Eclampsia Prevention and Cure

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and the Cover-Up That’s Killing Tens of Thousands Each Year

by Dr. Jonathan B. Wright

If you’re at all familiar with the history of medicine, you won’t be surprised to learn that in 2011 pregnant women are still getting ill and in some cases dying from an entirely preventable disease, toxemia of pregnancy. The “hallmarks” of toxemia are high blood pressure and protein in the urine occurring during pregnancy, often accompanied by edema. At this stage, the condition is termed pre-eclampsia. As blood pressure rises, the risk of convulsions rises. When they occur, the condition is termed eclampsia, and the risk of death is increased.

According to the most recent standard medical texts, the cause of toxemia is unknown, yet toxemia has been known to be a disease of malnutrition since the work of Strauss and Burke at Harvard in the 1930s and 40s.

From 1971 through 1974, a team from the National Institutes of Health (yes, that’s our taxpayer-supported NIH) exhaustively studied the remarkable records of Dr. Tom Brewer’s work at public health clinics in Contra Costa County, California, comparing with them with records of women from the same clinics but not under Dr. Brewer’s care. Using standard medical care of the time with the added dimension of nutrition education, Dr. Brewer virtually eliminated toxemia among his patients and drastically cut the incidence of low-birth weight infants. Yet the team from NIH has, to this day, not published their findings!

Where is the report, NIH? Where are the Centers for Disease Control and Prevention? Is the malnutrition explanation just too simple? If the CDC doesn’t believe, it should only take them a few months to disprove Dr. Brewer’s method. Aren’t poor mothers’ lives important enough to at least study this question?

Deadly Toxemia Completely Reversed

During 40 years in practice, I’ve observed that Dr. Tom Brewer (and his few predecessors) were and are “right on” about the prevention and reversal of toxemia, or pre-eclampsia. Encouraging the consumption of high-quality protein and supplements (especially vitamin B6 and magnesium) reverses to normal the early to middle stages of this possibly fatal disease. Even in later, more serious stages intravenous amino acids or human albumin, vitamin B6, and magnesium will eliminate the problem. There’s just no excuse for allowing death from toxemia to claim more mothers.

I interviewed Dr. Tom Brewer in 1996, some 22 years after the NIH team packed up and left his California clinic without issuing a report. In the 14 years since the interview – a total of 36 years – no report has been issued. So this entirely unnecessary illness continues.

According to one of the more recent reports, the number of cases of pre-eclampsia in these United States between the years 2000 and 2004 varied from 104,437 to 132,800.¹ Fortunately, the actual death rate from eclampsia has been very small in the United States – 72 total in 2002 – but worldwide deaths from toxemia are much greater, approximately 63,000 worldwide in 2002.^2,3

The Man Behind the Eclampsia Cure

From 1963 through 1976, Dr. Tom Brewer conducted a demonstration prenatal care and nutrition education project in Contra Costa County, California. His public prenatal clinic served low-income, high-risk women with a program based on nutrition education incorporated into routine prenatal care.

The incidence of babies with low birth weights born to women in Dr. Brewer’s care over those 12 years was 2.8% as compared with 13.7% among women seeing other obstetricians in the same county’s other low-income clinics. During the same time, he demonstrated the effectiveness of good nutrition in preventing metabolic toxemia of late pregnancy.

Tom Brewer served in the Army during the second World War. He was in the infantry in the southern Philippines and fought through the battle of Okinawa. After Army discharge, he took premedical courses and earned his MD from Tulane University Medical School in 1951. He started an internship at Charity Hospital, New Orleans, then worked as a carpenter’s helper and delivered milk until resuming his internship in Houston in 1953. After his internship, he spent a year as general practice resident at Charity Hospital in Independence, Louisiana.

From 1955 through 1958, Dr. Brewer was a “country doctor” in Fulton, Missouri. In 1958 he joined the obstetrics and gynecology department of the University of Miami as a resident under his former Tulane professor, and completed that program in 1962. He was also a Fellow at the Howard Hughes Medical Research Institute, Miami, during 1960–1961. During 1962–1963 he was an instructor in the Department of Obstetrics and Gynecology at the University of California, San Francisco.

