100 Years On: Pernicious Anaemia – from Raw Liver to Today’s Still‑Troubling Reality

In a recent feature on notable medical anniversaries of 2026, the BMJ highlights many milestones spanning centuries—from the birth of Averroes in 1126, master of philosophy, theology, medicine, and law, to landmark discoveries in bacteriology and major epidemics. Among these items sits a significant and sobering reference for our community: the introduction of liver therapy for Pernicious Anaemia in 1926.

While the list includes a wide sweep of scientific achievements—discoveries by Koch, Scheele, and Lombroso, the establishment of Edinburgh Medical School in 1726, and the 1976 Yambuku Ebola outbreak—few entries resonate quite like this one for those living with or supporting someone with this autoimmune condition.

1926: When Raw Liver Changed Everything—But at a Cost

In 1926, George Minot and William Murphy demonstrated that feeding patients large quantities of raw liver could reverse the deadly course of Pernicious Anaemia.

Historical accounts describe patients consuming up to a pound of raw liver daily—a treatment that was not only unpleasant but physically difficult for those already suffering severe symptoms. More detailed accounts of this era highlight the “astonishing recoveries” this therapy produced, but also how grim and arduous the approach truly was.

This represented medicine in its infancy for Pernicious Anaemia. At the time, cobalamin remained undiscovered and the mechanisms behind stomach cell damage and intrinsic factor deficiency were unknown. While the treatment was lifesaving, it was inherently horrendous by modern standards.

2026: A Century Later—How Are We Still Getting It Wrong?

And yet, as the BMJ paper marks 100 years since this breakthrough, an uncomfortable comparison emerges.

Despite advances in diagnostics, B12 therapy, and clinical understanding, today’s Pernicious Anaemia patients still endure experiences that many would argue are equally horrendous—just in a different guise.

Modern PA patients frequently report:

• Late or missed diagnosis — often after years of worsening symptoms
• Undertreatment, especially long intervals between B12 injections or inadequate dosing even though research and published guidelines advocate otherwise.
• Dismissal of symptoms, attributed to stress, ageing, or unrelated causes
• Fragmented care, with inconsistent primary care practice, lack of education and practitioner awareness
• Significant impact on work, cognition, mobility, and mental health leading to permanent neurological damage for the individual and a significant ‘hidden’ economic loss, characterised by thousands of lost working days and the high systemic costs associated with treating advanced, preventable complications.

While no one today is forced to eat raw liver to survive, many patients are left fighting for appropriate treatment, battling symptoms that could be alleviated, and struggling to have their concerns taken seriously.

The irony feels cruel to the patient and patient advocate:
In 1926, the treatment was brutal but effective. In 2026, treatment exists—but accessing it can be brutal.

A Tale of Two Horrors

When we compare the BMJ’s list of medical anniversaries, we see events that shaped medical science—major epidemics, Nobel Prize‑winning discoveries, groundbreaking publications. The liver treatment for pernicious anaemia stands among them as a turning point that transformed a fatal illness into a manageable one.
Yet, here we are a century later, in a world with far superior medical tools, and patients still face:

• Diagnostic delays longer than any acceptable standard
• Symptoms dismissed despite classic presentations
• Therapies limited not by science, but by protocol

And that is a tragedy no anniversary should have to commemorate.

What This Anniversary Should Inspire

The message is clear:

The raw liver era taught us that treatment matters—and that when clinicians take patient symptoms seriously, lives are transformed.

A century on, we have the knowledge, the tools, and the evidence to treat Pernicious Anaemia effectively. What we need now is the will—across healthcare systems, policymakers, and clinical practice—to ensure no patient is left suffering needlessly.

Because no one should look back at 1926 and feel that, in some ways, patients had it better.