110 JOHIST T. HALSEY 



later of tetany, also two cases of Jaeger's, in which the benefit obtained 

 was but slight. Hunt quotes Krabbel as reporting two successful results 

 from transplantation in patients suffering from idiopathic tetany. Com- 

 plete relief was secured in one of these, a girl, who suffered from tetany 

 only during her menstrual periods, while the other, a man with genital 

 hypoplasia, was reported as relieved. 



While the great majority of those recording their experience with this 

 method of treatment have reported successes from its employment, there 

 are also reports of more or less complete failure and doubtless many more 

 failures have remained unreported. In spite of the fact that occasionally 

 transplantation fails to afford any relief and that often the condition is 

 only ameliorated and not cured, it would appear that the results obtained 

 by many surgeons have proven beyond dispute that this operation holds 

 out the best chance for the cure or amelioration of tetany and that it has 

 often proven lifesaving in cases in which other methods of treatment had 

 been ineffectual. It is at least doubtful whether in a case in which there 

 is total parathyroid deficiency even numerous grafts will be able to entirely 

 relieve the condition. 



Parathyroid Insufficiency. Cases of this type must either be very 

 rare or else are almost never recognized. The only one found by me in 

 the literature is one reported by Hertz, which is of especial interest here 

 because of the apparently specific effect exerted by parathyroid substance 

 administered orally. The dosage employed was ^4 grain of dried ox 

 parathyroid four times daily, which was later reduced to once daily. 



Paralysis Agitans. Favorable effects from administration of para- 

 thyroid to patients suffering from paralysis agitans have been reported by 

 Berkeley (a) (1) (c) in this country and Limdborg in Sweden, and by a 

 number of others, among them Alquier, and quite recently by Gautier, who 

 considers its effects incontestable. Berkeley (1916), after eleven years' 

 experience, believed that parathyroid feeding is not a cure, but that 60 to 

 70 per cent of the patients, who have tried it faithfully for three to six 

 months, have been greatly benefited, the progress of the disease having been 

 arrested or markedly retarded. He advises one or two doses daily of 1/50 

 grain of the purified acetic acid extract (Berkeley and Beebe) which may 

 IK* given orally or hypodermically. If the dried gland preparations are 

 used, Sajous advises a daily dose of 5 to 7 capsules, each equivalent to % 

 grain of the fresh gland. The experience of the majority of clinicians with 

 this remedy appears to have been like that of Block, in whose hands it 

 failed to produce- any effect. Dercnm (&) states that in doses of 1/20 to 

 1/10 grain thrice daily it is temporarily of benefit by diminishing the 

 tremor but that it loses its effect in ten days to two weeks. The evidence of 

 its value in this disease is certainly questionable but, as most observers 25 



* I'incU-s (M states that Roussy and Clunet observed an aggravation of the 

 symptoms in t\v o of their cases under this treatment. 



