Tropical medicine: a clinical text

Abstract

This small paper-backed book represents "the third edition of a text that was first written by one of us (KMC) in 1964, and completely revised in 1975". The authors continue their preface: "This current edition reflects a decade long [of] mutual effort to present what we consider the essentials of a critical specialty in the international world of today". In fact, the format is virtually identical with an edition published by The Anniversary Press for the Royal College of Surgeons in Ireland in 1989! There are already several texts devoted to 'Tropical Medicine' on the market; what therefore persuaded Heinemann to publish this one year later? What are its advantages (and disadvantages) over its competitors?The book opens with chapters on malaria, the Trypanosomatidae (African and South American trypanosomiasis, and the leishmaniases) and amoebiasis, and then changes tack to cover "bacterial and rickettsial diseases", leprosy, and "fungal infections of the tropics". This rather curious (and haphazard) arrangement-which is neither clinically nor taxonomically inspired-continues with "diarrhoeal diseases" and "viral infections of the tropics". The reader is then transported back to more parasitoses: intestinal and larval helminth infections, filariasis, and schistosomiasis. And to round it off we have: malnutrition, hereditary anaemias, and "miscellaneous" (tropical tumours, snake bite, eye diseases, and heart diseases). Where though are the common bacterial diseases of the tropics: tuberculosis (in all its forms and with its varied manifestations), pneumonia, and meningitis, for example?These authors' concept of "tropical medicine" is therefore rather similar to that of Sir Patrick Manson in 1898 (as illustrated in his great monograph); the emphasis is on parasitoses, and everything else gets pretty short shrift. In 1991, the former ("colonial") discipline has been absorbed into the joint one of "communicable and tropical diseases" in most developed countries of the world. "Medicine in the tropics" is now oriented towards the common diseases encountered there-dominated by bacterial and virus infections, superimposed on an underlying background of cosmopolitan parasitic diseases (malaria and the intestinal helminthic infections are for example very widely distributed). The more "exotic" parasitoses, upon which this text dwells, have their own clearly delineated areas of distribution.One could make numerous minor criticisms. Malnutrition is allocated less than 4 pages, familial Mediterranean fever appears under "Hereditary anaemias", coverage of malaria chemoprophylaxis and chemotherapy is inadequate, respiratory viruses are not mentioned, the part on viral hepatitis is outdated, Hantaan is misspelt, the description of the treatment of amoebiasis requires updating (diloxanide furoate is not mentioned, and emetine is no longer produced in the UK), travel medicine (including immunization) is grossly underplayed, fascioliasis is not mentioned, and the chemotherapy of leishmaniasis and strongyloidiasis omits recent advances. The book is under-illustrated; inclusion of only 33 poorly reproduced figures is simply inadequate. The references are in many cases dated and on the whole poorly selected.It is my opinion, therefore, that this book has little to recommend it when compared with its several competitors-both large and small-which are currently available. It represents "tropical medicine" as it stood several decades ago and there are many better books than this.G.C. Cook