Until 25 years ago a diagnosis of pernicious anemia meant almost certain death. Then Minot and Murphy1 made the brilliant discovery that liver, eaten daily in large amounts, benefited patients with pernicious anemia and maintained their blood values at satisfactory levels if they continued on this regimen. The next milestone in the treatment of pernicious anemia was the preparation of highly refined liver extracts, which were more efficacious as therapeutic agents and more acceptable to the patient than whole liver. Many investigators contributed toward the working out of a satisfactory method of making such extracts; it was learned that most of the folic acid normally present in the liver was discarded in the process, with the result that the highly refined extracts which were potent in treating pernicious anemia were almost completely devoid of folic acid.
The chemical era in the treatment of certain types of macrocytic anemia followed