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This conceptual separation may refine acute shock recognition; leaves open standardization for trials and guidelines.
DEFINITION Many syndromes are grouped by investigators and clinicians under the general term "shock." Since the word has various connotations for different persons, it might well be discarded from medical nomenclature. However, no satisfactory synonym is available, and the widespread clinical use of the term seems to warrant its retention. Throughout this and subsequent publications, "shock" is used to denote a condition of acute circulatory failure characterized by prostration, apathy or stupor, tachycardia with feeble, regular pulse and, in many instances, diminished blood pressure. The temperature of the body is often subnormal. Pallor and slight cyanosis are usually present. Edema, visceral congestion and accumulations of fluid in the serous cavities do not occur in shock. The latter signs are characteristics of chronic circulatory failure ("cardiac decompensation," "congestive failure," etc.). Much confusion has resulted from a lack of complete differentiation between these two general conditions, which not only are different as
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Alfred Blalock (1927) studied this question.
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