Vincent Cope

Biographical Timeline

• Born on February 14, 1881 in Hull, Yorkshire, youngest of ten children to Thomas John Cope, Methodist minister, and Celia Anne Crowle.
• 1899 – Head boy at Westminster City School; awarded the school gold medal
• 1900 – Wins entrance scholarship to St Mary’s Hospital Medical School.
• 1905 – Qualifies MB BS (Hons) with distinction in surgery and forensic medicine. Appointed house physician to Dr David Lees, whose interest in abdominal inflammation influenced Cope’s subsequent career.
• 1907 – Graduated MD, University of London.
• 1909 – Awarded MS and FRCS.
• 1911 – Appointed assistant surgeon at St Mary’s Hospital, Paddington. Cope spent virtually his entire consultant career as a general surgeon at St Mary’s Hospital, London, where his name lives on in the Zachary Cope ward.
• 1912 – Joined the surgical staff of Bolingbroke Hospital, London.
• 1914 – Served with the Royal Army Medical Corps during the First World War, including service in Mesopotamia from 1916 to 1919. Mentioned in despatches.
• 1921 – Published Surgical Aspects of Dysentery and Early Diagnosis of the Acute Abdomen, a text with 14 editions over the next 50 years.
• 1939–1945 – Published Pioneers in Acute Abdominal Surgery, an early contribution to his extensive work in medical history. Served as a sector medical officer in the Emergency Medical Service during the Second World War.
• 1947 – Publishes The Diagnosis of the Acute Abdomen in Rhyme under the pseudonym “Zeta”.
• 1949–1952 – Chaired and contributed to Ministry of Health committees examining hospital services, medical manpower and the training of medical auxiliaries.
• 1951 – Elected Honorary Fellow of the Royal Society of Medicine, where he had served for many years as honorary librarian. Edited Medicine and Pathology (1952) and Surgery (1953), two volumes of the official British medical history of the Second World War.
• 1953 – Knighted as a Knight Bachelor in recognition of his public service and contributions to medicine.
• 1955 – Succeeds Lord Haden-Guest as chairman, National Medical Manpower Committee.
• 1961 – Elected Honorary Fellow of the Faculty of the History of Medicine and Pharmacology, Society of Apothecaries
• 1972 – Revises the 14th edition of Early Diagnosis of the Acute Abdomen at age 90.
• Died on December 28, 1974 Oxford, England, aged 93

Be a physician first, then a surgeon

Advice given to Cope by his mentor Dr David Lees

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Medical Eponyms

Cope obturator test (1919)

The Cope obturator test (thigh-rotation test) is a physical examination manoeuvre used to detect irritation of the obturator internus muscle, classically associated with pelvic appendicitis.

Cope described slight flexion of the right hip followed by passive internal and external rotation, with hypogastric pain indicating a positive test.

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Cope psoas test (1921)

The Cope psoas test (ilio-psoas rigidity test) is a physical examination manoeuvre used to detect irritation of the iliopsoas muscle, classically associated with retrocaecal appendicitis.

Cope described placing the patient on the unaffected side and passively extending the affected thigh to elicit pain from reflex or direct irritation of the iliopsoas muscle.

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Cope’s sign (1970)

Cope sign or cardio-biliary reflex is a historically disputed eponymous term. In 1970, Cope described the early presentation of his own acute cholecystitis, characterised by epigastric pain and a distended, initially non-tender gallbladder. Following a 1971 report by O’Reilly and Krauthamer, later literature increasingly associated his name with reflex bradycardia and conduction disturbances accompanying gallbladder disease. The latter phenomenon is more precisely termed the cardio-biliary reflex.

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Major Publications

Medical texts

• Cope VZ. The thigh-rotation or obturator test: A new sign in some inflammatory conditions. Br J Surg. 1919; 7: 537. [Cope obturator test]
• Cope VZ. Surgical aspects of dysentery including liver abscess. 1921
• Cope VZ. The early diagnosis of the acute abdomen, 1921. [1926, 1928, 1963, 1972] [Cope Psoas sign]
• Cope VZ. The diagnosis of the acute abdomen in rhyme [Pseudonym ‘Zeta’]. 1947
• Cope VZ. Medicine and pathology. 1952
• Cope Z. A sign of gall-bladder disease. Br Med J. 1970 Jul 18;3(5715):147-8. [Cope sign]

