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March 24, 1923


JAMA. 1923;80(12):848-849. doi:10.1001/jama.1923.02640390036015

The limitations of the so-called Goetsch test as an index of hyperthyroidism have already been pointed out in The Journal.3 This reaction consists in the response of patients to subcutaneous injections of small doses of epinephrin, a positive result being manifested by an increase in pulse rate and rise of blood pressure, exaggeration of tremor, palpitation and nervousness, appearing within a short time after the injection. The epinephrin was at first believed to produce sensitization of the organism so that a synergistic action of the thyroid secretion would manifest itself by pressor effects. Although Goetsch originally thought that the phenomenon might be of value in the diagnosis of thyroid disease by allowing a surplus output of thyroid hormone to manifest itself more readily, he later pointed out that the reaction, after all, is indicative only of alterations in the sympathetic system; that is, it becomes an index of sympathetic