As far as we now know, pernicious anemia is the result of a toxemia. The symptoms and course of the diseases are clearly in accord with this, and the study of the bothriocephalus anemias permits scarcely any other conclusion. What the exact nature of this toxin is is still a matter of speculation and doubt. It is generally agreed, however, that its origin is somewhere in the alimentary canal. The study of the bacteria in the intestinal canal has gone far towards establishing this consensus. In a recent publication by Dr. C. A. Herter, it is definitely shown, for instance, that the B. aerogenes capsulatus is an active hemolytic agent, and that when the B. coli type is sufficiently meager to permit a very large and free growth of the B. aerogenes alterations in the blood gradually appear and ultimately the blood picture of either a secondary or a
LICHTY JA. THE EARLY OR PREMONITORY SYMPTOMS OF PERNICIOUS ANEMIA.. JAMA. 1907;XLVIII(26):2177–2180. doi:10.1001/jama.1907.25220520007002c
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