ORGANOTHERAPY AND HORMONOTHERAPY 109 



weighed. One is the great difference in the severity of these cases and the 

 extreme difficulty of forming a correct prognosis. The other is the great 

 variation in the results (both in clinic and laboratory) reported by various 

 observers. From the available data it appears to me that while definite 

 and incontestable proof of the efficiency of such therapy may still be lack- 

 ing, the evidence is strongly suggestive that in some cases at least a 

 certain amount of benefit may result from its employment. In view of 

 this conclusion and as there is practically universal testimony that the 

 oral administration of parathyroid is harmless, I believe that in mild cases 

 it should be tried, either alone or in conjunction with other therapy, but 

 that in more severe cases, as so little is to be expected from it, it should be 

 used only as an adjuvant to other measures, including implantation. It 

 should be used also when it is impossible to have an implantation carried 

 out. As neither laboratory nor chemical experience has shown that the 

 therapeutic effects of injections are superior to those obtained by oral ad- 

 ministration, 24 and as various parathyroid preparations contain more or 

 less protein, oral administration is to be preferred on account of the usual 

 objections to injection of foreign protein. 



The greater efficiency of parathyroid implantation (as compared with 

 that of its administration), so clearly demonstrated in the laboratory, has 

 also manifested itself in the clinic. While it does not always entirely 

 relieve the symptoms, prevent the development, or avoid the fatal outcome 

 of tetany, the reports of its successful employment are constantly increas- 

 ing in number so that there can no longer be any question that it is the 

 method of choice in the treatment of this disease. 



Von Eiselsberg in 1907 was the first to report the successful relief 

 of a case of tetany through implantation of a parathyroid graft. His 

 patient was a woman of forty-two, who, as a result of a total strumectomy, 

 had suffered from chronic tetany for twenty-five years, and in whom thy- 

 roid and parathyroid feeding had been without effect. Following the 

 implantation of one parathyroid gland the convulsive attacks became less 

 frequent and the other symptoms of the latent tetany were decidedly ameli- 

 orated. In the same year Pool transplanted five parathyroid glands, 

 removed from cadavers, into the abdominal wall in a case of tetany para- 

 thyropriva, with prompt and complete relief of the condition. Similarly 

 favorable results were soon afterwards reported by a considerable number 

 of surgeons. In 1919 Borchers (a) (b) was able to collect from the litera- 

 ture twelve cases of post-operative tetany thus treated, with five temporary 

 and three permanent successes. To these he added two successful cases 

 of his own, to which may be added two successes reported by Thierry and 

 ane case reported in 1920 by Landois in which the implantation of three 

 parathyroids was followed by only temporary benefit, the patient dying 



"While various authors have claimed that injections are more efficient the evi- 

 dence presented is by no means conclusive. 



