CAUSE OF SUDDEN FALL IN BLOOD-PRESSURE WHILE EXPLORING THE COMMON BILE-DUCT
Annals of Surgery
The essential feature or symptom of shock is a fall in blood-pressure, which may be clue to one or many causes. Recent experiments, particularly by Crile, have shown that in most cases shock is clue to vasomotor paralysis from exces¬ sive nervous stimulation. Shock in abdominal operations is more marked in the upper regions of the abdomen, increas¬ ing as the diaphragm is approached. Mayo has noticed the great liability to shock in operations and manipulations of the common duct. All operators
... uct. All operators of any experience agree that during these operations the pulse may suddenly become rapid and small, and the respiration shallow and frequent. These symptoms have been attributed to a temporary vaso¬ motor paralysis due to excessive insult to the great splanchnic plexus of sympathetic nerves. We began this series of experiments with the preformed idea that these symptoms were dependent on the overstimu¬ lation and insults to the sympathetic nerves, but we soon learned that our premises were wrong. Rabbits of a uniform size were the subjects of these experiments. They were in all cases anaesthetized with ether before beginning the opera¬ tion. Under complete anaesthesia the trachea was exposed and the breathing cannula inserted. This was connected with a bottle and the anaesthetic continued in this way. The carotid was then exposed and a glass cannula introduced connected with a Hurthle manometer. The records were taken on smoked paper on a revolving drum of the Porter model.