Summary: A study of the diet, weight gain and incidence of pre‐eclamptic toxaemia has been carried out on a group of primigravidae and secundigravidae. The incidence of pre‐eclamptic toxaemia was significantly higher in primigravidae. No relationship could be established between dietary intake and the development of pre‐eclamptic toxaemia of pregnancy. The value of diets with a high protein content in preventing toxaemia could not be demonstrated. The mean initial weight was significantly higher in patients developing preeclamptic toxaemia. However, no significant relationship was found in those women who were overweight for their height and age (two standard deviations). Weight gain could not be related to caloric intake in either the 20 to 30 week period or the 30 to 40 week period. Weight gain in the 20 to 30 week period showed a positive regression to the incidence of pre‐eclamptic toxaemia, but no significant trend could be demonstrated in the 30 to 40 week period.

1. Results of tests for the diagnosis of Cushings syndrome of varoius aetiologies are discussed for twenty-five patients in whom the pathology was established by operation or autopsy. 2. Control values for the urinary excretion of free cortisol, 17-OHCS, Porter-Silber chromogens (P-SC) and 17-OS and plasma levels of P-SC are compared with those for normal subjects. 3. The results indicated that urinary values are within the normal range for some patients with Cushing's syndrome. 4. Plasma levels of P-SC in the morning were within the normal range for the majority and elevated for the rest. 5. Some patients showed day-night variation of plasma P-SC but evening values were above the normal range. 6. The expected response for low dosage dexamethasone was found in all patients tested but unexpected responses followed high dosage in some. 7. Plasma 11-OHCS in the five patients tested failed to respond to insulin induced hypoglycaemia. 8. Metyrapone administration and corticotrophin infusion tests had limited usefulness in establishing the aetiology of the disease. The 17-OHCS excretion became raised in the response to corticotrophin and the evaluation was prolonged beyond normal responsiveness.

S U M M A R Y1. The 24 h urinary excretions of Porter-Silber (P-S) chromogens, 17-hydroxycorticosteroids (17-OHCS) and free cortisol, and day-night variation of plasma P-S chromogens, were studied in normal and obese women and patients with a confirmed diagnosis of Cushing's syndrome.2. The mean absolute values of P-S chromogens, 17-OHCS and free cortisol were similar for the normal and obese subjects and elevated in Cushing's syndrome. With the exception of the 17-OHCS there was some overlapping of the individual values within the three groups. All the subjects with Cushing's syndrome and several of the obese subjects had values of 17-OHCS which were outside the normal range. 3.The 24 h urinary 17-OHCS and free cortisol excretion expressed per kg body weight were significantly lower for the obese than for the control subjects and subjects with Cushing's syndrome. The values were significantly higher for the subjects with Cushing's syndrome than for the obese and normal subjects. There was some overlapping of the individual values. 4. Two normal and two obese subjects failed to show significant day-night variation, whereas only four of the patients with Cushing's syndrome had significant daynight variation of plasma P-S chromogens.5. The urinary 17-OHCS for four of the obese subjects with some symptoms of adrenocortical hyperactivity were suppressed normally on a low dose of dexamethasone whereas those with Cushing's syndrome failed to do so.Porter-Silber (p-S) chromogens comprise the 17,21-dihydroxy-20-oxocorticosteroids which react with phenylhydrazine hydrochloride in ethanol-sulphuric acid to give a yellow colour. In plasma, cortisol and tetrahydrocortisone are the major steroids estimated by this reaction

1.The 24 h urinary excretion of free cortisol and aldosterone-l8-glucuronide has been studied in twenty-three control and twenty-three grossly obese subjects by a double-isotope-dilution derivative method.2. Day-night variation of plasma and urinary cortisol has also been investigated. 3. The mean absolute steroid values were similar for the obese and non-obese subjects.4. The 24 h urinary values for free cortisol expressed as pg/kg of body weight were significantly higher for the controls.5. The majority of the obese and control subjects had a day-night variation of plasma cortisol. All subjects, with two exceptions, showed day-night variation of free cortisol in the urine.6. It is suggested that the estimation of unconjugated cortisol in timed urinary collections could be useful for investigations of adrenocortical function.7. The findings do not support the presence of increased adrenocortical activity in developed obesity.