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Water Systems Analysis,
Design, and Planning
Water Systems Analysis,
Design, and Planning
Urban Infrastructure
Mohammad Karamouz
MATLAB® is a trademark of The MathWorks, Inc. and is used with permission. The MathWorks does not warrant the
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DOI: 10.1201/9781003241744
Typeset in Times
by codeMantra
To the great power of mind and those who have striven to
utilize it for the betterment of our hydro-planet.
Mohammad Karamouz
Contents
Preface............................................................................................................................................xxv
Acknowledgments..........................................................................................................................xxxi
Author......................................................................................................................................... xxxiii
Chapter 1 Introduction...................................................................................................................1
1.1 Introduction........................................................................................................1
1.2 Urban Water Cycle.............................................................................................2
1.2.1 Components...........................................................................................3
1.2.2 Interdependencies..................................................................................4
1.2.3 Impact of Urbanization.........................................................................4
1.3 Interaction of Climatic, Hydrologic, Cultural and Esthetic Aspects..................5
1.3.1 Climatic Effects—Rainfall Type..........................................................5
1.3.2 Hydrologic Effects.................................................................................5
1.3.3 Urban Heat Islands................................................................................5
1.3.4 Cultural and Esthetic Aspects...............................................................6
1.4 Urban Water Infrastructure Management.......................................................... 7
1.4.1 Life Cycle Assessment..........................................................................8
1.4.2 Environmental, Economic, and Social Performances...........................9
1.4.3 Urban Landscape Architecture........................................................... 10
1.5 Systems Approach............................................................................................ 12
1.5.1 General Systems’ Characteristics........................................................ 13
1.5.2 System Properties................................................................................ 15
1.6 Hydrologic Variability...................................................................................... 17
1.6.1 Hydrologic Variables and Parameters................................................. 18
1.7 Representations, Statistical, and Simulation Models....................................... 18
1.8 Extreme Values, Vulnerability, Risk, and Uncertainty.................................... 19
1.9 Tools and Techniques.......................................................................................20
1.9.1 Systems Modeling............................................................................... 22
1.9.2 Model Resolution................................................................................ 22
1.10 The Hierarchy of Water for Life and Total Systems Approach........................ 23
1.10.1 The Biosphere......................................................................................24
1.10.2 System-Based Thinking......................................................................24
1.10.3 Natural Systems..................................................................................25
1.10.4 Human and Institutional Systems.......................................................25
1.10.5 Built Environment—Infrastructure.....................................................25
1.10.6 Disasters and Interdependencies.........................................................25
1.11 People’s Perception—Public Awareness..........................................................26
1.11.1 Integrated Water Cycle Management..................................................28
1.12 Economics of Water.........................................................................................28
1.13 Clean Water Act............................................................................................... 29
1.13.1 The Basis of State Water Laws in the United States........................... 30
1.14 Concluding Remarks and Book’s Organization............................................... 31
Problems...................................................................................................................... 31
References................................................................................................................... 33
vii
viii Contents
Problems.................................................................................................................... 413
References................................................................................................................. 415
Index...............................................................................................................................................903
Preface
This book has been assembled with the intent of exploring various theoretical, practical, and real-
world applications of systems analysis, design, and planning of urban water infrastructures. Review
and inclusion of some of the recent research done in each area has also been covered. Fourteen
chapters of this book are organized in an integrated fashion in order to be used as a whole package,
while each chapter can be utilized independently. Four chapters have been dedicated to background
information regarding water science and engineering focusing on urban challenges. Subsequently,
another three chapters cover stormwater, water supply, and wastewater and related infrastructures,
followed by four chapters discussing a wide range of novel topics ranging from water assets man-
agement, water economics, systems analysis techniques, risk, reliability, and disaster management.
Finally, modeling, flood resiliency, and environmental visualization chapters are a compilation of
tools and emerging techniques that elevate us to a higher plateau in water systems’ assessment.
Another key feature of this book is the taking into account of the critical emerging urban and
coastal issues such as satellite applications, citizen science, and digital data model (DEM) advance-
ments in water-related issues.
We should ask what is precisely unique about the contents of this book that could make it dis-
tinctive. To address that, it could plausibly be argued that there are very few textbooks available
containing such different and comprehensive teaching materials on urban water infrastructure.
Furthermore, this book’s uniqueness has been assured through: (a) transparency, (b) technical
soundness, (c) containment of exciting materials, (d) practicality, and (e) being forward-looking.
These characteristics are further discussed in Chapter 1. The topics cover the state-of-the-art
emerging technologies available and the main challenges we are facing such as satellite and digital
data evolution, growing challenges of risk and uncertainty, and disaster preparedness.
It is emphasized that water conservation, better systems’ operation, higher end use standards, and
water allocation efficiencies are still the main instruments to offset the growing demand. But they
are perhaps not enough for many societies that are struggling to bring supply and demand as well
as storm and wastewater management to a sustainable level. More vigilant approaches are needed
combined with political will to identify champions for water management in every region that faces
scarce water and financial resources. Following some of the more recent initiatives in this book for
water reuse, asset management, and continuous planning and performance evaluation equipped
with the latest monitoring and environmental visualization techniques could be instrumental for
bringing true water sustainability and resiliency to communities and for the livable cities of the
future.
The materials covered in different chapters are described in a systematic and integrated fashion
that are useful for undergraduate and graduate students and practitioners as follows:
Chapter 1 provides an introduction to different aspects of water science, engineering, planning,
and management. It discusses the concepts of integration, sustainability, and public participa-
tion with an emphasis on laws, regulations, and public participation, and a brief reasoning on the
absence of water governance in this book. Three distinct pillars for analysis, design, and planning
are presented in this chapter: urban water cycle and variability as the state of water being; landscape
architecture as the medium for built by design; and total systems as the planning approach.
Chapter 2 presents an overview of water balance in the hydrologic cycle, and interactions of
climatic, hydrologic, and urban components are discussed. Losses or abstractions in hydrology
(evaporation, evapotranspiration, and infiltration) are covered in detail in this chapter including
physics-based methods such as Palmer drought severity index (PDSI). Inclusion of PDSI is particu-
larly interesting as it is a widely used index to determine the state of water availability that agencies
are relying on for short- and long-term planning. A case study of water balance-based water supply
and demand sustainability is also included. The need for a simultaneous change in the cognitive,
xxv
xxvi Preface
normative, and regulative conditions of the urban water management regime for sustainability tran-
sition is emphasized. Some attributes of livable cities of the future with emphasis on water drivers
are also presented.
