March 1923


Arch Surg. 1923;6(2):489-524. doi:10.1001/archsurg.1923.01110180062002

As stated in the first of these reports,1 these studies in exhaustion were initiated by an investigation of the cause of surgical shock. Chronologically, therefore, the publication of this article should have preceded that of the studies on insomnia, exertion and emotion.2 It seemed a more logical sequence, however, to offer evidence of the conditions demonstrated in exhaustion or shock due to extreme degrees of intensity of the factors of normal consciousness before considering exhaustion due to pathologic conditions.

Perhaps no other subject in surgical literature presents so extensive a bibliography as "surgical shock;" but the space at my disposal for this report prohibits any adequate review of this literature, or discussion of the various theories of the causation of shock, such as I have offered in previous publications.3

These studies, like those of many other investigators, were undertaken to investigate the essential nature and causation of

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