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722 GENERAL PATHOLOGY.
not shown that the blood-vessels will recover their tone so readily as
the heart, but, on the contrary, experiment and clinical observation
combine in the illustration of the fact that their enfeeblement is recov-
ered from with much greater difficulty.
The molecular disturbances in shock should not be passed over without
notice. All function is directly dependent upon remolecularizations of
matter, or at least molecular motion or chemico-vital changes in some
form. This is the opinion of the scientific world at the present time.
In the performance of labor by the muscles the sarcose material of the
fibres undergoes molecular changes with every contraction, and these
changes result in the formation of waste products which are eliminated.
Therefore if these changes occur with such rapidity that this cannot be
resupplied by the nutrient functions in the necessary proportion, the
muscle becomes exhausted ; rest is then necessary that nutritive repair
may bring the muscle up to the normal standard again. That which
is true of the muscles is true also of other tissues. If in any case a
functioning tissue is called upon for an extraordinary expenditure of
energy, exhaustion occurs very quickly. In the case of shock the ner-
vous system is overcome, and fails either partially or altogether in the
performance of certain of its normal functions, such as that of main-
taining the usual tension of tlie circulating system, and to a lesser
degree, perhaps, that of cerebration and the voluntary motions. This,
however, is not the only injury that occurs in shock. Under some cir-
cumstances the life-force as it exists in the individual cell is unable to
carry forward in the normal manner its remolecularizations of matter
in the processes of nutrition and denutrition, and the changes become
abnormal, resulting in the formation of substances unhealthful in quality
or quantity. This is seen in fatty degeneration. The tone of the life-
force as it exists in the individual cells is lowered to such a degree that
the matter of wliich the cell is composed, instead of passing regularly
on to the formation of waste products in the normal manner, falls into
the molecular groupings of oil. This oil gathers in the form of minute
globules in the midst of the cell, instead of passing away with the
normal waste products; which circumstance permits of its discovery
by means of microscopic examination—a thing that would be impossi-
ble if the abnormal substance were more soluble. Changes of a similar
nature undoubtedly occur in shock, though they difter in the character
of the products. Just what these changes are is unknown, but the
evidence that they occur is to my mind conclusive. It has long been
known that fright, or any other form of mental impression productive
of a slight degree of shock, is liable so to change the milk of the
nursing woman that it will act as a poison to the child. This can be
explained only on the supposition that the chemico-vital changes—the
remolecularizations of matter—which take place in the formation of the
waste products, and in the elaboration of the secretions as well, have
been imperfectly, or at least improperly, carried on, and have resulted
in the formation of abnormal molecular groupings, thus giving rise to
chemical substances that prove injurious.
In the discussion of the subject of fever it Avas explained that it
was always the effect of a material cause. One of the most common