56 INTERNAL SECRETION 



terminated fatally. They conclude from this that tetany causes 

 a specific toxin of uniform activity to accumulate in the serum, and 

 that this toxin does not pass into the urine. Seeing that latent 

 tetany is produced by partial parathyroidectomy and that tetanic 

 symptoms are occasioned by many poisons, this assumption 

 cannot be regarded as having any very great value. 



I have repeatedly found in the course of my own experiments 

 that violent tetanic attacks are arrested by copious blood-letting 

 and that the improvement may be maintained for as long as 

 twenty-four hours by the transfusion of fresh blood into the veins. 

 This seems to point and far more conclusively than do the results 

 obtained by Pfeiffer and Meyer to the presence of a toxin, cir- 

 culating in the blood, from which the organism may be tem- 

 porarily freed by bleeding. 



Ceni and Besta assumed that the toxin of tetany was of the 

 nature of an antigen, and they endeavoured to obtain specific 

 antibodies with which to treat the acute symptoms which follow 

 thyroparathyroidectomy. They immunized rabbits and goats with 

 serum obtained, at the height of an acute tetanic seizure, from 

 dogs deprived of the entire thyroid apparatus. The immune 

 serum they injected in doses of 9 to 15 c.cm. into dogs which had 

 undergone thyroparathyroidectomy and which showed severe 

 tetanic symptoms. They found that, although the course of the 

 condition was as a whole very little affected, there was a rapid, 

 and sometimes a complete, cessation of the acute phenomena in 

 nearly all their cases. The authors lay stress upon the fact that 

 the effects which they obtained with the immune serum are much 

 more energetic, prompt and complete than those obtained by 

 Gley with antipyrin, by Ughetti with chloral-hydrate, or by 

 Canizzaro with bromide of potassium. But they were not able 

 by means of the serum to produce a modification of the disease 

 and a prolongation of life, such as that which follows the 

 exhibition of thyroid gland. 



The suggestion that parathyroid tetany is due to the agency 

 of a toxic product of metabolism, was recently put forward by 

 Berkeley and Beebe. They believe that the toxin is formed by 

 the decomposition of albumin, for they found that with an ex- 

 clusively flesh diet, the symptoms were more violent and there 

 was a marked increase in the excretion of ammonia. They also 

 found that the symptoms provoked by the injection of ammonia 

 or xanthin, like those of tetania parathyropriva, are arrested by 

 the exhibition of calcium or strontium salts. 



Frouin found that the urine of animals from which the 

 thyroid and parathyroids had been removed, contained an excess 

 of ammonia and carbamic acid. He regards tetany as the result 

 of carbamic-acid poisoning. He produced a typical tetany in from 

 twenty-four to forty-eight hours after removal of the entire thyroid 

 apparatus, by the exhibition of 3-4 grammes of carbamate of 



