SHOCK REVISITED

Shock revisited. The concept of shock and its close relationship with that of stress dates back to the experiments of Hans Selye initiated i n 1936 at McGill University in Montreal, with wham I collaborated betw een 1939 and 1942. It was demonstrated that the General Adaptation Syn drome begins with an Alarm Reaction, which consists of a Stage of Shoc k and one of Counter-Shock, followed by a Stage of Adaptation and fina lly a Stage of Exhaustion. My Ph.D. thesis concluded that shock was du e to an adrenal insufficiency postulating that active metabolic proces ses drain the body of certain essential compounds the lack of which ca uses shock. My interest in the role of the glucose metabolism in shock led me to work with Bernardo Houssay in 1942 at the Institute of Phys iology of the University of Buenos Aires and in 1944 with C.N.H. Long at Yale University. There I developed a method for the induction of he morrhagic shock in the guinea pig with 94% lethality; curiously, the a dministration of 200 mg of ascorbic acid prevented death. Upon my retu rn to Buenos Aires, these results were confirmed and moreover, it was demonstrated that the administration of cortisone led to 40% survival of the animals while desoxycorticosterone had no effect. At the time, no explanation was available but to-day, half a centry later, this Sym posium should be able to explain the mechanisms leading to death by he morrhagic shock.