THE THYEOID GLAND AND ITS DISEASES 495 



thyroid disturbances, and that the hyperglycemia is influenced by so many 

 other factors, such as nephritis, it is impossible for us to interpret the 

 hyperglycemia test as pathognomonic of hyperthyroidism. The finding 

 of glycosuria and hyperglycemia' in other pathologic conditions, such as 

 fever, alcoholism, neurasthenia, and in the various endocrinopathies some- 

 what nullifies its significance; but if these can be excluded, its presence 

 is highly suggestive. When rationally corroborated with the remaining 

 clinical data this test is confirmatory. 



Further reliance must be placed upon the basal metabolism and 

 epinephrin hypersensitiveness tests. 



The Specific Ferment Test of Abderhalden in the 

 Diagnosis of Hyperthyroidism 



Lampe and his coworkers have made extensive studies upon the pos- 

 sibility of applying the Abderhalden test to the diagnosis of thyroid dis- 

 orders. They believe that the blood serum of patients suffering with 

 hyperthyroidism contains ferments which are specific for thyroid tissue 

 and for exophthalmic goiter gland. They feel that, if in cases of hyper- 

 thyroidism there is an overproduction of normal thyroid secretion, a 

 negative result with the Abderhalden test should be obtained, for in such 

 a case there is introduced into the blood merely an increased amount of 

 a purely native protein. There is, therefore, no production of ferments. 

 If, on the other hand, there is present in the blood a protein secreted by 

 the thyroid but of an altered composition on account of the pathological 

 changes in the gland, then this foreign protein would stimulate the pro- 

 duction of a specific ferment and the Abderhalden reaction would be 

 positive. They studied the digestive ferment action of the serum from 

 cases of Basedow's disease upon normal, exophthalmic, cystic and paren- 

 chymatous thyroid gland, upon normal and hyperthyroidism thymus, and 

 upon ovary, testicle, kidney, suprarenal and pancreas. In all cases in 

 which the serum from cases of hyperthyroidism was allowed to act upon 

 thyroid gland from hyperthyroidism cases, the gland was digested. In 

 relatively few cases was the reaction positive when normal thyroid tissue 

 was used. The reaction was positive also in four of the five cases of cystic 

 goiter and in the cases in which thymus and ovary were used. With other 

 tissues the reaction was negative. 



In the serum of myxedematous patients there is similarly an anti- 

 ferment for thyroid tissue, a fact which seems to indicate an abnormal 

 thyroid activity, though the functional disturbances of the thyroid 

 in myxedema are evidently of a very different character than in Base- 

 dow's disease. In other words, Lampe feels that the secretory dis- 



