The possible relation between pernicious anemia and "primary," or "idiopathic," hypochromic anemia has been emphasized in a number of reports. The common denominator in these conditions may lie in a disturbance in the gastric secretion. Castle and his collaborators1 demonstrated the importance of a defect in gastric secretion in the pathogenesis of pernicious anemia. Davies,2 Dameshek,3 Hartfall and Witts4 and others found either complete achlorhydria or distinct hypoacidity in the great majority of their cases of "primary," or "idiopathic," hypochromic anemia. It has, furthermore, been noted that complete gastrectomy or a widespread malignant condition of the stomach is not infrequently followed by the development of either the "liver extract" deficiency or the iron deficiency type of anemia.5
The relation between pernicious anemia and "primary" hypochromic anemia was first suspected when it was noted that achlorhydria was often familial.6 It was occasionally reported that one or more members
MILLER EB, DAMESHEK W. "PRIMARY" HYPOCHROMIC ANEMIA TERMINATING IN PERNICIOUS ANEMIA: REPORT OF TWO CASES. Arch Intern Med (Chic). 1941;68(3):375–394. doi:10.1001/archinte.1941.00200090002001
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