This famous text is much beloved by medical students and physicians-in-training throughout the English-speaking world, as its many editions indicate. Despite its relatively narrow focus, it is chock full of the pearls of
clinical wisdom that students and practitioners treasure, and many ofthese lessons apply to medicine in general. The book was well characterized by a reviewer of an earlier edition for The New England Journal of Medicine: "If only one book about surgery could be made available to physicians from all specialties, it should probably be Silen's recent revision of
Cope's Early Diagnosis of the
Acute Abdomen. Since the book first appeared more than 30 years ago, it has remained