■395 PATHOLOGY AND TREATMENT 0? SIIOCX AlsD SYNCOrE. 



distingnisli from it anotlier eretliismic form which Travers terms 

 ■" prostration witli excitement."* The countenances of patients 

 •suffering from it are distortsd, and express a nameless anxiety 

 :and excruciating agony. They toss wildly about, groan and 

 scream, and complain of a fearful oppression and want of breath, 

 oppressive presentiments of death, and a feeling of total anni- 

 hilation. No encouragement is of any use ; they lament and 

 behave themselves like madmen. The consciousness of these 

 sleepless and restless patients is unclouded, but seems to be 

 completely engaged by the frightful anguish. On this account 

 tliey answer no questions, but only sigh and moan. They mur- 

 mur to themselves, and pay no attention to what is going on 

 around them. Such parts of the mucous membranes as are 

 visible are pale, but the countenance, on the contrary, is slightly 

 Hushed, and tlie forehead hot ; the eyes are sunk, but have a 

 peculiar lustre, and the pupils are contracted. The skin of the 

 extremities is generally cool and insensible, but not to the same 

 degree as in the torpid form of shock seen in the case of the 

 patient already described. Occasionally no coldness is percep- 

 tible. Yomiting of quantities of mucus and painful retching are 

 constant and very obstinate symptoms of this form of shock. 

 Burning thirst is present, and liquids are greedily swallowed, 

 but no sooner are they down than they are again rejected. 

 Every movement is made hastily and accompanied by a remark- 

 able trembling. Occasionally all the limbs shiver as in a rigor, 

 and the patient has no power to control the movement. A 

 wounded ofhcer in this condition repeatedly requested me, says 

 Professor Fischer, not to consider it as a sign that he was afraid. 

 Convulsive movemenr.s, and fibrillary twitchings of the muscles, 

 and especially of those in the face, are observable. The respira- 

 tion is frequent and superficial, the pulse small, and cannot be 

 counted. 



Both these forms of shock may occur independently, but 

 there is a certain connection between them. Patients recovering 

 from the torpid form may come gradually to present the symp- 

 toms of the eretliismic, and vice versd, when the condition 

 becomes worse, the torpid may be developed from the 



* Traverd, ojp. vit., p. 407. 



