Friedrich Müller,1 in 1893, demonstrated a general increase in metabolism in exophthalmic goiter by showing that a patient with this disease lost weight and nitrogenous substances on a diet more than sufficient to prevent such losses in a normal individual. Since that time the conception has been prevalent that the increase in the basal metabolism is generally accompanied by, and even dependent on, an increase in the rate of destruction of the patient's own protein tissue. However, as shown by the studies of Magnus-Levy,2 of Falta3 and of Du Bios,4 who likewise have presented summaries of the subject, an increased protein destruction does not always occur, and these authors are rather guarded in their conclusions. Magnus-Levy says:
Sometimes, at least, a deleterious influence is exerted by the disease upon the protein metabolism. To establish a state of nitrogenous equilibrium it is necessary not only to increase
BOOTHBY WM, SANDIFORD I. THE TOTAL AND THE NITROGENOUS METABOLISM IN EXOPHTHALMIC GOITER. JAMA. 1923;81(10):795–800. doi:10.1001/jama.1923.02650100003002
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