Chapter 3 discusses runoff and water accumulation quantity analysis and related issues such as
excess rainfall estimation, rainfall–runoff analysis, calculation of peak flow, and its occurrence time
as well as hydrograph analysis. Overland flow and water conveyance in urban area are more compli-
cated than in undeveloped area because of the complexity of the paths that rain and stormwater are
taking. Interdependencies of water infrastructure with other infrastructures make the urban hydrol-
ogy and extreme value analysis more complicated and critical. Design values are key to many urban
development issues and are analyzed by frequency analysis and the use of probability distributions.
Time series analysis and modeling are discussed within a limited scope applicable to urban area.
This chapter’s unique feature is that it provides all the background needed on science and applied
techniques in hydrology in general and urban water in particular to handle the engineering and
planning issues presented in the other chapters.
Chapter 4 presents the technical aspects of developing and solving governing urban water
hydraulics principles. Measuring the effect of geomorphic changes (land use driven) on urban
water is essential to mitigate the potential effects. The urban water management is more effec-
tive if risk assessments included geomorphological changes to underpin nature-based management
approaches. The land use alterations are addressed. Changes in geomorphic process regimes can
also be triggered by extreme events. Implementing geomorphological adaptation strategies will
enable communities to develop more resilient, less vulnerable socioeconomic systems fit for an age
of climate extremes. The outcome of such approach will be of interest to landscape architects/plan-
ners and regulators because of the complexities related to stormwater collection and flood manage-
ment. In this chapter, these issues and some basic concepts of hydraulic design of urban drainage
and water distribution systems are introduced.
Chapter 5 describes different aspects of the design and planning of urban drainage systems. This
chapter is particularly useful for developing urban areas. Many street and highway drainage issues
and requirements are discussed that transportation engineers and contractors can effectively utilize.
A dedicated and perhaps unique feature of this chapter is the inclusion of detailed land use planning,
which is the essence of Integrated Urban Water Management, based on DSR (Driving force, State,
and Response) dynamic strategy planning procedure. The following issues are also addressed: spe-
cial characteristics of the urban storm; the complexity of urban watersheds; imperviousness and the
maze of water pathways/channels; local ordinances and risk-based design values; streets/highways
drainage (street gutters, stormwater inlets, and storm sewers); control structures/best management
practices (BMPs) (with emphasis on green solutions); and urban flood, combined sewer overflow
(CSO), and interdependencies (water, energy, and transportation). Perhaps the key to many growing
urban stormwater management challenges is the lack of appropriate land use planning and excessive
human intervention that exuberate the extreme events to disasters. Sections 5.3–5.7 are particularly
useful for transportation and highway engineers and contractors.
In Chapter 6 different components of urban water supply infrastructures have been presented
and their interactions among UWC have also been discussed. Basic concepts on water storage and
supply facilities are considered. Reservoir operation and supply and demand management are dis-
cussed. Some basic planning issue of the urban water supply infrastructures has also been dis-
cussed in this chapter. SIM (Structural Integrity Monitoring) of water mains in order to reduce
their repair, rehabilitation, and replacement costs/issues and increase the reliability of supplying
the demands are discussed. This requires monitoring the use of various methods for detecting leaks
and predicting the impacts of alternative urban water systems on the life cycle including opera-
tion, maintenance, and repair policies of these systems. The relationship of head/pressure, dis-
charge, and leakage as well as a brief head-driven modeling are presented for water distribution
systems. Economic and financial analysis plays an important role in infrastructure development.
Some examples are given. Environmental performance is investigated in the context of sustainable
Preface xxvii
development. The interactions of systems’ components are not often well integrated in the design,
construction, rehabilitation, and maintenance of these systems. Inclusion of many elements of water
supply system in this chapter could help the potential reader to better comprehend both analysis and
design as well as operational issues of this vital lifeline.
Chapter 7 presents different issues and challenges in urban wastewater management. Wastewater
treatment, an essential factor in urban wastewater planning, is discussed and followed by a detailed
description of each part of the treatment plant. Both quantitative and qualitative aspects of waste-
water treatment are addressed in this chapter. Then the concepts of wastewater planning are intro-
duced. Afterward, the case studies related to this chapter as well as some selected cities’ wastewater
infrastructures are described. Many other case studies in other chapters are also related to waste-
water treatment plants’ vulnerability to coastal flooding. A good number of wastewater treatment
facilities are located near water bodies and are prone to system failure with considerable conse-
quences for the communities in their sewershed and the environment as the CSO impacts are getting
more severe. Some planning and standard issues related to water utilities in general and wastewater
are covered in the later part of this chapter. The main challenge of wastewater systems around the
globe is in design, construction, operation, maintenance, funding, and standards of services. As
these facilities are aging in many cities, the issue of the needed funds for rehabilitating or replacing
them is in forefront of challenges many municipalities are facing.
Chapter 8 demonstrates how asset management (AM) can facilitate infrastructure performance
corresponding to service targets over time. It helps to make sure risks are adequately managed, and
that the corresponding costs of the life cycle are minimized. Lack of sound economic, regulatory
frameworks and enforcement setup, and poor asset management practices, particularly underpriced
water services, are common problems throughout the developing regions. The urban systems’ gov-
erning bodies need plans to prioritize limited resource allocation. Therefore, this allocation should
be in line with the current structure or reformed infrastructure asset management. In AM, effec-
tive decision-making requires a comprehensive approach that ensures the desired performance at
an acceptable risk level, considering the costs of building, operating, maintaining, and disposing
of capital assets over their life cycles. Sustainable management of the system’s resources should
respond to the growing need for financial stability and sound cash flow and investment strategies in
capacity expansion and resource generation.
Chapter 9 discusses the system representation and domains with the essence of water system
analysis. Data preparation and processing techniques are described followed by multicriteria
decision-making (MCDM). Then, data-driven neural networks and fuzzy inference are introduced.
Furthermore, mathematics of growth as a basis for systems dynamics is presented. Conventional
and evolutionary optimization techniques are also introduced. Finally, the conflict resolution in the
context of Nash bargaining theory, game theory, and agent base modeling is described. For consid-
ering integration and sustainability in water resources management, it is necessary to think over the
social, economic, and environmental impacts of decisions. This integration in planning and man-
agement, especially in urban areas, needs a systematic approach, considering all the interactions
among the elements of the system and with the outside world. Simulation of urban water dynam-
ics will give the collective impacts of all possible water-related urban processes on issues such as
human health, environmental protection, quality of receiving waters, and urban water demand.
