Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . ood may be just that occurrence that turnsthe scale and, if restored, even by gum, recoverymay be often assured. Some of the contributory causes have been al-ready mentioned, but demand some further details,especially in respect of treatment. Cold. This is generally recognised at the front as oneof the most important factors in exaggerating woundshock (see Cannon, Fraser, and Cowell, 1917, p. 85).Clearly, the most obvious precaution is to keep thepat
Intravenous injection in wound shock : being the Oliver-Sharpey lectures delivered before the Royal College of Physicians of London in May 1918 . ood may be just that occurrence that turnsthe scale and, if restored, even by gum, recoverymay be often assured. Some of the contributory causes have been al-ready mentioned, but demand some further details,especially in respect of treatment. Cold. This is generally recognised at the front as oneof the most important factors in exaggerating woundshock (see Cannon, Fraser, and Cowell, 1917, p. 85).Clearly, the most obvious precaution is to keep thepatient as warm as possible. Warmth and waterare the most insistent demands of the wounded. But certain experimental work indicates that, ifthe body temperature has fallen much, the existenceof a small amount of haemorrhage may preventrecovery on warming up. In wounded men, mouthtemperatures of 87° F. have been met with. Inexperiments made by Cannon and myself, we found ro6 INTRAVENOUS INJECTION that cats could be cooled to 25° C. rectal temperatureand completely recovered by warming (Fig. 35).This was not the case, however, if the cold was. Fig. 35.—Cooling with Recovery. Cat under urethane. a. Commenced cooling. Temp. 358°. b. Temp. 34°. Shivering. c. 1-25 hours later. Temp. 30-8°. d. After another hour. Temp. 28°. Pulse 128. e. Forty minutes later. Temp. 25°. Pulse 64. ently heart block. Muscles lax, no shivering. f. Began to warm. g. Shivering. Temp. 26°. Pulse 106. Resp. Half-an-hour after/ Temp. 27°.k. Seven minutes later. Temp. 28°. Pulse 130. Resp. 28 Seventeen minutes later. Temp. 30°. Pulse 140. Resp. a similar experiment on a decerebrate cat, the absence of shivering wasnotable, but there was increase of rigidity on cooling. Resp. 32. Resp. 10. Appar- General IN WOUND SHOCK 107
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