In a two-year period, April, 1957, to April, 1959, 11 nurses and an x-ray technician at the Billings Deaconess Hospital, Billings, Mont., were seen with a syndrome of incapacitating pain and exquisite tenderness along the superficial and deep veins of the legs. In addition to this group of cases, an outbreak of a similar illness involving 44 persons was observed in Laurel (population 3,660; located 16 miles southwest of Billings) in the fall and winter of 1958-1959. The illness in many of the cases was severe and lasted for several months. All cases were adults; a majority were females. Studies made of the two groups failed to reveal a causative agent or a common factor which might have precipitated the outbreak. Because of the high incidence and the unusual age and sex distribution of the cases, it was felt that a report describing the clinical and epidemiologic observations made of
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