To the Editor:
—The obstruction of the subclavian vein reported by Horwitz and Zinsser in The Journal (151:997 [March 21] 1953) is of considerable interest, principally because of the excellent phlebographic demonstration of subclavian vein obstruction in the region of the crossing by the clavicle. This situation, however, is not so unique as one might infer from the lack of references to other similar cases already published.The duration of symptoms in the patient reported on was quite brief, but nothing whatever is said about the circumstances surrounding the beginning of symptoms. It would be interesting to know whether this patient had been engaged in any unusual physical activity, particularly activity necessitating her to have her arm above her head. This patient's difficulty seems to fall in the category of effort thrombosis of the subclavian vein or the Paget-Schroetter syndrome. This latter designation was given by Hughes (Surg., Gynec.