PERNICIOUS ANEMIA

Abstract

The use of liver in pernicious anemia, following the discovery of its therapeutic value by Minot and Murphy,¹ has greatly increased the knowledge on the nature of blood regeneration during remission in this disease. The contributions to this subject of Peabody² and of Minot, Murphy, Cohn and their associates³ have been particularly valuable. According to their observations, the fundamental defect in hematopoiesis during a relapse in pernicious anemia depends on the inability of the primitive red blood cells of bone-marrow to differentiate normally to their adult state. As a result, the hematopoietic tissue of bonemarrow becomes hyperplastic and crowded with megaloblasts. The regenerative activity of bone-marrow being restricted in this fashion, the numbers of red blood cells in the peripheral blood decrease, and many of those present are abnormal. The liver,⁴ kidneys⁵ and stomach⁶ contain a substance which appears to stimulate the maturation of the primitive red blood cells and