THE THYROID APPARATUS 49- 



species, will not only heal into place, but will prevent the appear- 

 ance of symptoms of suppression of the glands. The grafted 

 organs undoubtedly retain their normal structure for some time, 

 but after a few months retrogressive changes usually set in which 

 lead, in time, to the disappearance of the organ. 



The transplantation of a parathyroid gland has been success- 

 fully performed in man by v. Eiselsberg. The patient was a 

 woman aged 42 who, twenty-seven years previously, had had 

 the whole of her thyroid removed and was suffering from tetany. 

 A parathyroid gland was implanted in the abdominal rectus 

 muscle. This gland was taken from a woman who had had a 

 cyst enucleated from one lobe of the thyroid gland, and in whom 

 the other parathyroids were intact. The transplanted gland 

 healed in, the tetany became reduced to isolated spasms of the 

 glottis, and the sensibility to electric stimulus became normal. 



The results of this experiment naturally suggested a sub- 

 stitution therapy by means of organic extracts. 



Experiments by parathyroid extract with man as the subject 

 have been repeatedly carried out. Some authors, especially those 

 who employed Vassale's so-called parathyroidin, obtained good 

 results; others (v. Frankl-Hochwart, Escherich, Reinsberg and 

 Rey) were unsuccessful. Pineles treated three cases of tetany 

 with 0.15 to 0.45 grm. (about 2\ to 7 gr.) of dried para- 

 thyroid substance daily, and continued the treatment for months, 

 but he was unable to report any change in either the frequency 

 or the intensity of the seizures. 



Quite recently Halstead (1907) and Putman (1909) described 

 favourable results obtained in post-operative tetany with the 

 parathyroid extract prepared by Berkeley of New York. When 

 given by the mouth, or, better still, by subcutaneous injection, 

 these nucleo-proteids are said immediately to subdue all symptoms 

 of tetany. 



J. Ott (1909) describes the physiological activity of this 

 substance as well as that of the watery extracts of parathyroid 

 gland. These substances increase intestinal peristalsis and the 

 muscular contractions of the uterus. When injected in small 

 doses into the veins of cats and rabbits, they produce a fall, which 

 is followed by a rise, in the blood-pressure. In large doses they 

 bring about a fall in blood-pressure unaccompanied by any change 

 in the frequency of the pulse; there is a slight reduction in 

 temperature, with slightly accelerated respiration. But the most 

 marked symptom is the extraordinary increase in diuresis, which 

 may rise to ten times the normal, and is due to stimulation of 

 the epithelial cells of the kidneys. 



It will be evident from what has gone before that the thyroid 

 preparations play an important part in the management of post- 

 operative tetany, whether therapeutically in man or experimentally 

 in animals. At a first glance, it seems reasonable to suppose 



4 



