Key points are not available for this paper at this time.
To the Editor:— A communication by Drs. Masters, Dack and Jaffe inThe JournalApril 22 referring to my paper entitled "Relation of Physical Exertion and Emotion to Precipitation of Coronary Thrombi" inThe JournalMarch 11 deserves some comment. I am afraid that your correspondents have missed the main point in my paper. I have shown that the formation of coronary thrombi is gradual, sometimes occupying several days before occlusion with its resulting precordial pain is produced. The onset of precordial pain, then, merely marks the final phase of a process which was initiated (by capillary rupture) some time previously. Therefore the activities of a patient just before the onset of precordial pain, as tabulated in 1,400 cases by your correspondents, are purely coincidental and have no relation to the cause of thrombus precipitation. Their smaller series of 250 cases warrants more attention. I have the greatest respect for
James C. Paterson (Sat,) studied this question.