Chapter 10 displays the topics needed to cover the objective of placing design and analysis of
infrastructure into a reliability framework. To do that, the concept of probability, basic statistics,
common probabilistic models; extreme value (flood) and frequency analysis—design values; and
basic concept of risk and uncertainty are discussed. Then reliability in the context of serial and
parallel components as well as load and resistant concept are described. The performance indica-
tor with emphasis on vulnerability and resiliency is presented including a case study. The basis of
uncertainty analysis is covered with a summary of how error and uncertainties have been quanti-
fied in the case studies of this book. The entropy theory including transinformation (measure of
redundancy in information) is also discussed in the context of water resources issues to measure the
xxviii Preface
information content of random variables and models, evaluate information transfer between hydro-
logical processes, evaluate data acquisition systems, and design monitoring networks. The materials
covered in this chapter allow a realistic assessment of how to characterize and manage risk. The
adaptation and mitigation issues are further discussed in other chapters’ case studies.
Chapter 11 provides information related to the nature of water disasters and the factors con-
tributing to the formation and extent of changes caused by a disaster. The notion of water hazard
(including water scarcity) as a “load” and our ability to withstand it as a “resistance” is discussed
in the context of reliability and risk-based design. The elements of uncertainty and how risk man-
agement can be coupled with disaster management are presented. This chapter is divided into 11
sections with the following focus areas: First, an introduction to UWDM is presented. Then the
planning process for UWDM is presented, followed by situation analysis, disaster indices, and risk
and uncertainty elements of disaster. Guidelines for UWDM and preparedness planning are also
presented.
Chapter 12 displays data-driven mathematical models’ applications with accentuation on new infor-
mation-based and machine learning models. In the subsequent part, various kinds of physical-based
hydrologic models of rainfall–runoff including lumped models, semidistributed models like IHACRES
(acronym for Identification of unit Hydrographs and Component flows from Rainfall, Evaporation, and
Streamflow data), StormNET, and HBV (Hydrologiska Byråns Vattenbalansavdelning) are briefly dis-
cussed. Distributed models with applications of HEC-HMS (Hydrologic Modeling System), Gridded
Surface/Subsurface Hydrologic Analysis (GSSHA), and LISFLOOD are presented that are widely
used in urban flooding applications. A hydrodynamic model of Delft3D with two modules of FLOW
and WAVE and hydraulic-driven models such as EPANET and QAULNET are also presented. The
three case studies presented show how these models can help the engineers and the decision makers
to better prepare for water-related incidents such as inland and coastal floods. There are many other
applications of these data-driven and system dynamics models throughout this book, especially in
Chapters 5, 6, 9, and 13.
Chapter 13 initiates flood resilient city that includes building smart communities, tools, models,
and data processing and information management; flood hazard characterization and warning appa-
ratus; inner and other links and interdependency characterization; infrastructure risk; sound asset
and financial management; and performance measures. A number of these issues are discussed
in this chapter and elaborated in the case studies. At the end, a gap analysis section discusses the
remaining challenges and looking-forward perspective for a livable city of the future. The historical
floods and real-world flood problems of water infrastructures which apply to one of the most crucial
systems, New York City’s WWTPs, are discussed. Factors contributing to flood hazards, evacua-
tion zones, resiliency and flood risk management are also presented. The application of resiliency
concept and how it can be used as a metric for performance evaluation and resource allocation are
explored through a number of case studies.
Chapter 14 presents the significance of visualization for information representation. Its function-
ality to serve as a storage mechanism, a processing and research instrument, and a communication
tool is increasing with the past of advances in optic and imagining technologies. Visualization tech-
nology is capable of transferring information into a simple image or animation. Environmental visu-
alization (EV) is one of the hottest areas that many imaging technologies have been realized and
utilized with many more potential for ground-breaking new developments. The generated image is
typically a compilation of hundreds of pages of information from large and cumbersome reports.
As a result, visualization acts as a data management tool that collates, organizes, and displays large
volumes of information. It has special application in disaster management and flood inundation
that can be utilized by a variety of users with low to very high technical capabilities. The water
movement and accumulation and water infrastructures need to be continuously monitored. With
the materials presented in this chapter ranging from sensors, to pattern recognition tools and tech-
niques, to satellite technology and data collections almost all in imaging forms, to development of
citizen science applications, we have realized many immerging opportunities. The future of water
Preface xxix
recourses assessment, protection, water hazard prevention, and effective visual communication lies
on the advancement of environmental visualization and how we are prepared to utilize it.
This book incorporates feedback from my students in water system analysis courses and from
my collaborators of many research and real-world projects in the national and international arena
in the past 30 and more years. It is my hope that this book can add significant value to the applica-
tion of systems analysis and design techniques for water infrastructure planning around the world.
Mohammad Karamouz
Tehran, Iran—Great Neck, New York
December 2021
MATLAB® is a registered trademark of The MathWorks, Inc. For product information, please
contact:
xxxi
Author
Mohammad Karamouz is a professor at the University of Tehran. He is an internationally known
water resources engineer and consultant. He is licensed as a PE in the state of New York since 1985.
He is the former dean of engineering at Pratt Institute in Brooklyn, New York. He is also a fellow
of the American Society of Civil Engineers (ASCE) and a diplomat of the American Academy
of Water Resources Engineers. Dr. Karamouz received his BS in civil engineering from Shiraz
University, his MS in water resources and environmental engineering from George Washington
University, and his PhD in hydraulic and systems engineering from Purdue University. He served
as a member of the task committee on urban water cycle in UNESCO-IHP VI and was a mem-
ber of the planning committee for the development of a 5-year plan (2008–2013) for UNESCO’s
International Hydrology Program (IHP VII). Among many professional positions and achievements,
he also serves on a number of task committees for the ASCE. In his academic career spanning
35 years, he has held positions as a tenured professor at Pratt Institute (Schools of Engineering and
Architecture in Brooklyn) and at Polytechnic University (Tehran, Iran). He was a visiting professor
in the Department of Hydrology and Water Resources at the University of Arizona, Tucson, 2000–
2003, and a research professor and Director of Environmental Engineering Program at Polytechnic
Institute of NYU, 2009–2014. He was also the founder and former president of Arch Construction
and Consulting Co. Inc. in New York City. His teaching and research interests include integrated
water resources planning and management, flood resilient cities, groundwater and surface water
hydrology and pollution, systems analysis and design, urban environmental systems management,
DEM and Satellite data error analysis and downscaling, environmental visualization including
image processing, pattern recognition, and data assimilation. He has more than 350 research and
scientific publications, books, and book chapters to his credit, including four text books: Water
Resources System Analysis published by Lewis Publishers in 2003 Urban Water Engineering and
Management (2010), and Hydrology and Hydroclimatology (2012), and Groundwater Hydrology
(1st ed. 2011 and 2nd ed. 2020) published by CRC Press. He also coauthored a book entitled Urban
Water Cycle Processes and Interactions published by Taylor & Francis Group in 2008, and was
the lead editor of the book Livable Cities of the Future (2014) published in collaboration with
the National Academy of Engineers (NAE) by the National Academies Press in Washington, D.C.
