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Cope's Early Diagnosis of the Acute Abdomen

Lloyd M. Nyhus, MD
JAMA. 1987;258(22):3316. doi:10.1001/jama.1987.03400220116051.
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The late Sir Zachary Cope (1881-1974) directed this classic through 14 editions. For 56 years (from 1921), the Cope book guided generations of medical students and, more recently, house officers through the shoals of inaccurate diagnoses. The 17th edition is the third on which William Silen of the Harvard Medical School has placed his imprimatur. The Silen touch has been soft in that he has maintained much of the Cope text and, of even more importance, concepts.

Silen continues to emphasize the necessity of obtaining a detailed history and performing a complete physical examination. Yet he recognizes the impact that ancillary laboratory tests and new instrumentation have made on a physician's ability to make a correct diagnosis. A new chapter has been added to cover these aspects.

It is expected of book reviewers to find fault with at least a portion of a given text. Certainly, after 17 editions, most


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