690 LEWELLYS F. BAEKEK 



Interesting reports of parathyroid transplantation in human beings 

 have been made by a number of observers. Pool (a), of New York, re- 

 ported, in 1907, the successful transplantation (to a woman with tetany) 

 of a parathyroid gland removed from another patient who had died. He 

 made two transplantations, one on March 1st, 1907, the other on the 17th 

 of April. Parathyroid nucleoproteid was also administered subcutaneously. 

 After one month the tetany symptoms had receded. It does not seem pos- 

 sible, in view of our present knowledge of viability, that these grafts really 

 grew. 



Yon Eiselsberg appears to have been the first intentionally and success- 

 fully to transplant a living parathyroid gland directly from one living 

 human being to another. The patient, a woman of 42, had suffered long 

 from tetany, owing to a total strumectomy done years before. The graft 

 (derived from a woman at operation for enucleation of a cyst from one 

 lobe of the thyroid) was placed in a pocket of the rectus abdominis muscle, 

 between the peritoneum and the fascia. This graft took, a-nd the patient 

 improved remarkably afterward. Though she still suffered occasionally 

 from laryngospasm, the tetany otherwise disappeared, and the electrical 

 excitability of the motor nerves returned to normal. Other successful 

 transplantations of human parathyroids have been reported by Bb'se and 

 Lorenz (1909), Danielson (1910), Krabbel (1911), and others. 



How easily surgeons may mistake tissues that are not parathyroid tis- 

 sue for the parathyroid bodies has been shown by Borchers (1912) of 

 Tubingen, who found that of the transplants of supposedly parathyroid 

 tissue in instances in that clinic, 8 were accessory thyroids, 1 was fat 

 tissue and 1 was a lymph gland. Burk (1921) of Stuttgart has re : 

 cently reported a case of postoperative tetany in which he transplanted at 

 the operation a single parathyroid that had been excised with the goitre 

 (autograft) and later attempted the transplantation of parathyroid 

 glands (obtained from a cadaver thirty minutes after death) into the ab- 

 dominal musculature of the patient (homoiotransplantation). For 4 

 days after the transplantation there seemed to be marked improvement ; the 

 spasms and convulsions ceased and Chvostek's sign and the Trousseau 

 phenomenon became less easily elicitable. Burk felt sure that he had res- 

 cued his patient but on the sixth day the picture suddenly changed; the 

 spasms increased, the respiratory muscles became involved, and on the 

 ciiilith day the patient died with all the signs of a most severe tetany. It 

 had seemed to him that the homoiotransplantation made 35 hours after the 

 primary operation had relieved the symptoms for 4 days. At autopsy, 

 however, he found that instead of parathyroid tissue he had transplanted 

 only minute lymph nodules, whose size and color in the cadaver had de- 

 ceived him. The temporary respite for 4 days must have been due, he 

 thinks, to the autotransplantation. This respite, he believes, would not 

 have been temporary except for the fact that an aseptic stitch abscess de- 



