TREATMENT OF PERNICIOUS ANEMIA 253 
ings, and especially the abnormal appearance of the 
erythrocytes are considered to be pathognomic. 
ENDOCRINE ASPECTS OF PERNICIOUS ANEMIA 
The hemopoietic organs have been frequently con- 
nected with the glands of internal secretion and by 
some are believed to have an endocrine function all of 
their own. Be that as it may, the hormones, or active 
principles of the glands, evidently exert a sufficiently 
well-marked control of blood production as to render 
this aspect of the study of pernicious anemia of extreme 
importance. As will be seen hereafter in our consider- 
ation of the treatment of this disease, especial efforts 
must be directed at the removal of the cause, and this 
is preeminently proper; but the associate reéstablish- 
ment of a more nearly normal function of those hor- 
mone-producing glands which are responsible for the 
maintenance of those factors which regulate hemopoie- 
sis, must be cared for simultaneously, and this is the 
explanation of the advantages which I have secured 
from the adjuvant use of organotherapy in the routine 
treatment of pernicious anemia. The thyroid gland, 
called by one writer ‘“‘the keystone of the endocrine 
arch,” certainly plays a very important part in the 
symptom-complex of pernicious anemia and efforts to 
reéstablish normal thyroid function add materially to 
the advantages of other indicated treatment. The adre- 
nal glands evidently also have something to do with this 
condition, and since adrenal insufficiency is a very com- 
mon occurrence in pernicious anemia the principles of 
adrenal support which constitute an important phase of 
organotherapy apply with equal force in these depleted, 
asthenic individuals. 
THE METHOD OF TREATMENT 
The positive locating of the causative infection is 
essential, and it is important, as the character of the 
