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The Physiologic Effects of Wounds

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MEDICAL DEPARTMENT, UNITED STATES ARMY

SURGERY IN WORLD WAR II

THE PHYSIOLOGIC EFFECTS OF WOUNDS

By

THE BOARD FOR THE STUDY OF THE SEVERELY WOUNDED
North African-Mediterranean Theater of Operations

OFFICE OF THE SURGEON GENERAL
DEPARTMENT OF THE ARMY
WASHINGTON, D. C., 1952


The volumes comprising the history of the Medical Department of the U.S. Army in World War II are divided into two series: (1) The Administrative and Operational series which constitutes a part of the general series of the history of the U.S. Army in World War II, published under the direction of the Office of the Chief of Military History, and (2) the Professional, or clinical and technical series, published as The Medical Department of the United States Army under the direction of the Office of The Surgeon General. Both series are being prepared by the Historical Unit, Army Medical Service. This volume is one of a number of surgical volumes to be published in the latter series.

Major General George E. Armstrong, The Surgeon General

Advisory Editorial Board

Brig. Gen. Albert G. Love, U. S. A. (Ret.), Chairman
Maj. Gen. Paul R. Hawley, U. S. A. (Ret.)
Brig. Gen. Stanhope Bayne-Jones, A. U. S. (Ret.)
Brig. Gen. Malcolm C. Grow, U. S. A. F. (Ret.)
Brig. Gen. Raymond A. Kelser, U. S. A. (Ret.)
Brig. Gen. Paul I. Robinson, U. S. A.
Col. Joseph H. McNinch, MC, U. S. A.
Michael E. DeBakey, M. D.
Morris Fishbein, M. D.
J. Ben Robinson, D. D. S.
Richard H. Shryock, Ph. D.
Lewis H. Weed, M. D.

Editors of Surgical Volumes

Fred W. Rankin, M. D.
Michael E. DeBakey, M. D.

Colonel Calvin H. Goddard, MC, A.U.S., Editor in Chief


For sale by the Superintendent of Documents, U. S. Government Printing Office
Washington 25, D. C. - Price $3.50 (Buckram)


THE MEDICAL DEPARTMENT OF THE UNITED STATES ARMY

The Physiologic Effects of Wounds

By

The Board for the Study of the Severely Wounded
North African-Mediterranean Theater of Operations

Members

Henry K. Beecher, M. D.
Formerly Lt. Colonel, MC, A. U. S.

Charles H. Burnett, M. D.
Formerly Major, MC, A. U. S.

Seymour L. Shapiro
Formerly Captain, SnC, A. U. S.

Fiorindo A. Simeone, M. D.
Formerly Colonel, MC, A. U. S.

Louis D. Smith, Ph. D.
Formerly Captain, SnC, A. U. S.

Eugene R. Sullivan, M. D.
Formerly Lt. Colonel, MC, A. U. S.

Tracy B. Mallory, M. D.*
Formerly Lt. Colonel, MC, A. U. S.
Chairman
*Deceased

Report of the Board edited by Henry K. Beecher.

This volume was prepared by the Historical Division, Army Medical Library, under the direction of Colonel Joseph H. McNinch, MC, U. S. A., Editor in Chief; Associate Editor, Sylvia Gottwerth.


Contents

FOREWORD

PREFACE

INTRODUCTION

Chapter

I - INTERNAL STATE OF SEVERELY WOUNDED MEN ON ENTRY TO THE MOST FORWARD HOSPITAL

II - LIVER FUNCTION IN THE SEVERELY WOUNDED

III - RENAL FUNCTION IN THE SEVERELY WOUNDED

IV - DIAGNOSIS OF LOWER NEPHRON NEPHROSIS RESULTING FROM TRAUMA AND SHOCK ("SHOCK KIDNEY"): CLINICO-PATHOLOGIC CORRELATION

V - CLINICAL, PHYSIOLOGIC, AND BIOCHEMIC CORRELATION IN LOWER NEPHRON NEPHROSIS

VI - TREATMENT OF LOWER NEPHRON NEPHROSIS

VII - EFFECT OF ALKALIS IN TREATMENT OF TRAUMATIC SHOCK

VIII - PIGMENT MOBILIZATION IN SEVERELY WOUNDED MEN

IX - PATHOLOGY OF THE KIDNEY IN TRAUMATIC SHOCK

X - SULFONAMIDES IN RELATION TO "SHOCK KIDNEY"

XI - THE CRUSH SYNDROME IN BATTLE CASUALTIES

XII - GENERAL PATHOLOGY OF TRAUMATIC SHOCK

Appendixes

A - ORGANIZATION AND OPERATION OF THE BOARD FOR THE STUDY OF THE SEVERELY WOUNDED

B - THE FIELD LABORATORY

C - BIOCHEMIC METHODS

D - SURVEY OF CASE RECORDS