In 1966, Dr. Brewer first published Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition (Keats Publishing, New Canaan, CT; 1982), which was updated in 1982. He also coauthored What Every Woman Should Know: The Truth About Diet and Drugs in Pregnancy (revised edition, Penguin Books, New York; 1985) and The Brewer Medical Diet for Normal and High Risk Pregnancy (Simon and Schuster, New York; 1983).

From 1962 onward he published 40 scientific papers concerning toxemia and other complications of pregnancy in such journals as the American Journal of Obstetrics and Gynecology, the Journal of Obstetrics and Gynecology of the British Commonwealth, and the Australia-New Zealand Journal of Obstetrics and Gynecology.

Here are excerpts from my 1996 interview with Dr. Brewer. The facts that he related 45 years ago have not changed!

Dr. Wright:

Figures recently released by the World Health Organization and others state that approximately 75,000 women worldwide die of toxemia of pregnancy. For decades you’ve taught that toxemia is an entirely preventable disease, a disease of malnutrition. Following your lead and a few other clues, I’ve helped women eliminate early to moderate cases of toxemia (technically pre-eclampsia). Why isn’t your work taken more seriously?

Dr. Brewer:

The major criticism of my work is that I wouldn’t do “controlled studies.” I contend that any such study is unethical: Who wants to be assigned to the “poor-diet control group” and risk harming herself or her child?

Dr. Wright:

When did you first become interested in the problem of toxemia of pregnancy?

Dr. Brewer:

Almost 50 years ago. I was a medical student at Tulane University, on obstetrics in my third year. My instructor was James Henry Ferguson, MD, who had been to the Mississippi countryside studying maternal deaths, particularly among poor black and white mothers.

Ferguson told us students the classic picture of toxemia: high blood pressure, edema, protein in the urine, progressing to headaches, spots in front of the eyes, dizziness, nausea, vomiting, and in the end a lethal situation of coma or convulsions or both, heart failure, kidney and liver damage, and death.

Toxemia was more common among the poor, teenagers, black women, unmarried women, older women with many children, women with diabetes, women with high blood pressure prior to pregnancy, lupus, and so on. There were a whole gamut of things associated with toxemia; it had been and still is studied to death. Yet then and even now the official line is “nobody knows what causes toxemia.”

Ironically, our instructor Ferguson had studied in Chicago with William Dieckmann, the author of a textbook Toxemias of Pregnancy. Dieckmann is the only American author I know who cited the work of Pinnard, a French professor at the Hospital of LaMaternité in Paris who discovered in 1893 that milk could totally prevent seizures in toxemia. The “régime latté absolut,” he called it. So there’s been evidence toxemia is a nutritional problem for over 100 years now. But I’m digressing …

Dr. Wright:

You were telling us you were a third year medical student …

Dr. Brewer:

Yes. I went out to the toxemia wards. In those days, the black and the white were on opposite sides of the hospital. Even the blood banks were segregated into “black blood” and “white blood.”

Dr. Wright:

Excuse me, you said toxemia wards? There were whole wards with toxemic women?

Dr. Brewer:

Yes.

Dr. Wright:

How many women in each one?

Dr. Brewer:

About 20. As a student, my job was to take and record blood pressures, collect urine specimens, run tests in the lab. I took medical histories … Do you remember doing that in school, they ran to 20 or 30 pages … One of the sections was for diet. Someone would tell me “I had fatback and cornbread and clay dirt and sago starch and sorghum” and so on. I’d ask “did you drink milk, eat any eggs, what about meat?” They mostly said no. After taking histories including diet from several hundred women with toxemia and then some who didn’t have toxemia, it occurred to me that toxemia must be a disease of malnutrition.

I then began to tell my fellow students, the interns, occasionally a resident “these women here, they’re malnourished, that’s why they’re sick, they’re seriously malnourished.” They usually told me “they can’t be.” When I found out the serum proteins in these women were very low, I thought that confirmed it, but the medical literature from all around the world said it was because protein was being lost in the urine.

