CHAPTER IV 



SOME NUTRITIONAL DISTURBANCES IN CHILDREN TETANY, CARBO- 

 HYDRATE DYSTROPHY (MEHLNAHRSCHADEN), ATROPHY 



In the description of these conditions, we must state, first of all, 

 that under this heading, besides conditions that really are avitam- 

 inoses, others have been included which possess, no doubt, a different 

 etiology. Unfortunately, at the present status of our knowledge, 

 this can not be avoided. 



TETANY (SPASMOPHILIA) 



Taking this disease as an example, the clinical picture of spasmo- 

 philia is not absolutely denned, and Luzzatti (1158) stated correctly 

 that it is difficult to differentiate between tetany and convulsions, 

 especially because of the atypical course of infantile epilepsy. 

 According to Stheehman and Arntzenius (1159), a poverty of 

 calcium may be followed by clinical consequences of various kinds. 

 The diagnosis of spasmophilia may be simplified by testing the 

 electrical irritability, but this test is not absolutely certain. It is 

 now generally assumed that the tetanic conditions in children are 

 brought about by the lack of calcium. That the calcium retention 

 is impaired in such cases, was demonstrated by Cybulski (1160). 

 Theoretically, however, it is possible that the calcium-impoverish- 

 ment of the body may take place in many ways. It may be asso- 

 ciated with a lack of calcium in the diet, a condition which may be 

 remedied by means of calcium therapy. The disease may be related 

 to an affection of the parathyroids, in which event an organo-therapy 

 would be in order. Finally, it may be associated with an impoverish- 

 ment of the organism in calcium salts, as a result of rachitic condi- 

 tions. Pepper (1161) correctly called attention to this possibility. 

 In practice, apparently all three causes may be accounted for. 



Etiology 



The lack of calcium as the sole cause of the disease must be quite 

 rare, since most of the available data do not report favorably on 

 calcium therapy. When calcium therapy is spoken of, as in the 



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