OF BLOOD-PRESSURE 63 



thigh. Crile envelops the patient in a pneumatic 

 suit under pressure, so as to prevent relaxation of 

 the vessels. Bandaging the limbs is a less efficient 

 but more serviceable means of obtaining the same 

 result. Intravenous transfusion with normal saline 

 is not as efficacious in the treatment of shock as of 

 collapse from haemorrhage or cholera, but it is never- 

 theless a valuable proceeding. The addition of 

 adrenalin up to I in 50,000 (even I in 20,000 may 

 be used) will restore the calibre of the vessels 

 even when the vasomotor centre is powerless. Crile 

 and Mummery speak disparagingly of the use of 

 stimulants ; alcohol does nothing but harm, and 

 strychnine, though it may perhaps raise the blood- 

 pressure for a while, soon allows it to fall even lower 

 than it was before. Indeed, Crile declares that large 

 doses of strychnine exhaust the vasomotor centre, 

 and induce shock apart from any injury. Pituitary 

 extract is probably more valuable ; it is given 

 hypodermically. The dose varies with the prepara- 

 tion. Needless to say, the head should be kept low, 

 so as to help by gravity the circulation through 

 the brain. It is quite probable that small doses 

 of strychnine spread over several days before the 

 operation may be of use. 



By the adoption of such means as the above it is 

 possible to bring about the resurrection of dogs 

 whose hearts have stopped beating for fifteen 

 minutes. 



