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BLOOD CONCENTRATION CHANGES IN EXTENSIVE SUPERFICIAL BURNS, AND THEIR SIGNIFICANCE FOR SYSTEMIC TREATMENT

FRANK P. UNDERHILL, Ph.D.; GEORGE L. CARRINGTON, M.D.; ROBERT KAPSINOW, M.D.; GEORGE T. PACK, M.D.
Arch Intern Med (Chic). 1923;32(1):31-49. doi:10.1001/archinte.1923.00110190034003.
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In extensive superficial burns involving considerable areas of the body's surface a rapid concentration of the blood occurs, and in our opinion this hitherto unconsidered factor is of the greatest importance in the development of the syndrome characteristic of burns. Concentrated blood is a factor which cannot well be left out of consideration in the study of any diseased condition in which it manifests itself. Marked concentration of the blood means a failing circulation, an inefficient oxygen carrier, oxygen starvation of the tissues, fall of temperature, and finally, suspension of vital activities. This viewpoint was initiated during the World War by the results of an extensive investigation of the action of the lethal war gases1 which produce a noteworthy concentration of the blood as a result of the acute massive edema. Similar conditions obtain in certain cases of influenza.2

On first consideration it may be difficult to correlate reactions in

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