During the spring and summer of 1940, 1941, and 1942, my work in the Nutrition Clinic at Birmingham, Alabama gave me the opportunity to study and record pertinent facts about 110 subjects who turned out to have vascular spiders but no obvious vitamin-deficiency disease. This group constituted about 10% of the patients I saw. The record I designed for these patients, the first systematic one kept at the clinic, had a place for noting facts about vascular spiders, palmar erythema, and such things. This caused much confusion when there was a flurry of interest in nutrition among certain eager persons who were not experienced in clinical nutrition. On several surveys in the 1940's information about "spiders" was collected, but it puzzled those who tried to interpret the results.My first return visit to Birmingham in 17 years was the occasion for another examination of some of these patients, several
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