SHOCK 43 



ing from chloroform and ether anesthesia — upon in- 

 jection caused marked symptoms of toxemia. 



As a result of the experimental research presented 

 in this chapter we may safely conclude that the pri- 

 mary cause of shock, regardless of the technique util- 

 ized to elicit the reaction, is the liberation of an endo- 

 cellular toxin which, by its action upon the circula- 

 tory system, results in an engorgement of the vessels 

 in the splanchnic area. 



In subsequent chapters we shall consider the con- 

 ditions under which cytost is liberated, its probable 

 nature, and the mechanism of its action on tissues. 

 We shall have little more to say regarding the various 

 aspects of shock; nevertheless it may interest the 

 reader to note that the writer's early experiments upon 

 the toxic nature of shock laid the groundwork for 

 more general investigations which are to be con- 

 sidered in this book. 



In the interests of historical accuracy, the follow- 

 ing may prove worthy of note: 



In 1896 and subsequently the writer published a 

 series of papers in which it was maintained that trau- 

 matic shock was essentially a "shock by toxin" from 

 damaged tissues. In discussing the results of experi- 

 ments with anesthetics it was stated (1903b) : "The 

 explanations that are usually given for the complex 

 symptoms found in shock from anesthesia cannot be 

 explained by the simple failure of blood pressure and 

 respiration, but there appear to be some direct toxic 

 bodies formed that are found in the blood serum. 

 The injection of serum from animals that have shown 

 evidence of shock produces many of the symptoms 

 manifested in shock, which include loss of sensation, 



