SURGICAL SHOCK 37 



1-053, 3.nd afterwards 1-063 '> there is said to have 

 been " mild shock," but the blood-pressure was 

 130. Three other cases were accidents each showing 

 " mild shock." The results were as follows : Case 

 2, when seen, specific gravity 1-063, next day 1-058. 

 Case 3, when seen, specific gravity 1-066, next day 

 1-064. Case 4, when seen, specific gravity 1-063. 

 next day 1-058. Although one is attracted by this 

 theory at first sight, and it has been accepted by 

 Malcolm and Yandell Henderson, it is difficult to 

 understand where all the fluid has escaped to, 

 or what drives it out. One does not see much 

 exudate, for instance, in an amputation at the hip- 

 joint, but shock may be severe. Vale's analyses 

 were made by the difficult Roy method, and although 

 his figures appear higher than usual, this is due to 

 the fact that those ordinarily quoted are obtained 

 by Hammerschlag's method, which gives results 

 decidedly lower. Moreover, it does not appear that 

 any of Vale's cases were suffering from a marked 

 degree of shock. However, it was not difficult to 

 obtain definite evidence as to the correctness of the 

 theory, and I have therefore estimated the specific 

 gravity of the blood in a number of cases of surgical 

 shock. 



Method. — Hammerschlag's method, slightly modi- 

 field, was employed. A mixture of chloroform and 

 xylol was prepared having a specific gravity approxi- 

 mately that of blood. A few drops of blood were 

 obtained from the patient's ear, without squeezing, 

 and immediately transferred by a capillary tube to 

 the mixture, to which chloroform or xylol were 



