W. W. Duke and His Bleeding Time Test: A Commentary on Platelet Function

The 1910 article by Duke¹ on platelets and bleeding has been judged by history to be one of the outstanding contributions to the science and practice of medicine during the first half of this century. In this article, Duke made two tremendous contributions. First, he firmly established with excellent data for the times that platelets are needed for hemostasis and that thrombocytopenia is associated with purpura and other hemorrhagic manifestations. The important role of platelets in the formation of thrombi had already been established in the 1880s by the work of Eberth and Schimmelbusch, Bizzozero, and Hayem. However, the origin of the platelets was uncertain. Hayem erroneously believed they were derived from red cell precursors, a view Osier gently ridiculed with the statement: "I have spent many weary hours over them, but I never caught one 'blushing.' "² In 1905, Wright demonstrated the platelet derivation from the megakaryocyte. Spaet,