Part VI 



Physiology and Biochemistry 

 of Shock 



AVAST LITERATURE lias accumulated concerning investigations of 

 the various aspects of shock. It is beyond the scope of this 

 monograph to survey every phase of the problems which have been in- 

 vestigated. In the present discussion, subjects dealing with and related 

 to the pathology of the antigen-antibody reaction in the animal system 

 will briefly be considered. The general literature has been adequately 

 reviewed by Feldberg (1941), Dragstedt (1941, 1945); Dragstedt and 

 Wells (1944), Rocha e Silva (1944), Selle (1946), and Rose (1947). 

 Anaphylaxis, caused by an antigen-antibody reaction, is a specific 

 biochemical problem in immunology. The pharmacological actions of 

 peptone, trypsin (papain and ficin) and animal venoms are likewise 

 biochemical in nature. The toxic reactions produced by these chemi- 

 cally unrelated primary factors, however, would seem to possess certain 

 common features. It is claimed that the liberation of histamine, as a 

 toxic reaction product, appears to be one of the important factors in 

 nearly all of these phenomena. Its release as a factor in trypsin shock 

 has, however, been recently contested (Wells, Morris and Dragstedt, 

 1946; Tagnon, 1945). Danielopolu (1947), however, claims that 

 acetylcholine is the primary and histamine a secondary factor in 

 anaphylaxis (see below). 



It has also been variously pointed out that the physiological changes 

 accompanying shocks caused by anaphylaxis, peptone, trypsin and 

 animal venoms are similar to those accompanying traumatic shock. A 

 survey of the similarities among these reactions might, therefore, be 

 advantageous for an understanding of these related phenomena. 



1. A Description of Anaphylactic Shock 



Anaphylaxis is considered as a special and severe form of a more 

 general pathological process, namely, of allergy. Allergic diseases of 



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