cnHuisTJi'Y OF (!<UTi:n 599 



ship of this <rhui(l to the totatiy, hut not tlio cah'iuiii deprivation liypothosis. A 

 critique of tiiis liyi)otiu'sis hy lU'ikch'y and IJeebo ■""' hrings out the foih^winf^ 

 points: Strontium, inaj^ncsiuni and harinni liavo tiie same elVect in tetany as 

 fak'iiim, wiiereas severe eah-iuni loss in diahetie acidosis does not cause tetany. 

 Tlie fact tiiat Ideedinj,' reduces tiie symptoms is ai^^ainst tiie cahdum de])rivation 

 theory and supports the intoxication tiieor.y. ^^'icne^ 47 even states tiiat it is 

 possible to secure an antitoxin for tiie poison of tetany thyreopriva hy immuniz- 

 ing with the serum of animals in tetany. On the otlier hand, the marked clianj;es 

 in dentition and l)one repair observed in paratliyroidectomized animals liy Krd- 

 heim -^s indicate an abnormality in calcium metabolism, whicli, however, mif;ht be 

 secondary to an intoxication. Also, in osteomalacia and osteoporosis the para- 

 thyroids are said to siiow hyperjilasia,^'' and 1 lowland and Marriott have found a 

 definite decrease in the calcium of the blood in human tetany and in paratliyroid- 

 ectomized doi:s.i'''i 



MacCallum •'^^" has fcmiul evidence that in paratliyroidectomized dogs the blood 

 contains something which greatly increases the irritability of tiie nerves, possibly 

 by abstracting calcium from the tissues. Removal of calcium from the blood by 

 dialysis results in nerve hyperexcitability resembling that seen in tetany. 



Cooke states that the metabolic changes precede, and presumably incite tlie 

 tetany. Im])lantation of parathyroid tissue in persons with tetany parathyreo- 

 priva has been successful in removing symptoms in a few cases. 5i The relation 

 of the parathyroids to tetany of infants is not so well established."'^ altliough 

 several observers have found hemorrhages in the paratliyroids in these cases. 

 Some cases of "gastric tetany'' have improved under parathyroid feeding, which 

 is also said to be beneficial in paralysis agitans,^-^ although there seems to be 

 no anatomic basis for assuming a parathyroid deficiency in this disease. 



CHEMISTRY OF GOITER 



In connection with his earliest studies of thyroiodin, Baumann ob- 

 served a great difference in the amount of iodin in the thyroid glands 

 of normal individttals living in goitrous districts, as compared with 

 those living in non-goitrous districts. Thus in Freiburg, a goitrous 

 district, the average weight of the dried thyroid was 8.2 grams, each 

 gram containing 0.33 mg. of iodin, a total of 2.5 mg. of iodin to each 

 gland. Glands from Hamburg averaged 4.6 gm. in weight, contain- 

 ing 0.83 mg. of iodin per gram, a total of 3.83 mg. per gland. Berlin 

 glands weighed 7.4 grams, and contained 0.9 mg. of iodin per gram, 

 or a total of 6.6 mg. of iodin per gland. Both of the last-named cities 

 are in districts where goiter is not endemic. The thyroids of young 

 children show the same relative paucity of iodin in goitrous districts, 

 as compared with non-goitrous districts. Wells ^^ found that the thy- 

 roids throughout the United States contain even larger amounts of 

 iodin than the Berlin glands, averaging 10 to 12 mg. per gland, agree- 

 ing with the fact that goiter is comparatively rare in this country.'^'* 



*fiJour. Med. Res., 1000 (20), 140. 



47 Pfliiger's Arch., inin fl.3G). 107. 



4s Frankfurter Zeit. Rathol.. 1011 (7), 175. 



40Todyo, Frankf. Zeit. Pathol., 1012 (10), 210. 



4na Trans. Amer. Fed. Soc, Vol. 28. p. 202. 



noVerh. Deut. Path. Cies.. 1012 (15). 206: Jour. Exp. Med., 1914 (20), 140. 



51 Danielsen, Beit. klin. Chir., 1010 (06), 85. 



52 See Haberfeld, Virchow's Arch., 1011 (203), 282. 

 52a Berkeley, Med. Record, 1016 (00), 105. 



53 Jour. Amer. Med. Assoc, 1807 (20), 807. 



54 It is probable, in view of the higher results obtained by later analyses, that 

 the results of Baumann and of Monery are somewhat too low. 



