Below is the OCR text representation for this newspapers page.

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, (Continued on pane iS)