MC CLAUGHRY 



BLAIR: Yes, anesthesia, of course, is a two-edged sword. 

 We are not dealing with hypothermia per se in its native true 

 state by any manner of means. We are dealing with modified 

 hypothermia or, if you will, modified anesthesia, and this is 

 because in reference to anesthesia, it is necessary to anes- 

 thetize both humans and experimental subject to a rather deep 

 level. We call this surgical anesthesia, and this is the level 

 primarily at which the reflex mechanisms responsible for main- 

 taining homeothermia are depressed. They have to be depressed. 

 The only instance of which I am aware and in which hypothermia 

 is produced in the absence of anesthesia is in patients who have 

 been treated with hypothermia for bacteremic shock and other 

 problems of that nature, and again I will touch upon that later. 

 These people, of course, are not anesthetized. 



MARCUS: Do you treat them with morphine or anything to 

 allay their pain? 



BLAIR: Our only experience in this regard, Dr. Marcus, has 

 been with individuals whom we have considered to be refractory 

 to the standard therapy. In the judgment of the physician, these 

 are individuals who have become refractory to very intensive 

 therapy in bacteremic shock; these people are usually comatose. 

 Their reflexes are markedly depressed, and these people are 

 cold. It has been very unusual to observe shivering. As a matter 

 of fact, we use shivering as an index as to when to rewarm the 

 patient. It is a sign that the patient is getting better. 



McCLAUGHRY: Dr. Campbell may have indicated one of the 

 very important possibilities here; namely that combining anes- 

 thesia with hypothermia may make it possible to sort out some 

 of the factors in pathogenesis of some infectious diseases. In 

 particular, it may provide a means of studying host responses 

 to stress, which are really protective mechanisms, but which 

 may become deranged. 



BLAIR: These studies are under way, I might add. Through 

 a contact with the United States Army, the University of Mary- 

 land has recently established a clinical shock unit which is de- 

 voted to treatment of shock, including bacteremic shock, and one 



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