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September 1949


Arch Surg. 1949;59(3):398-408. doi:10.1001/archsurg.1949.01240040406003

SHOCK may be defined as a condition of acute prolonged depression of blood pressure and circulating blood volume. Among the conditions in which it occurs are anaphylaxis, coronary occlusion, poisonings of various kinds, overwhelming infections and, most important from our standpoint, trauma and hemorrhage.1

This is not the place to discuss the various theories of the mechanism of traumatic shock, or to attempt to detail or analyze the great confusing mass of experimental and clinical observations which continue to appear in the literature. It is enough to say that there are three theories of the underlying mechanism of traumatic shock: first, that it is of predominantly nervous origin; second, that there is produced by trauma a circulating vasodepressor substance, and, third, that it is due to loss of blood, either externally or internally into the tissues. At present, the consensus is that though the nervous system and a circulating