40 GLANDS IN HEALTH AND DISEASE 



merit is carried out before the administration of 

 food in the morning (that is, after he has fasted 

 for 12 to 14 hours). This is the so-called "basal 

 metabolism," and constitutes the unit of reference 

 whereby we can measure what are the deviations 

 from the normal. 



Metabolism in thyroid disease. All this is a 

 long, but, I believe, a necessary preface to what we 

 are now coming to : metabolism in thyroid disease. 

 We started out by saying that the thyroid, by 

 means of its hormone, regulates, perhaps more than 

 any other organ of the body, the amount of metab- 

 olism in the body. Under normal conditions, with 

 a normal thyroid, the metabolism of the individual 

 is such as to show a normal a basal metabolism." 

 When, however, hyper-thyroidism sets in, with a 

 gland that is excessively active, the rise in metab- 

 olism above the normal amount is considerable. 

 Vice versa, where the patient suffers from hypo- 

 thyroidism, with a decreased activity of the thy- 

 roid, there is a decided drop in the metabolic rate. 

 For example, when the metabolism of a patient 

 suffering from exophthalmic goiter (hyper-thyroid- 

 ism) was investigated it was shown to be 75 per 

 cent, above the normal basal of 39.7 calories (usu- 

 ally written +75) ; on the other hand, with a cretin 

 the metabolism was 22 per cent, below normal 

 ( 22). Incidentally the same cretin, after being 



