7 6 



THE DISEASES OF THE THYROID GLAND 



dant supply of calories, in Basedow's disease the body weight often falls. 

 The demonstration, that the fundamental exchange, that is the CO 2 produc- 

 tion and the 62 consumption in a fasting condition with the exclusion of all 

 muscular activity, is increased in Basedow's disease, was first furnished by 

 Magnus-Levy, and later by Thiele and Nehring, Stuve, H. Salomon and others, 

 by means of the Zuntz apparatus. Steyrer investigated the increase of ex- 

 change by the Voit-Pettenkofer respiration apparatus. In the severer cases 

 the increase of exchange may reach 70 per cent. I reproduce here Magnus- 

 Leva's instructive table: 



A very interesting example is furnished by the following case investigated 

 by Dr. Bernstein. 



Observation IX. H. J., twenty-two years old, pronounced true infantilism. Two 

 years ago and one year ago tetany, simultaneously with aggravation of a stomach affec- 

 tion that had lasted a long time. With the decline of the second period of tetany pro- 

 nounced manifestations of hyperthyrosis. After a gastroenterostomy there was no 

 recurrence of the tetany. The Basedow's manifestations (tachycardia, sweats, tremors) 

 remained, or improved only a little. Eye symptoms were entirely absent. The in- 

 vestigations of the fundamental exchange gave 



COj 



182.2 

 180.2 

 185.6 



2 



229. i 

 227.4 



222. I 



RQ. 



0.796 j 



0-793 f 

 o.8 3 6j 



Per kilogram of body weight 

 CO 2 O 2 



4-45 



5-6i 



In other cases Salomon could show that the caloric production is also 

 present in the formes frustes. The case just detailed (Observation IX) and 

 Observation V agree in that they show that the increase of the exchange 

 may also be distinct in the formes frustes that pursue their course without 

 eye symptoms. 



Furthermore, I would refer to Observation VIII where the examination of 

 the gaseous exchange showed that like the rest of the Basedow's symptoms 

 the caloric production is subject to great variation. 



The increase of fundamental exchange may also be demonstrated ex- 

 perimentally through the administration of thyroid gland; it is, however, not 

 very great, and in some individuals remains absent. 



The question as to which way the influence of the thyroid-gland secretion 



