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September 1944


Author Affiliations

From the Department of Surgery of the Johns Hopkins University and Hospital. The work described in this paper was done under a contract, recommended by the Committee on Medical Research, between the Office of Scientific Research and Development and Johns Hopkins University.

Arch Surg. 1944;49(3):167-169. doi:10.1001/archsurg.1944.01230020173003

Reduction in the effective volume of circulating blood in traumatic shock results in varying degrees of anoxia of the different structures of the body. The nervous system is probably more sensitive than other tissues to a deficit of oxygen and it is likely that irreversible changes take place there first. Many studies have been performed in recent years on metabolism and blood flow in the kidneys, the liver and other organs in shock. The brain has not received sufficient attention in this regard because of difficulties connected with methods for determining the cerebral blood flow and for collecting cerebral venous blood. These difficulties are to a considerable extent anatomic, in that the arterial blood is supplied to the brain through a number of different vessels. In the dog and the cat the external carotid arteries supply a considerable part of the total. As emphasized by Dumke and Schmidt,1 the

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