636 



LEWELLYS F. BARKEK 



sugar in tetany; and he has maintained that, in rabbits, either the ad- 

 ministration of guanidin or the removal of the parathyroid glands will 

 cause a hypoglycemia. 



Brown and Fletcher (1915), of Toronto, feel sure that tetany may 

 be produced in children by high carbohydrate feeding, provided the carbo- 

 hydrate foods have, in the course of their preparation, been heated to the 

 boiling point or higher. Such improper feeding results, they believe, in a 

 disturbance of the body salts. At the height of tetany there is, they assert, 

 an almost complete retention of sodium and potassium (irritating salts) 

 and a great loss of magnesium (sedative salt). As improvement of the 

 child ensues, there is an increased flow of urine, accompanied by relief of 

 the constipation; with the diuresis and the evacuation of the intestines, 

 the stored up sodium and potassium salts are rapidly excreted. In 78 per 

 cent of the cases they observed, the children that manifested the tetany 

 were being fed upon proprietary or upon cooked foods, and 43 per cent of 

 them developed tetany while being fed upon the former alone. In five of 

 their patients tetany developed during a period when the food consisted 



entirely of bread and milk (see 

 Fig. 10). Infants fed over long 

 periods with food containing large 

 percentages of carbohydrates (e. g., 

 proprietary foods) are prone to 

 the development of a water reten- 

 tion. Such infants, frequently 

 spoken of as "water babies," show 

 a great susceptibility to tetany, 

 owing. Brown and Fletcher think, 

 to the retention of sodium and po- 

 tassium ions, which are direct ex- 

 citants of the nervous tissues. 



Finkelstein (a) stated, as early 

 as 1902, that cow's milk fed to in- 

 fants causes a functional anomaly 

 of intermediary metabolism that 



leads to increased electrical excitability of the motor nerves. This hyper- 

 excitability, he asserted, does not develop when the diet consists of human 

 milk, of vegetables, and of bouillon and egg. 



Larsson, of Stockholm, in 1917 advanced the view that some crystalloid 

 heat stable element in the whey of cow's milk is responsible for spasmo- 

 philia in children. According to the results of his experiments, the sev- 

 eral constituents of milk albumin are incapable of producing spasmophilia, 

 whereas wliev alone, entirely free from albumin, will produce it. 



The relations of carbohydrate metabolism to tetany are, as will be seen 

 from the above reports, as yet far from clear. It is obvious that a series 



Fig. 10. Showing the relation of the 

 number of cases of tetany to the previous 

 feedings. (After Brown and Fletcher, Am. 

 J. Dis. of Children, Chicago, 1915.) 



