Since Hippocrates reported his observation on the occurrence of fusiform swelling of the terminal phalanges in persons with consumption this phenomenon has been noted repeatedly by physicians, who, though ignorant of its pathogenesis, nevertheless attached great significance to its appearance in wasting patients. The French physician Pigeaux1 wrote in 1832: "The secret and almost mysterious relationship between phthisis and the state of nails evidently shows that older physicians were inclined to attach importance to small details which even in the 19th century represent elements of good diagnosis."
Interested in small details, physicians of the past overlooked, however, another detail, namely, that fusiform thickening of the phalanges sometimes accompanies a diffuse involvement of the skeleton. When similar widespread lesions were observed, they were not associated with the clubbed fingers and were not looked on as a sequel of a visceral disease, such as a disease of the lungs or heart,
FRIED BM. CHRONIC PULMONARY OSTEOARTHROPATHY: DYSPITUITARISM AS A PROBABLE CAUSE. Arch Intern Med (Chic). 1943;72(5):565–580. doi:10.1001/archinte.1943.00210110002001
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