A disturbance of cholesterol and lecithin metabolism frequently accompanies anemia. The literature1 reveals, however, a considerable variation in the results obtained by many observers, even when allowance is made for differences in technic. This variation may be partly due to deficient observations on the same patient and failure to correlate the various factors involved. In pernicious anemia there is a definite relationship between the stage of the disease and the lipoids of the blood.2 Cholesterol and, in many instances, the plasma lecithin phosphorus are decreased during a relapse, but as remission is inaugurated there occurs a sudden rise in the lipoids of the blood, concomitant with the reticulocyte response. This reaction develops before there is significant alteration in the concentration of the red blood cells or hemoglobin, and is apparently proportional to the rate of remission.
In so-called secondary anemia, which is usually of the hypochromic type, the