104 ENDOCRINE GLANDS 



and was considered for a long time to be of rheumatic 

 origin or to be a variety of tetanus. It is following the 

 experimental researches of Gley and Moussy in France, 

 that certain clinicians, struck by the clinical resemblance 

 between human tetany and the nervous phenomena 

 observed in animals after the removal of the parathyroids, 

 suggested that this disease might be the result of a dis- 

 turbance of the function of the parathyroids. 



THE SYNDROME OF TETANY. 



Tetany must not be considered as an autonomous 

 affection, but as a syndrome coming on under a variety of 

 conditions and characterized on one side by contractures, 

 on the other by a mechanical and electrical hyperexcita- 

 bility of the nerves and muscles. 



A. CONTRACTURES. They are usually symmetrical and 

 localized to the extremities. They are preceded by tingling 

 and a sensation of falling asleep of the part which is some- 

 what painful. It affects the muscles of the hands and feet. 



The hand can take one of two characteristic attitudes. 

 It takes the shape of a cone due to the forced adduction 

 of the thumb and all the other fingers pressed tightly 

 against each other and in which the first phalynx is half 

 flexed, while the other two are extended. 



In the cases in which the hand is cupped, it resembles 

 the position of an obstetrician making an examination. 

 Sometimes the thumb is flexed in the palm and completely 

 covered by the other fingers, also flexed. The contrac- 

 ture is sometimes so marked that the nails penetrate into 

 the palm. 



The foot gives a similar deformity and was described by 

 Escherisch under the name of carpo-pedal spasm: the 

 foot is in varus equinus; the planter surface is cupped and 

 the toes are flexed. 



