[Skip to Content]
[Skip to Content Landing]
June 1969

The Nature of Resistance to Shock

Author Affiliations

From the Harvard Surgical Unit, Boston City Hospital and Harvard Medical School, Boston.

Arch Surg. 1969;98(6):679-684. doi:10.1001/archsurg.1969.01340120027001

Differences in the ability to tolerate comparable degrees of shock-producing trauma are commonplace in clinical experience and animal experimentation. The phenomenon of tolerance to shock was not known to be related to any particular function until it was shown that an animal made resistant to a lethal dose of bacterial endotoxins would also survive an otherwise lethal exposure to hemorrhagic shock.1 We had already observed that similar prophylactic protection could also be provided by substantial suppression of the coliform flora in the intestine.2 From such data we concluded that a gram-negative bacterial factor is involved in the death from hemorrhagic shock that persists in spite of full replacement of the blood volume deficit. But, when prophylactic antiadrenergic agents and corticosteroid were also found to be equally protective, it was difficult to find a common factor among such apparently disparate agents that could explain the protection conferred. The likelihood

Smiddy, F.G., and Fine, J.:  Host Resistance to Hemorrhagic Shock: Induction of Resistance by Shock Plasma and Endotoxins ,  Proc Soc Exp Biol Med 96:558-562 ( (Nov) ) 1957.Crossref
Fine, J., et al:  The Bacterial Factor in Traumatic Shock ,  Ann NY Acad Sci 55:429-437 ( (Sept) ) 1952.Crossref
Ashford, T.; Palmerio, C.; and Fine, J.:  Structural Analogue in Vascular Muscle to the Functional Disorder in Refractory Traumatic Shock and Its Reversal by Corticosteroid ,  Ann Surg 164:575-586 ( (Sept) ) 1966.Crossref
Fine, J.; Palmerio, C.; and Rutenburg, S.H.:  New Developments in Therapy of Refractory Traumatic Shock ,  Arch Surg 96:163-175 ( (Feb) ) 1968.Crossref
Milliken, J.C.; Nahor, A.; and Fine, J.:  A Study of the Factors Involved in the Development of Peripheral Vascular Collapse Following Release of the Occluded Superior Mesentric Artery ,  Brit J Surg 52:699-704 ( (Sept) ) 1965.Crossref
Schweinburg, F.B., and Fine, J.:  Evidence for a Lethal Endotoxemia as the Fundamental Feature of Irreversibility in Three Types of Traumatic Shock ,  J Exp Med 112:793-800 ( (Nov) ) 1960.Crossref
Rutenburg, S.H., et al:  Detoxification of Endotoxin by Liver and Spleen ,  Proc Soc Exp Biol Med 125:455-459 ( (Nov) ) 1967.Crossref
Palmerio, C,. et al:  Further Studies on the Nature of Circulating Toxin in Traumatic Shock ,  J Reticuloendothe Soc 1:243-247 ( (July) ) 1964.
Palmerio, C., et al:  Denervation of the Abdominal Viscera for the Treatment of Traumatic Shock ,  New Eng J Med 269:709-716 ( (Oct 3) ) 1963.Crossref
Alper, M.; Palmerio, C.; and Fine, J.:  A Further Note on the Mechanism of Action of Endotoxin ,  Proc Soc Exp Biol Med 124:537-538 ( (Jan) ) 1967.Crossref
Carey, F.J.; Braude, A.I.; Zalesky, M.:  Studies With Radioactive Endotoxin: III. The Effect of Tolerance on the Distribution of Radioactivity After Intravenous Injection of E coli Endotoxin Labelled With Cr51 ,  J Clin Invest 37:441-449 ( (March) ) 1958.Crossref
Springer, G.F., et al:  Relations Between Bacterial Lipopolysaccharide Structures and Those of Human Cells ,  Ann NY Acad Sci 133:566-579 ( (June) ) 1966.Crossref
Palmerio, C., et al:  Cardiac Tissue Response to Endotoxin ,  Proc Soc Exp Biol Med 109:773-776 ( (Feb) ) 1962.Crossref