THE CLUBBING of the digits described by Hippocrates in the fifth century B. C. was associated with one of the progressive morbid states that may present this physical finding, i. e. empyema. Other maladies which may produce clubbing include chronic suppurative lung disease, cyanotic congenital heart disease, subacute bacterial endocarditis, liver cirrhosis, and inflammatory or neoplastic disorders of the gastrointestinal tract. But not all clubbing of the fingers or toes portends serious organic dysfunction. Clubbing may be present as an hereditary anomaly in selected families.1 When this anomaly is observed in a presumably healthy person, inquiry into the duration of the abnormality and the possible familial distribution may be rewarding. At least this was our experience.
Although the familial and acquired forms of clubbing have a similar appearance superficially, the former variety occasionally may involve only one or two fingers symmetrically. The rule, however, is symmetrical involvement of all digits.