to call on Dr. Eastman to present the history and the findings in a case which we will use to illustrate various points.
The patient is a white woman, aged 37, who came to the outpatient clinic on June 26, 1946, complaining of itching, dark-colored urine and jaundice of eight days' duration.Her past history is of significance. Thirteen years previously, at the age of 24 and during her first pregnancy, toxemia of pregnancy developed. She was delivered of a stillborn infant during the eighth month. In spite of this and of the sequela of hypertension, she became pregnant two years later and was delivered of a normal female infant (by cesarean section). In the years following until her appearance here in 1946 she complained of such symptoms of hypertension as headache and dizziness. These were controlled by