Abstract
Dr. Donald Skinner: A 53-year-old man was struck by an automobile, and a few minutes later he was admitted to the Emergency Ward at the Massachusetts General Hospital. He was unconscious, and his blood pressure was 55/0 mm Hg. He had sustained multiple injuries, including open fractures of his tibia and fibula bilaterally, evidence of contusion of the right side of the temple, and a right flank hematoma. On physical examination his chest was symmetrical; his lungs were clear to percussion and auscultation, and there was no evidence of either external chest trauma or injuries to the osseous thorax. His neurological examination revealed a dilated pupil on the right, but otherwise was unremarkable. He regained consciousness, and his blood pressure returned to normal levels after he had received 1500 cc of whole blood. At this time it was also noted that there was blood behind his left ear drum which
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