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American Sunday Monthly Magazine Section
Tho Amazing Effects of
rr) T X f\ T ^ L FA Special Lecturer in Geriatrics
ljy J.j.L . Cl S'C/XG 7 ^ lYL.U. Ford ham University School of Medicine 'N.Y
r^y-V. ««^UK term shock is most frcc|uently
.. * used to denote a sudden depres-
sion of organic, nervous and vital
power, generally accompanied by
perturbation of mind and fol
lowing an injury or a profound
mental impression. A bullet
wound ordinarily produces se
vere shock, mental and physical, yet in the excite
ment of battle a bullet wound may be unnoticed
until the loss of blood produces weakness, vertigo and
collapse. The news of a calamity will produce
mental shock and this causes physical weakness
although the latter may follow so rapidly as to be
virtually simultaneous with the shock to the brain.
In physical shock which follows an injury there may
be so profound a mental depression as to amount to
coma; there may be delirium or there may be no
mental disturbance at all.
The press frequently reports accidents in which a
person was mortally injured and died from shock
yet retained consciousness to the last. There are
two explanations for these cases. It requires a
stronger mental impression to supplant a weaker
one and if there was a strong mental impression,
emotion or excitement at the moment the shock was
produced the impression produced by the cause
may not be sufficiently powerful to overcome the
other. This explains the absence of mental shock
in the heat of battle. The other explanation is
found in the disposition of some persons who are not
readily affected by pain, who are unemotional and
accustomed to sudden or startling experiences, to
the sight of blood, and other causes of shock.
While mental and physical shock generally go
together we must differentiate between the two if
we want to understand just what happens in each
case. A person under an anaesthetic, say ether,
during an operation, is perfectly unconscious and is
not susceptible to mental impressions. There is,
however, no mental depression except perhaps such as
would come with the realization of the loss of a limb,
an eye or other disfigurement. This is not mental
shock. As a result of the operation itself there would
be physical shock, the severity depending upon
the nature of the operation and the condition of the
patient. We
must remem
ber that an
operation is
virtually the
same as an
injury in its
shock - produc
ing effect upon
the body while
the anesthetic
produced un
consciousness
and thereby
prevented
mental shock.
In mild physical shock
momentary feeling of
pale, there is chi"'
gasping for breath.
A bullet wound ordinarily produces severe
shock mental and physical but—
Persons sentenced to be bled to death
have died at the sound of
water trickling
there may be simply a
faintness, the face becomes
liness, trembling and perhaps
Many persons get these symp
toms when they first enter a cold bath. In severe
shock there is sudden prostration, the skin is ghastly
pale, cold, a clammy sweat covers the forehead or
the whole body, the features are pinched, the lips
bloodless, nostrils widely dilated, the eyes sunken,
lustreless and partly hidden by the drooping eyelids.
I'he respiration is slow, shallow or gasping, the pulse
is irregular, slow and often so weak as to be scarcely
felt. In extreme cases the patient is in the state of
collapse, with all these symptoms exaggerated.
Nausea, vomiting and hiccough occur in inter
mediate degrees of shock and these also often occur
in mild mental shock. If the person suffering from
severe shock is conscious he will complain of feeling
cold and faint and that his head is swimming. There
is usually dimness of vision with black spots floating
before the
eyes, and ring
ing in the ears
while the
hearing is
sometimes ab-
normally
acute. The
shock may be
so intense as to
cause sudden
stoppage of the
heart which
means instant
death.
The good
sport says it
isn’t fair to hit a man below the belt but he probably
does not know that there is a physiological reason
for this rule. Just behind the stomach lies the solar
plexus, a collection of nerve centers sending branches
to all the abdominal organs. Branches also join
branches of nerves from the spinal cord and from
the great nerve that goes to the heart, lungs and
stomach. A shock to the solar plexus produces a
shock to every organ in the abdomen and also
to the heart and lungs. A mild shock will
temporarily paralyze the organs in the abdo
men but a severe shock will also paralyze
the heart and cause instant death. That
is the reason the solar plexus blow is so
often fatal.
Interference with the heart action causes
interference with the circulation in
the brain and for that reason the
brain is almost always affected in
shock. In a mild shock it may be
only a momentary confusion or
stunning. In severe shock the inter
ference may be so great as to produce
unconsciousness; yet cases some
times occur in which the mind is but
slightly affected. 1 n extreme shock
or collapse the mind is a blank.
