2. The Second Theory

The Second Theory, advanced by Germain See,1 explains these tonic and clonic convulsions as a reflex action from the nerves of the stomach. Friedrich Muller is also in favor of this view, for the two following reasons: First, tetany is occasionally met with in cases in which there is no considerable loss of fluid, as for instance in cases of intestinal worms. Secondly, Muller was able to produce such an attack of tetany in one of his patients by striking his epigastrium.

3. The Third Theory

The Third Theory explains tetany and similar conditions on the basis of auto-intoxication. In cases of ischochymia, many processes of fermentation and decomposition exist, and these give rise to the tion of toxic elements, which are liable to give rise to the above-described symptoms. Gerhardt, Baginski,1 Paliard,2 Loeb,3 Bouveret and Devic, Ewald, Heim,4 Albu, Schlesinger,5 and Kulneff 6 are all firm believers in this auto-intoxication theory. Bouveret and Devic, and likewise Kulneff, have been able to obtain from the gastric Contents of patients with chronic ischochy-mia by Brieger's method (extraction with alcohol and precipitating with chloride of mercury) toxic products of the diamine group. Ewald and Jacobson, and later Albu, have obtained from the urine of a patient af-. fected with tetany an alkaloida1 substance (the picrin salt). This substance usually appeared in the urine during the attacks of tetany only and not during the intervals. Bouveret and Devic are of the opinion that the toxic products develop much quicker in cases of hyperchlorhydria if alcoholics have been indulged in.

Although the auto-intoxication theory seems to be the most plausible, its verification remains to be demonstrated.

1 Germain See: Bull, de 1'Acad, de med., 1888.

1Baginski: Arch. f. Kinderheilk., Bd. vii., 1880. 2Paliard: Rev. de medic, 1888, p. 406.

3 Loeb: Deutsch. Arch. f. klin. Med., Bd. 46, p. 98.

4 Heim: Inaug. Diss., Bonn, 1893.

5 Schlesinger: Berl. klin. Wochenschr.. 1894, No. 9 6Kulneff: Berl. klin. Wochenschr., 1891, No. 44