THE SYMPATHETIC SYSTEM 111 



Post operative tetany, described under the name of 

 strumic tetany or acute post operative myxedema, is due, 

 without a doubt, to destruction of the parathyroids in the 

 course of partial or complete thyroidectomies. 



Can medical tetany be considered as a manifestation 

 of parathyroid insufficiency? Pineles has shown the 

 clinical identity of the different types of tetany. In all 

 the cases of tetany, be they post operative, infantile, 

 gravid or idiopathic, the chief signs of the syndrome are 

 present: contractures, convulsions, hyperexcitability of 

 the nerves, electrical reactions. Furthermore, experi- 

 mental tetany shows very similar symptoms. In animals 

 in which the parathyroids have been removed, not only 

 are the severe symptoms present but also the electrical 

 hyperexcitability of the nerves. 



(a) INFANTILE TETANY. Many types of lesions of the 

 parathyroids have been observed at autopsy of children 

 having shown symptoms of tetany. 



The most frequent are hemorrhages in the glands. 

 Described by Erdheim, they have been studied by Yanase, 

 Harvier, Strada, Auerbach, etc. They can be seen with the 

 naked eye when the lesions are extensive. When they 

 are discrete they can only be seen under the microscope. 

 They are rarely found in all the glands; in the majority 

 of cases only one or two glands are affected. The cause of 

 these hemorrhages is unknown and their frequency 

 very variable according to the writers. 



In certain cases, generalized or localized glandular 

 sclerosis has been noticed; in others, simple anomalies of 

 the parathyroids, either in size or the number of the glands. 



These various alterations, or anomalies, cannot be 

 considered as the determining cause of tetany. They are 

 also found in children who have never had any signs of 

 tetany (Harvier, Auerbach, Strada). Furthermore, cer- 



