PAEATHYKOID GLANDS 685 



substitution therapy. The route to follow in the parathyrogenous cases is 

 obviously that of organotherapy, and to the progress that has been made 

 in this direction we may now conveniently turn. 



1. Organotherapy in Tetany 



Three forms of organotherapy can be utilized: (1) substitution 

 therapy, that is, the administration of parathyroid gland substance in one 

 or another form to the tetany patient: (2) surgical transplantation of 

 parathyroid glands into the persons suffering from tetany; and (3) endo- 

 crin therapy, with the use of products derived from glands other than 

 the parathyroids. 



SUBSTITUTION THERAPY. Various forms of substitution therapy with 

 parathyroid substance and parathyroid products have been tried. Moussu 

 (1898) was able to arrest postoperative tetany in dogs by subcutaneous and 

 intravenous injections of extracts of horse's parathyroid. He made ex- 

 tracts with sterile water and also extracts with glycerin, but preferred 

 the former. 



' Vassale (c) (1905) introduced an extract of parathyroid glands, which 

 he called parathyroidin. He asserted that it had a favorable effect upon 

 tetany attacks in human beings. He did not, however, describe the method 

 that he used in preparing the extract. Vienna physicians (von Frankl- 

 Hochwart, Escherich) could not convince themselves that this parathy- 

 roidin caused any improvement in cases of tetany. According to Gussio, 

 Vassale's parathyroidin produces in dogs and rabbits a pronounced, though 

 temporary, tachycardia. 



Vincent and his colleagues (1904-5) reported that they were unable to. 

 prevent the onset of symptoms after complete thyroparathyroidectomy by 

 the use either of extract of thyroid or extract of parathyroid glands. 



W. G. MacCallum (1909) injected an emulsion of four or five para- 

 thyroid glands of the cow, prepared aseptically, beneath the breast of a 

 girl suffering from tetany after a thyroid operation. Seventy-two hours 

 after the operation a violent attack of tetany occurred, the girl becoming 

 rigid and perfectly helpless, with typical obstetrical hand, the feet ex- 

 tended, and the jaws tightly set. Several hours after the injection of the 

 parathyroid emulsion there was complete relaxation of the rigid muscles 

 and the patient fell asleep, to wake up the following morning apparently 

 quite well. Four days later she had another severe attack, which was 

 treated in the same way with, apparently, the same good results. After 

 this, she had no more tetany symptoms, probably due, MacCallum thought, 

 to recuperation of her injured parathyroid glands. 



Berkeley of New York found that he could relieve promptly the symp- 

 toms of tetany in a man of 39 by administering orally capsules of fresh 



