TETANY 



189 



of tetanic spasms in the upper extremities and later abdominal pains of a twitching 

 character. Temperature as high as 38. Indican much increased. Rapid recovery. 



In other cases the gastric disturbances occur later, and are made worse 

 by a later exacerbation of the tetany. We find likewise that in the cases of 

 the first category the gastrointestinal disturbances may increase markedly at 

 the time that the tetany is added to the clinical picture. 



FIG. 26. Tetany face (Observation XXI). 



In many cases, as seen by the fluoroscope, there is an abnormally rapid 

 emptying of the stomach. In some cases there is a marked pyloric spasm, 

 in the acute stage, that leads to acute dilatation of the stomach. The cases 

 that belong here, which Kahn and myself have reported, are those of 

 the first category, in which gastric disturbances existed previously. It is 

 probable that the tetany increases the pyloric spasm, or in many cases 



