The contribution represented by the brilliant discovery of the effect of liver therapy on the management of pernicious anemia should not be allowed to obscure some of the unsolved mysteries of the disease. It is, of course, extremely gratifying to know that before the advent of the liver dietary the outlook in pernicious anemia was grave and recovery was rare, whereas today the prognosis is much better. Liver and its extracts have been used for only a few years. It becomes imperative, therefore, not to allow the early enthusiasms to awaken unwarranted hopes in every instance, and particularly desirable to continue intensive studies on the problems of the disorder. Pernicious anemia has been defined1 as a grave progressive disease interrupted by remissions "occurring without any discoverable cause whatever." It is characterized by certain changes in the blood and blood-forming organs, the central nervous system, and the gastro-intestinal tract.
THE THREATENING MANIFESTATIONS OF PERNICIOUS ANEMIA. JAMA. 1931;97(8):543–544. doi:10.1001/jama.1931.02730080035013
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