THE REMOVAL OF CALCIUM FROM THE BLOOD BY DIALYSIS IN THE STUDY OF TETANY

We may devise a fluid containing practically all the inorganic diffusible constituents of the blood except calcium, and use it to dialyze normal blood in such a way as to remove from it a large part of its calcium. The dialyzed blood when perfused through an isolated extremity produces an extreme hyperexcitability of the nerves quite like that observed in tetany. Since perfusion with blood dialyzed in precisely the same way against a fluid of the same composition, but containing calcium in the proportion found in the normal blood, causes no hyperexcitability of the nerves, it is evident that the hyperexcitability is due to the lack of calcium. This effect can be attained in only a slight degree by replacing the blood of a whole animal with the dialyzed blood, since under the conditions of the experiment the tissues cannot be sufficiently depleted of their calcium. It seems probable that the parathyroid secretion is not removed by dialysis, but is returned to the body with the dialyzed blood. To bring this result into relation with the condition in tetany following parathyroidectomy, animals in tetany were bled and the blood was replaced in one case with normal blood, in the other with dialyzed blood poor in calcium. The normal blood immediately relieves the tetany and lowers the excitability, while the dialyzed blood does not. We therefore believe that this is a further proof that in the tetany of parathyroidectomy also the twitching and hyperexcitability of the nerves is due to lack of calcium in the blood and tissues.