A study of the blood after splenectomy following trauma / Jerome Meyers.

  • Meyers, Jerome.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A study of the blood after splenectomy following trauma / Jerome Meyers. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    oglobin lower, only SO per cent.1 If the later figures are normal for a boy of 11, his color index should then be calculated from a basis which is his normal. Even with the first figures as a basis, a variable color index is seen with a few high figures. If the second figures are used as normal, a variable but very high color index is obtained, resembling that found in pernicious anemia; for here the percentage value of the red cells remains, with the exception of three instances, constantly far below the percentage value of the hemoglobin. Unfortunately, no leucocytic count was made soon after the accident; accordingly we have no means of comparing the degree of leucocytosis previous to the operation with the first count of 28,320 on the evening of the day of the splenectomy. The leucocytosis re- mained high until August 23, when it was 10,000; it will be noted that it never fell quite to normal, the cause being a slight wound infection. The sudden rise to 20,000 on August 17 to 28,400 on September 3 is to be explained by attacks of acute gastritis due to the eating of an excessive quantity of fruit surreptitiously given to the patient by visitors on the ward. Examin- ing the series of white counts we see that we have varia- tions with the temperature, but that the count is per- sistently above normal. Even on October 22, when the wound was entirely healed and perfectly closed, the count was yet high, being 14,100. Examining now the different leucocytic elements, it will be noted that at first with a high leucocyte count there is a marked polynuclear neutrophilic liyperleu- cocytosis with a very evident hypolymphocytosis. But as the case develops, and even in the face of ordinary inflammatory processes, it is seen clearly that the lymphocytes (adding the small and large varieties to- gether) are gradually gaining, until on August 7, with a total count of 15,600 white cells, there are only 42 per cent, of polynuclear neutrophilic leucocytes con- trasted with 53.2 per cent, lymphocytes. A hyper- lymphocytosis, absolute and relative, is surely develop- ing; on September 1 there are 34.2 per cent, poly- nuclears and 64 per cent, lymphocytes. Still, when there was a sudden rise in the number of leucocytes, 1. Blutkorperchenziihlungen und Hoemoglobinbestimmungen bei Kindern, Arch. f. klin. Med., 1889, xlv.