In reviewing the history of the knowledge concerning acute coronary obstruction, it is remarkable that the first publication that satisfactorily correlated symptoms, signs and pathologic data has been overlooked, for the most part. In 1884, in the Zeitschrift für klinische Medizin, Leyden1 gave an excellent account of coronary sclerosis and thrombosis, in a paper entitled "Ueber die Sclerose der Coronar-Arterien und die davon abhängigen Krankheitszustände." It is to the Russians. Obrastzow and Straschesko,2 who published an article in the same journal in 1910 that credit is usually given for the description of the clinical features. These authors were able to make a correct antemortem diagnosis in two of the three cases reported by them. In Europe, however, very little interest was aroused by these publications, and their importance for clinical medicine was unrecognized. It was in 1912 that Herrick,3 in his classic paper on "Clinical Features of Sudden Obstruction of