A teamster, American, aged 32, entered the Massachusetts General Hospital, June 14, 1913, with a two years' history and blood typical of pernicious anemia.
In the five years between this date and his death, Sept. 11, 1918, he was seven times in the hospital. Splenectomy was performed in January, 1914; a remission occurred over a year afterward, and five transfusions were performed. He was able to work a considerable part of the time.
Scores of blood examinations were made, of which one made in June, 1916, is typical: red cells, 792,000; white cells, 4,000; hemoglobin 20 per cent.
At necropsy there were the usual lesions of pernicious anemia. The marrow showed megaloblastic hyperplasia. The myocardium was fatty, and there was slight edema of the lungs.
The heart weighed 710 gm. The arteries and kidneys were normal and there was nothing in the heart itself or elsewhere to account for hypertrophy.