PARATHYROID GLANDS 583 



capped to a certain extent by the imperfect knowledge, then existent, 

 regarding the anatomical relations of the parathyroid glands and of the 

 thyroid gland in the rabbit. Five years later, Kohn made a very accurate 

 study of the region of the thyroid gland in the cat and in the rabbit, and 

 added two parathyroid glands to the two that Gley had earlier recognized 

 in the latter animal, thus making more exact experimental investigation 

 of the region possible. 



The next great advance in knowledge was to come from Italy. In 

 1896-7, Vassale and Generali (a)(b) applied to man Gley's idea of the 

 relation of the parathyroid glands to tetany in animals. At a meeting of 

 the medical and surgical society in Modena, these Italian investigators 

 made the following interesting statement : "If, in man, the parathyroid 

 glands are removed during thyroidectomy, tetany may appear ; if they are 

 not removed with the thyroid, then cachexia strumipriva or myxedema may 

 appear." In this very year, 1897, and in the preceding year, 1896, the 

 best monographs (vide infra) that had been written on tetany up to that 

 time (respectively that of L. von Frankl-Hochwart of Vienna, and that 

 of B. Oddo of Marseilles) were published, and though, in them the 

 clinical phenomena of the disease and its history are so admirably 

 described that these monographs must be permanently used as sources, 

 still they contain not a single reference to the parathyroid glands or to 

 their possible relations to tetany. That such a fundamental observa- 

 tion as that made by Gley in 1890 could, for so long a period as 

 seven years, be thus overlooked is astonishing. But 'tetania strumipriva 7 

 had come to be so generally regarded as a "tetania thyropriva" by both 

 surgeons and clinicians that even the report of Vassale and Generali in 

 1897 passed almost unnoticed. Indeed, as late as 1901, von Eiselsberg, 

 who afterwards became one of the strongest supporters of the parathyrog- 

 enous doctrine of tetany, when commenting upon Vassale and Generali's 

 view that the functional disturbance of tetany is due to loss of function 

 of the small parathyroid glands rather than to that of the large thyroid 

 gland, remarked "das 1st von vomherein nicht wahrscheinlich." I shall 

 mention a little later the further observations, experiments and inferences 

 that have led to a general acceptance of the doctrine that tetany, at least 

 in many of its forms, depends upon loss of, or insufficiency of, function 

 of the parathyroid glands. 



In tetany, as in 'other subjects in clinical medicine, progress has been 

 furthered, not alone by investigators that have made original observa- 

 tions and experiments and have recorded their results, but also by those 

 physicians that from time to time have taken stock, as it were, of the 

 knowledge existent, and presented it to the profession in organized form. 

 The ability thus to organize knowledge and prepare it for general diffu- 

 sion is second in value only to the ability to conduct fruitful original 

 research. That ability in its highest form presupposes a mind of great 



