TETANY IN GASTROINTESTINAL DISEASES 2 19 



to-day why the thyroid medication formerly employed in tetany was without 

 results. It is remarkable, however, that no decisive results are obtained by 

 the administration of subcutaneous employment of dried parathyroid gland 

 or of extracts of parathyroids. The favorable statements of a few authors 

 (parathyroid tablets, Marinesco, Lowenthal, Wieprecht; parathyroantitoxin, 

 Vassale) stand in contradiction to the negative results of the exact trials of 

 Pineles and the statements of many other authors. 



Pineles found that neither stomachal, nor subcutaneous, nor intra- 

 peritoneal administration of parathyroid extract in large doses served to 

 influence in any way parathyroprivic tetany. Again, the feeding of very 

 large amount of the extract of the parathyroids of horses, remained without 

 results in human beings. One is reminded of the negative results of pancreas 

 feeding (islands of Langerhans) in diabetes. The parathyroids are, like the 

 pancreas, no storage glands. 



The attempts to transplant the parathyroids at first awakened great 

 hopes; v. Eiselsberg and later Payr transplanted the thyroid gland in the 

 abdominal wall or in the spleen and (on account of associated transplantation 

 of the parathyroids) prevented the outbreak of the tetany. Enderlen first 

 showed microscopically that the parathyroids transplanted with the thyroid 

 gland remained capable of .functionating, in that in part they regenerated. 

 Since that time numerous transplantations have been undertaken by Biedl, 

 Pfeiffer and Meyer, Halstead, Harvey, Cristiani, Leischner, et a/.); favorable 

 results have also been reported in man (first by v. Eiselsberg) ; favorable 

 results were reported by Pool-Kocher (transplantation into the bone marrow), 

 v. Garre, Boese and Lorenz, and Danielsen. The clinic of v. Eiselsberg later 

 met with unfavorable results. On this account, the question was restudied 

 by Leischner and Kohler, who concluded that the parathyroids behave 

 quite similarly to the thyroid, that is, that only autotransplantation is at- 

 tended with favorable results; while on homiotransplantation it is true 

 that the parathyroids functionate for a time at first, but later they become 

 absorbed. 



The administration of calcium salts has been regarded by MacCallum and 

 Vogtlin as a causal therapy. Theoretically, the condition of excitability in 

 ectomized animals should become dampened. Improvement is reported by 

 Curschmann in three cases of tetany in man, and by E. Meyer in a case of 

 tetany of pregnancy. Kahn and I studied the excitability of the nerves at in- 

 tervals of two to three hours, and, after the administration of even a large 

 amount of calcium lactate never observed a distinct influence on the same. 

 Also the intramuscular administration of "Kalzine" (v. Muller and Saxt) 

 was ineffective. If the assumption that in tetany the assimilation of calcium 

 in the nervous system is disturbed holds good, it seems to me that the nega- 

 tive results become intelligible; the person with tetany behaves against in- 

 creased administration of calcium just as a patient with pancreatic diabetes 



