Carious teeth are seen extremely com monly in this disease; inflammation of the mouth and tongue is also exceedingly common, as are gastric symptoms; the gastric catarrh is of an infectious nature and is dependent upon the caries of the teeth. The original infection may usu ally be traced to the teeth. Sometimes to drain poisons. Hunter (Lancet, Jan. 27, 1900).
Case of pernicious anaemia following on traumatic stricture of the small in testine. The necropsy confirmed the diagnosis of pernicious anaemia. The ex amination of the blood presented a typ ical picture of that disease. The patient had always had bad teeth, with alternate alveolar and ethmoidal suppuration, and chronic gastric catarrh, thus bearing out Hunter's idea as to pernicious anmmia being due to self-intoxication from the intestinal tract. A. E. Barker (Lancet, July 21 1P00).
Eighteen cases of bothriocephalus laths anmmia and 3 of pernicious ante 'ilia showed that, before removal of the worm, increased decomposition of albil min was present, while after removal of the parasite albuminous metabolism was not as greatly affected. Decomposition of albumin is probably due to some toxin produced by the worm. E. Rosen quist (Berliner klin. Woch., June 24, 1901).
Conclusions regarding the enteroge nous origin of pernicious anmmia from experiments performed on metabolism are not tenable because we do not al ways know under what form of diet the disease occurs. Personal disposition must be taken into consideration. Many theories are exaggerated; the symptoms present in pernicious anmmia frequently exist without serious blood changes being present. E. Grawitz (Ber liner klin. Woch., June 17, 1901).
The spleen is generally thought to pre sent no characteristic lesion, although the amount of iron in it is usually in creased.
Case in which there was, besides severe lmmolysis, sclerosis of the spleen and. pancreas, with marked changes in the suprarenal capsules. Douglas Stanley (Brit. Med. Jour., Feb. 16, '95).
Case in which a microscopical exami nation of the spleen showed no increase of connective tissue and a marked diminution of cellular elements, both of the Malpighian bodies and of the spleen pulp. In many of the Malpighian bodies the small, round cells were entirely want ing. A slight reaction for iron, hmmo siderin, was developed by potassium ferrocyanide and acidified glycerin, but it was much less marked than in the liver. There was no granular pigment
observed as a result of the extensive de struction of the red blood-cells. James Ewing (Med. Record, Sept. 5, '96).
Case in which the total quantity of iron found in the liver was 0.2433 per cent, by weight calculated to the fresh undricd tissue. This is equivalent to about 0.72 per cent. in the dried tissue. The estimation accords fully with the observations of previous observers, as showing the very great increase in the iron contained in the liver in this disease. R. V. Ruttan and J. G. Adami (Brit. Med. Jour., Dec. 12, '96).
The jaundice is probably due to accu mulation of iron in the hepatic system.
Fatal case of pernicious anaemia in a woman aged 49. Chemical examination of liver, spleen, and kidney showing that the liver contained a large proportion of iron in the ferric state, while the spleen was free from iron in appreciable amount. F. IV. Mott (London Lancet, Feb. S, 'DO).
Autopsy of a case. Iron reaction well marked in liver and kidneys, but absent in spleen; the amount of iron in the liver found by quantitive analysis to be five times greater than normal. T. N. Kelynack and F. J. II. Coutts (Medical Chronicle, Sept., '92).
Inquiry into the after-history of 22 eases. The disease believed to be due to an increase in the destructive action of the liver upon the red blood-corpuscles. While the 22 cases were thought to be "cured" by various means, 10 died of the disease, and only 2 were known to be living at the time of the investigation. H. C. Colman (Edinburgh Med. Jour., Mar. and Apr., 1901).
The posterior and lateral spinal tracts present changes resembling those ob served in tabes.
Study of seventeen cases. The degree of nervous affection not necessarily pro portionate to the degree of anaemia. In pernicious anaemia any of the spinal symptoms of tabes may he present, while symptoms entirely foreign to tabes may also occur. Diseased centres in any por tion of white substance, preferably in posterior columns; gray substance, zone of Lissauer, and intermedullary roots re main unaffected. Nonne (Deutsche Zeit schrift filr Nervenh., vol. v).