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Shock, Physiological Surgery, and George Washington Crile: Medical Innovation in the Progressive Era

Claude E. Welch, MD
JAMA. 1981;245(18):1870. doi:10.1001/jama.1981.03310430060030.
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The author began this fascinating story as a historical study of shock. He discovered that from 1890, for almost 30 years, the career of George W. Crile was inextricably entangled with investigations into the causes and therapy of this mysterious syndrome. The book thus has two purposes: it is a description of changing concepts of shock and a biography of this unusual and distinguished surgeon.

The details of Crile's life are portrayed with great sensitivity. His humble education, his great intelligence and enthusiasm, his astonishing energy, and his reliance on physiology based on clinical observations, parallel in a striking way the attention paid to shock. In 1880, little was known about it; the development of major operations led to clinical studies and intense interest, which reached their culmination in World War I. Meanwhile, the evolution of academic physiologists with new theories provided tension and controversy. Finally, the theory of Crile's


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