338 HENRY A. MATTILL AND HELEN I. MATTILL 



have not been able to show alkalosis in cases of infantile tetany, 

 but medication with NaHCO 3 for other causes has in four cases resulted 

 in tetany convulsions accompanied by low blood Ca, both of which were 

 corrected when the NaHCO 3 was stopped. They conclude "it is apparent 

 that the symptoms of tetany and the lowering of the Ca content of the 

 serum may be produced in a variety of ways, but we have not been able to 

 show that any of these means is operative in infantile tetany." 



Administration of Ca salts per os may or may not (Haskins and Ger- 

 stenberger) have a beneficial effect on infantile tetany. Injection of 

 calcium lactate gives temporary relief and if accompanied by administra- 

 tion of phosphorized cod liver oil it speeds the recovery which phosphorized 

 cod liver oil alone will accomplish (Brown, et al.). 



There is apparently an intimate relation between blood sugar and cal- 

 cium. Thyreoparathyroidectomy is accompanied by a decrease in both, 

 and the injection of Ca will temporarily restore blood sugar to normal 

 (Underbill (ft) ; Underbill and Blatherwick). The question as to whether 

 the hypoglycemia is a result of the thyreoparathyroidectomy or of the re- 

 sulting reduction in blood calcium is still unanswered. Hyperglycemia 

 occurs in pneumonia, tuberculosis and especially diabetes, and each of these 

 diseases is characterized by loss of calcium (Kahn and Kahn; Loeper and 

 Bechamp) and upon injection of calcium salts the glycosuria is decreased. 

 Administration of CaCl 2 to diabetics is claimed to reduce the glycosuria 

 (Phocas). Urinary elimination of phosphorus is about normal, that of Ca 

 and especially of Mg is high in diabetes (Euler and Svanberg; Nelson). 

 In experimental diabetes in rabbits a decalcification has been observed 

 (Robert and Parisot). There is possibly some connection between the 

 diabetes of pregnancy and the unusual drain on calcium (Kahn and Kahn 

 (a) ) . In the acidosis of diabetes the loss of Ca may be due to the elimina- 

 tion through the urine of Ca salts of volatile fatty acids (Palacios). 



Because of the marked changes in mineral metabolism and in the 

 composition of the bone in rachitis and osteomalacia (Goldthwaite, et al. ; 

 Holt, Courtney and Fales(d)(e); Schabad(a) (&) ; Schloss(&) ; Bru- 

 backer; McCrudden(a) (c)) these have often been considered diseases of 

 lime metabolism. There is usually a negative lime balance in the active 

 stage of rachitis, but rachitis does not always result from a low Ca intake 

 and it frequently occurs in children receiving plenty of CaO. The blood 

 Ca is not invariably abnormal in rickets or osteomalacia (Stheeman and 

 Arntzenius). Attempts to establish a relation between the thyroid, thy- 

 mus, or sex glands and rickets or osteomalacia are not convincing ( Sarvonat 

 and Roubier; Zuntz(c) ; Bieling; Claude and Rouillard; Rominger; 

 Aschenheim(c)). The seasonal variation of rachitis, its incidence being 

 greatest in the spring and least in the early fall months, has been associated 

 with the increased Ca retention shown by lactating cows when changed 

 from a dry to a fresh green ration containing the same amount of Ca. 