Professor Karamouz serves internationally as a consultant to both private and governmental agen-
cies, such as UNESCO and the World Bank. In 2017, he received the year distinguished researcher
award of the University of Tehran. Dr. Karamouz is the recipient of the 2013 ASCE Service to the
Profession and 2018 ASCE Arid Land Hydraulic Engineering Awards.
During my academic career as a professor and in conviction of my personal life, I have received
help and encouragement from so many people that it is not possible to name them all. To all of you,
I express my deepest thanks. There were a few including some colleagues and former students that
have tried to stop or discourage me. I am grateful to them too because without them I could not be
so determined to improvise. Water resources system analysis has been a part of a personal journey
that began years ago when I was a young boy with a love for water. Books are companions along the
journey of learning, and I hope that you will be able to use this book in your own exploration of the
field of water resources. Have a wonderful journey.
xxxiii
1 Introduction
1.1 INTRODUCTION
This book has been assembled with the intent of exploring various theoretical, practical, and real-
world applications of system analysis, design, and planning of urban water infrastructures. Review
and inclusion of some of the recent research done in each area has also been covered. To that end, 14
chapters of this book are organized in an integrated fashion in order to be used as a whole package,
while each chapter can be utilized independently. Four chapters have been dedicated to background
information regarding water science and engineering focusing on urban challenges. Subsequently,
another three chapters cover stormwater, water supply, wastewater, and related infrastructures, fol-
lowed by four chapters discussing a wide range of novel topics ranging from water assets, water
economics, systems analysis, risk, reliability, and disaster management. Finally, modeling, flood
resiliency, and environmental visualization chapters are a compilation of tools and emerging tech-
niques that elevate us to a higher plateau in water systems’ assessment. Another key feature of this
book is the taking into account of the critical emerging urban and coastal issues such as satellite
applications, citizen science, and digital elevation model (DEM) advancements in water-related
issues.
One might think what is precisely unique about the contents of this book that could make it
distinctive. To address that, it could plausibly be argued that there are very few textbooks avail-
able containing such different and comprehensive teaching materials on urban water infrastruc-
ture. Furthermore, this book’s uniqueness has been assured through: (a) transparency, (b) technical
soundness, (c) containment of exciting materials, (d) practicality, and (e) being forward-looking.
Each of the mentioned attributes is further elaborated as follows:
a. Transparency: Arguments made in this book are supported by latest journal articles’
citations and then illustrated through example problems. They are easy to follow and
flow in a logical order. Chapters have a clear organizational structure with an introduc-
tion and a concluding remarks sections that sum up the most significant points of the
chapter.
b. Technical soundness: Much experience and feedback have been derived from the last four
textbooks of the author and have been put to use in gatherings in this book. The scientific
phenomena discussed in this book are professionally based and have been tested in the
included case studies.
c. Excitement: Each chapter has a distinctive characteristic and attributes ranging from sci-
ence to engineering to a planning voyage, urban lifeline characteristics, system thinking,
and dynamics all the way to asset/value-driven goals, to resiliency, pattern recognition,
and environmental visualization.
d. Practicality: Targeting some of the most pressing real-world challenges through a practi-
cal approach by means of case studies that include engineering judgments and practice
attributes.
e. Forward-looking: Covering the state-of-the-art technologies available and the emerging
challenges topics such as satellite and digital data evolution; growing reliance on risk and
uncertainty based solutions; and disaster preparedness planning.
Water and science of water (hydrology), urban water movement and services, infrastructures, and
institutional supports are our domain in this book. Spatial and temporal variability; and social,
DOI: 10.1201/9781003241744-1 1
2 Water Systems Analysis, Design, and Planning
environmental, and economic issues are the states. The driving forces are natural hazards; human
and anthropogenic interventions; water lifeline services; and health, safety, and preparedness attri-
butes for planning purposes.
A watershed is the best hydrological unit that can be used to carry out water studies and planning.
In urban areas, the term sewershed is often used that has watershed characteristics with man-made
drainage elements. The urban setting alters the natural movement of water. Drastic land use changes
in urban areas are a subset of urban and industrial development affecting natural landscapes and
the hydrological response of watersheds. Although anthropogenic factors concerning waterways,
pipes, abstractions, and built environment affect the elements of the natural environment, the main
characteristics of the hydrological cycle remain the same in urban areas but are significantly altered
by urbanization impacts of the services to the urban population, such as water supply, drainage, and
wastewater collection and management.
As a conceptual way of looking at water balances in urban areas, the context of the urban water
cycle is a total systems approach of natural, human and institutional, and built environment systems
(see Section 1.10 for more details). Water balances studies are generally conducted on a different
time scale, depending on the type of applications in a planning horizon. Among the planning objec-
tives, water has to be distributed to growing populations and communities should be prepare to cope
with storms from extreme weather and climatic variability and potential climate change.
Wastewater collection and treatment with a biological operation unit (which is climate sensitive)
plays an essential role in a city’s daily operation with many external elements such as stormwater
that could threaten its safe operation by causing sewer overflow. Along with water supply and dis-
tribution, these threefold water-related services constitute a valuable asset for a city. Assets that are
often poorly managed with their state of operation and maintenance. They should be consciously
evaluated and planned to face/reduce the risk of failures as the natural disasters are getting more
frequent, the customer dependencies are higher, and there are growing interdependencies with other
infrastructures. These systems can be simulated with different models such as data-driven models
that are subject to input, parameters, and model structure uncertainties. The climate-induced hazards
and the sheer size of water systems, which are subject to many interdependencies and uncertainties,
have brought new paradigms to measure performance and a new metric for resource allocation. It
is called resiliency. In a number of case studies, it is demonstrated how resiliency is being used as a
new norm for performance evaluation. Finally, new imaging and digital/satellite data technologies
combined with pattern recognition and its machine learning attributes have brought new opportuni-
ties for utilizing many environmental visualization techniques. These emerging issues and opportu-
nities have been realized through applications such as water-related land use and landscape, water
and soil interactions, and flood hazard mitigation in this book. In the remaining of this chapter,
three distinct pillars for analysis, design, and planning are presented: urban water cycle and vari-
ability as the state of water being; landscape architecture as the medium for built by design; and
total system as the planning approach.
