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July 16, 1927


JAMA. 1927;89(3):207. doi:10.1001/jama.1927.02690030039017

Shock has been described as a condition in which there is more or less paralysis of the sensory and motor portions of the reflex arc, with profound disturbances in the circulatory system, subnormal temperature, and frequent and shallow respiration.1 This formidable array of symptoms is not more portentous than the distressing phenomena encountered not infrequently in clinical experience. Although the subject can scarcely be said to have required new interest to promote its investigation, the medical problems of the World War focused attention on it. Perhaps the most significant outcome of the war-time investigations was the growing conviction that shock is not an individual entity. Whenever some single conspicuous etiologic possibility was critically considered, other causative factors would present themselves for equally serious recognition. They have been rehearsed from time to time in The Journal. Today it is probably reasonable to conclude that shock is due to a variety

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