PARATHYROID GLANDS 587 



thyroid function stimulated attempts at restoration of this function by 

 (1) substitution therapy (administration of parathyroidin by Vassale; ex- 

 hibition of beeves' parathyroid glands by Halsted and MacCallum; hypo- 

 dermic injections of parathyroidnucleoproteid by Beebe), and (2) trans- 

 plantation of parathyroid glands in animals after parathyroidectomy 

 (Biedl, Pfeiffer and Meyer, Halsted (a) (&) (c) (d), Landois (&), Joan- 

 novics, and many others), and, later, in man in tetany after strumectomy 

 (von Eiselsberg, Pool, Bb'se and Lorenz, Danielsen, Krabbel, and others). 

 The difficulties encountered and the results thus far obtained will be re- 

 ferred to when the treatment of tetany is described (vide infra). 



Following upon the studies of Sabbatani, of Jacques Loeb, and of J. 

 B. MacCallum on the physical significance of certain kations, and 

 especially of calcium ions in depressing neuromuscular excitability, inter- 

 est was aroused in the mineral metabolism in tetany. Quest, ]STetter, 

 Underbill, MacCallum and Voegtlin, Stoltzner (a), Cooke (&), Cybulski, 

 Ott and Scott, Howland and Marriott, Hoskins and Gerstenberger, 

 Binger, Grant and Goldman, and others, have studied the subject and have 

 reported somewhat conflicting results. Three facts, however, appear to have 

 been established: (1) in tetany, the blood and tissues often become defi- 

 cient in calcium; (2) the administration of calcium salts will often exert 

 an ameliorative effect upon the symptoms of tetany; and (3) the acid-base 

 equilibrium in the body may be disturbed, either in the direction of an 

 acidosis, or of an alkalosis. 



Recently, researches in intermediary and end metabolism have been 

 undertaken with the hope of throwing light upon a hypothetical tetany 

 toxin, some seeking through it to support the old theory of auto-intoxi- 

 cation from the gastrointestinal tract (Bouveret) ; others looking for an 

 intoxication due to disturbances of the acid-base equilibrium (Moussu (c), 

 Binger, Grant and Goldman) or to disturbances of the kation equilibrium 

 in the body (MacCallum and Voegtlin) ; others suspecting the cause of 

 tetany to lie in a thymus intoxication (Uhlenhuth (a)) ; and still others 

 identifying the cause with an accumulation of guanidin or guanidin deriv- 

 atives in the blood and tissues (W. B. Koch (a.) (&), D. Paton (c) and 

 collaborators). That, in the last analysis, the parathyroid insufficiency of 

 tetania parathyropriva may prove to be an insufficiency of certain specific 

 ferments is another hypothesis now looming above the horizon (Beebe, 

 Rowe, Barker). 



Very recently (1920) evidence has been brought by Collip and Backus 

 of Canada and by Grant and Goldman of St. Louis that tetany can be 

 experimentally produced in human beings by forced respiration, and that 

 this tetany is associated with a definite alkalosis. 



Several of the more recent collective reviews of the literature of 

 special phases of tetany and of the subject as a whole may be mentioned 

 in concluding these historical notes. Among the former, I would refer 



