3. Pathological Anatomy and 

 Histology 



DSKAE KLOTZ 



PITTSBURGH 



Introduction 



Paucity of Data. Partly on account of the small size, the hidden posi- 

 tion and the difficulty in recognizing the parathyroid glands in the gross 

 specimen, routine examination of them is not undertaken at the autopsy 

 table, and hence reliable statistics on the incidence of various disease 

 processes within these glandules are not available. Furthermore, as an accu- 

 rate knowledge of the relationship, save in a fdw conditions, of these tiny 

 structures to clinical manifestations is not clearly known, the general 

 pathologist has not been sufficiently impressed with their importance to 

 spend the necessary time in a study of their gross and microscopical char- 

 acters. When the parathyroids are analyzed, sufficient information to be 

 of value cannot be gained by a naked-eye examination alone, but must be 

 followed up by a careful microscopical study of each glandule which is 

 isolated. It is, therefore, impossible to lay much stress on the sporadic 

 reports of the occurrence of lesions within the parathyroids and their 

 bearing upon symptoms during life. 



Neglect of the Study of the Parathyroids. The lesions which have 

 been reported in the parathyroids have, in large part, been described by 

 those who set themselves the special task of analyzing them in a limited 

 number of cases. In a certain number of instances attention was attracted 

 to the parathyroids by the presence of tetany, altered calcium metabolism, 

 imperfect development of bones and teeth, as well as nutritional disturb- 

 ances in infants, in which it has been shown through animal experimenta- 

 tion that the parathyroids may have been primarily at fault, or have suf- 

 fered associated disturbance. I know of no laboratory in which the para- 

 thyroids receive routine attention at the autopsy. It is probable that 

 tissue changes are more frequent within the parathyroids than is indicated 

 by the various reports ; and it is also probable that the parathyroids suffer 

 damage in diseases which affect the body at large, and that such disturb- 

 ances may assist at times in inducing new complexities in the clinical 

 manifestations. 



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