The gastric mucosa in anaemia in Punjabis TABLE I RELATIONSHIP OF INCIDENCE OF ATROPHIC GASTRITIS TO DIET AND BLOOD LOSS

Although the aetiology and pathological significance of chronic atrophic gastritis is still unknown, the incidence of the disorder in normal subjects and in a variety of pathological conditions is becoming known. Coghill (1960), in a full review of the subject, discussed the possible relationship between gastritis and hypochromic anaemia. It has been suggested that the gastric mucosal lesion may result from iron deficiency (Witts, 1956; Badenoch, Evans, and Richards, 1957), but this view is not supported by Foy and Kondi (1960), who found that achlorhydria was rare in patients with severe iron deficiency secondary to hookworm infestation, or by Coghill (1960), who showed that atrophic gastritis occurred more frequently in patients with 'idiopathic' hypochromic anaemia, that is, in whom there was no evidence of blood loss or exceptionally low iron intake to account for the iron deficiency, than in patients suffering from chronic haemorrhage. Many patients with iron-deficiency anaemia attend Brown Memorial Hospital, the chief causes being hookworm infestation, dietary deficiency, and gynaecological disorders. In view of the high incidence of this type of anaemia, it was decided to extend the routine haematological investigation of these patients to include biopsy of the gastric mucosa in an attempt to establish the incidence of gastritis and gastric atrophy, and also to see if there were any clinico-pathological associations which might shed further light on the pathogenesis of the gastric mucosal lesion.