one: Pathophysiology of Blood Loss.- A. Pathophysiology of Hemorrhagic Shock.- B. Spontaneous Regulation Processes of the Organism Following Blood Loss.- I. Losses of 500–1000 ml of Blood.- II. Larger Blood Losses.- C. Problems of Oxygen Transport.- I. Rest Conditions.- II. Jeopardy of Adequate Oxygen Supply.- III. Necessity of Erythrocyte Replacement.- IV. Evaluation of the Oxygen Supply of the Body.- V. Flow Properties of Blood.- VI. To what Extent May the Blood Volume be Replaced with Erythrocyte-free Solutions?.- D. Summary and Conclusions: Pathophysiology of Blood Loss.- TWO: Various Methods of Volume Replacement.- A. Volume Replacement Using Blood.- I. Disadvantages and Dangers of Blood Transfusion.- 1. Mortality.- 2. The Transmission of Disease.- a) The Frequency of Transfusion Hepatitis.- b) Mortality of Transfusion Hepatitis.- c) Measures for Preventing Transfusion Hepatitis.- 3. Reactions due to Bacterial Contamination.- 4. Incompatibility.- 5. Hemolytic Reactions.- 6. Allergic Reactions.- 7. Citrate Toxicity.- 8. Acidity of Preserved Blood.- 9. Temperature Drop after Addition of Larger Amounts of Cold Blood.- 10. Blood Coagulation Disturbances after Massive Blood Transfusions.- 11. Potassium Intoxication.- 12. Ammonia Intoxication.- 13. Post-transfusion Hyperbilirubinemia.- 14. Various other Factors.- 15. Reduction of Bacterial Resistance.- 16. Impairment of the Flow Properties of Blood.- 17. Survival of Transfused Erythrocytes.- II. The Volume Effect of Blood Transfusions — Therapeutic Results.- III. Summary and Conclusions: Volume Replacement with Blood.- B. Volume Replacement with Plasma.- I. The Various Plasma Preparations.- 1. Fresh Plasma.- 2. Pooled Plasma (Aged Plasma, Normal, Whole) Stored at 32° C.- 3. Human Dried Plasma = HDP.- 4. Pasteurized Plasma Protein Solution = PPS.- 5. Albumin.- II. The Volume Effect of Plasma.- 1. Fresh Plasma.- 2. Stored Pooled Plasma.- 3. Dried Plasma.- 4. Pasteurized Plasma Protein Solution.- 5. Albumin.- III. Therapeutic Results.- IV. Summary and Conclusions: Volume Replacement with Plasma.- C. Volume Replacement with Artificial Colloid-Containing Infusion Solutions.- I. Introduction.- II. Terminology.- III. The Requirements for Artificial Colloid-Containing Infusion Solutions.- IV. Physico-chemical Characterization of Artificial Colloids.- 1. Molecular Weight.- 2. Viscosity.- V. The Various Artificial Colloids.- 1. Dextran.- a) Definition.- b) General Preliminary Remarks for Evaluating Literature on Dextran.- c) The Various Dextran Preparations.- d) Compatibility of Macrodex and Rheomacrodex with Medications.- e) Colloid Osmotic Pressure and Effect, Water Retaining Capacity.- f) Metabolism.- g) Plasma Concentration, Excretion in Urine, Renal Function.- h) Histological Investigations.- i) Immunological Investigations.- k) Allergic Reactions.- l) Influence on Sedimentation Rate, Aggregating and Disaggregating Properties 7% m) Influence on Viscosity.- n) Influence upon Blood Group Determination 82 o) Influence upon Defence against Infection and Nonspecific Resistance.- p) Carcinogenicity.- q) Influence upon Blood Coagulation.- r) Pharmacological Properties.- s) Influence on Laboratory Investigations.- t) Stability During Storage.- u) The Volume Effect of Dextran.- v) Hemodynamics.- w) Therapeutic Results.- x) Summary and Conclusions: Volume Replacement with Dextran.- 2. Gelatin.- a) Definition.- b) General Remarks Concerning Evaluation of Gelatin Literature.- c) The Various Gelatin Preparations.- d) Compatibility of Gelatin Preparations with Medications.- e) Colloid Osmotic Pressure and Effect, Water Retaining Capacity.- f) Metabolism.- g) Plasma Concentrations, Excretion in Urine, Renal Function.- h) Histological Studies.- i) Immunological Studies.- k) Allergic Reactions.- l) Influence on Sedimentation Rate, Aggregating and Disaggregating Properties.- m) Influence on Viscosity.- n) Influence on Blood Group Determination.- o) Influence upon Defence against Infection and Nonspecific Resistance.- p) Carcinogenicity.- q) Influence on Blood Coagulation.- r) Pharmacological Properties.- s) Stability during Storage.- t) The Volume Effect of Gelatin.- u) Hemodynamics.- v) Therapeutic Results.- w) Summary and Conclusions: Volume Replacement with Gelatin.- 3. Polyvinyl Pyrrolidone (PVP).- a) Definition.- b) The Various Preparations.- c) Metabolism.- d) Volume Effect.- e) Summary: Polyvinyl Pyrrolidone.- 4. Starch (Hydroxyethyl Starch).- a) Definition.- b) Manufacture.- c) Metabolism.- d) Plasma Concentration.- e) Renal Function.- f) Histological Investigations.- g) Influence on Blood Coagulation.- h) Immunological Studies.- i) Influence on Sedimentation Rate.- k) Pharmacological Properties.- l) Volume Effect.- m) Therapeutic Results.- n) Summary: HO-ethyl Starch.- 5. Alginon.- 6. Levan.- D. Volume Replacement with Colloid-free Solutions.- Three: Discussion.- A. Oral Therapy.- B. Intra-arterial Infusion.- C. Hemoglobin, Oxygen Transport.- I. The Gas Phase.- II. The Blood Phase.- III. The Tissue Phase.- D. Shock Models.- E. Problems of Blood Volume Determination.- F. Colloid Osmotic Pressure, Filtration, Interstitial Pressure.- G. Comparison of the Various Possibilities which are Available for Replacement of Blood Loss.- H. Dextran or Gelatin?.- I. Practical Conclusions.- J. Concluding Remarks.- K. Outlook.- FOUR: Summary.- Literature.- Additional Literature.- Appendix to the Literature.