THE THYEOID GLAND AND ITS DISEASES 497 



does not believe that the resistance to aceto-nitrile is in proportion to 

 the percentage of iodin in the thyroid tissue as was maintained by Hunt. 

 Ghedini concludes that the reaction of thyroid extract in increasing aceto- 

 nitrile resistance is specific. His finding that the iodin content is with- 

 out appreciable effect upon resistance confirms Trendelenburg's findings 

 but refutes those of Eeid Hunt. In brief, the aceto-nitrile has not proved 

 to be of real clinical value. 



Two other tests might be briefly mentioned. They are of considerable 

 interest but of little diagnostic value. They are the test of Claude, Bau- 

 douin and Porak, and the Marinesco-Koseo complement deviation test 

 for hyperthyroidism. 



The Test of Claude, Baudouin and Porak for 

 Hyperthyroidism 



This test is characterized by the production of bradycardia by the 

 subcutaneous injection of pituitary posterior lobe solution in cases of 

 hyperthyroidism. In normal cases, under these conditions there is an 

 acceleration of the pulse. The former inhibitory effect upon the pulse 

 rate is thought to be due to stimulation of the vagus nerve, whereas in 

 cases without hyperthyroidism a stimulating effect is produced upon the 

 sympathetic accelerator nerves to the heart. These authors feel that in 

 cases of hyperthyroidism there exists a tachycardia which is due to 

 hyperexcitation of the sympathetic nervous system as a result of which 

 the sympathetic does not react to the pituitary extract. On the other 

 hand, the nerve endings of the vagus which are not excited feel the full 

 effect of the pituitary stimulation and the pulse rate is retarded. This 

 test does not take into account the many cases of latent hyperthyroidism, 

 particularly those dependent upon adenoma or diffuse adenomatosis in 

 which there is no preexisting tachycardia, and in which the results of 

 the test would therefore be negative entirely or nearly so, the pulse in 

 these instances often being normal or even subnormal. 



Marinesco-Roseo Complement Deviation Test 



These authors suggested that in states of hyperthyroidism there is 

 sufficient thyroid substance (antigen) present in the blood serum to give 

 rise to the formation of antibodies in the patient's blood. They pro- 

 posed to test for these antibodies by means of antigen prepared from 

 thyroid gland removed at operation from cases of hyperthyroidism. The 

 experimental and clinical results are not sufficient or conclusive enough 

 to warrant more than mention of this test and, therefore, opinion is 

 withheld as to its clinical diagnostic value in states of hyperthyroidism. 



