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January 7, 1933


JAMA. 1933;100(1):46. doi:10.1001/jama.1933.02740010048014

Until recently, traumatic or surgical shock was the basis for numerous theories. During and immediately following the World War, attacks on the problem from various angles resulted in a satisfying explanation of the genesis of shock. The mechanism of traumatic toxemia, reported by the Special Research Committee1 and further elaborated by Cannon2 and others, explains all the characteristic features of shock. The test of subsequent experimentation has not only shown no discrepancies but has served to corroborate the explanation. Injurious products of tissue autolysis, arising in' areas of extensive trauma, are absorbed into the circulation. These products affect the circulation in a manner similar to histamine, causing injury to the capillary walls resulting in increased permeability and dilatation. Extensive capillary dilatation results in the withdrawal of blood from currency as effectively as if by external hemorrhage. The individual "is bled to death into his own capillaries." The effects