But I found out that isn’t true: The protein loss into the urine doesn’t start until the toxemia has well progressed all over the body.

Dr. Wright:

Didn’t Professor Maurice Strauss of Harvard publish in the 1930s about low serum albumin in women with toxemia?

Dr. Brewer:

Exactly. He influenced my thinking. And a fellow Harvard faculty member, Bertha S. Burke, worked it out very clearly that women who ate over 60 grams of protein a day simply didn’t get toxemia.

That was in the 1930s and ’40s. But one of the most important influences on my thinking were my experiences in the war in the Pacific, where I observed directly that people could get malnourished enough to get sick from it.

But nobody wanted to listen to me; I was just a student and besides at that time I was making a racial issue of it, as there were many more malnourished blacks than whites. It didn’t help at all that I was a lower middle class white anti-segregationist Texan in Louisiana in the late 1940s and early ’50s. But I’m digressing again …

They were using a potent diuretic made with mercury, Mercuhydrin …

Dr. Wright:

Which works by actually damaging the kidneys …

Dr. Brewer:

Yes, we were actually ordered to give mercury diuretics to these pregnant women. Later on I worked in the outpatient clinics; we would have as many as 300 women, occasionally 350 a day …

Dr. Wright:

All with pre-eclampsia?

Dr. Brewer:

Every one. And all that we did in those clinics was check the blood pressure, give the mercurial diuretic, weigh them, and give drastic warnings about not gaining weight or eating salt or they might swell up with water and have seizures and die.

That’s where I first encountered what I called iatrogenic starvation. They were putting women I knew to be malnourished onto starvation diets. I complained and said “these women simply need more and better food and not starvation and all these drugs.” That didn’t make me any more popular with the professors in charge; remember I was still a medical student.

After I graduated from medical school I started an internship at Charity Hospital, but it was all the same, and I couldn’t do anything about it. I got discouraged and dropped out, worked as a carpenter’s helper and delivered milk for a couple of years. I went back to another internship in Houston in 1953.

Dr. Wright:

We’re happy you didn’t quit medicine entirely.

Dr. Brewer:

I thought about it. After I finished the internship, I was a general practice resident for a year. This was in Independence, Louisiana, which was a very, very poor rural area. About 25% of the women delivered there had one stage or another of toxemia; at Charity Hospital in New Orleans it had been 19%.

Again I took dietary histories and got the same stories: fatback, cornbread, sorghum, grits, soda pop, maybe an apple a week or so. No good quality sources of protein. None of this was formal research, though. But after the residency, a partner and I took over a practice in Fulton, Missouri, and we saw only one woman of the first hundred we delivered with toxemia. Only 1%! It was easy to predict: She was very poor, lived in a shack on an easement by the Missouri River, and was malnourished.

While I was in Fulton, drug company “detail men” were calling me all the time. They were promoting the latest diuretics for toxemia; it drove me crazy. By early 1958 I just had to do research on toxemia, so I went to Miami where my former instructor James Henry Ferguson was now professor.

He was the only one who would listen to me. He couldn’t get me any money for research, so I became an ob/gyn resident in his department because he would let me do research “on the side.”

I didn’t really want to be an ob/gyn specialist but it was the only way. I finally got a paper published in the American Journal of Obstetrics and Gynecology about the limitations of diuretics and the meaning of low serum albumin in toxemia.

Dr. Wright:

That was in 1962?

Dr. Brewer:

Yes. By 1963, I had done another study where I gave intravenous human albumin to a few toxemic women with massive edema. These were women with already-low serum albumin; the lowest was 1.2 grams per hundred grams blood.

It was just dramatic. Women who were in shock came right out of it, their edemas lessened, their blood pressures lowered; they felt much better. It seemed almost miraculous, but it was just simple physiology. Every gram of albumin given intravenously could draw 50 cc’s of edema fluid back out of the tissues into the bloodstream, where it belongs.

