Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . r that the prematureinhibition might be produced in two ways. Eitherthe vagus endings in the lungs are abnormallysensitive, as may be the case after exposure topulmonary irritant gases, in the cases known asdisordered action of the heart or the effortsyndrome, described by Haldane, Meakins, andPriestley (1918); or, the respiratory centre may beabnormally sensitive to the normal degree ofstimulation of the vagus receptors. This latterexplanation seems
Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . r that the prematureinhibition might be produced in two ways. Eitherthe vagus endings in the lungs are abnormallysensitive, as may be the case after exposure topulmonary irritant gases, in the cases known asdisordered action of the heart or the effortsyndrome, described by Haldane, Meakins, andPriestley (1918); or, the respiratory centre may beabnormally sensitive to the normal degree ofstimulation of the vagus receptors. This latterexplanation seems the more probable one in thecases where the type of respiration comes on afterwound shock or haemorrhage. Fig. 13 indicatesthat the excitability of the vagus is exaggeratedafter haemorrhage. There are some facts whichsuggest that the abnormal excitability is a stage inthe progressive failure of the centre, owing todeficient blood supply. The first effect of a fairlylarge haemorrhage in the cat is the rapid, shallowrespiration. This passes into a slow, shallow type(Fig. 11) and later still into a very slow but deep 44 INTRAVENOUS INJECTION. Fig. 13.— Effect of Haemorrhage on the Respiratory Reflex fromthe Vagus. Upper curve—respiration. Lower curve—blood pressure. Stimulation signal—between the curves. The strength of the stimulus was adjusted until the rapid, shallow respira-tion, shown at a, was produced. Blood was then removed and the bloodpressure fell to the level at b. At c the same strength of stimulus as beforecaused a marked inhibition of the respiratory movements. The last threestimulations show a partial return to the first state, after blood had beenreinjected. There is a slight quickening of the rate with a decrease in decrease in magnitude of the depressor reflex on the blood pressure, asthe height of this pressure is lowered, may be noted. IN WOUND SHOCK 45 type (Fig. 34 below). After muscle injury theremay be some other factor in addition to th
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