General Surgery 27 



SHOCK. 



Shock is a profound reflex depression of the nerve centers re- 

 sulting in vaso-motor paresis. The arteries losing their tone, the 

 veins become distended, and less blood than normal reaching the 

 brain, the vital centers are insufficiently nourished. It is due to 

 afferent impulses set up by injury or operation. It may occur even 

 under anesthesia, for though the afferent impulse constituting pain 

 is abolished by general anesthesia, those affecting the vaso-motor, 

 respiratory, and cardiac mechanisms are not controlled thereby. 

 Happily, the condition is rare in the dog, but it sometimes occurs in 

 animals of high nervous excitability, particularly where the injury 

 concerns the genital apparatus. It has occurred during the removal 

 of large tumors. I have experienced it following ablation of cancer- 

 ous testicular tumor, and Goubaux and Cadiot and Almy have re- 

 corded instances following removal of mammary tumors. This form 

 of shock is to be distinguished from that following profuse hemorr- 

 hage, or removal of a quantity of fluid from the abdomen, though in 

 either instance, the effects are the same. Both the latter forms are 

 of the nature of mechanical syncope, in the one case owing to cerebral 

 anemia, in the other to sudden removal of pressure and consequent 

 rapid distension of intraabdominal veins. 



Symptoms and Diagnosis. The temperature is subnormal, the 

 pulse is rapid, irregular, weak and compressible, the respiration 

 shallow and irregular. The pupils are dilated and react but slowly 

 to light. One peculiar symptom is a sort of stupid expressionless 

 indifference to the surroundings. 



Treatment. The indications are to raise the blood pressure as 

 quickly as possible. This may be accomplished by injecting large 

 quantities of hot saline solution (5:1000 to i :ioo) both hypodermi- 

 cally and by the bowel. Eichel has shown that absorption of salt solu- 

 tion will compensate for considerable loss of blood in a short while, 

 particularly when transfused intraperitoneally. Heat should be ap- 

 plied to the body, adrenalin chloride solution administered internally 

 and hypodermics of trinitrin, digitalin, and minute doses of strych- 

 nine given. It may be necessary to practice artificial respiration. 



ABSCESS. 



An abscess is an accumulation of pus in any tissue of the body. 



