ADDENDUM 221 



b. Conditions of Hyperfunction of the Parathyroids 



Certain cases of adenoma of the parathyroids are known, without there 

 having been found conditions that would be regarded as those of hyper- 

 function (Erdheim). Also the tumors, in size up to that of a child's head, 

 described by Benjamin, Hulst, and de Santi, were attended with symptoms 

 that were purely local, and otherwise remained without symptoms. In 

 paralysis agitans, which was brought into relation with the parathyroids by 

 Roussy and Clunet, Erdheim found the parathyroids normal in three cases. 

 Lundborg and Chvostek ascribed myasthenia pseudoparalytica to hyper- 

 function of the parathyroids. Chvostek sought to establish that the clinical 

 pictures of myasthenia and tetany were diametrically opposed to each 

 other. Both would seem to affect the voluntary muscles with nonin- 

 volvement of the sphincters. The electrical behavior in myasthenia is 

 directly opposite to that in tetany; and in the one is found fatigue of accom- 

 modation, in the other accommodation spasm. Each sometimes accom- 

 panies myxedema or Basedow's disease. The finding of the collection of 

 cellular infiltrations and of discontinuous fatty degeneration of the muscle 

 fibers, that is extraordinarily frequent (for literature see Marburg), points 

 rather to the fact that myasthenia belongs more to the diseases of the 

 muscular system; moreover, Haberfeld recently has been unable to find any 

 alteration of the parathyroids in the cases of myasthenia gravis (see also the 

 first chapter). 



Addendum 



The author's criticism that some of the negative results ofthyropara- 

 thyroidectomy may be due to the leaving behind of inaccessible parathyroids 

 or portions of parathyroids seems also to the opinion of MacCallum, Thomson, 

 and Murphy. At all events it appears that adult herbivorous animals (the 

 sheep, Simpson) are capable of sustaining thyroparathyroidectomy without 

 appreciable effect, although in Simpson's experiments the lambs that were 

 operated on developed acute tetany and died. 



The results obtained by Mustard on transection of the spinal cord agree 

 with BiedVs and MacCallum's in that they are diametrically opposed to 

 Munk's and to F alto's as to noncontinuance of tonic contractions in the 

 parts below the seat of cutting after transection of the spinal cord. It 

 is a pity that the divergence in results whether they are due to differences 

 in interpretation or differences in technique have not as yet been explained. 



Has kins and Wheeler have tested the effects of the injection of nicotin, 

 adrenalin, and pituitrin in parathyroidectomized dogs, and have found that 

 in these dogs there is a marked increase of vasomotor irritability affecting 

 all components of the vasomotor mechanism, sympathetic cells, myoneural 

 junctions, and musculature. 



