PAKATHYKOID GLANDS 701 



Chvostek theory of the origin of myasthenia gravis, has not gained general 

 acceptance. It is out of accord (1) with the pathological-anatomical 

 studies of Haberfeld, who pointed out (a) that in the many cases of 

 hypertrophy of the parathyroid glands and of tumors (adenoma, carci- 

 noma) originating in these glands no signs of myasthenia have ever been 

 observed, and (b) that in two cases of myasthenia gravis examined by 

 him at autopsy, he could discover no changes pointing either to hyper- 

 function or to hypof unction of the parathyroids; (2) with the experi- 

 mental studies of Biedl on dogs and those of Iselin on rats, in which 

 a hyperparathyrosis produced by implantation of parathyroids gave rise 

 to no myasthenic symptoms; and (3) with the experimental studies of 

 Uhlenhuth, who found that thymus substance fed to Amblystoma will 

 give rise to tetany (and in myasthenia gravis there is not only a per- 

 sistent thymus but also, as Weigert demonstrated, an infiltration of the 

 muscles themselves with thymic tissue) . 



HYPERPARATHYROID PSYCHOSIS. Roger Morris (1915-16) has de- 

 scribed an interesting psychosis that appeared in a woman suffering from 

 Parkinson's disease, to whom parathyroid substance had been fed, partly 

 in the form of fresh ox parathyroid, partly in the form of desiccated para- 

 thyroid gland, over a long period. After about a year of this treatment 

 the patient began to fail and the signs of a peculiar psychosis developed. 

 The patient became disoriented as to time, grew indifferent to her sur- 

 roundings, lost interest in everything, became forgetful, negative, rest- 

 less, sleepless, and irrational, and exhibited signs of auditory hallucina- 

 tions, loss of sphincter control, anorexia, marked tachycardia and irregular 

 menstruation. 



Morris interrupted the parathyroid medication and treated the pa- 

 tient with wet packs, veronal, and tincture of nux vomica. Sleep was 

 soon restored, the sphincter control was regained by the patient, and her 

 mental state began to improve. But 17 days after stopping the para- 

 thyroid treatment, the patient developed signs of tetany spasm (?), 

 though Trousseau's sign and Chvostek's sign could not be elicited. On 

 administration of calcium lactate and a little parathyroid, the signs of 

 tetany disappeared. At the end of three months, the mental state had 

 become normal, though the patient had amnesia for the last four months 

 of her psychosis and for the first two months of her convalescence. 



Morris recalled that Berkeley (1913) had observed nervousness and 

 insomnia following parathyroid treatment and that Salvioli and Carraro 

 had asserted that parathyroid substance is toxic for the heart muscle. In 

 view of these and his own observations, Morris suggested that there may 

 be fairly definite clinical syndromes that are due to parathyroid intoxi- 

 cation, that is, to hyperparathyroidism. 



