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April 6, 1940


JAMA. 1940;114(14):1312-1318. doi:10.1001/jama.1940.02810140012003

Circulatory disturbances may arise from defective action of the pumping mechanism itself, from the agencies which influence the heart's action and from abnormal vasomotor reactions. It is obvious that loss of blood or fluid, directly or indirectly, may disturb the circulation. These causes for circulatory deficiency are discussed adequately in medical-literature. But circulatory disturbance originating in the visceral capillary stream bed has not received the attention it merits.

CAPILLARY DISORDER  Increased knowledge concerning the capillaries and their reactions has made possible an analysis of several enigmatic circulatory phenomena. It has been shown (Ebbecke,1 Krogh,2 Lewis3) that capillaries possess tonus and contractility independent of the adjacent arteries and veins. Capillary endothelium is delicately sensitive to physiologic conditions such as oxygen tension and products of metabolic activity. Likewise it is exceedingly susceptible to the action of a wide variety of noxae, including chemicals, poisonous drugs, anesthetics, venoms, bacterial

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