Dr. Wright:

Starling’s Law.

Dr. Brewer:

You’re onto this, aren’t you? Starling, Journal of Physiology, 1895, Volume 19, pages 312–336. His paper on “Absorption by Blood Vessels.” That was Professor Maurice Strauss of Harvard’s takeoff point.

Dr. Wright:

How many women did you give intravenous human albumin?

Dr. Brewer:

I personally gave it to 13, and all 13 had marked diuresis, loss of edema fluid.

Dr. Wright:

That would support your theory. What happened?

Dr. Brewer:

No one would accept the results.

Dr. Wright:

So you kept working on it?

Dr. Brewer:

During my entire residency in ob/gyn, from 1958 through 1962. Then I went to the University of California, San Francisco, as an NIH Fellow Instructor in the ob/gyn department. But when I started a program of trying to teach the women at the outpatient clinic to eat right, to gain any weight they wanted as long as it came from a good diet, the other ob/gyn instructors and professors wouldn’t support me.

You’d have thought I was the worst food faddist in the world. I got so frustrated all over again. Somebody else would see one of my patients and lecture her about not gaining weight and put her on a low-salt low-calorie diet and give her amphetamines to promote weight loss.

Honest to God, they were giving amphetamines to pregnant mothers. I nearly went mad and told myself, “I can’t stay here another year, I have to go somewhere and do this on my own!”

So the next year I went across the Bay to the Contra Costa County Health Services, and I started my program in Richmond. I talked to every woman who came in there about good nutrition on her first visit. I told them this was the most important part of prenatal care. Just as importantly, I eliminated all the stuff about low calories, low salt, diuretics, and so on. I just stopped all that.

Dr. Wright:

What were the results?

Dr. Brewer:

After I had been there a few years, the NIH agreed to come in with a sophisticated team and go over the records. They compared records from patients in my program at Richmond to records from Richmond patients prior to my program. They found a 10-fold reduction in what they called “pregnancy-induced hypertension” in first pregnancies.

Dr. Wright:

Did they publish that anywhere?

Dr. Brewer:

No.

Dr. Wright:

Why not?

Dr. Brewer:

I don’t know; it’s political, I guess.

Dr. Wright:

How long were you with Contra Costa County Health Services?

Dr. Brewer:

Twelve and a half years.

Dr. Wright:

Were any other statistics collected during that time?

Dr. Brewer:

NIH actually carried out an extensive study. They hired seven clerks. They brought a big trailer office, set it up on the hospital grounds, and supposedly abstracted every record of every woman delivering a baby there for a five-year period.

They coded them as to whether they were from the Richmond Clinic with Brewer or not Brewer, the Martinez Clinic with Brewer or not Brewer, and the Pittsburgh Clinic with or without Brewer. I thought “what wonderful statistics we’re going to have.” They checked every serum protein, every urinalysis was recorded, every blood pressure was coded on cards and tape … and they came out with nothing at all.

Dr. Wright:

Where is all this data?

Dr. Brewer:

Supposedly the NIH still has it. They gave me a copy of the computer tape. I sent it to five different computer experts; they couldn’t decipher it. I finally gave up. I’m not a computer person.

Dr. Wright:

They studied five years worth of records?

Dr. Brewer:

Yes. Several women clerks were working five days a week, eight hours a day from 1971 through sometime in 1974. I kept asking, when is something going to show? I know personally there were no cases of toxemia in my patients.

I had people visit to see if I was doing anything wrong from the University of California-Davis, University of California-Berkeley, Planned Parenthood, March of Dimes, and so on. No one could find anything the matter, but none of them publicly acknowledged my work. By the way, have you heard of the 1958 Vanderbilt Study?

Dr. Wright:

No.

Dr. Brewer:

It was done by Darby, one of the so-called leading nutritionists at Vanderbilt, and someone from the ob/gyn department. They concluded from a study of reasonably well-fed middle class white women that nutrition had nothing to do with toxemia, or for that matter with low birth weight or infant mortality. It was believed by all the academics. I was up against that, and to some degree we still are.

