Primary Hypochromic Anemia

In the past few years, interest has developed in a "new" type of primary or idiopathic anemia. This disease, characterized by the presence, usually in middle-aged women, of pallor, weakness, atrophied tongue, brittle finger nails, achlorhydria and hypochromic ("secondary") anemia, responding readily to large doses of iron and tending to spontaneous relapse, has recently been described under numerous synonyms. Among these may be mentioned chronic microcytic anemia,¹idiopathic hypochromic anemia,²simple achlorhydric anemia,³chronic chlorosis,⁴achylic chloranemia,⁵essential hypochromic anemia,⁶and simple achylic anemia.⁷In a previous paper⁸the term "primary hypochromic anemia" was suggested, since it was felt that the disease was "primary" or idiopathic in nature and since its chief hematologic feature was the hypochromia ("achromia") of the red blood cells. It was thought that the disease could be compared with another "primary" anemia; namely, pernicious anemia. Indeed, the points