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July 1945


Author Affiliations

Montreal, Canada. Medical Arts Building.

Arch Intern Med (Chic). 1945;76(1):60. doi:10.1001/archinte.1945.00210310068009

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To the Editor:  I should like to present the following concept of pernicious anemia and related macrocytic anemias for the consideration of your readers. Just as pellagra is no longer considered a "disease" if the skin, gastrointestinal tract or nervous system lut is classified rather as a vitamin deficiency disorder, manifested by a disturbance in the metabolism of probably every tissue cell, so, too, the known facts relating to pernicious anemia may be construed to define not a "blood disorder" but one which affects the metaboism of diverse systems of the organism.Thus, the "intrinsic factor," possibly an enzyme secreted into the stomach (Lasch [1937], Taylor [1938], Kessler [1940]), acts on the "extrinsic factor," possibly iome portion of the vitamin B complex (Goodall [1932], Ungley [1933 and 1934], Strauss [1932], Wintrobe [1939]), with the resultant formation of a thermoabile substance which is conveyed to the liver by way if the blood stream. The

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