Water governance is not discussed here as the focus of this book is more on tools and techniques
and less on institutional and administrative aspects of water infrastructure management. There are
so much variability on the past practices, politics, organizational structure, even cultural aspects of
water governance that is too difficult and sometimes too impractical to find and prescribe a good
governance model for a region. We should hope that through the exercise of sound analysis and
planning of water systems described in this book, the regional evolution of water governance hap-
pens. See Chapter 2 of Karamouz et al. (2010) on the water governance.
environmental components so that the analysis results can be incorporated holistically. For provid-
ing such a framework, an understanding of system concepts is needed.
Furthermore, the interactions and the variability in physical, chemical, and biological processes
in and among urban system components need to be addressed. This understanding and knowl-
edge can also be used to develop prediction and early warning systems widely used concerning
the behavior of different components of the hydrologic cycle in general and urban water cycle in
particular.
1.2.1 Components
Changes in the material and energy fluxes and the amount of precipitation, evaporation, and infil-
tration in urban areas result in changes in water cycle characteristics. The impacts of large urban
areas on local microclimate have long been recognized and occurred due to changes in the energy
regime such as air circulation patterns caused by buildings, transformation of land surfaces and land
use planning, water transfer, waste generation, and air quality variations. These changes, which are
depicted in Figure 1.1, can be summarized as follows:
• Land use: The transformation of undeveloped land into urban land, including transporta-
tion corridors
• Demand for water: Increased demand because of increased concentration of people and
industries in urban and nearby suburban areas
• Increased entropy: The redundant use of unsustainable forms of energy
• Waste production: Substantial waste and industrial hazardous wastes and decreasing qual-
ity of different resources such as air, water, and soil
• Water and food transfer: Moved from other places to urban areas
FIGURE 1.1 Changes in natural process of the hydrologic cycle due to urbanization. (From Marsalek,
J., Cisneros, B.J., Karamouz, M., Malmquist, P.A., Goldenfum, J.A., and Chocat, B.. Urban Water Cycle
Processes and Interactions: Urban Water Series-UNESCO-IHP (Vol. 2). CRC Press, Boca Raton, FL, (2008).)
4 Water Systems Analysis, Design, and Planning
FIGURE 1.2 Interdependencies in natural, biological, and constructed environments in urban watershed
scale.
1.2.2 Interdependencies
The urban water cycle may be depicted as a system on a watershed with varied land uses to show how
it is impacted by external forces. The components and processes impacting this cycle are altered as a
result of the interdependencies in such a watershed. These interdependencies in natural, biological,
and constructed environments have ripple effects on the urban water cycle. Figure 1.2 demonstrates
that as an overlay of four layers of: components; links and correlations (processes); interdependen-
cies; and externalities. Externalities are costs and benefits that are passed down through the system
as a result of the system’s component interactions and anthropogenic activities. Furthermore, the
urban water cycle as an open vapor/water/matter circulation system should be presented in a water-
shed scale and should be looked at as a hot spot as the temperature and pollution have intensified
variations and impacts in urban regions.
1.2.3 Impact of Urbanization
Physical, chemical, and biological impacts on the water cycle have caused severe and adverse deple-
tion of water resources in many urban areas worldwide. Modifications of significant drainage canals
from natural to human-made structures impact the runoff hydrograph that affects the rate of erosion
and siltation. Pollutants such as hydrocarbon and other organic wastes, food waste, garbage, and
other substances are carried by surface runoff. Discharging urban drainage into bodies of water
causes a variety of harmful effects on the nearby environment, both short- and long-term. The mag-
nitude of the impacts depends on factors such as the condition of the water body before the dis-
charge occurs, its carrying capacity, and the quantity and distribution of rainfall, land use in the
basin, and type and quantity of pollution transported. The problems cause esthetic changes as well
as pollutions from toxic substances.
The soil will be consolidated in metropolitan areas due to the high density of houses and other
structures. As a result, soil porosity declines, reducing the quantity of water that can be held and
released from urban aquifers. Another impact of urbanization on urban aquifers is the decreasing
recharge to the aquifer because of decreasing infiltration. Certain urban areas with many absorption
Introduction 5
wells are subject to a high rate of wastewater infiltration into the aquifer. Groundwater resources
have been polluted by urban activities in many cities of the world. For example, landfill leakages
and leakage from wastewater sewers and septic tanks and gas stations are the most well-known
point sources that cause groundwater pollution in urban areas.
The hydrological response of urban regions is determined by calculating surface runoff hydro-
graphs, which are then routed via the drainage network’s conduits and channels to create outflow
hydrographs at the urban drainage outlets. In various areas of an urban region, the physical param-
eters of a catchment basin in terms of the rainfall–runoff process might change dramatically. The
unit hydrograph is a traditional means of representing linear system response. However, it suffers
from the limitation that the response function is lumped over the whole catchment and does not
explicitly account for spatially distributed characteristics of the catchment’s properties. Drought and
flood severity and their impacts on urban areas are more significant. After urbanization, the peak
of the unit hydrograph increases and occurs earlier, and the flooding condition is more severe. Also,
because of high water demand, urban areas are more vulnerable during hydrological drought events.
Due to the high rate of water use in urban areas, social, political, and economic issues related to
water shortage in urban areas are intensified.
• Convective rainfall is more frequent, with high intensity and a short duration of time, cover-
ing small areas. This type of rainfall is more critical for an urban basin with a short time of
concentration (high flow velocity due to gutter and pipe flows) and a small catchment area.
• Long periods of rainfall with high volumes of water result in water ponding in the streets.
This situation is critical for detention systems. Since the wet periods are concentrated in
only a few months (e.g., 500 mm in 15 days has a return period of about 15 years) and there
is a storage system, its critical design condition is mainly based on rainfall volumes of a
few days rather than on a short period of rainfall.
