TETANV 195 



mental exchange in chronic tetany. Partially parathyroidectomized animals 

 often show a severe cachexia; and often in human idiopathic tetany, cachetic 

 manifestations later make their appearance (v. Frankl-Hochwart}. The cases 

 of relapsing tetany that Kahn and / observed all showed more or less dis- 

 tinct signs of cachexia (see later the relations to the thyroid gland). Here 

 there must be a profound disturbance of metabolism, as has been mentioned 

 by Segale and others. 



The behavior of the calcium metabolism in tetany has been much studied. 

 Stimulating were the observations of Sabbatani and Loeb. Sabbatani found 

 that application of calcium salts to the surface of the brain reduced the 

 excitability, application of sodium salts increased it; Loeb found that sub- 

 stances that precipitate calcium heightened the excitability of the nerves. 

 This holds true also for the vegetative nerves (R. Chiari and A. Frohlich). 

 MacCallum and Vogtlin as well as Parhon and Orechie have tried to influence 

 favorably the tetanic spasms of parathyroidectomized dogs by the subcu- 

 taneous or peroral administration of calcium. Magnesium salts work directly, 

 as do the calcium salts, but show in addition strong toxic action. Potassium 



ilts increase the irritability. Quest had already stated before this that the 



>rain of new-born infants, which is relatively slightly excitable, is very 

 rich in calcium, but that later the calcium-contents of the brain reduces. 



te further states that diet poor in calcium makes the animal hyperexci table, 

 ind that the brains of children after they have died of tetany are very 



>oor in calcium. MacCallum and Vogtlin found the calcium-contents of 

 the brain of parathyroidectomized dogs lowered, as well as those of the blood, 

 elimination of calcium through the urine and feces was increased. This 

 last fact was also found by us. The same was also observed by Cattaneo. 

 Neuralh, who estimated the so-called active calcium in the blood of children 

 with tetany by Wright's method, found very low values. Investigations as 

 the calcium balance in children with tetany frequently show increased 

 elimination of calcium (L. V. Iddo and Sarle, and others}. Aschenheim has 

 recently pointed out that there does not exist so much an absolute calcium 



>overty of the tissues as there does [an increase of] the relation of alkalies to 

 earthy alkalies. He found in children who had died of spasmophilia an 

 increase of this quotient just as in parathyroidectomized dogs. Finkel- 

 stein and Rosenstern arrived at similar views. According to Rosenstern the 



g 



administration of common salt to children brings forth anodal hyperexcita- 

 bility, and indeed even laryngospasm. 



Experimental investigations show also that the function of the para- 

 thyroids influences bone formation. Morel and Canal found in parathy- 

 roidectomized dogs that the healing of fractures is delayed and the callus 

 formation slowed. Erdheim showed that such callus is remarkably poor in 

 calcium. Leopold and v. Reuss found the skeletons of youthful parathyroidec- 

 tomized rats poorer in calcium than those of the control animals. To a loss 



