The real cause of eclampsia is unknown, but the most plausible explanation of this "disease of theories," as Zweifel of Leipsic called it, is that it is a toxemia which attacks the liver, and directly or indirectly the kidneys, and brings on convulsions by toxic action on the anterior cerebral cortex. The great difficulty is to explain how these toxins originate. One authority suggests that the poison comes from the liver; another, from the fetus; a third, from the placenta, the intestines, the general metabolism, disturbed glandular balance, bacteria, and so on, but nothing is certain as to the etiology except that it is an intoxication. On an average, 20 per cent. of the women who have eclampsia die,--but statistics vary from 5.31 per cent. to 45.7 for the mother and from 30 to 42 per cent. for the child. Eclampsia occurring ante-partum has the worst mortality; intra-partum, less; post-partum, least. About half the children die from prematurity, toxemia, asphyxiation, narcotics administered to the mother, or injuries at birth. If the patient's pulse remains full and hard and below 120, there is no immediate danger of death; but if faster, weaker, and running, the prognosis is bad. High fever is not necessarily fatal to the mother, but it is very dangerous to the fetus. Edema of the lungs is a very grave symptom, but recovery is possible. When the convulsions have gone beyond twenty the prognosis is bad, but there have been recoveries. Deep cyanosis, marked restlessness, anuria, and intense albuminuria are all bad symptoms. Apoplexy is nearly always fatal. After delivery the recovery of the woman is by no means certain. She may get pneumonia, sepsis, or another eclamptic attack. Hirst finds that if the diastolic pressure does not rise above a ratio of 1 to 3 times the pulse pressure (_i. e._, the difference between the systolic and diastolic pressures), the prognosis is good. Every pregnant woman should be watched to prevent eclampsia, if possible, because all are liable to this outcome. The hygienic methods mentioned in the chapter on Abortion are most important here. The family history is of weight--if the women of the patient's family have been eclamptic, if her parents were alcoholic or insane, these facts increase her liability to the disease. If she has had eclampsia before, if her kidneys are acutely diseased,--especially if injured by infections,--if she is inclined to digestive disturbance, she is disposed to eclampsia. Albuminuria, diminishing amounts in the daily excretion of urine, and decrease in the total solids of the urine, casts or blood in the urine, are serious symptoms. If albumin increases and urea decreases, this is a grave sign.