[Central problems in the general pathology and pathologic anatomy of shock]

From the results of detailed clinico-anatomical studies of traumatic, exotoxic, burn, cardiogenic, bacterial, hemorrhagic, and other kinds of shock (1500 observations) and the data of the literature, the paper analyses some disputable aspects of shock: the role of neurogenic factors and vasomotor disorders in its pathogenesis, shock and collapse relationship, possibilities of shock diagnosis at autopsy, the concept of shock organ and shock cell. The importance in the pathoanatomic diagnosis of shock of hemodynamic disorders (sequestration of blood in the microcirculatory bed, shunting of the bloodstream in vital organs) and of hemocoagulation (liquid state of cadaver blood, DIBC) as well as of rapid mobilization of glycogen from tissue depots (liver) and circulatory-hypoxic injuries to the internal organs. The specific features of the individual kinds of shock are determined by different combinations of the above signs or predominant involvement of some internal organ. The lack of a single complete definition of the shock organ concept is indicated. The importance in the pathogenesis of shock of hemodynamic disorders, complications of the main disease, and pathology of therapy (the third factor) is emphasized.