Mechanism of traumatic shock.

Although many attempts have been made to demonstrate the existence of a shock-producing toxin, little success has been attained. Traumatic shock is generally believed to be caused by simple loss of blood. Evidence is presented that tissue trauma causes hemolysis. Although hemoglobin is harmless, the stroma of the broken red cells is a clotting stimulant which, in the presence of the slow capillary flow of hemorrhagic shock, sustains a continuing disseminated intravascular coagulation. This disseminated intravascular coagulation produces a clotting defect, morbidity and death. The condition is not responsive to intravenously administered fluids but is responsive to fibrinolysin therapy.