Addison (1855) in his classical description wrote of the patient's mind “as occasionally wandering” during the final stages of pernicious anaemia. The relative frequency with which different psychiatric syndromes present differs from that recorded by previous writers and is probably due to earlier psychiatric consultation in the present group, though mode of referral may also play a part. Bowman (1935) found organic confusion in 48 per cent., a death rate of 35 per cent. and a red blood cell count of below 4 0 million in 65 per cent. of his 23 cases. Herman, Most and Joliffe (1937) found organic confusion in 35 per cent. compared with the present writer's 5 per cent., a death rate of 22 · 5 per cent. compared with 10 per cent. and a red blood cell count of under 3 · 0 million in 75 per cent. of his 40 cases, compared with 25 per cent. of the present group.