. Medical diagnosis for the student and practitioner. haracteristicgoose flesh is often seen due to the contraction of the erector pili muscles,which are of the smooth variety and under sympathetic control. Thereaction lasts for one and one-half to two and one-quarter hours as comparedwith one-half to three-quarters of an hour in a normal individual, in whom,furthermore, the area of blanching is much less definite and the peripheralzone of red is usually entirely absent. In practically all cases of hyperthyroidism, Goetsch states that the reac-tion is more marked and of longer duration than in
. Medical diagnosis for the student and practitioner. haracteristicgoose flesh is often seen due to the contraction of the erector pili muscles,which are of the smooth variety and under sympathetic control. Thereaction lasts for one and one-half to two and one-quarter hours as comparedwith one-half to three-quarters of an hour in a normal individual, in whom,furthermore, the area of blanching is much less definite and the peripheralzone of red is usually entirely absent. In practically all cases of hyperthyroidism, Goetsch states that the reac-tion is more marked and of longer duration than in a normal individual. It should be added that of late much stress is laid on the behavior of thecolor of the areola produced in this test, which, in victims of hyperthyroidism,though fading to a lavender color remains for nearly or quite four hoursafter the time of the original injection. The Hypodermic Test (Goetsch).—Seven and one-half minims ( ) Over-ratedsigns. lS2 MEDICAL DIAGNOSIS May for a timeexist alone. Cardiac dilata-tion of a 1:1000 solution of adrenalin chloride is injected hypodermically in thedeltoid region. If hyperthyroidism is present there is an early rise of bloodpressure, and pulse variation of from 10 to 50, and normally proportional tothe degree of toxicity present. Among the associated symptoms producedare asthenia, tremor, throbbing, vasomotor changes, apprehension andnervousness. Note.—It is obvious that the second of these tests should be used withsome discretion and that both must contain possibilities of error. With respect to the hypodermic test, it would appear that the condi-tions under which it is performed should be controlled carefully, this beingespecially true if we are to draw fnimtinrimmmumany conclusions of importancefrom the rise in blood pressure ofthe lesser grades. Every practis-ing physician knows how readilydecided increases in systolicpressure occur and there wouldseem to be a considerable oppor-tunity for error
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
