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July 3, 1954


JAMA. 1954;155(10):902-903. doi:10.1001/jama.1954.73690280001007

Anemia is a frequently missed clinical diagnosis; its severity too often is assumed to be a matter of conjecture. Nevertheless, the presence and intensity of anemia often can be suspected with fair accuracy by careful examination of the patient without recourse to complicated laboratory methods. In evaluating anemia at the bedside, the clinician examines particularly the skin, mucous membranes, conjunctiva, and fingernails. It is the purpose of this communication to direct attention to study of the creases of the palm as a simple clinical method for estimating the degree of pallor.

The hand as a source of clinical information is so obvious that it may be neglected.1 The hand is richly endowed with blood vessels through which an enormous amount of blood flows. From time immemorial, the color of the palms and fingernail beds, has been utilized for evaluating anemia. According to Wintrobe,2 the palms are more reliable

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