Investigation Relative to B. Welchii Infection of the Intestinal Tract as the Etiological Factor in Pernicious Anemia 1

This work was originally undertaken with the purpose of confirming Herter's (1) and Simonds' (2) observations on the prevalence of B. Welchii in the stools of patients with pernicious anemia. In view of the toxin produced by all strains, the marked hemolytic properties of many strains of B. Welchii and the presence of anemia associated with B. Welchii infection as reported by Klotz and Holman (3) and of hemoglobinuria as noted by Herter (1) and by Schumm (4), chronic infections with B. Welchii of some portion of the gastro-intestinal tract with consequent absorption of hemolysins seemed to offer an attractive and quite plausible etiology for the disease, pernicious anemia. The possibility of intestinal absorption as an etiological fac- tor in pernicious anemia was seriously considered a number of years ago by Hunter (5), and more recently the idea has been mentioned by van der Reis (6) and upheld by Seyderhelm (7).