Celebrating 100 years of Cope's Early Diagnosis of the Acute Abdomen

Background: No list of the iconic books in surgery would be complete without The Early Diagnosis of the Acute Abdomen by Sir Vincent Zachary Cope, MS, MD. First published in 1921, few books have stood the test of time like this treatise on the acute abdomen. It is also fitting that, after Mr Cope's passing, William Silen would assume the mantle with the 15th edition and maintain his legacy work through the 22nd and final edition. Methods: Each edition of The Early Diagnosis of the Acute Abdomen and The Acute Abdomen in Rhyme was curated and reviewed in detail within the historical context of the era in which the book was printed. Results: The tenets of physical diagnosis and history did not change during the 100 years through the current printing; however, the emphasis on related medical diseases evolved due to antibiotic therapy and the prevalence of nonsurgical diseases that evolved across this period. Early editions highlighted the value of plain radiography as it came into common use, whereas later editions included cross-sectional imaging as a valuable diagnostic tool. Conclusion: The context and evolution of this masterpiece are fundamental to the legacy of the abdominal surgeon. Cope's lessons on the value of dedication and attention to detail to formulate clinical diagnoses by engaging with the patient rather than excessive use of laboratory testing and imaging still apply in today's rapidly evolving and increasingly value-based world.