Hyperthyroidism. 



117 



the intestinal capillaries, the blood from an intestinal vein is not 

 different from that from the jugular vein. 



We find therefore that marked damage to the liver and intestine 

 fails to induce acidosis, and that the kidney also is not a necessary 

 factor. We believe at present that the condition essential is an 

 injury to the muscle capillaries. 



55 (1637) 



The glucose mobilization rate in hyperthyroidism. 



By BERTRAM J. SANGER. 



[From the Medical Clinic, Presbyterian Hospital; Columbia 

 University, New York City.] 



The work presented here is a preliminary report of some 

 special investigations we have undertaken during the past twelve 

 months at the Presbyterian Hospital in order to shed more light 

 on the complex problem of hyperthyroidism. The decreased 

 sugar tolerance, so frequently found in this condition, was taken 

 as our point of departure. It occurred to us that the study of the 

 respiratory quotient and the blood sugar at frequent intervals 

 after glucose ingestion might give us a good deal of information as 

 to how cases of Grave's disease utilize carbohydrate. 



In brief, our procedure was as follows: the metabolism deter- 

 minations were made with a 90-liter Tissot apparatus, using a 

 Siebe-Gorman mask and Douglas valves. Samples of gas were 

 taken over mercury in the usual way and were analyzed in dupli- 

 cate in a Haldane gas analysis apparatus and in triplicate if the 

 two analyses did not check satisfactorily. Previous to the use of 

 the Haldane apparatus each day an analysis of outside air was 

 made as a control. The usual technique was observed as to the 

 preparation of the patient — 14 to 16 hours fast and absolute rest 

 for thirty to sixty minutes before the start of the determination. 



After obtaining two basal periods each of ten minutes, blood 

 was taken for a fasting blood sugar. The patient was then given a 

 dose of glucose made as palatable as possible with a small amount 

 of fruit juice. For the most part, a standard dose of 1.75 grams 



