700 LEWELLYS F. BAKKEK 



ity is increased, though only closure contractions occur and AnCC is usu- 

 ally greater than KCC. The striking feature is the slow tonic character of 

 the muscular contractions and their persistence. 



The manifold relations of tetany and myotonia, have been exhaus- 

 tively discussed in the article by von Orzechowski (vide supra). The 

 occurrence of a case of myotonia in a family in which cataracts were prev- 

 alent has been observed by Fearnsides (1915), and this is suggestive of 

 a relationship to chronic tetany. 



Interesting clinical observations on Thomsen's disease have been made 

 by Johnson and Marshall (1915), and the metabolism of the disorder has 

 been examined by Kosenbloom and Cohoe (1914). 



Lundborg (fr) (1904) suggested that Thomson's disease, as well as 

 Parkinson's disease and certain myoclonias, might be due to a parathyrop- 

 athy, probably hypoparathyroidism. But thus far there would seem to be 

 no evidence of this on the pathological-histological side. 



MYOCLONIA. Lundborg (&) (1904) placed myoclonias, and especially 

 myoclonic epilepsy, in the hypoparathyroid group of neuropathies, ap- 

 parently chiefly, if not entirely, on speculative grounds. I have been un- 

 able to find anything in the bibliography confirmatory of Lundborg' s view. 



CHOREA MINOR. Haberfeld, in two cases of chorea minor, observed 

 circulatory changes in the parathyroid glands, a fresh hemorrhage in one 

 case, marked congestion in the other, and suggested that these changes 

 pointed to a possible relationship of chorea minor to lesions in the para- 

 thyroid glands. 



MYASTIIENIA GRAVIS. This condition, known also as asthenic bulbar 

 paralysis, or the Erb-Goldflam syndrome f is characterized by a quick fa- 

 tiguability of the muscles, manifesting itself on chewing (dysmasesia), 

 on speaking (dysarthria), on swallowing (dysphagia), and on making 

 other oft repeated movements. There are no sensory disturbances. The 

 condition is subject to the most marked remissions and exacerbations. 



On electrical examination, a characteristic myasthenic reaction, well 

 described by Jolly, appears ; when a tetanizing faradic current is applied 

 to either motor nerve or muscle, and is repeated at intervals of a second, 

 the muscular contractions grow feebler with the successive stimulations, 

 until they finally disappear, though the muscle may regain its normal 

 excitability after a short period of rest. 



Lundborg (a) (1904) suggested that myasthenia gravis may be due to 

 a hyperthyroidism and Chvostek (c) (1908) supported this view, urging 

 that the symptoms in myasthenia gravis are diametrically opposite (like 

 the negative contrasted with the positive in a photograph) to those of 

 tetany. If tetany is due to hypoparathyroidism, it is reasonable, Chvos- 

 tek stated, to assume that myasthenia gravis is due to hyperparathyroid- 

 isin. 



This view, sometimes referred to in the bibliography as the Lundborg- 



