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Claims for vitamin E in angina pectoris have not been based on controlled observations. Even some negative ' DTRING the course of our studies on the visceral and somatic components of chest pain in patients with heart (lisease, 1-4 Vogelsang, Shute and Shute5-9 and ilolotchick'0 reported beneficial effects of vitamin E on "anginal pain" and heart disease. It occurred to us that the relief of pain in such cases might be due, at least in part, to effects of vitamin E on the voluntary muscles rather than on the heart. This concept was supported by the fact that animals deprived of vitamin E show reversible changes in both cardiac'" 12 and skeletal"3 14 musculature, and by reports on the usefulness of vitamin E in the muscular dvstrophies and somatic pain syndromes such as filbromyositis. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] We decided, therefore, to classify chest pain in our cardiac patients according to visceral and somatic components, and to evaluate by the blind-test method the effect of alpha tocopherol on these components in parallel series of control and treated subjects. The need for such a blind-test study is emphasized by Vogelsang, Shute and Shute themselves,9 as well as by recent editorial comment.'9 The latter conclhdes: "Subjective benefits claimed [for vitamin E] may justify a series of well controlled experimental studies in human heart disease

We were led to study the effects of vitamin E on chest pain in patients with heart disease because of our interest in what we have called the "somatic component" of cardiac pain.1*2* 3 I n extension of the work of Weiss and Davis: we had shown that spasm of the chest muscles results from impaired coronary flow and may cause persistent pain which responds to local treatment of the voluntary muscles themselves.'. 2 .During the course of these studies, it occurred to us that the reported relief5* 6 . ' * I) of effort angina by alpha-tocopherol might be due not solely "Ephynal Acetate" supplied by Hohann-La Roche, Inc.

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