DERANGEMENTS OF THE PARATHYROIDS 193 



between internal secretions : it is probable that although interaction 

 such antagonism may be direct or inhibitory, more often secretions. 

 it is related to the results produced by the opposing 

 secretions in the general metabolism, as here shown ; 

 that is to say, an excessive ovarian secretion, such as 

 may occur in osteomalacia, causes too great an excretion 

 of lime salts, and if the parathyroids undergo hyperplasia 

 in this disease it may be in order to bring about the 

 opposite state of affairs in regard to the calcium meta- 

 bolism. 



Tetany of pregnancy is attributed to insufficiency of Tetany of 

 parathyroid secretion ; and the experiments of Vassale and lactation 

 and General i 1 and of Adler and Thaler 2 appear to bear ^ratiTroids 

 out this view. These observers found that partial para- 

 thyroidectomy may give rise to no symptoms unless the 

 animal be pregnant, when tetany is prone to occur or to 

 follow parturition. It is, therefore, more than probable 

 that the tetany which may be seen in the human subject 

 during the later stages of pregnancy is associated directly 

 or indirectly with the metabolism of calcium and the 

 control of this metabolism by the parathyroids. 



It is possible, also, that the parathyroids influence 

 the metabolism of the lime salts during lactation, and 

 that the tetany of lactation may be due to some 

 insufficiency of the parathyroids in this respect. 



Vassale 3 believes that insufficiency in the para- Eclampsia 

 thyroids is to be found in eclampsia — a toxaemia which parathyroids. 

 he thinks may be successfully treated by an extract of 

 these organs. It seems likely that this method of 

 treatment acts indirectly — that is, calcium retention 

 is promoted and excessive acidosis, so constant in this 

 disease, is prevented 4 . 



1 Vassale, G., and F. Generali, Archiv. Ital. de Biol., 1896, vol. xxv, 

 p. 459. 



2 Adler, L., and H. Thaler, Zeitsch. f. Geb. u. Gynak., 1908, vol. lxii, 

 p. 194. 



3 Vassale, G., Archiv. Ital. de Biol, 1905, vol. xliii, p. 177. 



4 For a disoussion of the role of the alkaline bases in this connexion 

 the reader is referred to an excellent review of ' Acidosis ' by E. I. 

 Spriggs, Quart. Journ. Med., 1908-9, vol. ii, p. 325. 



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