Nine years has elapsed since Minot and Murphy discovered the value of liver therapy for pernicious anemia. This period of time appears sufficiently long to allow a fair evaluation of the results achieved. But while this may hold true for the hematologic phase of the disease, there is considerable diversity of opinion concerning the neurologic aspects. This relates to two distinct questions: one is whether neurologic complications, once they have arisen, can be ameliorated or made to disappear by means of liver therapy; the other is whether adequate therapy can prevent the onset of neurologic complications in a patient not as yet affected.
In a previous study1 I reported some observations bearing on the first problem. The findings indicated that in cases of advanced subacute combined degeneration treatment with liver had negligible effects. These findings appeared in conformity with what one would anticipate from a knowledge of the underlying