In spite of the enormous amount of work that has been done on the subject, the question of a specific toxemia in burns is not yet settled. There are at least six distinct attitudes to be found in the literature:
1. There is no true burn toxemia (Fender,1 Lam2).
2. Infection can account for the whole picture of burn toxemia (Aldrich,3 Cruickshank,4 Marsh,5 McSwain,6 Wakeley,7 Siler8).
3. Hemoconcentration (secondary shock) can account for the whole picture of burn toxemia (Underhill and Kapsinow,9 Osterberg and others10).
4. Whatever burn toxemia really is, it cannot be explained solely on the basis of plasma loss and hemoconcentration (McClure,11 Elkington,12 Boyce,13 Harkins,14 Lee and Rhoads,15 Bosse and associates16).
5. Burn toxemia is a result of hepatic damage caused by anoxia, in turn a result of hemoconcentration and impaired
VAN DUYN J. DEGENERATIVE WHITE BLOOD CELL PICTURE AS AN INDICATION OF TOXEMIA FROM BURNS. Arch Surg. 1945;50(5):242-252. doi:10.1001/archsurg.1945.01230030251005