SHOCK 27 



unique train of physiological events which finally 

 lead to the condition termed shock. While recogniz- 

 ing that an adequate understanding of the cause of 

 such a condition is of paramount importance to the 

 surgeon, our interest in the subject is to be rather 

 closely confined to the underlying physiology of the 

 reaction and the relationship of such physiological 

 behavior to the problems of general physiology. 



That the reader may properly understand the 

 underlying mechanism by which such reactions are 

 produced, we must revert to some experiments which 

 antedate by some years the majority of those pre- 

 sented above. 



Since our problem is to determine the effects of a 

 localized tissue damage upon the organism as a whole, 

 it is obvious that development of a technique for pro- 

 ducing such a localized injury in various parts of the 

 body is highly desirable. By means of an apparatus 

 termed the gyromele, the author (Turck, 1896b, 

 1903a) has been able both to apply various reagents 

 to specific areas of the stomach mucosa and to with- 

 draw at will material from any portion of the organ. 

 The instrument consists essentially of a hollow rotat- 

 ing sound which may be introduced into the stomach 

 by way of the esophagus. By means of the rotating 

 mechanism, the distal portion of the sound may be 

 approximated to any desired area of the gastric mu- 

 cosa, the exact position of the tip being easily located 

 by palpatation or fluoroscopy. Once the tip of the 

 instrument has been placed in the desired position, a 

 small sponge heretofore sheathed in the hollow sound 

 may be extruded, thus permitting the localized appli- 

 cation of any desired reagent to the mucosa. Similarly 



