Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . n-sate, a change of hydrogen-ion represented by thatof PH from 6*9 to 6*8 may occur when the bicarbonateis reduced to one-half. We must examine, therefore, 48 INTRAVENOUS INJECTION what effects have been found to be produced byincrease of hvdro^en-ion concentration. Stimulation of Nerve Centres.—The respir-atory centre is exceptional in its extreme sensibilityto hydrogen-ions. The bulbar vaso-motor centresare also excited, but require greater concent
Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . n-sate, a change of hydrogen-ion represented by thatof PH from 6*9 to 6*8 may occur when the bicarbonateis reduced to one-half. We must examine, therefore, 48 INTRAVENOUS INJECTION what effects have been found to be produced byincrease of hvdro^en-ion concentration. Stimulation of Nerve Centres.—The respir-atory centre is exceptional in its extreme sensibilityto hydrogen-ions. The bulbar vaso-motor centresare also excited, but require greater concentration m f C 0± 30 y^-CJ^t I \ \ I f SccJfc A B Fig. 15.—Effect of Acid on Vaso constrictor Centres. A. On bulb, 2 of 0 6 per cent, lactic acid into vein. B. In spinal cat, 8 of 13 per cent, glycollic acid into carotid artery. (Mathison.) and the spinal centres greater still (Mathison, ) (see Fig. 15). The effect on the blood pressure of this vaso-constrictor action is counteracted by other effects onthe heart and blood vessels (see Fig. 19 below). The Heart.—Patterson (1915) showed that IN WOUND SHOCK 49. III, IV. Fig. 16.—Effect of Carbon Dioxide and Adrenaline on the Heart. Upper curves—heart volume. Systole downwards. Rise 01 general levelmeans increase of heart curves—arterial Adrenaline. III. Carbon dioxide and adrenaline. IV. Adrenaline. The combination of carbon dioxide and adrenaline gives greater outputthan normal, or adrenaline alone. (Patterson.) 50 INTRAVENOUS INJECTION carbon dioxide inhalation depressed cardiac con-traction in the dog ; but at least 5 per cent, in theair breathed was necessary, while cats were morerefractory. According to R. W. Scott (1917),breathing 5 per cent, carbon dioxide raises the PH ofthe blood from 74 to 7*2, an increase greater thanthat produced by neutralising half the bicarbonatewith acid. We have further to remember that thiseffect of carbon di
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