38 SURGICAL SHOCK 



added until the blood neither rose nor sank. The 

 whole estimation needs to be carried out quickly. 

 Then the specific gravity of the mixture was taken 

 with a hydrometer. It is easy to obtain readings 

 correct to the third decimal. As Levy has pointed 

 out, the method gives results which are rather too 

 low, because the hydrometer is graduated for watery 

 solutions, and surface tension in the chloroform- 

 xylol mixture is different. One has therefore to 

 use the same hydrometer and correct its readings by 

 a special estimation. With the hydrometer used 

 in these experiments one has to add 0-003 to the 

 reading obtained. The normal specific gravit}^ of 

 human blood is about 1-057 i^ women and 1-060 

 in man. These results are rather higher than those 

 quoted by the older text-books, because these did 

 not correct the hydrometer readings. All the figures 

 given here are corrected readings. Out of a large 

 number of anahi'ses made on patients under the care 

 of various surgeons at the Bristol Royal Infirmary, 

 it was found that there was never a marked rise of 

 specific gravity in ordinary surgical shock. In all 

 but one case, there was practically no rise, and 

 several times there was a fall. Therefore oligsemia 

 cannot be an important factor in shock. Three 

 typical analyses are given here as illustrations. 



I. Female, aged 43. Wertheim's hysterectomy 

 for cancer of cervix. Full anoci-association. Bladder 

 wounded and sewn up. Bad shock at end (two 

 hours), pulse quick and feeble, blood-pressure 70. 

 At beginning, specific gravity, 1-046 ; at end, specific 

 gravity, 1-047. Sequel, died fifteen hours after. 



