The Chemistry of Pernicious Anemia. 31 



20 (1395) 



Study of the chemistry of pernicious anemia. 



By Joseph Barsky and Max Kahn. 



[From the Department of Laboratories, Beth Israel Hospital, 

 New York City.] 



In the study of three cases of pernicions anemia we found a 

 condition of marked intestinal putrefaction, with a reduction of 

 the detoxication functional capacity of the liver as evidenced by 

 the sulfo-conjugation test. While the functional activity of the 

 pancreas is normal, the intestinal digestion, investigated by means 

 of the Schmidt-Strassburger test diet, shows failure to absorb the 

 normal amount of nitrogen, there being a very high nitrogen loss 

 through the feces; the bulk of the feces is increased; the fat elimi- 

 nation is normal. The kidney function is normal. A study of 

 the functional activity of the stomach by means of the fractional 

 method reveals a complete anacidity, a total absence of pepsin, 

 an increased gastric residuum, and a negative gastroalbumorrhea 

 test. Examination of the duodenal contents, following the in- 

 vestigations of Schneider, 1 shows that the excessive hemolysis of 

 pernicious anemia is attended by both a pleochromie and a uro- 

 bilinocholie. The patients showed evidence of acidosis, as shown 

 by the carbon dioxide of the plasma and of the alveolor air and 

 by the H' ion concentration of the blood. The nitrogen partition 

 of the blood is normal, except for the high creatinine figure. The 

 blood showed an increased ash and lime content, and a normal 

 glucose, cholesterol and total lipin percentage. The urinary 

 nitrogen partition was normal. The urinary oxyproteic acid 

 fraction was increased. There was a marked increase in the 

 ethereal sulfate and neutral sulfur fractions of the urine. 



'Schneider, J. P., Arch. Int. Med., 1916, XVII, p. 32. 



