THIS BOOK is confessedly "somewhat unusual," as it was heralded to be, three years ago, in my circular letter to the members of the American College of Surgeons. For example, the preface is illustrated, the epilogue offers resolutions, the index is a chart of differential diagnosis, and every chapter in the central portion presents original ideas which may, or may not, be of value. The introduction should be in keeping, and it shall be, for I invite each reader to write his own introduction and provide for him several blank pages on which to do so in ink. If his opinions on the frequency and importance of rupture of the supraspinatus or on professional advertising differ from mine, let him record them now, so that in ten years he may look back and see which of us was right. Let him attack my views as sharply as he likes, but let him not in the intervening years excise and burn the pages bearing his handwriting! I am on record as long as copies of the book exist; let him be fair and commit himself also.
Introductions are usually written by some distinguished friend or patron of the author. The reader may ask why some one of the surgeons in the group on page xiv has not written this one. There are several reasons. One is that I feel quite sure that not a single one of them would take the time to read the book through. Those who are still living are all older than I am, and I know that, young as I am, I could not read one of their books through, without falling asleep in my chair, time after time! I think that any of them would probably write for me a conventional introduction in spite of my cartoons, but I do not propose to subject them to such responsibility. However, since they know me, they may all wish to express their opinions, and here are blank pages provided for them!
After indulging in a luxurious preface and speaking frankly of various taboos usually mentioned by doctors only in hushed voices— income, results, motives, religion, advertisements, dependence on bankers, personal poverty—I must have made plenty of enemies! Let them write introductions. An introduction from an enemy who has read the book should be more enlightening than from a friend who only dozed through it.

If you are inclined to avoid controversy, you may use these blank pages for references to future articles on shoulder injuries. If you do, begin with one which has appeared since the central portion of the  book  was   completed.    Dr.   Keyes   has   already   confirmed  Dr. Akerson's work, and some of my ancient prophecies.

KEYES, E. LAWRENCE—Observations on Rupture of the Supraspinatus Tendon. Annals of Surgery, Vol. 93, pp. 849-856. June, 1933.

But please do not avoid controversy. Study the book; write an introduction; send one copy of it to the president of the American College of Surgeons, and another to me; then pass your book to another member of the college, or better still get him to send $5.00 for one for himself, so that he also may write an introduction. For the present, although each copy will cost me nearly twice this amount, I am glad to sell one to any member of the college, in order that the President and Board of Regents may be informed of the opinions of as many other members as possible, in case I may be encouraged to present resolutions, similar to those in the epilogue, at the next meeting of the Board of Governors.

Provided for Your Comrients Before You Pass This Volume to Another Fellow of the American College of Surgeons

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