Mental shock arises from some
sudden, strong, emotional excite
ment—especially a depressing
passion. This form of shock may
be so mild as to produce merely
a momentary confusion which passes away in an
instant, or it may be so severe as to cause instant
death. We have all heard of persons frightened to
death or dropping dead upon hearing of some calam
ity. In these cases the shock was so severe as to
paralyze the brain and if the brain is paralyzed the
nerve going from the brain to the heart is paralyzed
and the heart stops beating. There are many his
toric instances of persons having been frightened to
death.
Persons sentenced to be bled to death died when
they heard water trickle into a basin after a scratch
was made upon the arm. Professor Desault, the
most eminent surgeon in France in his day, intended
to operate upon a patient and marked with a pencil
the line of the proposed incision. The patient, think
ing that the operation had begun, fainted and could
not be revived. A bed
ridden woman seeing
flames before her win
dow gave one shriek
and died. Many sim
ilar instances where
fright caused death
could be related. In
stances where death
from shock followed the
receipt of bad news are
equally numerous,
although in such cases
the shock is not quite so
intense as from fright
and persons generally
In the excitement of battle a bullet wound
may be unnoticed
A shock to the solar plexus
produces shock to the heart
and lungs and every or
gan in the abdomen
recover from the shock. The after effects of shock
upon hearing bad news are more serious than if the
shock was due to fright, as the mental depression
remains and may lead to insanity. The temperament
of the individual has much to do with the effect of
mental shock. A soldier, severely wounded, was
hopeful of recovery and cheerfully submitted to a
painful examination. The surgeon thought the
wound would be fatal and told the sufferer so. The
soldier turned pale, fainted and died.
Shock has sometimes very peculiar effects. In
some cases mental shock is followed by loss of mem
ory, even the name being forgotten. The press
recently reported the death of a mysterious woman
who had been an inmate of a hospital in Philadelphia
for sixty-one years. She was picked up in the streets
suffering from some illness. She could not give her
name or any other information about herself and in
ail the years that she was in the hospital she was
unable to recall anything prior to the time that she
regained consciousness in the 'hospital. I know of a
similar case in which the shock of a fall upon the
ice produced loss of memory. This was a girl of
sixteen who after the accident was taken home.
She soon recovered consciousness and speech to
the extent that she would complain of pain and
answered rationally where the pain was but she
did not know her name, did not recognize her rel
atives or surroundings, and for over two weeks she
could not recall anything that occurred before her
fall or even the happenings of a few minutes
4 before. Memory suddenly returned after a
hysterical attack and then it was found that
she had forgotten what had occurred be
tween the time of the fall and the hysterical
attack. This period has always re
mained a blank to her. The station
master of an electric light station
in this city touched a highly charged
wire and dropped unconscious.
He describes the sensation as a
sudden crushing as though a
heavy safe had fallen upon him,
the sensation lasting but an
instant. Consciousness returned
in a few hours and he could
answer questions but he imme
diately forgot, occurrences.
It was really a semiconsciousness
from which he could be roused momentarily by a
question or by a noise, or bright light, strong odor or
slight surface irritation. Thiscondition lasted several
days then memory slowly returned. During thesefew
days he was able to make a statement of the condition
of the station and the circumstances surrounding
the accident and could sign a paper. When memory
fully returned he had no recollection of the events
during these days. Another phenomenon frequently
found as the result of shock from fright is an uncon
trollable, often groundless fear of the recurrence of
the cause of the fright. A man who lost his wife in
the Slocum disaster remarried. His present wife
promised him under oath that she would never go on
a boat unless he was with her, yet he often leaves his
work and hurries home to see if his wife is there.
The fear that his wife may be burnt or drowned often
assails him when he is at home and his wife is in an
adjoining room. If she is in sight and this feeling
overtakes him it is in the form of a dread that she
might in the future meet the same fate as his first wife.
Another popular belief is that the hair can turn
suddenly white from shock. The cases where this is
said to have occurred, happened hundreds of years
ago and no case in recent years could stand the light
of scientific investigation. Metchnikoff says the
whitening of the hair is due to the action of chro-
mophags, microscopic bodies which are formed from
the cells of the central cylinder of the hair. These
cells are converted into active bodies which destroy
the hair pigment. While I do not accept the view
that the cell is suddenly turned into a chromophag,
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