Section on Surgery - 1919 Author:American Medical Association Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: THE COURSE OF EVENTS IN SECONDARY WOUND SHOCK W. B. CANNON, M.D. George Higginson Professor of Physiology, Medical School of Harvard University BO... more »STON In the issues of The Journal of February 23 and March 2, 1918, there was published a series of articles by Cowell, Fraser, Hooper and myself which described certain clinical observations that we had made on soldiers who suffered from shock and allied conditions. These observations confirmed earlier reports on the persistent low arterial pressure, the rapid pulse and respiration, and the lowered body temperature of the shock state; they also revealed a concentration of corpuscles in the capillaries, a reduction of the alkali reserve corresponding in general to the degree of lowering of arterial pressure, a marked sensitiveness to ether or chloroform anesthesia, and a tolerance of nitrous oxid and oxygen as an anesthetic. On the basis of these facts a definition of traumatic or wound shock might be-offered; it is a general bodily state occurring after severe injury and characterized by persistent low arterial pressure, rapid pulse, pallor or slight cyanosis, sweating, superficial rapid respiration, and usually by a dulled mental condition. EXEMIA AS A CAUSE OF LOW PRESSURE Among the articles in the series above mentioned was a theoretical discussion of the nature of wound shock, in which the low blood pressure was regarded as the central fact of the fully developed complex.1Reasons were given for refusing acceptance of the acapnia theory and the nerve exhaustion theory of the low pressure. The factors determining arterial tension were then analyzed, with the result that the low pressure was ascribed to "exemia"; that is, a temporary lessening of the volume of circulating blood, though not a loss of blood from t...« less