DEFINITION OF THE PROBLEM
WHEN AN extremity, predominantly the lower one, is suddenly or gradually deprived of its arterial blood supply, ischemia develops, which, depending on its extent, may cause death of the limb or functional disability or go unnoticed and remain subclinical. Since almost invariably even the subclinical forms progress toward manifest disease, early recognition and early treatment are essential. The problem then revolves around the finding of the cause of the ischemia, the localization of the process to a segment or to a regional vascular area, and the relief of this arterial stoppage. It seemed worth while to summarize the activities of our group along these lines. I shall attempt to present the philosophy underlying the activities of our peripheral vascular clinic, first started in 1926. Many of the thoughts expressed here were developed and reported in association with my former or present associates,* for whose help and