STUDIES ON THE PHYSIOLOGY OF THE PARATHYROID GLANDS

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Abstract
The diagnosis of idiopathic hypoparathyroidism in a 14-yr.-old boy rested upon the demonstration of low serum Ca, high serum P, cataract, normal density of bones (x-ray) and aggravation of tetany by exertion. Administration of large amounts of phosphate showed a normal ability to excrete this, with no evidence of accumulation in the blood. Following injections of parathyroid extract, the P excretion increased and reached a maximum within 2 hrs.; the reduction of inorganic phosphate in the serum almost coincided with this and the increase in Ca concentration appeared much later. The primary effect of the extract is believed to be on the excretion of phosphate. The increase in this leads to diminished concentration in the plasma and this, in turn, stimulates solution of Ca phosphate from the bones. As the serum Ca rose from 5.2 to 11.2 mgm. per 100 cc. following the injection of parathyroid extract, there was little or no increase in the excretion of Ca in the urine until the concentration in the serum reached 8.5 mgm. per 100 cc. Then there was a marked increase with an abrupt return to the previous small excretion as the serum Ca again fell below 8.5 mgm. per 100 cc.

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