PARATHYROID GLANDS 627 



in the thyroid administered yields no therapeutic effect. Postoperative 

 tetany undergoes prompt improvement on treatment with thyroid sub- 

 stance. In experimental animals life is considerably prolonged by this 

 medication, and Biedl urges that thyroid therapy should always be re- 

 sorted to in postoperative tetany of human beings, in order to give time 

 to any accessory parathyroid glands remaining to develop their full 

 function. 



In idiopathic tetany there are often signs of simultaneous disease of 

 the thyroid; thus, von Frankl-Hochwart pointed out that, in chronic 

 tetany, struma is often present (13 out of 26 cases). He also noticed that, 

 in a few cases, mild myxedematous symptoms appeared in chronic tetany. 

 Similar observations have been made by other clinicians, and it has been 

 asserted that the administration of thyroid extract diminishes the trophic 

 disturbances of tetany and causes the mononucleosis of the blood in that 

 syndrome to disappear. 



In the acute stage of tetany, or just after it has passed, signs of mild 

 hyperthyroidism not infrequently appear (Falta and Kahn). It looks as 

 though there were in many cases of tetany, during the acute exacerbations, 

 a temporary increase in the activity of the thyroid, though, later on, in 

 cachectic states, a mild degree of thyroid insufficiency develops. 



Enough has been said to prove conclusively that a close relation exists 

 between the functions of the thyroid and the parathyroid glands. The sim- 

 ilar histological structure, the hypertrophy of one organ after extirpation 

 of the other, the results of organotherapy above referred to, the tendency 

 for disease in one organ to be accompanied by changes in the other, all 

 attest to this. The evidence seems to me to support the idea of a recip- 

 rocal supporting function rather than that of reciprocal antagonism. 



Hypophysis Cerebri 



The hormonopoietic glands are so closely linked together into a chain 

 that, when one endocrine gland is disturbed, we have learned always to 

 look for disturbances in one or more of the other glands. There is as yet 

 but relatively little, however, pointing to the hypophysis in tetany. 



Certain observations suggestive of hypophyseal implication in tetany 

 have nevertheless been recorded and may here be briefly referred to. 

 Crises of polyuria, for example, sometimes occur in the course of tetany. 

 They have been described by E. A. Locke of Boston (1902) and by Gatti 

 (1910), and an analysis of the cases reported in the literature will show 

 that polyuria has not infrequently been recorded as having been ob- 

 served, especially during spontaneous attacks. This polyuria in tetany 

 may be simply an evidence of vasomotor or secretory hyperexcitability, but 

 the possibility of an associated disturbance of the pars intermedia of the 

 hypophysis should be kept in mind, now that some believe in a relationship 

 of the pars intermedia to the polyuria of diabetes insipddus. 



