Nature and Treatment of Septic Shock

The occurrence of circulatory failure, falling blood pressure, and a shock-like state during a severe infection is a serious complication. Death is usually imminent within hours, and treatment is generally unsuccessful. Shock, associated with sepsis, has been recognized for many years, having been described by Laennec in 18311and Boise in 1897.2More recently, Ebert3has emphasized the frequent occurrence of this complication on medical wards in relation to infections, and Davies4has described seven cases subsequent to ruptured abdominal viscera. Relatively little is known concerning the pathologic physiology of shock associated with infection, and it is obvious that more detailed knowledge would be helpful in the search for any improvements in therapy. A review of the published work5-18indicates that at least four factors may be concerned with its development. A loss of fluid from the circulation, resulting from dehydration, persistent vomiting, continued diarrhea, or massive exudation into