Reports of Societies

1900 Boston Medical and Surgical Journal  
two cases of acute hemorrhagic pancreatitis, with counts of 9,200 and 22,800 ; eight scattered cases of tuberculosis, with an average of 10,912 ; two cases of suppuration of the knee-joint, 24,000 and 21,200. To summarize all these cases, 189 non-inflammatory eases, such as cysts, fibroids, extra-uterinos, tumors, chronic appendicitis, gall-stones, etc., were averaged, giving 8,811 ; 71 cases of inflammation not so great as to form pus, with an average of 12,645 ; and 299 cases of pus
more » ... es of pus formation, with an average of 17,696. These averages show a slight increase from the noninflammatory to the inflammatory and again to the purulent cases. On the average, blood counts may be of value, but now in individual cases in the non-inflammatory group the counts varied from 4,000 to 25,800, in the simple inflammatory from 5,600 to 32,000, and in the purulent from 4,800 to 47,000. The counts that are common to all three lie somewhere between 5,600 and 25,800. As most of the counts fall within these limits, they are of no practical value to the surgeon when brought'face to face with an individual ease, and the blood count should have very little weight ¡is compared to the physical signs in helping him to the diagnosis. From our present knowledge of the causes and variations of leucocytosis we cannot yet make any deductions which are simple enough to be of any great use to the surgeon at the bedside. Doubtless hidden truths might be discovered by juggling with the above counts, but the paths to them would be too tortuous to follow except for scientific investigation. . To end this paper, let me cite one more case, showing how the blood count may point exactly, as we understand it at present, opposite to the physical signs : An abdominal case entered the hospital on October 10th, the second day of illness, with a white count of 19,000, temperature 102°, pulse 108. The abdomen was uniformly rigid and distended. The diagnosis of appendicitis was made. The next day the temperature was 101°, and there were less pain and distention, and yet the blood count had risen to o,400. The symptoms were never severe enough to Warrant an operation, and the initient recovered.
doi:10.1056/nejm190004191421606 fatcat:egt3fj3qvjdrnactxnpru7vgza