On the pathology of shock : a dissertation for the degree of M.D., read December, 1879 / by C.W. Mansell-Moullin.

  • Moullin, Charles William Mansell, 1851-1940.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology of shock : a dissertation for the degree of M.D., read December, 1879 / by C.W. Mansell-Moullin. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    he has attributed great importance, viz., the sudden action of the vasomotor nerves on even large vessels which is called into play when a limb or any other part of the body is suddenly raised from a horizontal to a vertical position. Astley Cooper, too, by deligating the vessels that supply the brain, and Flemming by compressing them, have shown that the local change is the immediate cause, and naturally the same explanation may be extended to those cases where, without there being any actual obstruction, an unequal distribution in the amount of blood is caused by some of it stagnating in a distant part of the circulation, as after a prolonged hot bath or in a crowded room, and to those also where syncope results from not a relative diminution, but an actual one, affecting this organ only in common with the rest of the body. Shock, on the other hand, however severe the degree of nervous depression by which it is accompanied, never presents such a train of symptoms as could result from the implication of a single organ : the change that has taken place, whatever it may be, seems to be universal and uniform in its distribution: all parts of the body appear to suffer alike, and very nearly in equal propor- tions : whatever structure is examined there is invariably found to be a lessening of its normal functional activity : the life of each part, its energy, and the amount of blood circulating through it, seem to have been reduced to a minimum. Even when there has been no actual loss of blood, the livid pallor and coldness of the skin, the dimi- nution of sensibility, the sluggishness of the cerebral functions, the lessened vigour of contraction and readiness to respond to stimulus shown by the muscles, the rapidit}r, smallness of volume, and compressibility of the pulse, and the partial suppression of the secretions, can point to nothing else than a general failure in the capillary circulation, such as could only result from an equally general fall in the arterial pressure. What the cause of this may be, and how it produces such effects, are the fundamental questions that underlie the pathology of shock. It is to Goltz * that we are indebted for the generally * Virchow's Archiv, xxvi. and xxix.
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