Abstract
<h3>To the Editor.—</h3> Although it has been reported in the literature,<sup>1</sup>abdominal pain is now rarely seen as a primary manifestation of hyperthyroidism. Also, the inability to swallow saliva has not been regarded as a manifestation of thyrotoxicosis. We describe a patient whose unusual symptoms of abdominal pain and spitting masked the diagnosis of thyrotoxicosis. <h3>Report of a Case.—</h3> A 44-year-old man was admitted to the Kaiser/Permanente Medical Center in Hayward, Calif, in February 1979 with a one-month history of an 18-kg weight loss and vague diffuse abdominal pain. Physical examination findings were normal except for a pulse rate of 100 beats per minute and a generalized abdominal tenderness. His weight was 97 kg and his face expressionless. No goiter was at first appreciated because of a "bull neck." There was no evidence of congestive heart failure or hepatomegaly. Attention was focused on his abdomen, and numerous x-ray films,
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