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November 4, 1944

Current Comment

JAMA. 1944;126(10):643. doi:10.1001/jama.1944.02850450039014

THERAPY OF ADVANCED SHOCK  Many investigators hold that there is strong contraction of the arterioles and arteries in hemorrhagic and traumatic shock and that the use of vasoconstricting agents is contraindicated and harmful because it results in further decrease of blood to important organs. Recent observations raise serious doubts of the correctness of this assumption and its therapeutic implication. Chambers and his co-workers1 noted that a vasopressor agent is present in the blood only in the primary phase of shock, while in the late and therapeutically most important stage a vasodepressor substance predominates. In experiments on dogs with sectioned aortic depressor and carotic sinus proceptor nerves Schafer2 found that the hypertension did not elicit any shock syndrome. These results as well as observations in surgical practice do not lend support to the theory of a sympathicoadrenal hyperactivity in shock. The application of heat in shock may aggravate the

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