Following the early descriptions of pernicious anemia by Combe,1 Addison2 and Biermer,3 other investigators reported the occurrence of changes involving the nervous system in patients suffering with this disease. Lichtenstern4 described certain lesions of the spinal cord, Hamilton and Nixon5 reported symptoms which they ascribed to peripheral neuritis, and Woltman6 called attention to involvement of the brain. The pathology of lesions of the central nervous system has been described by many investigators. There is also an abundance of literature on the clinical symptoms and signs with reference to the neural and psychic changes.
REVIEW OF THE LITERATURE
Numerous theories have been advanced regarding the etiology of pernicious anemia and the associated neural manifestations. Several British investigators, most notably Hurst,7 have stated the belief that the predisposing factor is achylia, and that the anemia and subacute combined degeneration of the cord are caused by
K. C. SMITHBURN, L. G. ZERFAS. THE NEURAL SYMPTOMS AND SIGNS IN PERNICIOUS ANEMIATHE EFFECTS OF LIVER EXTRACT. Arch NeurPsych. 1931;25(5):1100–1110. doi:10.1001/archneurpsyc.1931.02230050176009