[Respiratory distress due to traumatic lesions in newborn infants and in adults]

1. The clinical features of the condition we presently term resipratory distress syndrome of neonates, was described by Jörg in 1832 and 1835. 2. In many, however not in all cases in which this syndrome is clinically observed, band-like ("membranous") and also massive depositions of fibrin occur in bronchioli, alveolar ducts and alveoli. They develop as the consequences of acapillary exudation process. 3. More frequently and more regularly, often combined with fibrin precipitation, intraalveolar, intrabronchiolar and intrabronchial hemorrhages arise in such cases. Peribronchial, peribronchiolar and periarterial extravasations also belong to the typical histological findings. These hemorrhages originate in capillaries during circulatory disturbance due to vasomotor excitation. 4. Excessive dilatation of the entire pulmonary vascular net, arteries, veins and capillaries, their overfilling with quite frequently conglutinated blood, is considered the basic phenomenon of the pulmonary changes. It signifies the climax of a peristasic circulatory derangement caused by vasomotor paralysis, i.e. the stanstill of an organ function. 5. A similar, pathogenetically and functionally equivalent circulatory interruption occurs in many other organs of the neonate. 6. Typical birth traumatic cerebral lesions, hemorrhages and softening processes ensue in the majority of cases of the respiratory distress syndrome. We consider them to be the cause of the generakl circulatory paralysis and therefore also of the respiratory dysfunction. 7. The respiratory distress syndrome represents a partial manifestation of the neonatal parturitional crisis, displaying many resemblances to a shock of traumatic origin. 8. Resipratory distress and morphologic pulmonary lesions observed in neonates are identical with acute clinical, pathophysiological as well as pathoanatomical finidings in adults, victims of cerebral of extracerebral traumatic or of other critical, sudden interventions. 9. The lungs with their extraordinarily rich vascularization and their insertion in the cenyer of a systme exposed to hormonal and nervous influences, belong to organs which frequently produce deleterious instant reactions...