The disease prevails among the underprivileged and is seldom seen among the well-fed and well-cared-for patients
With these words Mengart and Tweedie in 1964 introduced their report on "acute vasospastic toxemia: therapeutic nihilism."
This generalization has been widely accepted by clinical obstetricians in the United States, but little scientific effort
has been expended to answer the question: How is this so? Popular theories of the pathogenesis of this disease, "toxemia
of pregnancy," have totally ignored its obvious relationship to poverty, malnutrition, ignorance and socioeconomic deprivation.
This work provides part of the scientific answer to that question and will lay the foundation upon which more complete biochemical
knowledge may be rapidly acquired.
This disease which is responsible for a number of maternal deaths and even more fetal deaths in our nation each year is no
longer a complete "enigma." We have acquired enough scientific knowledge to prevent it completely. I hope that this work
will convey this knowledge to a significant number of physicians responsible for the care of pregnant women. I also hope
that this knowledge will be a stimulus to public health and political authorities to take the steps necessary to improve the
maternal health of large numbers of American women now living in poverty.
I want to express my deep appreciation to Mr. Payne Thomas for his encouragement and for making possible the publication of
Thomas H. Brewer