University Surgical Tutor, St. Vincent's Hospital The Budd-Chiari syndrome is a disease entity which follows occlusion of the hepatic veins. Originally described by Budd in 1845 and subsequently by Chiari in 1899, it had been recorded in 116 cases up to 1952. Later reports have referred to involvement of the inferior vena cava in addition to the hepatic veins. The aetiological factors are numerous (Palmer, 1954). Thrombotic complications being relatively frequent in polycythaemia vera, it is not surprising that the syndrome should have been recorded in that condition. Nevertheless, Sohval (1938) states that the hepatic veins are the rarest thrombotic site in polycythaemia-the first case having been described by Oppenheimer in 1929, and not more than 10 cases had been reported up to 1938. A case is reported which presented the features of the chronic phase of the syndrome as described by Budd and by Chiari, due to hepatic-vein thrombosis in polycythaemia vera. Fi. I.-Infra-red photograph showing abnormal venous pattern. Note also external genitalia.