496 EMIL GOETSCH 



turbance in exophthalmic goiter is one affecting more the character of 

 the secretion than its amount. He believes further that in cases of 

 "hyperthyroiclism" there is a true dysthyroidism with the production 

 of a secretion differing from the normal. This view is supported by 

 the fact that the serum of the patients with exophthalmic goiter di- 

 gested exophthalmic goiter tissues, but not the normal gland except in 

 very few instances. 



Two distinct methods have been devised for detecting the presence 

 of the antibodies upon which the Abderhalden test is based, the first 

 the optic method, and the second the dialyzation method. The first re- 

 quires considerable skill and technical ability as well as rather expensive 

 apparatus. The second, the dialyzation method is much simpler both in 

 tcclmic and necessary equipment. Both of these methods require the 

 most assiduous attention to the various details given, if any reliance is 

 to be placed on the results. Thus far the Abderhalden ferment test has 

 not proved to be of practical clinical value. 



The Aceto-Nitrile Test of Reid Hunt for 

 Hyperthyroidism 



Reid Hunt found in a small series of determinations that mice when 

 fed upon thyroid gland developed an increased tolerance for aceto- 

 nitrile or methyl cyanid (CH 3 dN"). He found that this reaction was 

 specific for thyroid tissue and more delicate than any chemical test. 

 Ho furthermore suggested that the increased resistance to aeeto-nitrile 

 might be used as a delicate test for thyroid substance and also as a 

 means to determine whether there is an increased amount of thyroid 

 secretion in the blood in cases of hyperthyroidism. 



The test is carried out by giving mice 1 or 2 c.c. of blood taken from 

 a suspected case of hyperthyroidism. The blood is mixed with meal and 

 givon for nine or ten days before the mice are tested for their resistance 

 to aceto-nitrile. A series of control animals is used. In recording re- 

 sults it is borne in mi rid that one-fourth of a milligram of aceto-nitrile 

 per grain of body weight of mouse may be fatal to a normal animal in 

 a few hours. 



Hunt's experimental series was too small to enable one to draw final 

 conclusions and although the results have been partially confirmed the 

 exceptions and qualifying results of others have been so many as to 

 render the test of interest but of no real clinical value. Thus Ghedini 

 found that the injection of 20 milligrams of dried thyroid extract in 

 eleven days time is sufficient to raise the resistance of the animals to 

 withstand twenty times tho fatal doses of aceto-nitrile. Hunt's results 

 have been partially confirmed by Trendelenburg. The latter, however, 



