Carbohydrate in the Treatment of Postoperative Tetany, With Special Reference to Lactose
The usual methods of treatment of postoperative tetany are not entirely satisfactory. To any who have experienced the difficulties in the management of this condition, the need of simpler effective measures is apparent. The oral administration of calcium, even in large doses, is not always sufficient to control the symptoms, and repeated injections of it over long periods is undesirable or impossible. Injections of parathyroid extract alone or in addition to calcium may be effectual, but are inconvenient and expensive. Methods are reported here for the control of phosphate metabolism to an extent that will afford distinct benefit to patients suffering from this disease.
The best-known and perhaps- the most satisfactory single criterion by which the severity of parathyroid tetany may be judged is the degree of depression of the level of total serum calcium. Examination of a large series of serum calcium levels in tetany makes the fact apparent, however, that the symptoms do not necessarily parallel the total calcium levels. This confirms the opinion of John.1
It is known that the total serum calcium can be raised and frequently brought to normal in tetany by the feeding of large doses of calcium. In some of our cases the symptoms were not controlled by these measures, and their severity was thought to be out of proportion to the calcium level. This was especially striking since a patient might be symptom-free with a certain calcium level on one day, while on another occasion, although the serum calcium was. . .