A method for measuring quantitatively the volume of cerebral blood flow in man by inhalation of nitrous oxide (1) found its first application in a study of the cerebral circulatory effects of low CO2 tension achieved by hyperventilation; of high CO2 tension, and of high and low 02 tensions obtained by inhalation of appropriate gas mixtures (2). Only the first part of this study, the effects of active and passive hyperventilation, has been published in detail (3). The purpose of the present paper is to present the remainder of these findings and to derive from them, together with those of the hyperventilation experiments, evidence bearing on the intrinsic control of the human cerebral circulation as revealed by quantitative measurements.

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The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow and cerebral oxygen consumption of normal young men

Rupture or laceration of the aorta is a more common result of nonpenetrating traumatic injury than is generally appreciated. Approximately 15 per cent of individuals with traumatic rupture survive temporarily. If the lesion is promptly diagnosed appropriate surgical treatment may be life-saving. Diagnosis may be difficult and at times the rupture may remain clinically silent for variable periods. The natural course from aortic rupture to false aneurysm formation with secondary rupture of the aneurysm may be brief or extend over many years. Surgical treatment of a false aneurysm that has remained stable for a prolonged period has been successful, but in some instances conservative management may be the treatment of choice.

Nonpenetrating Traumatic Injury of the Aorta

SUMMARYSixty-eight convergent dorsal horn neurones have been recorded at the lumbar level in anaesthetized intact rats. All cells received prominent Aα and C fibre afferents and correspondingly could be activated by high and low threshold stimuli applied to the peripheral excitatory receptive field.

Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat.

Knowledge about the role of the right ventricle in health and disease historically has lagged behind that of the left ventricle. Less muscular, restricted in its role to pumping blood through a single organ, and less frequently or obviously involved than the left ventricle in diseases of epidemic proportions such as myocardial ischemia, cardiomyopathy, or valvulopathy, the right ventricle has generally been considered a mere bystander, a victim of pathological processes affecting the cardiovascular system. Consequently, comparatively little attention has been devoted to how right ventricular dysfunction may be best detected and measured, what specific molecular and cellular mechanisms contribute to maintenance or failure of normal right ventricular function, how right ventricular dysfunction evolves structurally and functionally, or what interventions might best preserve right ventricular function. Nevertheless, even the proportionately limited information related to right ventricular function, its impairment in various disease states, and its impact on the outcome of those diseases suggests that the right ventricle is an important contributor and that further understanding of these issues is of pivotal importance.

For this reason, the National Heart, Lung, and Blood Institute convened a working group charged with delineating in broad terms the current base of scientific and medical understanding about the right ventricle and identifying avenues of investigation likely to meaningfully advance knowledge in a clinically useful direction. The following summary represents the presentations and discussions of this working group.

The right ventricle is affected by and contributes to a number of disease processes, including perhaps most notably pulmonary hypertension caused by a variety of lung or pulmonary vascular diseases (cor pulmonale). Other diseases affect the right ventricle in different ways, including global, left ventricular–, or right ventricular–specific cardiomyopathy; right ventricular ischemia or infarction; pulmonary or tricuspid valvular heart disease; and left-to-right shunts.

The right ventricle pumps the same …

Right Ventricular Function and Failure Report of a National Heart, Lung, and Blood Institute Working Group on Cellular and Molecular Mechanisms of Right Heart Failure

Diffuse noxious inhibitory controls (dnic) .1. effects on dorsal horn convergent neurons in the rat

The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog, with a discussion of the relation between clinical congestive failure and heart disease

Studies on the estimation of cardiac ouptut in man, and of abnormalities in cardiac function, from the heart's recoil and the blood's impacts; the ballistocardiogram

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A clinical study of the action of 10 commonly used drugs on cardiac output, work and size; on respiration, on metabolic rate and on the electrocardiogram

Counterirritation has always been one of the most important methods available to physicians for the relief of pain, yet it is poorly understood and in recent years has claimed scant attention. Our purpose was to experience, study, and analyze the phenomena of counterirritation in the hope of obtaining information which would lead to the improvement of the clinical methods now in use. The extreme difficulty of evaluating a patient's statements regarding the discomfort from which he is suffering need not be emphasized. Therefore , it seemed wise to begin by inducing pain in ourselves and to experience the effects of the various forms of counterirritation upon it. The larger part of this communication is a report of such experiences. Preliminary reports have already appeared (1). In this way the stimuli commonly used in coun-terirritation-heat, cold, rubbing, scratching, etc.-were tested and their relative effectiveness assayed. Also, the utility of electrical stimulation of varying strength, duration, and frequency, was investigated. Later we performed experiments designed to give insight into the physiological mechanism of the relief secured; first on ourselves, and second, with the help of Dr. D. W. Bronk, on animal preparations. Finally, we attempted to make some use of the information gained by applying it to relieve the pains of over 80 patients. This phase of our work merits a preliminary report only. But the results have convinced us that the orditnary clinical methods of relieving pain by counterirritation are far from the best which can be devised. TECHNIQUE Methods employed to induce pain in ourselves (1) Application of irritants to the skin. When an ointment containing 3 per cent capsicum,' 10 per cent turpentine and certain other irritants was rubbed into the skin, burning pain began in about 10 minutes and lasted several I Capsolin from Parke Davis and Co. hours. By large dosage and vigorous rubbing the discomfort was made as great as could be tolerated. The pain could, however, be ended by repeated applications of petrolatum rubbed into the area and then wiped off. (2) Subcutaneous injection of irritating solutions. A 10 per cent sterile solution of NaCl proved most satisfactory for our purpose. Injection of amounts up to 0.25 cc. could be tolerated. The violent pain which followed immediately was characteristically a deep seated ache with an occasional more severe \"shooting pain\" and was sometimes accompanied by tingling. This pain lasted with little diminution of intensity for …

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Studies on the relief of pain by counterirritation

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Isaac Starr

Papers

The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog, with a discussion of the relation between clinical congestive failure and heart disease

Studies on the estimation of cardiac ouptut in man, and of abnormalities in cardiac function, from the heart's recoil and the blood's impacts; the ballistocardiogram

A clinical study of the action of 10 commonly used drugs on cardiac output, work and size; on respiration, on metabolic rate and on the electrocardiogram

Studies on the relief of pain by counterirritation

Ballistocardiogram. ii. normal standards, abnormalities commonly found in diseases of the heart and circulation, and their significance.