In this paper I shall try to give a general picture of the diabetic patient with gangrene, to describe the organization for and the principles of management of cases of diabetic gangrene at the New England Deaconess Hospital and possibly, through a study of my results, to indicate how I have arrived at my present conception of the operative treatment of this condition. I do not wish to add to the many reports on the details of management of diabetic gangrene or to enter into any controversy as to the indications for amputation or the level at which it should be done. ORGANIZATION FOR THE CARE OF "SURGICAL DIABETIC" PATIENTS AT THE NEW ENGLAND DEACONESS HOSPITAL I did my first amputation for gangrene—a closed amputation through the upper third of the lower part of the leg—in May 1923. Insulin had been given to the first patient in the New England