THE EFFECT OF TOTAL SYMPATHECTOMY ON THE OCCURRENCE OF SHOCK FROM HEMORRHAGE

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Abstract
A condition of shock was produced in normal dogs by means of hemorrhage. This condition was characterized by hemoconc., failure to respond to blood transfusion, and characteristic pathological changes in the tissues. After total sympathectomy, even though the blood pressure was reduced to a lower level, for a longer period of time, shock was not produced. Dilution of the blood took place, there was prompt and beneficial reaction to blood transfusion, and similar pathological changes in the tissues did not occur. The sympathectomized dogs, however, were unable to tolerate as large hemorrhages as the normal dogs. The blood pressure also fell to a lower level at an earlier period than in the normal dogs. The difference in reaction of normal and sympathectomized dogs to hemorrhage was correlated with the peripheral blood flow. In the normal dog, as the blood pressure was reduced by hemorrhage to 70 mm. Hg., the blood flow was reduced below 2 cc. per min. In the sympathectomized dog, at the same level of blood pressure, the blood flow was above 2 cc. per min. In two normal dogs which recovered, although the blood pressure was reduced to between 60 and 80 mm. Hg. the blood flow continued above 2 cc. Absence of fear in these dogs probably predisposed them to recovery. Vasoconstric-tion in the presence of hemorrhage gives preferential treatment of blood supply to the vital centers, the heart and the brain. In the sympathectomized dog, such preference is lost. As long as the vital centers receive sufficient blood supply, all the tissues of the body probably receive an adequate amount of circulation, and the condition of shock is prevented.