Note: Missing pages 11 and 55. / Hypothermia is proving its value in surgery through its ability to reduce the basal metabolism and oxygen requirements of the body tissues. This enables the tissues to withstand prolonged periods of total or partial ischemia without injury. The vascular supply to organs may thus be occluded, allowing the surgeon to work in a comparatively bloodless field with little danger of tissue damage due to anoxia.

Gallbladder disease has doubtless been present for as long as man and animals have existed, and known for as long as cadavers have been opened. There is on record a case of gallstones in an Egyptian mummy of the 2lst Dynasty. (British Museum). Since the first report of gallstones in the 14th Century, extensive studies have been carried out in an effort to determine the etiology of the condition. [...]

Renal calcinosis is a well recognised entity to-day, occurring as a complication of a wide variety of clinical conditions. It is known to shorten the span of life of the individual in most cases bi-progressive renal insufficiency. There is an everyday growing interest in the subject leading to case presentations and to accumulation of a voluminous literature on its clinical, pathological and experimental aspects. The experimental work has been concerned with the production of renal calcinosis, along with studies of its physiochemical and pathological nature.

From our studies in biology we are taught that man, like many other mammals, is a homeothermic animal, capable of maintaining the constancy of his internal enviroment. Included in this milieu interieur of Claude Bernard is the maintenance in the constancy of the body temperature through a thermoregulating mechanism. Because of this mechanism man is a warm blooded animal in contrast to the so called poikilotherms or cold-blooded animals, whose body temperature varies with that of their environment.

In the last few years, increasing attention has been paid to the pharmacological, physiological and clinical role of histamine and related compounds in the tissues of the living organism, both human and in experimental animals. Although very little is known about the beneficial role of histamine in the physiological process, except of its secretagogue action on the gastric mucosa, much evidence has accumulated in the past to show its harmful effect on the living cell.

The clinical condition of acute gastric dilatation is of considerable importance to both surgeons and physicians because of the rather sudden onset and the frequently fatal outcome if one fails to recognize it immediately. Fortunately, the event is rare, nevertheless it is serious and embarrassing because it develops usually as an unexpected complication. It is known to follow trauma, infections and particularly surgical procedures. The incidence of gastric dilatation has decreased considerably since the introduction of methods of anaesthesia and of gastric intubation in abdominal procedures. However, it still remains a problem of unknown etiology in many of the cases studied.

Recent experimental studies have thrown considerable light on some of the mechanisms acting to produce the picture of irreversible shock. These have emphasized the importance of the liver (104), the capillary “pool” (12,105), and bacterial toxins probably originating from bacteria in the portal system, and prior to this the bacterial flora of the intestines (33,37). There are, however, very few studies on the possible role or roles played by the lungs during the shock process to be found in the literature. A few authors have written on the pathological picture (69,77) which may or may not be present; others have studied the circulation of the blood (27,60) and lymph following hemormage and tourniquet shock; and still others have studied the oxygen content of the mixed venous and the arterial blood during various forms of shock (94). Careful study of these and other articles, however, does not leave the reader completely satisfied as to the actual role of the lungs. Do they have a primary function in the response of the body to the decreased circulating blood volume that may eventuate in irreversible shock? Or are they merely passive reactors in the chain of events? Undpubtedly, in tbose cases where the congestive and other changes have became advanced, the normal respiratory functions must be unfavourably effected; but is there a basic pulmonary effect that is being obscured?[...]

The search for a greater knowledge of the physiology and biochemistry involved in gastric secretion has advanced very slowly for many years. Many of the possible roads of investigation have been blocked waiting for progress in special fields. However, much investigation can be done using the present knowledge to help elucidate the extremely difficult but important problems. Any advancement in the knowledge of gastric secretion would be a valuable step forward in the understanding of this complex function and might be used to great value in many important problems including that of peptic ulcer and combined systems disease.

The electric excitability of nerves has been known since 1780-83 when Galvani(48,29) and his coworkers first applied electric sparks to exposed nerves and muscles. Since then many famous investigators have devised new or improved means of conducting a known current to a definite nerve for a prescribed period of time. The problem has always been to control the action of the nerve over a flexible period of time and to attempt to evaluate the changes caused by its action. [...]

The surgical service of a teaching hospital presents an unique opportunity for the study of the physiological and pathological response of individuals to alterations in circulating blood volume. Surgeons are frequently confronted with problems relating to the management of dehydration, massive hemorrhage, thermal and mechanical trauma and the preparation of elderly, malnourished, chronically ill patients for major operative procedures. The hemodynamic response of patients to anaesthesia and operation is an important factor determining operative mortality and morbidity rates.