History of parathyroid gland surgery: an historical case series

The history of the parathyroid glands is a fascinating one full of famous medical names. The discovery of the glands was followed by laborious research into their anatomy, embryology and pathology and into the physiology of calcium metabolism; this led to the manufacture of hormone substitutes and, finally, to the refinement of surgical techniques. The glands were first identified in 1850 by Sir Richard Owen, conservator of the Hunterian Museum, but it was not until 1880 that the term 'glandulae parathyroideae' was first used. The physiology of parathyroid hormone and calcium metabolism eluded physicians and the forefathers of thyroid surgery alike for several decades more. Patients were treated as curiosities and were documented as untreatable medical patients or as inexplicable thyroid surgery complications. Halsted noticed the 'disastrous results from the loss of the glands' and the resulting tetany, as did Billroth. It is the patients, however, who best illustrate the journey of discovery. In this review, we discuss three cases, highlighting their contributions.