Occasions frequently arise when it is extremely difficult to make a diagnosis of pernicious anemia with absolute certainty. This difficulty has been enhanced since the discovery of the efficacy of liver1 and other potent materials2 because of the widespread tendency of physicians, before making every effort to reach a definite diagnosis, to treat all patients with anemia, and often patients with vague neurologic disturbances, as if they had pernicious anemia. The premature feeding of potent material will often so mask the natural course of the disease and the typical morphologic changes in the blood that two of the most valuable diagnostic aids will be lost.
The result of this tendency to treat anemic patients as patients with pernicious anemia naturally leads to a certain degree of uncertainty on the part of both patient and doctor, so that ultimately the treatment will be carried out half-heartedly, and the patient
BEEBE RT, WINTROBE MM. DIAGNOSIS OF OBSCURE CASES OF PERNICIOUS ANEMIA. Arch Intern Med (Chic). 1933;51(4):630-637. doi:10.1001/archinte.1933.00150230145006