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July 1936


Author Affiliations


From the Department of Medicine, Division of Neuropsychiatry, Stanford Medical School.

Arch Intern Med (Chic). 1936;58(1):45-59. doi:10.1001/archinte.1936.00170110053004

The experimental work of Whipple and his associates on anemia, leading to the clinical application of liver therapy by Minot and Murphy in 1926, is one of the brilliant chapters of achievement in American medicine. Owing to these researches physicians are now able better to understand and control the disease of the blood classified as pernicious anemia. One of the serious complications of this condition is a degenerative process of the spinal cord designated as combined sclerosis because of the pathologic areas of gliosis resulting from degenerative processes in the most involved portions of the cord, the posterior and lateral fiber tracts. A far better nomenclature for this disease is subacute myelinic degeneration, for the fibers in the brain may also be involved, and there is evidence of involvement of the myelin sheaths of the peripheral nerves as well.

The neural complications may be present without appreciable anemia and may

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