A study of sedimentation rate of the erythrocytes

Abstract

1. An abnormal rate of sedimentation of the erythrocytes is a non-specific phenomenon, occurring during the later months of pregnancy and in the puerperium, in cases of malignancy, in all acute inflammatory and infective processes, in active rheumatism, in chronic infections, including syphilis and tuberculosis, and after surgical operations.

2. Slight alterations in the S.R. have no definitely pathological significance.

3. Estimation of the S.R. is of definite value in clinical medicine, the rate being a delicate index of the activity of the disease in rheumatism and in tuberculosis. In practically all the other conditions associated with an increased S.R., however, the sedimentation test supplies no more valuable information than can be obtained from a careful and systematic clinical examination.

4. In rheumatism, the sedimentation test is a valuable guide in treatment and in following the course of the disease, giving more reliable information as to the activity of the disease process than the temperature, pulse -rate or subjective symptoms of the patient. (The same statements hold good in respect of the value of the test in pulmonary tuberculosis.)

5. The sedimentation test, which is already in use in the routine examination of cases of pulmonary tuberculosis, ought to be employed similarly in cases of rheumatism.

6. The sedimentation test is further of value in indicating the presence of an infective process in surgical cases where the diagnosis is in doubt. This is especially to be remembered in dealing with female patients who may have an unsuspected focus of infection in the pelvis, and the test might with advantage be employed before operation in gynaecological cases.

7. In obstetrics, the sedimentation test has little or no practical value.

8. In view of the non-specific nature of the phenomenon of sedimentation and of the unexpected findings sometimes met with in performing the test, the results must always be interpreted and used in conjunction with a careful clinical examination in every case.