1.3.2 Hydrologic Effects
Urbanization increases surface runoff volumes and peak flows. Such excess rainfall may lead to
flooding, sediment erosion and deposition, habitat washout (Borchardt and Statzner, 1990), geomor-
phologic changes (Schueler, 1992), and reduced recharge of groundwater aquifers. These effects
may be divided into two categories: acute and cumulative. Flooding and stream channel incision go
into the first category, whereas groundwater table lowering and morphological changes go into the
second. There are more explanations about this heading in Chapter 2.
been steadily increasing at a rate of 1.5°F every 10 years. Each city’s UHI varies based on city layout,
structure, infrastructure, and the range of temperature variations within the island. The urban area will
have a higher temperature than the rural area due to the absorption and storage of solar energy by the
urban environment and the heat released into the atmosphere from industrial and communal processes
(Ytuarte, 2005). The UHI effect can adversely affect a city’s public health, air quality, energy demand,
and infrastructure costs (ICLEI, 2005). Attention should be paid to the following issues in UHI:
• Poor air quality: Hotter air in cities increases the frequency and severity of ground-level
ozone (the primary component of smog) and can drive cities out of compliance. Smog is
formed when air pollutants such as nitrogen oxides (NOx) and volatile organic compounds
(VOCs) are mixed with sunlight and heat. The rate of this chemical reaction increases
when the temperature exceeds 5°C.
• Risks to public health: The UHI effect prolongs and intensifies heat waves in cities, making
residents and workers uncomfortable and putting them at increased risk for heat exhaustion
and heat stroke. In addition, high concentrations of ground-level ozone aggravate respira-
tory problems such as asthma, putting children and the elderly at particular risk.
• High energy use: Higher temperatures increase the demand for air conditioning, thus
increasing energy use when demand is already high. This, in turn, results in power short-
ages and raises energy expenditures when energy costs are at their highest.
• Global warming: The combustion of fossil fuels to generate power for heating and cooling
buildings contributes significantly to global warming. UHIs exacerbate global warming by
increasing the demand for electricity to cool buildings. Depending on the fuel mix used in
producing electricity in the region, each kWh of electricity consumed can produce up to
1.0 kg of carbon dioxide (CO2), the main greenhouse gas contributing to global warming.
Mitigating UHI is a simple way of decreasing the risk to public health during heat waves while also
reducing energy use, the emissions that contribute to global warming, and the conditions that cause
smog.
Cities in cold climates may benefit from the wintertime warming effect of heat islands. Warmer
temperatures can reduce heating energy needs and may help melt ice and snow on roads. In the sum-
mertime, however, the same city may experience the adverse effects of heat islands. Fortunately,
communities can take a number of steps to lessen the impacts of heat islands. These “heat island
reduction strategies” include the following:
• Reducing the high emission from transportation through traffic zoning and well-managed
public transportation
• Installing ventilated roofs and utilizing passive sources of energy in buildings
• Planting trees and other vegetation
rainwater collection systems, the material used in construction, and wastewater collection sys-
tems are significant factors, among others, that alter the urban water cycle. The change in design
paradigm has made significant changes in architecture and moves it towards ecological-based
design.
Lifestyles in urban areas affect the hydrologic cycle through changes in domestic water demands.
Water use per capita and water used in public centers such as parks and green areas are the main
characteristics that define the lifestyle in large cities. Even though economic factors are important
in determining these characteristics, the patterns of water use, tradition, and culture have more sig-
nificant effects on the lifestyle in urban areas.
A turning point in exploring ideas and revisiting a combination of landscape architecture and
stormwater management has been the occurrence of the notorious Superstorm Sandy in October
of 2012. Sandy was a real wake-up call as far as the urgency for integration of critical infrastruc-
tures has been concerned but also for utilizing esthetically enhancing practices that could bring
livelihood, mobility, and relief to the affected communities. There was an apparent lack of holistic/
system-based thinking and an inadequate understanding of the region’s vulnerability that had led
to large-scale losses and casualties. Nationwide concerns led to the formation of a comprehensive
effort through “Rebuild by Design.” In December 2013, President Obama signed an executive order
creating the Hurricane Sandy Rebuilding Task Force to ensure that the Federal government con-
tinues to provide appropriate resources to support affected state, local, and tribal communities to
improve the region’s resilience, health, and prosperity building for the future. The Task Force was
commissioned to ensure cabinet-level, government-wide, and region-wide coordination to help com-
munities make decisions about long-term rebuilding.
Following the presidential executive order, the US Department of Housing and Urban
Development (HUD) initiated a competition with the collaboration of the Netherlands govern-
ment called Rebuild by Design (RBD). It consisted of ten teams, including the finalists BIG U,
New Meadowlands, Hudson River Project, and Hunts Point Lifelines among other groups made
up of experts, landscape architects, and engineers to generate ideas and conceptual designs for
flood risk management. The main objective was to find solutions suitable and adaptable for flood
control infrastructure during both extreme events and normal weather conditions. The BIG U
represented the notion of integrating a city park with floodwalls. The New Meadowlands team
suggested an integrated linked system of embankments and wetlands to flood protection through
the Meadowlands in New Jersey. The Hudson River Project proposed the green and gray infra-
structure approach for reducing flood risk and achieving a more comprehensive flood management
strategy such as landscape-based and engineered-based coastal defenses. Hunts Point Lifelines’
proposal also included green and gray flood protection and measures to protect critical economic
assets, including transportation in the region. See RBD (2014a–d) for more information. This
competition provided a unique opportunity for landscape architects, planners, and engineers to
explore many ideas generated for rethinking and rebuilding of flood resilient cities. Local cultural
and esthetic reflections were core issues confronted by all the design groups involved. See Chapter
13 for more details.
from using a mix of systems, and this mix will change with location and time. Centralized, large-
scale systems will still dominate water infrastructure in many regions for the next few decades,
partly because they are there and because it is difficult to change them due to engineering, environ-
mental, economic, and social reasons. For example, headwater dams and other facilities will be too
difficult and costly to alter to any significant degree. The smaller alternative systems will have an
increasingly important role, but their role will be limited by the source of supply in most cases. The
more congested the site and the more the property interests involved, the harder it will be to replace
centralized systems with other alternatives. In the following sections, narratives are presented for
assessment, performance aspects, and more recent paradigm shifts to bring landscape architecture
in the core water flow and conservation with many cultural, recreational, and esthetic exposures of
urban life as an ultimate sustainability goal. Water Eco-Nexus System discussed in Section 1.4.3
could bring innovative and distributed treatment solutions to replace or enhance large-scale central-
ized systems for urban systems.
