The Occurrence of Parathyroids on the Anterior Surface of the Thyroid Gland

One of the great problems in thyroid surgery has always been the avoidance of injury to the parathyroids. Early surgeons soon found that total thyroidectomy frequently led to fatal tetany. Such postoperative tetany was first described in 1881 by Weiss in Billroth's clinic. Tetany at first was confused with the symptoms of hypothyroidism following total thyroidectomy, and the two were regarded as different expressions of the same condition. Attempts to solve this problem by animal experimentation led at first to contradictory and confusing results. Schiff, in 1884, showed that total thyroidectomy in cats and dogs led almost invariably to tetany and death. On the other hand, total thyroidectomy in rabbits and other herbivorararely produced tetany but was followed by the development of cachexia strumipriva. For a time an explanation was not offered for these diverse results. In 1891, Gley published a series of papers describing the effect of experimental total