SHOCK 23 



If the arguments advanced above are valid, 

 then shock should be induced by any other means 

 capable of producing a localized death of cells 

 and the subsequent release of the shock toxin by 

 in vivo autolysis. Further to test this hypothesis, 

 animals under anesthesia were superficially burned, 

 w^hereupon shock ensued. This result, of course, 

 was to be expected from our knowledge of the ef- 

 fect of severe burns on humans. When, how- 

 ever, the burned area was transplanted to the back 

 of a second animal, and the normal skin of the latter 

 grafted onto the area of the first where the burned 

 tissue had been removed, the second animal passed 

 into shock and died, whereas the donor which had 

 been burned recovered with but slight symptoms of 

 shock. In one such experiment, in which the extent 

 of the burn was slight, the host did not develop symp- 

 toms for four days. On the other hand, a third animal 

 upon receiving an injection of a sterile autolysate of 

 the burned tissue of the first animal suffered immedi- 

 ate shock. 



Such experiments as these demonstrate that in vivo 

 some time is necessary for the autolysis of the in- 

 jured tissue, and consequent production of a concen- 

 tration of the toxic substance sufficiently high to elicit 

 the response which we term shock. It is because of 

 this that the prompt removal of damaged tissues fol- 

 lowing an injury is efficacious in preventing the onset 

 of shock, whereas cases in which surgical interven- 

 tion is unduly delayed often show some degree of it, 

 all too frequently resulting in death. From the experi- 

 mental results cited above, it is clear that in such in- 

 stances in order to be efficacious in preventing shock, 



