210 THE DISEASES OF THE PARATHYROID GLANDS 



an outbreak of tetany. The assumption that the poisoning constitutes only 

 the determining factor has a firm basis in the investigations of Rudinger. 

 Rudinger first determined that in cats the peroral administration of calomel, 

 the subcutaneous administration of morphine, atropine, tuberculin, and 

 ergo tin, and the inhalation of ether does not influence in any way the elec- 

 trical excitability. After these animals had been placed in the condition of 

 latent tetany by a partial parathyroidectomy, the administration of these 

 poisons led to spasms. 



4. Idiopathic Tetany (Occupation Tetany) 



In the description of this form I chiefly follow the exposition of v. Frankl- 

 Hochwart. Idiopathic tetany shows the characteristic that it chiefly occurs 

 in persons following certain occupations, that it is especially frequent in 

 certain localities, and that it shows an epidemic-like increase during certain 

 months. The last observation was first made by N. Weiss and v. Jaksch. 

 The statistics of v. Frankl-Eochwart from the years 1880 to 1905 embrace 

 five hundred and seventy-six cases (among which, however, only five hundred 

 and twenty-eight were cases of occupation tetany). Of these occurred in 



Jan. 66 Apr. in July 12 Oct. 10 



Feb. 88 May 52 Aug. 9 Nov. 15 



Mar. 137 June 36 Sept. 9 Dec. 31 cases 



The especial predisposition of the followers of various occupations was 

 first mentioned by v. Murdoch, later by von Jaksch, Mader, Hoffmann, 

 Schultze, and others. It is especially cobblers and tailors that become af- 

 fected with tetany. Among five hundred twenty-eight cases of v. Frankl- 

 Hochwart were two hundred twenty-three cobblers, one hundred seventeen 

 tailors, thirty-eight carpenters, thirty locksmiths, thirty turners and the 

 remainder were divided among the other occupational classes. In women, 

 it is especially the maids [i.e., lady's maids] that become affected (thirty- 

 two of ninety-nine female cases) . Also soldiers become affected with it not 

 at all rarely (M attauschek) . 



Another characteristic of occupation tetany is as has already been 

 mentioned that it prefers certain cities. It is most frequent in Vienna, 

 Heidelberg, and is not rare in Budapest; it is, however, especially the lead 

 workers who become its victims (Jakobi). Moreover, its epidemic exten- 

 sion presents variations. For instance it was very frequent in Paris in the 

 years 1830-1860. Since that time it has been very rare there. In Heidel- 

 berg also according to the most recent statement of Schonborn has it become 

 rarer. In the other cities that now harbor it, it shows a large increase in 

 certain years. Thus Mattauschek observed an epidemic among soldiers of 

 the Vienna garrison in the year 1896. Outside these cities, tetany is sporadic 

 nearly all over. In several places, small epidemics have been observed. 



