Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


Any one or any combination of these influences may cause shock, but the
most potent, and the one which most concerns the surgeon, is physical
injury, _e.g._, a severe accident or an operation (_traumatic shock_).
This is usually associated with some emotional disturbance, such as fear
or anxiety (_emotional shock_), or with haemorrhage; and may be followed
by septic infection (_toxic shock_).


The exaggerated afferent impulses reaching the brain as a result of
trauma, inhibit the action of the nuclei in the region of the fourth
ventricle and cerebellum which maintain the muscular tone, with the
result that the muscular tone is diminished and there is a marked fall
in the arterial blood pressure. The capillaries dilate--the blood
stagnating in them and giving off its oxygen and transuding its fluid
elements into the tissues--with the result that an insufficient quantity
of oxygenated blood reaches the heart to enable it to maintain an
efficient circulation. As the sarco-lactic acid liberated in the muscles
is not oxygenated a condition of acidosis ensues.

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