PARATHYROID GLANDS 581 



Though France no longer claims priority for the earliest observations 

 of tetany, still she has the right to emphasize the great importance of the 

 contributions of French medical men in the form of accurate clinical 

 descriptions of the disease in several of its forms. Dance's paper dealt 

 with tetany in the adult, not with tetany in the child, and, in the year 

 following Dance's publication, Tonnelle described tetany in children, in a 

 paper entitled "Upon a New Convulsive Affection of Infants." This writer 

 described the contractures in the extremities of children and spoke of the 

 affection as being relatively benign. He believed that the nervous excita- 

 bility of childhood strongly predisposes to this syndrome, and he laid 

 stress, also, upon disorders of the digestive apparatus as a cause. The 

 value of tepid baths in the treatment of tetany, too, was emphasized by 

 Tonnelle; indeed, his paper as a whole must be regarded as a valuable 

 early contribution to the literature of infantile tetany. 



During the succeeding fifty years, a number of papers were written 

 by French authors upon tetany. These papers contributed to the termi- 

 nology as well as to the clinical features of the disease. Tetany was 

 described at this period under the term "essential contractures." The 

 present name, "tetany," we owe to Corvisart, who wrote a thesis on the 

 subject in 1852. Those interested in the history of tetany should read 

 the report of a discussion of the disease, in which several eminent clin- 

 icians participated, at a meeting of the Societe medicale des Iwpitaux, 

 held in Paris in 1875. During this discussion the speakers established 

 the relations of some cases of tetany to infections like typhoid and 

 dysentery, and of others to digestive disturbances. The occasional epi- 

 demic character of the affection was also made clear, for several epidemics 

 were definitely referred to. But above all, it is interesting that Trous- 

 seau took part in this discussion. After stating his ideas of the rheumatic 

 nature of the affection and of its relation to lactation he called the 

 syndrome "nurses' contracture" he also reminded his hearers of his 

 own really great contribution to the subject, of the sign that still bears 

 his name, namely the contractures in the hand and forearm that can 

 be elicited, in latent tetany, by applying a ligature to the arm above the 

 elbow. These terminological and clinical descriptive advances made by 

 French physicians were of fundamental importance in the development 

 of our knowledge of this strange malady. 



From the middle of the nineteenth century on, clinicians in Germany 

 and in Austria made noteworthy contributions to our knowledge of tetany. 

 Especially between 1870 and 1890 were observations of great importance 

 recorded. Thus, in 1871 and 1872, Kussmaul (a) (&) first called attention 

 to the peculiar convulsive states that sometimes accompany dilatation of 

 the stomach ; his observations on gastric tetany were followed by confirma- 

 tory reports from other physicians. ^ 1874, Erb, of Heidelberg, made his 

 careful study of the electrical hyper excitability of the motor nerves, a 



