The Surgical Diseases of the Genito-urinary Organs Including Syphilis

original work came from my pen except Chapters XIV, XV, XVI, and XVII-on stone. One of these chapters I have left unchanged, out of respect to my former partner; the others have been rewritten.

The book as it stands is an honest exhibit of the subjects considered.

1 PARK AVENUE, NEW YORK, February, 1888.

views upon all

E. L. KEYES.

PREFACE TO THE ORIGINAL TREATISE.

THE steady growth of the science and art of surgery has involved a corresponding increase in bulk of the text-books in which its principles and practice are set forth-an increase already suggestive of either a limit in bulk soon to be reached, or the omission. or slurring over of special subjects. In this alternative the preparation of text-books on special subjects would seem to be the appropriate remedy.

The tendency of mankind to aggregate in large and constantlyincreasing cities has led to a corresponding tendency to the growth of specialists in the different departments of medicine and surgery; and the development in large cities of hospitals and schools, and opportunities for teaching, would seem to render them the natural repositories of accumulating experience and the sources of advancing knowledge. It is from city practice and hospital experience, therefore, that the materials for the preparation of text-books on special subjects would be naturally sought, and from these sources the substance of the present work has been mainly derived. Its object is to present to the student and general practitioner a succinct account of the nature and treatment of the diseases incident to the genito-urinary organs as they are encountered in private and hospital practice by those engaged in their daily and especial study. The literature of this department of surgery has been carefully studied with the purpose of reproducing every fact of practical value. It is hoped that the reader will recognize a conciseness in the grouping of these facts which will save him the necessity of reference to the numerous monographs and essays from which they have been collected.

On account of the general character of the work as a text-book, it has been impossible to refer very largely to personal authority and experience, and this has been for the most part avoided except in reference to mooted points and exceptional or noteworthy phenomena. The extent of the subject-matter treated of, and the necessity for compression, will be regarded, it is hoped, as a sufficient

apology for terseness and directness of expression or defect in style, while the circumstance of joint-authorship will explain any lack of uniformity in manner throughout the work, of which the preparation for the press has devolved mainly upon the junior author.

The plan of the work is based upon an anatomical classification of the tissues and organs of which the diseases and deformities form the subjects of description. This necessitates some repetition and frequent reference to facts, cases, or illustrations already given, or to be given, in connection with other anatomical divisions of the genitourinary tract. These references are usually made thus: (Nephralgia), (Plate XX), (Case 45), the page not being specified, as the constant appearance of signs scattered through a page tends to confuse the reader. No difficulty need be experienced in turning to these references promptly, as the parenthetical word, case, or plate may be found at once credited to its proper page in the general index at the end of the book, or in the index to plates, or list of cases, at its commencement.

The terms of measurement employed are uniformly English, with the exception of the centimetre and millimetre, which frequently occur in the text. These may be readily reduced to their equivalent in inches by computation from the subjoined table.*

The subject of syphilis is included, of necessity, in a treatise like the present. Opportunities for the observation and study of this disease on a large scale fall mainly to the share of the metropolitan hospital-surgeon and special practitioner. Although properly belonging to the department of Principles of Surgery, there is no disease falling within the limits of this work concerning which clear and correct ideas as to nature and treatment will, at the present time, so seriously influence success in practice.

Chapter VIII, Part II, on "Syphilitic Diseases of the Eye," has been kindly furnished, at the request of the authors, by Prof. H. D. Noyes, M. D., whose authority on this subject is undisputed.

They beg leave to thank Dr. Roosa for aid, both personally and through his excellent work "On Diseases of the Ear," in the preparation of Chapter IX, Part II, "On Syphilis of the Ear.”

Acknowledgments are also due to Dr. Partridge and Dr. Morrison-Fiset, of the house-staff of the Charity Hospital, for kind assistance; and to Dr. L. A. Stimson for aid in many ways.

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