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SPECIAL CONTRIBUTION |

Septic Shock

Jacob Fine, MD
JAMA. 1964;188(5):427-432. doi:10.1001/jama.1964.03060310027006.
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In THIS STATEMENT I will undertake to demonstrate that when traumatic shock fails to yield to appropriate treatment, death occurs because of the injury produced by a persisting deficiency of flow in the splanchnic circulation. Furthermore, as a corollary of this proposition, evidence will be given that treatment to improve flow in this area can succeed in relieving the state of shock when all other methods fail. This thesis will be stated in the form of an argument, followed by the evidence in support of it and, finally, by a summing up in which other views are considered.

The Argument  The critical feature common to all forms of traumatic shock is an acute and persisting deficiency of flow through the peripheral vessels. The longer it persists, the more likely the resulting injury will become irreversible, in which case death will follow in a matter of hours. The threat to life

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