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CHAPTER III. 

 SURGICAL SHOCK. 



The exhausted vasomotor centre theory of Crile and Mummery — 

 The acapnia theory of Yandell Henderson — The oligjemia theory 

 of Cobbett and Vale — The adrenalin exhaustion theory — The 

 nature of surgical shock ; its diagnosis, treatment, and prevention 

 — Intravenous saline transfusion. 



THERE were four great barriers which stood 

 across the path of the first pioneers of surgery, 

 and even to this very day make the quack and the 

 bonesetter hesitate to resort to the knife. The first 

 of these was haemorrhage. The second was pain. 

 This barrier fell down when anaesthetics were intro- 

 duced. The third was sepsis, a danger which Lord 

 Lister showed us how to triumph over. The last 

 great barrier to be conquered is shock. But three 

 victories make us very confident of final success, 

 and we believe that one day surgery will have lost 

 its main terrors and will be able to bring benefit to 

 patients who are now doomed to die unrelieved ; 

 for instance, cases of intracranial or intrathoracic 

 disease, and what we now call inoperable carcinoma. 

 We may not hope to prevent or treat surgical shock 

 until we have an accurate conception of its nature 

 and causation, and we shall proceed to pass in review 

 some of the suggestions which have been made, and 

 to see how they fare under the criticism of exact 

 experiment. 