The application of LCA to water resources systems must respect and take into account cultural
limitations to be effectively utilized. The sustainable development of accessible urban water resources
is unquestionably at the start of a much longer process. Its goal cannot be achieved by using simple
techniques to end the debate before a more in-depth discussion takes place. The physical and socio-
logical elements of the urban water system are distinctive. It furthermore has a continuity that is both
spatial and temporal. This continuity constitutes an essential value; it is a fundamental urban resource
and must be protected. Protection is required to ensure sustainability through the continuity of devel-
opment and the embedded social and physical values for urban residents (Hassler et al., 2004). See
Chapter 8 for more explanation of LCA in the context of asset management and life cycle cost.
• Waste and contamination at any stage negatively affect the sustainability of the cycle as a
whole and the health and safety of the community using that water.
• Urban planning, without considering the water cycle, results in water supply shortages,
deteriorating aquifer water quality, groundwater infiltration into the distribution system,
endemic health problems, and other symptoms of an unsustainable situation.
• Every citizen, institution, agency, and enterprise in the community has a contribution to
make towards the goal of sustainability.
It should also be noted that all components of source control through management of the cycle at
this level offers the opportunity to provide benefits for the consumer and the environment. The phi-
losophy of source control is to minimize the cost of providing water and collection of stormwater
and wastewater. Source control can be implemented through retention of roof rainwater (rainwater
tanks), stormwater detention, on-site treatment of gray water (laundry, bathroom, and kitchen) and
black water (toilet), use of water-efficient appliances and practices, and on-site infiltration.
10 Water Systems Analysis, Design, and Planning
TABLE 1.1
Examples of Community-Based Enabling Systems for a Sustainable Urban
Water Cycle
1. Source
• A long-term urban and watershed management master plan
• A source water quality and quantity monitoring system
• A geographic information and decision support system
• An inspection and enforcement system to protect source water
• A community education program
2. Use/reuse
• A metering and billing system
• An industrial discharge control program
• Regulations and bylaws
• An industrial incentive program
• A community education program on water conservation
• A network of supporting laboratories
• A monitoring and control system
• An emergency spill response system
3. Treatment/distribution
• A potable water quantity and quality monitoring and control system
• A utility operation and maintenance system, including training and accreditation of operators
• A financial, administrative, and technical management structure
• A flexible water treatment process
• An operation, maintenance, leak detection, and repair system
• Continuous pressurization
4. Treatment/disposition
• An effluent quality monitoring and control system
• A utility operation and maintenance system, including training and accreditation of operators
• An environmentally sustainable biosolids management program
• A financial, administrative, and technical management structure
• A flexible treatment system
• An end-user market
Source: United Nations University, International Network on Water, Environment and Health
(UNU-INWEH). 2006. Four pillars. Available at http://www.inweh.unu.edu/inweh/.
T
Tabes mesenterica, 939
Tænia solium, 310
Tagliacozzi’s method of rhinoplasty, 644
Talipes, 465
calcaneus, 471
equinovarus, 466
treatment of, 466
equinus, 470
causes of, 470
treatment of, 471
valgus, 468
etiology of, 468
treatment of, 469
Talma’s operation on omentum, 936
Tapping, paracentesis by, 185
Tarantula, poisoning by, 172
Tarsectomy, 467
Tartar on teeth, 657
Tattoo marks, 318, 720
Taxis, 899
T-bandage, 191
Teale’s method of amputation of foot, 1042
Teeth, caries of, 657, 664
treatment of, 665
cysts of, 666
eruption of, faulty, 665
extraction of, 666
accidents from, 666
instruments required, 666
malformations of, 652
odontoma of, 665
re-implantation of, 667
tartar of, 657
tumors of, 665
Telangiectasis, 277
Temporal artery, ligation of, 352
Temporomaxillary joint, ankylosis of, 667
dislocation of, 667
postgonorrheal arthritis of, 667
resection of, 668
synovitis of, acute, 667
Temporosphenoidal abscess, 569
Tendon sheaths, tuberculosis of, 118
Tendons, dislocation of, 330
grafting of, 324
injuries of, 218
ligation of, 326
surgical diseases of, 321
suture of, 324
syphilis of, 136
transplantation of, 324
Tendoplasty, 322
Tendosynovitis, 321
chronic, 322
treatment of, 322
suppurative, 321
treatment of, 321
Tendovaginitis, gonococcus of, 331
Tenorrhaphy, 324
Tenotomy, 327
Teratomas, 268
embryonal adenosarcoma, 268
of thyroid, 712
Tertiary syphilis, 132
Testicle, absence of, 1015
atrophy of, 1015
cancer of, 1017
chondroma of, 1017
congenital abnormalities of, 1014
contusions of, 1015
cystic degeneration of, 260
cysts of, 1016
epididymitis, 1016
treatment of, 1017
fibroma of, 1017
gonorrhea of, 151
hematoma of, 1015
hydrocele of, encysted, 260
injuries to, 1015
lipoma of, 1017
orchitis, 1017
treatment of, 1017
retained, 1014
treatment of, 1014
syphilis of, 138, 1016
tuberculosis of, 118, 1015
treatment of, 1016
tumors of, 1017
Tetanin, 98
Tetanotoxin, 98
Tetanus, 97
cephalicus, 99
chronic, 100
death in, 100
diagnosis of, 101
from hysteria, 101
etiology of, 97
hydrophobicus, 99
of newborn, 97, 99
parasitic nature of, 98
postmortem appearances in, 100
