The first description of idiopathic anemia by Addison in 1855 and the subsequent work in 1872 by Biermer, who coined the term pernicious anemia, contained no mention of achlorhydria or combined cord degeneration. It was not until 1866 that Cahn and von Mehring1 first discovered the absence of free hydrochloric acid in the gastric juice in a case of pernicious anemia. Since then the relationship of achlorhydria and pernicious anemia has been recognized and of late has been the subject of considerable conjecture.
I propose to consider here this association of the gastric anacidity, the cord changes and the anemia, and it is hoped that by a survey of the literature and the study of some new material that the important known facts in this relationship may be summarized.
The absence of free hydrochloric acid in the gastric contents of pernicious anemias has been reported to be 100 per cent