Patients with polycythaemia vera commonly first consult a physician because of vascular thromboses.1The frequent situation of these lesions in cerebral, peripheral and intra-abdominal vessels is well recognized. The clinical picture is essentially determined by the vitality of the organ deprived of its blood supply. An opportunity was recently afforded to study a patient with polycythaemia vera in whom huge enlargement of the liver, ascites and jaundice supervened owing to thrombosis of the hepatic veins. Because of the rarity of this complication, the difficulties in making a differential diagnosis and the gravity of the prognosis, this case was deemed worthy of recording, and the pertinent literature was surveyed. REPORT OF A CASE2 History. —A Jew aged 30 years entered the hospital because of increasing shortness of breath, weakness and abdominal enlargement. He had measles, mumps and diphtheria in childhood. Tonsillectomy was performed uneventfully seven years previously. Varicose veins