PERNICIOUS .AN.LEMIA.—It is very doubtful whether bone-marrow can in any way be compared to arsenic as a remedial agent in pernicious anwritia. The belief that the active agent of mar row is iron would sustain this view, iron being as useless in true pernicious anm mia as it is useful in the benign form. There is ground for the suspicion that an erroneous diagnosis led to some of the favorable reports published. These are not included in this review.
Again, in the majority of the cases of pernicious anaemia treated with bone marrow hitherto reported, their value as therapeutic records is much diminished by the fact that other drugs were often given in addition, and also that in no case has the further history and ultimate fate of the patient been recorded. It is well known that such cases often im prove for a time under various forms of treatment, but they tend always to re lapse, and ultimately to die.
Case of pernicious anaemia in a man, aged 60, treated with iron, arsenic, and salol, Nvho made no progress until 3 ounces of ox-marrow were given in ad dition. Complete recovery followed. Fraser (Brit. Med. Jour.. vol. i, p. 1172, '94).
Bone-marrow given in one case of per nicious without benefit; in a second, however, occurring in a man aged 43, who had become worse under arsenic and to whom 3 ounces of fresh marrow were then given daily, the results were remarkable. In two months the blood
condition had returned to the normal in every respect. Barr (Brit. Med. .Tour.. vol. i, p. 353, '95).
Three eases of pernicious anaemia in which the red marrow did not have the least effect. In one of the cases rapid improvement was noted as soon as the patient was placed on arsenic. Bone marrow should not be given unless arsenic has failed. G. B. Hunt (Lancet, Feb., '96).
Case in which marked improvement was brought about by bone-marrow and in which benefit had persisted up to the date of the report. Janeway (Ther. Gaz., May 16, '96).
Two cases of pernicious anutia treated with bone-marrow. The first, a man aged 39, had various ups and downs, but ultimately succumbed. The second case occurred in a woman aged 60: but under similar treatment she also progressively sank. Stengel (Then Gaz., '96).
The most that can be said for bone marrow in pernicious anemia is that it should be tried where arsenic fails.