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S.V.

JAMA. 1970;213(2):289-290.

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Tests of functional reserve which employ application of stress often provide diagnostic evidence where none existed in the nonstressed state. Glucose loading will unmask diabetes in patients whose resting blood sugar level was normal. Prescribed exercise will disclose electrocardiographic evidence of myocardial ischemia which was not evident at rest. Stimulation of an inactive adrenal cortex, thyroid gland, or ovary by its respective tropic hormone will pinpoint a primary target organ deficiency if the response was inadequate, or will indicate a malfunction of a higher control center in the anterior hypophysis if the response was appropriate. Attempted provocation of ACTH secretion by L-arginine will similarly discriminate between primary impairment of pituitary function and failure of ACTH-releasing hypothalamic hormone. A great variety of such provocative tests now serve the physician both in screening procedures and in discriminatory refinements of differential diagnosis. Thus, the introduction of one or more tests of the same . . . [Full Text PDF of this Article]

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