Medical History

• Cope VZ. Pioneers in acute abdominal surgery. Oxford, 1939
• Cope VZ. The versatile Victorian: being the life of Sir Henry Thompson, Bt. 1820-1904. 1951
• Cope VZ. William Cheselden 1688-1752. 1953
• Cope VZ. Surgery: History of the Second World War. 1953
• Cope VZ. The History of St. Mary’s Hospital Medical School. 1954
• Cope VZ. A Hundred Years of Nursing at St Mary’s Hospital. 1955
• Cope VZ. Florence Nightingale and the doctors. Museum Press, 1958.
• Cope VZ. The Royal College of Surgeons of England: A History. 1959
• Cope VZ. Six disciples of Florence Nightingale. Pitman Medical Publishing Co., 1961
• Cope VZ. Some famous general practitioners and other medical historical essays. 1961
• Cope VZ. Sir John Tomes: A Pioneer of British Dentistry. 1961
• Cope VZ. Contributions to the history of surgery from 1912 to 1962. Proc R Soc Med. 1963;56(Suppl 1):37-9.
• Cope VZ. A History of the acute abdomen. Oxford Univ. Press, 1965
• Cope VZ. Almroth Wright: founder of modern vaccine-therapy. 1966
• Cope Z. The influence of the free dispensaries upon medical education in Britain. Med Hist. 1969 Jan;13(1):29-36.

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References

Biography

• Obituary: Sir Vincent Zachary Cope. Br Med J. 1975 Jan 11; 1(5949): 98–99.
• Sir Arthur Porritt. Vincent Zachary Cope 1881-1974. Br J Surg. 1975 Aug;62(8):668-9.
• Lefanu W. Vincent Zachary Cope, Kt., M.D., M.S., F.R.C.S. Med Hist. 1975 Jul;19(3):307-8.
• Vincent Zachary Cope. Lancet. The Lancet, 1975; 305(7898): 115-117
• Eastcott HH. Sir Zachary Cope. Ann R Coll Surg Engl. 1975 May;56(5):276-7. 
• Burke PF. The dexterous hand; Zachary Cope, surgeon and author 1881-1974. Surgical News. The Royal Australasian College of Surgeons. 2016;17(1):40-42
• Biography: Sir Vincent Zachary Cope. Plarr’s Lives of the Fellows Online. Royal College of Surgeons of England
• Zachary Cope ward. St Mary’s Hospital
• Bibliography. Cope, Zachary 1881-1974. WorldCat Identities
• Gravestone of Sir Vincent Zachary Cope (1881–1974), confirming his birth and death dates.

Eponymous terms

• Carling ER. British Surgical Practice: Abdominal Emergencies to Autonomic Nervous System. 1947; I: 293-319
• Berry J, Malt RA. Appendicitis near its centenary. Ann Surg. 1984; 200(5): 567-575.
• Izbicki JR et al. Accurate diagnosis of acute appendicitis: A retrospective and prospective analysis of 686 patients. Eur J Surg. 1992; 158(4): 227-231
• Schwaitzberg S. Celebrating 100 years of Cope’s Early Diagnosis of the Acute Abdomen. Surgery. 2023 Oct;174(4):874-879.
• Cadogan M. Appendicitis eponymous signs. Eponymythology

Cope’s sign

• Kaufman JM, Lubera R. Preoperative use of atropine and electrocardiographic changes. Differentiation of ischemic from biliary-induced abnormalities. JAMA. 1967 Apr 17;200(3):197-200
• O’Reilly MV, Krauthamer MJ. “Cope’s sign” and reflex bradycardia in two patients with cholecystitis. Br Med J. 1971 Apr 17;2(5754):146.
• Lau YM, Hui WM, Lau CP. Asystole complicating acalculous cholecystitis, the “Cope’s sign” revisited. Int J Cardiol. 2015 Mar 1;182:447-8. 
• Ola RK, Sahu I, Ruhela M, Bhargava S. Cope’s sign: A lesson for novice physicians. J Family Med Prim Care. 2020 Oct 30;9(10):5375-5377.
• Mainali A, Adhikari S, Chowdhury T, Shankar M, Gousy N, Dufresne A. Symptomatic Sinus Bradycardia in a Patient With Acute Calculous Cholecystitis Due to the Cardio-Biliary Reflex (Cope’s Sign): A Case Report. Cureus. 2022 Jun 1;14(6):e25585.
• Yale SH, Tekiner H. Clarifying misconceptions about Cope’s sign. J Family Med Prim Care. 2022 Jun;11(6):3378-3379. 
• Shehata R, Anos A, Mohammed MFK, Hekal M, Elatiky M. The Cardio-Biliary Reflex in Gallbladder Disease: A Case Report and Literature Review. Cureus. 2025 Oct 10;17(10):e94272.