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chest. In severe shock the individual falls " all of a heap," as the saying is, which is exactly expressed by the word " collapse " (collapses, collabor, fall in ruins). The explanation of the condit See also:

ion is that the heart is suddenly deprived ,of its See also:

POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power to See also:

PUMP

pump See also:

BLOOD

blood up to the See also:

BRAIN (A.S. braegen)

brain which, like the See also:

FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face itself, is See also:

LEFT

left anaemic and has no power to send out See also:

CONTROL (Fr. contrdle, older form contre rolle, from Med. Lat. contra-rotulus, a counter roll or copy of a document used to check the original; there is no instance in English of the use of " control " in this, its literal, meaning)

control to the muscles. The blood at once sinks into, and remains stagnant in, the large See also:

VEINS

veins of the abdomen. And inasmuch as the condition of collapse is due to.See also:

ANAEMIA (from Gr. ay-, privative, and aiµa, blood)

anaemia of the brain, it is met with in those cases in which a sudden and serious loss of blood has been sustained, as in the " flooding " of See also:

child-See also:

bed, the giving way of an aneurism, or the opening of some large blood-See also:

VESSEL (O. Fr. vaissel, from a rare Lat. vascellum, dim. of vas, vase, urn)

vessel. It may also supervene on the rupture of a gastric See also:

ULCER

ulcer, and is then the result of the injury to which the network of nerves in the interior of the abdomen has been subjected by the sudden See also:

ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape on to them of the contents of the See also:

STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach. In severe shock the patient is See also:

PALE (through Fr. pal, from Lat. palms, a stake, for paglus, from the stem pag- of pangere, to fix; " pole " is from the same original source)

pale, and bathed in clammy See also:

PERSPIRATION (Lat. per, through, and spirare, to breathe)

perspiration; his sensibility is blunted; his See also:

PULSE

pulse is small and weak, sometimes, indeed, it is imperceptible, and even on laying the See also:

hand over the heart no cardiac impulse may be See also:

FELT (cognate with Ger. Filz, Du. vilt, Swed. and Dan. fill; the root is unknown; the word has given Med. Lat. filtrum, " filter ")

felt. The See also:

PERSON, OFFENCES AGAINST THE

person is unable to make any exertion, but lies indifferent to See also:

EXTERNAL

external circumstances, and can be roused only with difficulty or not at all. He complains of a feeling of See also:

COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

cold, and he may have a distinct shivering. These symptoms may continue for some See also:

HOURS, CANONICAL

hours. The first See also:

EVIDENCE (Lat. evidentia, evideri, to appear clearly)

evidence of improvement is that he shifts his position, becomes restless and complains of the injury.

Perhaps he vomits. The pulse becomes stronger, and he then passes from the See also:

state of shock into that of reaction. If the improvement continues, recovery takes See also:

PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place; but if it is only transient, he sinks back again into a drowsy condition, which may end in See also:

DEATH

death, for it must be clearly understood that shock may end fatally. Sometimes there is no rallying, death following the injury immediately. In cases where there is no reaction, the patient gradually becomes weaker, and his pulse feebler, till death ensues. Shock is due to an impression conveyed to the medulla oblongata, by which the See also:

NERVE (Lat. nervus, Gr. vevpov, a bowstring)

nerve-centres are so affected that a partial See also:

PARALYSIS, or PALSY (from Gr. aapal,6a , to relax; Wycliffe has palesy, and another old form of the word is parlesy)

paralysis of the voluntary and involuntary See also:

MUSCULAR

muscular See also:

fibres in the body takes place, the patient being, perhaps, unable to lift his See also:

ARM (a common Teutonic word; the Indo-European root is ar, to join or fit; cf. the Lat. armus, shoulder, and the plural word arma, weapons, Gr. apphs, joint, and the reduplicated apapilKSV, to join)

arm or move his See also:

leg. The See also:

RESPIRATORY

respiratory functions are performed wearily, and the muscle of the heart contracts feebly. The walls of the blood-vessels lose their tonicity and the vessels dilate, the blood See also:

COLLECTING

collecting in the large venous trunks, more especially of the abdomen. The vessels of the skin being emptied of blood, marked pallor ensues. The heart beats feebly because its See also:

NERVOUS

nervous See also:

ENERGY (from the Gr. ivipyela; iv, in, ipyov, work)

energy is lowered, and because it has not a sufficient quantity of blood upon which to See also:

ACT (Lat. actus, actum)

act. An understanding of these facts gives the See also:

general indications for treatment, which comprise external stimulation over the heart by See also:

MUSTARD

mustard poultices or See also:

TURPENTINE (in M. Eng. turbentine, adapted through the O. Fr. turbentine or terebentine from Lat. terebinthina, sc. resina, resin of the terebinth, Gr. eepiOtvOos or eippavOos)

turpentine stupes; See also:

ELEVATION

elevation of the limbs—to cause the blood to gravitate towards the heart, and so to the brain; See also:

MANUAL

manual pressure on the abdominal cavity from below upwards—to encourage the flow of blood from the overloaded abdominal veins into the heart. In urgent cases an injection may be given into the veins of warm See also:

WATER

water in which table See also:

salt (6o grains to a See also:

PINT (derived probably through Spanish, from Lat. pincta, pitta, a painted or marked vessel)

pint) is dissolved.

These different See also:

MEASURES

measures may be supplemented by the See also:

ADMINISTRATION (Lat. administrare, to serve)

administration of stimulants by the mouth, or, if the patient cannot See also:

SWALLOW (A. S. swalewe, Icel. svala, Du. zwaluw, Ger. Schwalbe)

swallow, by subcutaneous injection of See also:

BRANDY

brandy, See also:

ETHER, (C2H5)2O

ether or a See also:

SOLUTION (from Lat. solvere, to loosen, dissolve)

solution of See also:

STRYCHNINE

strychnine. In all See also:

PROBABILITY (Lat. probabilis, probable or credible)

probability many men have been left for dead upon the See also:

field of See also:

BATTLE

battle who were only in a state of extreme collapse; in the future many such cases will be saved by the prompt injection of ether over the region of the heart. In See also:

SYNCOPE (Gr. vvyKO7n , a cutting up or short, from Kbirrew, to cut)

syncope from mental emotion the weakened heart cannot drive a sufficient quantity of blood to the brain; the patient feels dizzy and faint, and falls down insensible. The condition is transitory and the recumbent posture, assisted if need be by elevation of the limbs, causes the blood to gravitate to the heart, which is thereby stimulated to See also:

contract. A sufficient quantityof blood is then driven to the brain, and the insensibility passes off. If the patient is in the sitting posture when he feels faint, the head should See also:

bet depressed between the knees, which will cause the blood to flow to the brain, and the faintness will pass off. Otherwise he should be laid See also:

FLAT (a modification of O. Eng. flet, an obsolete word of Teutonic origin, meaning the ground beneath the feet)

flat on his back, his head being kept See also:

low. When a collapsed person is put to bed, no See also:

PILLOW (O. Eng. pylu; Lat. pulvinus, a cushion)

pillow should be allowed, and the See also:

FOOT

foot of the bed should be raised above the level of the head. (E.

End of Article: SHOCK, or COLLAPSE

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