Action of Human “Pernicious Anemia Liver Extract.”

Abstract

How the antianemic principle in liver which is active in pernicious anemia produces its effect is not known. Neither is it known whether the active principle is stored and depleted, like certain vitamins, nor if the liver in vivo secretes it in a hormone-like manner for the purpose of governing hematopoiesis. It was considered desirable to ascertain whether the liver of a pernicious anemia patient contains the antianemic principle. Since an opportunity to perform 2 experiments bearing on this question occurs so rarely at present, we desire to record the results we have obtained. The livers of 2 pernicious anemia patients were extracted. The first extract was made from a liver of a pernicious anemia patient who had received liver extract prior to her death sufficient to produce a reticulocytosis, the bone marrow at autopsy showing an active hemopoietic response. The liver was extracted and the extract administered intravenously to 3 pernicious anemia patients with positive results. The second extract was made from the liver of a case of pernicious anemia who entered the hospital in a moribund condition and died shortly after entrance. Because of her rapid exitus, the liver extract she received intramuscularly and intravenously did not produce an active hemopoiesis, which was shown by the absence of reticulocytosis and hemopoietic activity in the bone marrow. An extract was made from this liver and administered to a pernicious anemia patient subcutaneously with no result.

Experiment I. A white female patient, 75 years old, entered the hospital in a semi-stuporous state. Pernicious anemia had been diagnosed 5 years previously. The classical findings with achlorhydria and spinal cord complications were present. The patient had received therapy in a haphazard manner during the past 5 years.