prognosis of, 100
toy-pistol, 97
treatment of, 101
Tetany, bacillus of, 54
gastric, 798
Thecitis, 328
Thiersch method of skin grafting, 188
Thigh, amputation of, 1043
above knee, 1044
fracture of, 509
diagnosis of, 511
prognosis of, 511
treatment of, 512
Thoracentesis, 736, 746
Thoracic duct, injuries to, 725
treatment of, 726
viscera, injuries to, 724
walls, diseases of, 726
Thoracoplastic operations, 748
Thoracotomy, 747
drainage in, 747
irrigation in, 747
Thorax, actinomycosis of, 729
carcinoma of, 730
chondroma of, 730
fibroma of, 729
granuloma of, 729
injuries to, 721
lipoma of, 729
malformations of, 718, 719
operations on, 746
osteoma of, 730
sarcoma of, 730
tumors of, 729
treatment of, 730
wounds of, gunshot, 230
Thrombo-arteritis, 91
Thrombophlebitis, 37, 90
Thrombosis, 34
annular, 35
causes of, 35
following abdominal operations, 784
gangrene from, 73
infective, 36, 570
marasmic, 36, 570
mechanical, 36
of mesenteric vessels, 938
obstructive, 36
parietal, 35
primary, 35
propagated, 36
sinus, 570
diagnosis of, 571
prognosis of, 571
symptoms of, 570
treatment of, 573
traumatic, 36
valvular, 35
Thrombus, calcification of, 36
decolorization of, 36
organization of, 36
softening of, 37
Thrush, oïdium albicans of, 657
Thumb, amputation of, 1029
Thymic asthma, 163
Thymus, hypertrophy of, 717, 751
inflammation of, 717
Thyroglossal duct, 710
Thyrohyoid cysts of neck, 707
Thyroid arteries, inferior, ligation of, 353
body, adenoma of, 712
bronchocele, 712
congenital affections of, 710
endothelioma of, 712
goitre of, 712
hypertrophy of, acute idiopathic, 711
intra-uterine, 711
sarcoma of, 712
struma of, 712
teratomas of, 712
tumors of, 711
dermoids, 267
Thyroidectomy, 715
Thyroidism, 82
Thyroiditis, 711
Thyroids, accessory, 710
Thyrotomy, 674, 688
Tibia, dislocations of, 543
fractures of, 518
treatment of, 521
Tibial arteries, ligation of, 360
nerve, operations on, 623
Tibiotarsal amputations, 1037
Tic douloureux, 640
Toe-nail, ingrowing, 318
Toes, amputation of, 1034
hammer, 321
treatment of, 321
Tongue, absence of, 652
actinomycosis of, 659
bifid, 652
cysts of, retention, 659
epithelioma of, 660
treatment of, 660
gangrene of, 659
inflammation of, 658
leukoplakia of, 659
treatment of, 659
macroglossia of, 660
malformations of, 652
nevi of, 659
operations on, 661
Kocher’s, 661
Langenbeck’s, 662
Regnoli-Billroth’s, 661
Sédillot’s, 662
Whitehead’s, 661
papilloma of, 659
ranula of, 660
syphilis of, 659
-tie, 652
tuberculosis of, 659
tumors of, 659
Tonometer, use of, 177
Tonsillotomy, 663
Tonsils, absence of, 662
calculi of, 663
enlarged, 662
foreign bodies in, 663
hypertrophy, 662
infection through, 49
syphilis of, 662
tuberculosis of, 662
tumors of, 664
Torsion, control of hemorrhage by, 236
of omentum, 935
Torticollis, 457
diagnosis of, 458
pathology of, 457
treatment of, 458
Tourniquet for control of hemorrhage, 234
Toxic antiseptics, 175
Toy-pistol tetanus, 97
Trachea, operations on, 691
rupture of, 699
scabbard, 713
tumors of, 687
wounds of, 699
Tracheal tugging, 345
Tracheocele, 707
Tracheotomy, 691
Trachoma, 599
Transfixion suture, 241
Transfusion of blood, 185
Transhyoid pharyngotomy, 664
Transplantation of bone, 431
of tendons, 324
Transudates, 23
Trauma as cause of tumor, 255
Traumapnea, 724
Traumatic abscess of brain, 567
erysipelas, 93, 94
fever, 85. See Surgical fever.
hematoma of scalp, 218
hernia, 890
insanity, surgical treatment of, 582
intraventricular hemorrhage, 564
mania, 175
neuroma, 280
othematoma, 605
peritonitis, 786
spondylitis, 462
thrombosis, 36
Treatment of abscess, 60
of bone, 426
of brain, 573
of liver, 912
of rectum, 879
of actinomycosis, 110
of acute catarrh of biliary passages, 918
cholecystitis, 921
pancreatitis, 948
after abdominal operations, 777
of adenoids of pharynx, 680
of aneurysm of abdominal aorta, 346
of angioma of veins, 367
of ankylosis, 405
of anthrax, 107
of arthritis, chronic, 386
deformans, 389
tuberculous, 398
of atrophy of muscles, 332
of biliary calculi, 926
of boils, 304
of bow-leg, 465
of bunions, 311
of burns, 301
x-ray, 304
of carbuncle, 305
of carcinoma, 295
of breast, 763
of intestines, 828
of rectum, 887
of stomach, 803
of cardiospasm, 798
of caries of hip, 454
of cerebral palsies, 478
of cervical lymph-node affections, 706
of chancre, 128
of chancroid, 145
of cholelithiasis, 926
of chondroma, 272
of chronic affections of pancreas, 951
pancreatitis, 950
prostatitis, 995
sapremia, 87
tendosynovitis, 322
of cold abscess, 114
peri-articular, 399
of compression of brain, 562
of concussion of brain, 559
of chest, 722
of spine, 629
of congenital anomalies of neck, 698
club-foot, 466
dislocation of hip, 474
of congestion, 23
of contraction of fasciæ, 320
of muscles, 332
of contusions, 212
of brain, 560
of chest, 722
of cryptorchidism, 1014
of curvature of spine, 460
of cutaneous horns, 311
of cystitis, 985
of cysts of pancreas, 952
of skin, 310
of dacryocystitis, 600
of delirium tremens, 174
of dental caries, 665
of dermatitis calorica, 299
of desmoids, 271
of dilatation of stomach, 796
of dislocations, 527
of clavicle, 529
of elbow, 536
of foot, 544
of hip, 539
of jaw, 528
of knee, 544
metacarpophalangeal, 537
of patella, 543
of shoulder, 532
of spine, 632
of duodenal ulcers, 826
of Dupuytren’s contraction, 320
of ectopia of bladder, 978
of epididymitis, 1017
of epistaxis, 681
of epithelioma of skin, 315
of tongue, 660
of erysipelas, 95
of exophthalmic goitre, 714
of exophthalmos, 594
of exstrophy of bladder, 978
of fat embolism, 40
of fibroma molluscum, 313
of fistula, 63
of rectum, 880
of floating liver, 911
of foreign bodies in esophagus, 740
in pharynx, 673
in stomach, 794
of fractures, 486
of clavicle, 493
Colles’, 504
of femur, 513
of fibula, 521
of forearm, 501
of humerus, 495
of inferior maxilla, 490
of leg, 521