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 reestablish- 

 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 

 reestablish 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 