Dr. Wright:

It would seem so. Since you left the Contra Costa County Health Services, what have you been doing?

Dr. Brewer:

I’ve been involved with SPUN (the Society for the Protection of the Unborn through Nutrition), writing, lecturing, doing telephone consultations, and promoting my book Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition.

My Experience with Dr. Brewer’s Methods

From 1973 through early 1979, I helped women with home births in the area south of Seattle; there were no midwives in our area at that time. Very fortunately, Dr. Brewer’s book was published in 1966. I worked with pregnant women who only had high blood pressure, and some with high blood pressure and protein in the urine, the definition of pre-eclampsia.

None of these women proceeded to actual eclampsia, the convulsive stage. Using a high-protein diet, magnesium, and vitamin B6, all of them returned their blood pressures to normal, and the protein in their urine went away. Let me tell you about the worst two cases.

The first was a young woman who walked in with support from her mother. She appeared shaky, but told me that she was determined not to be hospitalized as she had been advised. She had just heard from another young woman whose pre-eclampsia had been reversed the year before, so here she was.

Her blood pressure was 180/110; a quick “dip-stick” test showed protein in her urine. Because her pre-eclampsia was fairly advanced, we gave her 500 cc of intravenous amino acids (which our bodies use to make protein), followed by three grams of magnesium sulfate and 300 milligrams of vitamin B6. During the course of these IVs, she had to be helped to the restroom to urinate several times.

When the IVs were done, she went home, returning with her mother the next day. This time she was walking by herself. Her blood pressure was 145/90; she reported she’d lost 12 pounds, which we verified on the office scale. We gave her one more set of IVs, recommended Dr. Brewer’s book and his high-protein diet, and asked her to come back in a week, or of course sooner if necessary. When she returned, her blood pressure was 120/76, and she’d lost a total of 20 pounds. The rest of her pregnancy was “uneventful.”

The second was a 35-year-old woman who came from New Orleans after reading some of my articles in Prevention magazine. She’d read Dr. Brewer’s book after miscarrying her first two pregnancies during the “middle” stages of pre-eclampsia. Despite reading the book, she’d developed pre-eclampsia and lost her third pregnancy, too. Since miscarriage isn’t usual with pre-eclampsia and she’d used Dr. Brewer’s program, she was at a loss for what to do next.

Testing showed that her stomach was producing no acid at all (achlorhydria). With no stomach acid, it’s difficult to digest protein well, so I advised her to take betaine hydrochloride with pepsin capsules (to help digest proteins and help the absorption of minerals and other nutrients) with meals, and to take a high potency vitamin and mineral from then on to make up for the nutrients that hadn’t been absorbed well, likely for years. As she was planning to try to have at least one child, I recommended she take extra calcium, magnesium, and other minerals, as minerals are especially poorly absorbed by those suffering from achlorhydria.

Although we never saw each other in person again, we talked on the telephone several times until after her first child was born, healthy, and from a “perfectly normal” pregnancy, with no sign of pre-eclampsia.

Dr. Brewer’s books are still available today. Check your library or find a copy for purchase online. There’s absolutely no need for any pregnant woman to develop pre-eclampsia or eclampsia, even if standard medical textbooks say the cause is “unknown.”

Notes

1. Wallis AB, Saftlas AF, et al. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987–2004. Am J Hypertens. 2008;21:521–526.

2. Centers for Disease Control. Deaths: final data for 2000. Natl Vital Stat Rep. September 16, 2002;50(15):106. Available at: http://www.cdc.gov/nchs/data/erratas/nvsr50_15p106.pdf. Accessed 7 January 2011.

3. Vigil-De Gracia P. Maternal deaths due to eclampsia and HELLP syndrome. Int J Gynaecol Obstet. Feb 2009;104(2):90–94.

Reprinted with permission from Dr. Jonathan V. Wright’s Nutrition & Healing newsletter, published monthly by Healthier News LLC, 702 Cathedral Street, Baltimore, Maryland 21201. For subscriptions, go to www.tahomaclinic.com.