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Abnormal changes in the fingernails often provide evidence of systemic diseases. This paper calls attention to a hitherto undescribed change which has been relatea to severe hypoalbuminaemia. This is the appearance of paired narrow white bands in the fingernails of patients with serum albumin levels persistently below 2.2 g. per 100 ml. These two transverse bands run parallel to the lunule. They are not palpable, do not indent the nails, and are separated from each other and from the lunule by areas of normal pink nail (Special Plate, Fig. 1). The distal white band may be slightly wider than the proximal band (Plate, Fig. 2). Method of Study and Selection of Patients

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