TREATMENT OF PERNICIOUS ANEMIA 257 
physicians was that he would not live one month. Five 
months after treatment was initiated, he passed the 
army examination and worked in a chemical laboratory 
during the balance of the war. Since his cure he has 
remained well and very active. The blood count and 
hemoglobin are normal, and the color index is below 
one. He has been in perfect health for over two and a 
half years. 
Mr. C., aged 34 years, was transfused at Rochester, 
Minnesota, sixteen times. He also had twelve intra- 
venous injections of Neo-Salvarsan, as he had shown a 
slightly positive Wassermann, despite the fact that 
there was no known infection. The condition from 
which he suffered was diagnosed as typical pernicious 
anemia and not syphilis. The cause was diagnosed by 
me as due to an infected gall bladder, and after three 
months of the above treatment, the blood was tested 
and the hemaglobin found to be 80 per cent., while the 
red cells were 3,800,000 with a white count of 6,000 per 
cu.mm. The food was digesting well and at this time 
the gall bladder was removed, forty-two stones having 
been found therein. Unfortunately, the renal function 
seemed to have been paralyzed from the anaesthetic 
and there was complete anuria after the operation. The 
patient died forty hours later from uremic poisoning. 
Mr. C., aged 56, ill for four years. Pernicious anemia 
was first diagnosed in Chicago, and later in St. Louis. 
He went to Rochester, Minn., where the diagnosis was 
confirmed and had over twenty transfusions of blood at 
various places. 
The blood findings were as follows: Hemoglobin, 20 
per cent. ; red cells, 1,000,000; white cells, 3,000. A his- 
tory of an old peritonitis was the only evidence of a 
previous infection. The urine was found to be loaded 
with bile and treatment similar to that mentioned 
above was carried out. The appetite did not seem to be 
particularly bad, and during treatment it became still 
better. The blood findings increased to hemoglobin, 44 
per cent.; reds, 2,000,000; whites, 5,800. He then suf- 
fered from an acute dysentery, which lasted forty-eight 
hours, and died. The post mortem disclosed a greatly 
distended gall bladder, an old septic appendix, and 
adrenal glands which were almost entirely obliterated. 
No other striking condition was found. 
