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. 



