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THE DIAGNOSIS AND TREATMENT OF THE IRON-DEFICIENCY ANEMIAS

FRANK H. BETHELL, M.D.; S. MILTON GOLDHAMER, M.D.; RAPHAEL ISAACS, M.D.; CYRUS C. STURGIS, M.D.
JAMA. 1934;103(11):797-802. doi:10.1001/jama.1934.02750370001001.
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A lack of sufficient iron available for the requirements of hemoglobin formation leads to anemia of the hypochromic or "secondary" type. Such an anemia may properly be attributed to iron deficiency, even though this element is supplied in usual quantities in the diet.

The most frequent cause of iron-deficiency anemia is continued or recurrent excessive loss of blood. The replacement of hemoglobin lost by hemorrhage depletes and finally exhausts the body's reserves of iron.1 In such cases the dietary iron is insufficient for the increased demand, and anemia results.

A "secondary" anemia, occurring most often in middle-aged women, and frequently not associated with excessive loss of blood, has recently attracted a great deal of attention. Its commonly accepted designation is idiopathic hypochromic anemia.2 Achlorhydria or marked hypochlorhydria is an invariable accompaniment of this condition. The anemia is presumably due to defective absorption of dietary iron, dependent on the

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