Thirty years have elapsedsince Minot and Murphy (1926) published their historic report on the value of liver in the treatment of pernicious anaemia. With each passing year fewer and fewer physicians remain on the staffs of the teaching hospitals who have had per-sonal experience ofthe clinical features and course of pernicious anaemia in the era prior to the introduction of liver therapy. Duringthe period 1920-7, first as assistant and then as a lecturer in the Department of Medicine, University of Edinburgh, I had ample oppor-tunity of observing the tragic and inevitably fatal ter-mination of the disease in large numbers of patients admitted to the wards of the Royal Infirmary under the charge of my chief, Professor GL Gulland, a famous haematologist.

I believe that the number of persons suffering from pernicious anaemia at the present time is much greater than it was when I first became interested in the disease 36 years ago. Hence the importance of early and cor-rect diagnosis. There are two main reasons for this increased incidence. Firstly, the introduction of liver extract and later of vitamin B, 2 has enabled patients suffering from Addisonian pernicious anaemia to have a normal expectation of life. Secondly, at the present