ABSTRACT
Attempts to define the pathophysiology of shock are as old as the practice of medicine itself. Hippocrates (460-380 B.C.) recognized the state, following traumatic wounds with significant blood loss. He described the Hippocrates facies of a person in the premorbid state from shock, and suggested the use of a tourniquet to control blood loss. Galen (130200 A.D.) described ligation of the bleeding vessel to control blood loss, though the technique did not gain widespread acceptance till the work of the French surgeon Ambroise Pare (1510-1590). At about the same time, the groundbreaking work of Andrea Vesalius (1514-1564), and of William Harvey (1578-1657), helped elucidate the anatomy and circulation of the cardiovascular system. The term ‘‘shock’’ itself appeared for the first time in the medical literature in 1743 in an English translation of Henri Francois Le Dran’s (1685-1770) A Treatise, or Reflections Drawn from Experiences with Gunshot Wounds. It referred to a violent physical impact, rather than the physiological changes as a consequence of the impact. The term was used to describe such physiologic sequelae, following major trauma, by George James Guthrie (1785-1856) in his book On Gunshot Wounds of the Extremities, published in 1815.
