PAKATHYKOID GLANDS C91 



stroyed this graft on the 6th day. Burk urges (1) that every goiter be 

 examined closely immediately after removal for excised parathyroids, 

 (2) that autotransplantation never be made near the operation wound, 

 and (3) that before implanting supposedly parathyroid tissue, a minute 

 portion of the graft be examined microscopically. 



Even though it may be possible to cure tetany by transplanting para- 

 thyroid glands from one living human being to another, this form of 

 therapy is greatly handicapped by the difficulties that will be encountered 

 in securing the glands for transplantation. The danger to the donor may 

 be grasped, if one recalls that the removal of a single parathyroid gland 

 has been the cause of postoperative tetany in human beings. Two such 

 instances have been reported by Bose and Lorenz. No wonder then that 

 Biedl speaks of the excision of a parathyroid for this purpose "mii Rilck- 

 sicht auf den Spender als ein unheimlicher Eingriff." And von Eiselsberg, 

 who first successfully resorted to it, expressly warned us of the danger to 

 the donor. 



Despite the successes reported, it would yet seem doubtful whether 

 homoiotransplantation is ever really successful. That autotransplantation 

 occasionally succeeds there is good reason to believe. 



OTHER FORMS OF ENDOCRIN THERAPY IN TETANY. Organotherapy 

 with organ extracts other than parathyroid has also been tried for tetany. 

 Thus, there are many reports in the literature of the beneficial effects of 

 the administration of -thyroid extract, especially in postoperative tetany. 

 Many clinicians are skeptical of the good results that have been reported, 

 but there are now so many observations on record that it would certainly 

 seem worth while to try thyroid extract in tetania strumipriva if the 

 symptoms cannot be sufficiently ameliorated by other measures. 



The administration of pituitrin and of pituitary extracts seems also 

 to mitigate the symptoms of tetany both in experimental animals and in 

 man (Ott and Scott). 



2. Pharmacotherapy in Tetany 



Diuretics, purgatives, sedatives, and antacids have all been used in the 

 treatment of tetany. In tetany in children, especially, emptying the bow- 

 els and bringing about diuresis and diaphoresis all seem to be helpful 

 measures. 



The use of sedative substances has played an important role in the 

 treatment of tetany. Among the sedatives earlier employed, chloral hy- 

 drate, bromide of potassium, and antipyrin may be mentioned. Kecently, 

 since better's clinical observations and especially since MacCallum and 

 Voegtlin's studies of calcium deficiency in tetany, calcium has been ad- 

 ministered as a sedative in tetany and often with good results. MacCal- 



