The contributions of Cannon, Blalock, Wiggers, Moon, and others have thrown much light on the pathogenesis of traumatic and hemorrhagic shock. In recent years attention has been focused on the etiology of shock associated with infection from Gram-negative bacteria. Spink, in the current issue of the Archives of Internal Medicine (Sept. 1960), reports clinical studies on this subject which were initiated ten years ago in the Department of Medicine at the University of Minnesota Medical Center. Shock was observed particularly in elderly patients; it was characterized by peripheral vascular collapse. In a study of 278 cases of bacteremia due to Gram-negative bacteria observed between 1950 and 1955 it was found that 43 patients suffered shock. The mortality rate was 65%.
In a more recent group (1955 to 1959) studied in the University Hospitals of Minneapolis there were 41 patients with peripheral vascular collapse due to infection. Of these 41 patients