VITAMIN B12 AND COORDINATION EXERCISES FOR COMBINED DEGENERATION OF THE SPINAL CORD IN PERNICIOUS ANEMIA

Pernicious anemia, first described by Combe¹ in 1824, was not recognized as a clinical entity until Addison's reports² appeared in 1849 and 1855. It invariably terminated fatally until the epochal discovery of Minot and Murphy³ in 1926 that the oral administration of liver was effective in controlling the anemia and certain other clinical manifestations of the disease. Neurologic manifestations, however, were not well controlled by oral therapy. Later, extracts of liver were introduced which could be administered parenterally. These yielded far better clinical and hemopoietic responses. Progression of neurologic manifestations was prevented, and in cases in which neurologic involvement was of recent onset improvement frequently occurred.

Search for the active factor or factors in liver that possessed anti-pernicious-anemia properties resulted in the discoveries of folic acid in 1945 and of vitamin B₁₂ in 1948. While folic acid elicited hemopoietic responses in patients with pernicious anemia in