646 



LEWELLYS F. BARKER 



90 



85 



Mil 



80 



75 



70 



05 



60 



55 



50 



35 



large number of cases were seen during the periods extending from 

 January to April, inclusive, the acme of incidence being reached in 

 March. 



Epidemic Character. The incidence of tetany in Vienna seems to have 

 varied much in different years. Thus, in 1886 there were 44 cases and in 

 1883 about the same number, but in the year 1882 there were only 19 

 cases. Then the numbers fell to 32, 19, 20, 23, 15, 17, 13 and 11 per year. 

 In 1895 there was another rise in incidence, the number for that year 

 being 25. It is obvious, therefore, as von Frankl-Hochwart points out,- 

 that the curve is characteristic of the movement of an epidemic; for this 

 is evidenced, not only by the rapid rise of the curve in March and April 



of each year, but also by the variations in 

 frequency in the different years. 



Sex. In this epidemic form of tetany it 

 is the males that are almost exclusively 

 affected. It is in reality rare for women to 

 contract this form of the disease. Thus, von 

 Frankl-Hochwart observed that the. lists in- 

 cluded 391) males and only 19 females. 



Occupation. Von Frankl-Hochwart an- 

 alyzed the patients also according to occupa- 

 tion, and found that among the men shoe- 

 makers and tailors predominated, though 

 carpenters and joiners were also numerous; 

 among the women seamstresses were the most 

 numerous. It is evident, therefore, that cer- 

 tain occupations predispose to the idiopathic 

 form of tetany. 



It was further found that, in Vienna, 

 persons of the better classes were scarcely 

 ever affected by epidemic tetany. 



Age. As to age, it is the young men 



between 16 and 25 who are chiefly affected. Young men of these years 

 make up 83 per cent of all the patients. Among women, too, the disease 

 was more prevalent between the ages of 15 and 35 than at other ages. 



In other words, von Frankl-Hochwart' s analyses show that, in Vienna, 

 tetany epidemics occur, which appear chiefly in March and April and 

 which affect chiefly male shoemakers and tailors, rarely females (seam- 

 stresses) between the ages of 15 and 25 years. 



Distribution. The geographical distribution of idiopathic tetany is 

 very interesting. In Germany, Heidelberg has many cases and Berlin only 

 a few. Paris has reported, from time to time, the occurrence of many 

 cases. In America spontaneous tetany is relatively rare. In 1894 J. P. 

 Crozier Griffith brought together some 72 clinical records from this coun- 



15 



10 



Fig. 12. The graph shows 

 the number of tetany admis- 

 sions (1880-1895) admitted 

 to the General Hospital in 

 Vienna, according to months, 

 in he year.s 1880-1895. (After 

 L. von Frankl-Hochwart.) 



