584 LEWELLYS F. BAEKEE 



compass and comprehensiveness, the power to weld widely divergent 

 materials into a homogeneous and symmetrical unity, the faculty of see- 

 ing to the*heart of things through masses of accessory details, as well 

 as deftness in the use of language, a feeling for accuracy and for fair- 

 ness in the distribution of credit, a broad training not only in the clinical 

 but also in the preclinical medical sciences, and, finally, a calmness and 

 sagacity of judgment that will ensure caution and temperance in the con- 

 sideration of matters concerning which there is still clash of opinion. We 

 owe to the writers of good textbooks and of comprehensive monographs, 

 therefore, a debt that is not always fully recognized, for such writers are 

 the preparers of paths that often lead quickly to the discovery of new 

 knowledge. Two publications of this kind on tetany that appeared near 

 the end of the nineteenth century deserve especial mention, (1) that of 

 B. Oddo of Marseilles (1896), and (2) that of L. von Trankl-Iiochwart 

 of Vienna (1897). I have already referred to them above. In both of 

 these monographs we meet with a breadth of treatment and a mastery 

 over materials that have placed students of tetany under a debt of grati- 

 tude to the authors hard to overestimate. 



One of the important contributions made by von Frankl-Hochwart in 

 his monograph was his classification of the tetany of adults from the 

 etioloii'ical standpoint. He subdivided tetany into (1) the tetany that 

 occurs in otherwise healthy individuals (kliopathic tetany, epidemic- 

 endemic tetany, tetany of workmen), (2) tetany in gastric and intestinal 

 diseases, (3) tetany in acute infectious diseases, (4) tetany after intoxi- 

 cations. (,")) tetany in maternity (pregnancy, parturition, lactation), (6) 

 tetany after operations for goiter, and (7) tetany associated with certain 

 nervous diseases. His descriptions of these seven forms of tetany and of 

 the tetany that occurs in children are to-day most valuable for reference, 

 and I have drawn much upon them, as well as upon B. Oddo's descrip- 

 tions, in the preparation of the present article. 



Since the appearance of Oddo's exhaustive review and of von Frankl- 

 Hoch wart's elaborate monograph, the interest of the internists and of the 

 experimental workers who have studied tetany has centered in the problem 

 of the etiology and pathogenesis of the disease with especial reference to 

 the parathyroid "lands on the one hand, and to mineral and inter- 

 mediary metabolism on the other; and coincident with these studies of 

 etiology and pathogenesis, much progress has been made through clinical 

 observations and animal experiments in the search for successful methods 

 of diagnosing and treating tetany and parathyroid insufficiency. 



After the publication of Vassale and Generali's papers, surgeons, 

 physiologists and pathologists began actively to busy themselves with 

 experiments upon thyroidectomy (with, and without, parathyroidectomy) 

 in animals. A consensus of opinion was gradually arrived at. Eemoval 



