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these are scarcely normal, for they are not seen in women with very
elastic skins and are rare among peasants and savages. The whole
carriage of the woman tends to become changed with the development of the
mighty seed of man planted within her; it simulates the carriage of pride
with the arched back and protruded abdomen. The pregnant woman has
been lifted above the level of ordinary humanity to become the casket of
an inestimable jewel.
It is in the blood and the circulation that the earliest of the most
prominent symptoms of pregnancy are to be found. The ever increasing
development of this new focus of vascular activity involves an increased
vascular activity in the whole organism. This activity is present almost
from the first--a few days after the impregnation of the ovum--in the
breasts, and quickly becomes obvious to inspection and palpation. Before a
quite passive organ, the breast now rapidly increases in activity of
circulation and in size, while certain characteristic changes begin to
take place around the nipples. As a result of the additional work
imposed upon it the heart tends to become slightly hypertrophied in order
to meet the additional strain; there may be some dilatation also.
The recent investigations of Stengel and Stanton tend to show
that the increase of the heart's work during pregnancy is less
considerable than has generally been supposed, and that beyond
some enlargement and dilatation of the right ventricle there is
not usually any hypertrophy of the heart.
The total quantity of blood is raised. While increased in quantity, the
blood appears on the whole to be somewhat depreciated in quality, though
on this point there are considerable differences of opinion. Thus, as
regards haemoglobin, some investigators have found that the old idea as to
the poverty of haemoglobin in pregnancy is quite unfounded; a few have even
found that the haemoglobin is increased. Most authorities have found the
red cells diminished, though some only slightly, while the white cells,
and also the fibrin, are increased. But toward the end of pregnancy there
is a tendency, perhaps due to the establishment of compensation, for the
blood to revert to the normal condition.
It would appear probable, however, that the vascular phenomena of
pregnancy are not altogether so simple as the above statement would imply.
The activity of various glands at this time--well illustrated by the
marked salivation which sometimes occurs--indicates that other modifying
forces are at work, and it has been suggested that the changes in the
maternal circulation during pregnancy may best be explained by the theory
that there are two opposing kinds of secretion poured into the blood in
unusual degree during pregnancy: one contracting the vessels, the other
dilating them, one or the other sometimes gaining the upper hand.
Suprarenal extract, when administered, has a vaso-constricting influence,
and thyroid extract a vasodilating influence; it may be surmised that
within the body these glands perform similar functions.
The important part played by the thyroid gland is indicated by its marked
activity at the very beginning of pregnancy. We may probably associate the
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