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V. Further Evidence for the Essential Participation of Extrinsic Factor in Hematopoietic Responses to Mixtures of Beef Muscle and Gastric Juice and to Hog Stomach Mucosa

W. B. Castle, M.D.; Thomas Hale Ham, M.D.

JAMA. 1984;251(4):514-521.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Observations on patients with addisonian pernicious anemia have appeared to us to demonstrate that the immediate basis of the anemia is a "conditioned" defect of nutrition. Thus, patients suffering from pernicious anemia are seemingly unable to derive from food some substance essential for normal function of bone marrow. The nutritional defect in such patients is apparently caused by the failure of a reaction which occurs in the normal individual between a substance in the food (extrinsic factor) and a substance in the normal gastric secretion (intrinsic factor). This conclusion is based on the following evidence derived from previous observations1 on cases of addisonian pernicious anemia:

1. The daily administration of (extrinsic factor) 200 Gm. of beef muscle is without significant effect on blood formation.
   
2. The daily administration of (intrinsic factor) from 150 to 300 cc. of normal human gastric juice is without significant effect on blood formation.
   
3. If,
   

Author Affiliations
Boston

From the Thorndike Memorial Laboratory, Second and Fourth Medical Services (Harvard), Boston City Hospital, and the Department of Medicine, Harvard Medical School.

Footnotes
The expenses of this investigation were defrayed in part by a grant from the Proctor Fund of Harvard University for the Study of Chronic Disease and by the J. K. Lilly Gift to the Harvard Medical School.

Owing to lack of space, this article has been abbreviated in The Journal by the omission of a section of the text and corresponding bibliography. The complete paper will appear in the authors' reprints.

The observations on certain patients were made possible through the kind cooperation of members of the staff of the First and Third Medical Services (Tufts) of the Boston City Hospital. We are indebted to Miss Margaret Evans and to Miss Eleanor Fleming for assistance in performing the blood studies.

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