ON THE PATHOLOGY AND TREATMENT OF 

 SHOCK AND SYNCOPE. 



(Address read before the Abernetliian Society, St. Bartholomew's Hospital. 

 Eepriuted from the Practitioner, vol. xi, p. 246, Oct. 1873.) 



The assemblage of phenomena which we designate by the term 

 *' shock " is so much more frequently met with in surgical than 

 in medical practice that it may almost seem that in writing a 

 paper on this subject I have left the proper domain of the 

 physician, and trespassed on that which the surgeon claims as 

 his own. We shall hereafter see, however, that shock may 

 occur in the course of diseases for which the physician alone is 

 called into consultation, and it is intimately connected with 

 fainting or syncope, a condition which is usually treated of in 

 medical rather than in surgical text-books. So closely, indeed, 

 are syncope and shock connected that they were considered by 

 the celebrated surgeon, Travers,* to differ in degree rather than 

 in kind, and we shall find it convenient to take a glance at the 

 conditions which we find in syncope, before we proceed to 

 examine those of shock. 



I shall divide this paper into three parts. First, the injuries 

 or impressions on the nervous system which occasion syncope 

 and shock, and the symptoms which are observed in these con- 

 ditions ; Secondly, the causes of each symptom ; and Thirdly, the 

 remedies used and their mode of action. To put them shortly, 

 these three heads are: 1. The symptoms and causes; 2. The 

 pathology ; and 3. The t7^eatment of shock and syncope. 



As I have already said, it will be convenient to consider the 

 symptoms of syncope before those of shock. Having had little 

 surgical experience myself, I shall quote very freely from the 

 works of others ; and the first case I shall give is one taken, 

 not from a scientific work, but from the pages of a popular 

 religious periodical. I cannot even vouch for the historical 



* Treatise on Constitutional Irritation, 182G, p. 466. 



