What Is Metabolic Toxemia of Late Pregnancy? (MTLP)

SPUN REPORTS — October 1, 1974 — Suite #603 — 17 N. Wabash — Chicago, Illinois 60602

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In St. Petersburg, Florida, in May 1973, Dr. Jack Pritchard, Professor OB/GYN, Southwestern Medical School, Dallas, Texas, and the International Childbirth Education Association Meeting:

“I can’t understand this metabolic toxemia of late pregnancy; it is too vague a concept. Hypertension is something I can measure.”

It is SPUN’s firm opinion that scientific nutrition practices and the scientific use of drugs in human prenatal care will never be established in the U.S.A. until our OB/GYN experts can grasp the role of malnutrition in the etiology of this “ancient enigma of obstetrics”. Since there are a number of common causes of “hypertension” in pregnancy, it is necessary to make a careful differential diagnosis in each patient. SPUN’s Dr. Tom Brewer is the author of a book, Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition, published in 1966. Dr. Pritchard, along with the great majority of U.S.A. OB/GYN experts decided to ignore Brewer’s work, just as they have ignored the classical works of M.B. Strauss, Robert A.Ross, Bertha S. Burke, Reginald Hamlin and many others who have concretely linked MTLP with malnutrition during pregnancy.


The following book review was published in THE MEDICAL JOURNAL OF AUSTRALIA, April 15, 1967, pp. 763-4:

Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition. by Thomas H. Brewer, M.D.; 1966. Springfield, Illinois: Charles C. Thomas. 9″ x 6″, pp. 127. Price $8.50.

“This monograph of 127 pages strikes a blow for a scientific point of view about toxemia of late pregnancy. Brewer declares that metabolic toxemia of late pregnancy is not the accepted toxemia syndrome, but a distinct entity caused by malnutrition, and in particular protein deficiency in the diet leading to hepatic dysfunction. It is interesting that he records that ‘Hamlin of Australia became convinced of the role of malnutrition in causing toxemia of pregnancy.’ Hamlin was well known to many in Australia when he was Superintendent of Women’s Hospital, Crown Street, Sydney.

Brewer makes the striking and encouraging statement that ‘this disease can be totally prevented by good pre-natal nutrition.’ He regrets that the clinical obstetricians have generally ignored Strauss’ belief, in 1935, in ‘the role of lowered serum protein colloid osmotic pressure.’ Brewer supports this claim, stating that ‘each gram of infused albumin can mobilize 20 ml of interstitial fluid.’ In this connection, he vigorously attacks the use of salt restriction and saline diuretics in pregnancy except for cardiovascular or renal disease. [Editor’s note, 1999: Dr. Brewer states that he now attacks liver-toxic, anti-hypertension drugs.]

“This is the product of a man — he writes, he states, as a clinician, not as a biochemist — who has studied his subject with an original and critical approach. This book is a challenge to more than one presently accepted idea, and this lends to it a healthy and stimulating colour. To any who are interested in looking at the etiology as well as the treatment of disease –and one would like to think these days that there are many — this book can be warmly recommended.”


One of the few U.S.A. OB/GYN authorities who have supported Brewer’s work is Dr. J.P. Greenhill of Chicago who published a review in FERTILITY AND STERILITY 18:431, 1967: “Every obstetrician knows that for many decades toxemia of pregnancy has been called the disease of theories” and the theories have been numerous.

In this book, Brewer attempts to provide part of a scientific answer to the etiology of toxemias. His thesis is that there is a simple and direct causal relationship between poor nutrition in pregnancy and the development of toxemia.

…For the prevention of metabolic toxemia of late pregnancy the author does not stress to the patient the importance of “total weight gain” but rather he emphasizes the importance of good nutrition. He does not use diuretics or salt restriction.

…The author makes out an excellent case for his belief that malnutrition is the cause of late toxemia. This book should be read not only by obstetricians by also by everyone who cares for pregnant women, including family physicians, nurses, dietitians, social service workers, and others.”

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  • Copyright  1999-2013 Marci J. Abraham (formerly O'Daffer) and/or Thomas Brewer, M. D. - All Rights Reserved
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