A clinical syndrome of diaphragmatic flutter with symptoms of angina pectoris occurring in a man of 57 was described under the foregoing title, inThe Journalby Dr. W. B. Porter1of Richmond, Va., about two months before the same patient was admitted to the Colorado General Hospital under another name. Dr. Porter described the patient as a "deep sea diver." To us he stated that he was a "trapper" from the high mountains and that he had been living and working as a trapper near Berthoud Pass—an average elevation of 13,800 feet above sea level. This report will serve as supplementary to that of Dr. Porter, presenting certain similarities, certain additional complaints and certain discrepancies. A telegram under date of Jan. 29, 1937, from Dr. William J. Kerr of San Francisco indicated that the same patient was in the Hospital of the University of California. A supplementary report