“…is an example, may result from: 1) the absence of a socalled intrinsic factor, normally contained in the gastric secretion (1,2); 2) the absence of an extrinsic factor associated with the nitrogenous portion of the d1et(3); 3) the lack of absorption (4,5,6,7,8) of the product of the interaction(2,9) of the intrinsic and extrinsic factors; 4) the interference with or derangement of the storage mechanism for this principle in the liver (10,11,12,13,14,15). Acute or chronic liver damage as seen clinically may be accompanied by a typical macrocytic hyperchromic anemia presenting in a greater or lesser degree the cytological changes characteristic of perniCiOUS anemia.…”