Most practitioners of wide experience have probably been puzzled at times by a class of patients presenting an anomalous grouping of general and nervous symptoms, which have passed from one physician to another; perhaps labelled as "general debility" by one, "neurasthenia" by another, "crankiness" by a third, "hysteria" by others; cases which steadily progress toward a fatal termination in spite of supporting treatment, "rest cures" and optimistic prognoses.
Occasionally a residence for a more or less prolonged period in a well-equipped hospital, or an accidental falling into the hands of some young "up-to-date" village doctor, leads to a routine blood examination and the surprising discovery is made that the patient has "pernicious anemia."
During the past decade it has fallen to my lot to have under observation a number of such patients, whose chief complaints were of a distinctly mental and nervous character, and who in the course of time
LANGDON FW. NERVOUS AND MENTAL MANIFESTATIONS OF PRE-PERNICIOUS ANEMIA. JAMA. 1905;XLV(22):1635–1638. doi:10.1001/jama.1905.52510220021001g
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