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May 20, 1944


JAMA. 1944;125(3):211-212. doi:10.1001/jama.1944.02850210033012

The role of nervous factors in the production and development of traumatic shock is not clearly established. Slome and O'Shaughnessy1 have reemphasized the importance of the nervous impulses from the traumatic area in determining the production and course of shock by demonstrating, under controlled conditions, that trauma applied to limbs isolated from the body except for nerve connections resulted in irreversible shock. Circulatory collapse could be prevented, or its onset delayed, when the animals were subjected to prolonged spinal anesthesia or when section of the nerves to the limbs had been previously performed. Under these experimental conditions, traumatic shock was believed to have resulted mainly from the discharge of nociceptive nervous impulses from the traumatized area acting by virtue of a neurocirculatory reflex. The local fluid loss that occurs during the traumatization of the limb would be responsible only for the initial depressor effect, the progressive state of shock

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