The value of color index, volume index and hemoglobin determinations in the differential diagnosis of anemias is well known. But the absence of correct normal standards for the number, volume and hemoglobin content of red cells and the inaccuracy of almost all the clinical hemoglobin methods is a great handicap.
Kern1 calls attention to the number of widely different hemoglobin figures used as 100 per cent by various authors and instrument makers (e. g., 13.8, 15.0, 15.6, 16.92 and 17.3 Gm. of hemoglobin per hundred cubic centimeters of blood). He emphasizes the importance of knowing the normal amount of hemoglobin per hundred cubic centimeters of blood calculated to a count of 5 million red cells, since this figure forms the basis for the calculation of the color index. Brown and Rowntree2 state: "The normal standard of hemoglobin is as yet unsettled; this is somewhat surprising in a substance so important."
OSGOOD EE. HEMOGLOBIN, COLOR INDEX, SATURATION INDEX AND VOLUME INDEX STANDARDS: REDETERMINATIONS BASED ON THE FINDINGS IN ONE HUNDRED AND THIRTY-SEVEN HEALTHY YOUNG MEN. Arch Intern Med (Chic). 1926;37(5):685–706. doi:10.1001/archinte.1926.00120230090006
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