ABSTRACT
When exposed to a series of noxious stimuli such as surgical insults and bacterial infection, the autonomic nervous system exhibits supraphysiological responses and thereby causes nonspecific vasomotor derangements in multiple organ systems. This phenomenon, known as irritation syndrome, was proposed in the late 1930s by Dr. James Reilly, a French experimental pathologist in Claude Bernard Hospital. When he studied the pathophysiology of typhus, he recognized that, independently of the nature of the stimulus (e.g., bacterial toxin, surgical insult, temperature changes), application of excessive levels of the stimulation (irritation) in a particular local organ evoked autonomic nervous perturbation which in turn caused hemorrhagic changes in a variety of organs including lung, stomach, and adrenal glands (1). Prior to the occurrence of the hemorrhagic changes, the organ hemodynamics exhibit a biphasic fluctuation similar to ischemia-reperfusion that results from alternate excitation of sympathetic and parasympathetic nervous systems.
