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January 1979

Certain Things Physicians Do: Red Cell Indices

Author Affiliations

Division of Hematology-Oncology Scripps Clinic and Research Foundation 10666 N Torrey Pines Rd La Jolla, CA 92037

Arch Intern Med. 1979;139(1):23-24. doi:10.1001/archinte.1979.03630380011004

In 1930 Wintrobe proposed a classification of anemias based on the size and hemoglobin content of the red blood cells, a system that brought nosologic order where there had been none. Now 50 years later, classifications are etiologic rather than morphologic, yet we still speak of "macrocytic anemia," "hypochromic anemia," "normocytic anemia," terms that Wintrobe introduced. He also devised the red cell indices: MCV, MCH, MCHC (for mean cell volume, hemoglobin, and hemoglobin concentration).1 These replaced "volume index," "color index," and "saturation index," which had been derived, unrealistically, from values stated in terms of percentage of an ideal normal. Coming at the time of the discovery of liver therapy for pernicious anemia, Wintrobe's proposal to classify anemia on a commonsense, mathematical basis became a part of the revolution that converted hematology from a laboratory to a clinical science.

Valuable as they were in establishing a systematic classification of anemia,