SURGICAL SHOCK 65 



rectum to avoid the reversal of the effect. If Bright' s 

 disease is known to be present, the treatment should 

 be used only when the need is desperate. 



Unfortunately, saline transfusion is usually wanted 

 at a moment's notice, and a freshly distilled water 

 may not be obtainable. It is fortunate therefore 

 that the effects are not likely to be very serious even 

 if a stale but sterile sample has to be used. 



What has been said with regard to intravenous 

 transfusion applies also to subcutaneous injection. 



It is becoming increasingly common to replace 

 some of the sodium chloride in saline solutions given 

 by the bowel by glucose, which acts as a food. Two 

 drachms of glucose with one drachm of salt may be 

 dissolved in a pint of water. Stronger solutions of 

 glucose are apt to be irritating to the bowel. 



REFERENCES. 



Rendle Short. — " Hunterian Lecture," Lancet, 1914, i, 

 p. 371. (Includes full bibliography.) 



HoRT and Penfold. — Brit. Med. Jour., 1911, ii, p. 1589. 



Grunbaum, a. S. and H. — Brit. Med. Jour., 1911, ii, p. 1281. 



