PAEATHYROID GLANDS 649 



basis of a disturbance of the acid base equilibrium in the body. Thus, 

 McCann (1918) suggested that the tetany may be due to an alkalosis that 

 results from a disproportion between the rates of secretion of acids and 

 alkalis- by the gastro-intestinal tract. In pyloric stenosis the gastric acid 

 does not pass into the duodenum to excite the intestine to secrete its alkaline 

 secretion, and this might be expected to lead to an excess of basic sub- 

 stances in the blood. MacCallum's experiments (1920), referred to else- 

 where in this article, point in a similar direction. 



Tetany Due to Stenosis of the Duodenum 



Some five cases of tetany of supposed duodenal origin are on record. 

 In that reported by Fenwick Young (1902) the stenosis of the duodenum 

 was due to adhesions. In the case of Blazitek (1894) the obstruction was 

 caused by a tumor of the gallbladder. Two cases of duodenal obstruction 

 with tetany have been associated with tumor of the pancreas and one with 

 retroperitoneal hematoma. In the case described by Barker and Estes a 

 so-called "idiopathic dilatation of the stomach and duodenum" existed and 

 was associated with familial hematoporphyrinuria and tetany. The so- 

 called idiopathic gastric-duodenal dilatation probably falls in the group 

 known as "gastromesenteric ileus." 



Tetany in Colonic Dilatation 



In 1907 Longleaf, of London, described four cases of colonic tetany. 

 Dilatation of any part of the gastro-intestinal tract, with obstruction and 

 absorption of the contents of the tube, may, apparently, give rise to tetany 

 in predisposed individuals. 



Tetany in Helminthiasis (Worm Tetany) 



According to Deplaigne tetany in the adult may occur in association 

 with invasion by intestinal worms. In 1874 Riegel reported a case of 

 tetany associated with tapeworm (TaBnia.mediocanellata) in the intestines. 

 A careful search for tapeworm in tetany patients in Vienna, where the 

 disease is common, was, however, fruitless. 



Greenfield (1903) reported a fatal case of tetany associated with tape- 

 worm (Tsenia mediocanellata) in the intestines. 



3. Tetany in Association with Infectious Diseases 



The occurrence of tetany has often been observed in association with 

 acute and chronic infections. Though in the literature mention is made 



