R. M. HARDAWAY 
25 
^Figure 4. — On the left are three blood samples taken 
from a dog subjected to one hundred blows of a 
padded mallet on one thigh. The first tube was drawn 
before the trauma, the second tube 30 minutes follow- 
ing the trauma, and the third tube 48 hours after the 
trauma. Note that hemolysis, which was only mild 
right after the trauma, had increased markedly by 
the end of two days. This is thought to be due to 
absorption of hematoma and ecchymosis probably via 
lymphatics. If no hemolyzed blood had been absorbed, 
the mild hemolysis shown in the second tube would 
have completely disappeared in a few hours. On the 
right are two tubes drawn before and after the ad- 
ministration of 20 ml of autogenous blood which had 
been frozen and thawed. Note that the amount of 
hemolysis 48 hours after trauma and immediately 
after the administration of 20 ml of hemolyzed blood 
is approximately the same. 
MORTALITY DATA 
CONSECUTIVE PAIRS OF DOGS 
20 
18 
5 
13 
Dead 
1 6 
1 1 
Survived 
14 
(28%) 
(72%) 
3 
12 
(21%) 
1 1 
10 
8 
6 
^(72%): 
$(79%): 
(79%) 
4 
H28%)^ 
2 
0 
$(2l%)v 
Control 
Heporin 
Control 
Fibrinolysin 
Figure 5. — Proctection by heparin and fibrinolysin of 
dogs subjected to "irreversible" hemorrhagic shock. 
Figure 6. — Aortic blood pressure of dog subjected to 
hemorrhagic shock at 40 mniHg arterial pressure for 
four hours and treated with an agent which causes 
pure peripheral vasoconstriction without any cardiac 
effect. Upper panel shows results of initial and second 
bleed. Abrupt elevation between the first and second 
bleed is result of change in scale. Each small arrow 
represents the administration of 40 ml of blood. Note 
that administration of first dose of methoxamine 
(Vasoxyl) results in elevation of mean pressure from 
40 to 70 mmHg. Although no blood was withdrawn 
to restore pressure to 40 mmHg, the pressure spon- 
taneously fell to below 40 mmHg and required several 
transfusions of approximately 160 cc each to maintain 
pressure at 40 mmHg. Note that subsequent doses of 
the drug resulted in a temporary elevation of pressure 
but that pressure quickly fell even though no blood 
was withdrawn. These dogs died. 
found after indotoxin administration. It was 
also found that heparin was inactivated in the 
presence of a pH below 7.2. In severe shock the 
capillary and tissue pH not only went below 
7.2, but in severe shock reached levels 6.5 or 
below. These severe levels were not indicated 
by pH determinations of either arterial or ven- 
ous blood, but required tissue pH determina- 
tions to document. This extreme acidosis was 
caused by the tremendous outpouring of lactic 
acid as the result of anaerobic cellular metab- 
olism. 
Working on the theory that DIG required two 
separate factors for its production, namely slow 
blood flow and a thromboplastic agent, it was 
thought that DIG could be prevented by promot- 
ing adequate flow even in the face of thrombo- 
plastic agents. With this in mind, it was de- 
cided if the arterioles could be opened up 
instead of being violently constricted due to 
