All clinicians agree that the diagnosis of appendicitis must rest on an interpretation of the clinical history and the physical signs rather than on a laboratory test. However, surgeons have often been impressed with the lack of correlation between the clinical manifestations of appendicitis and the observations at operation and the microscopic pathologic aspect of the appendix. Any laboratory test which aids in preoperative differentiation between inflammatory and noninflammatory conditions or which can serve as an index of the severity of the infection should prove of value.
It is desirable that the stage, severity and complications of appendicitis be determined as accurately as possible before operation. This is particularly important in clinics where the conservative (Ochsner) treatment is employed in selected cases. In this connection the history and physical signs are of foremost importance. The duration of symptoms, the change in the character, location or severity of the pain and