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My interest in this subject was aroused by the following incident: A working man who had fallen from a building was brought into the emergency ward of the Massachusetts General Hospital with a broken leg and a somewhat spastic abdomen. The possibility of a ruptured viscus was considered. The white count of 20,000 gave little information. Although far above normal, it was yet not high enough to be diagnostic of peritoneal irritation or of free blood in the abdominal cavity. The question then arose whether or not the leukocytosis might be due to the fracture. Nobody knew. A subsequent search of the literature did not reveal anything on the subject of an elevated white count in cases of fracture.
During the following year, therefore, I attempted to find out what effect a broken bone might produce on the number of white cells in the blood. For the purpose of investigation
WALTON RW. LEUKOCYTOSIS ACCOMPANYING FRACTURES: A STUDY OF TWO HUNDRED AND SIXTY CASES. JAMA. 1927;88(15):1138–1140. doi:10.1001/jama.1927.02680410014006
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