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Tropical medicine: a clinical text
TRANSACTIONS
1Book
OF THE ROYAL
SOCIETY
OF TROPICAL
MEDICINE
AND
Reviews1
A New Short Textbook of Preventive Medicine for the Tropics, 3rd edition. A. 0. Lucas and H. M.
Gilles. Sevenoaks,UK: Hodder andStoughton, 1990. 322 pp. Price c12.95. ISBN 0-340-53591-l. Short textbookshave a great place,especiallyin the esteemof the student. Knowledge is not all equally useful, but how is the beginnerto know what to begin with? The selectionhastherefore to be done for him. One of my fellow students at Cambridge, who subsequentlybecamea distinguishedhaematologist, prided himself on passinghis tripos on Best and Taylor’s Physiology for Nurses. So humble books can contain most of what matters, and they can alsobe a nleasureto read: this one is not. Its style is dry and factual. It is so brief that it cannot deal with the realitiesand the difficulties of real life, and socannot hold the interestof the reader. Why is medicine still so chary about using the imperative?Why write ‘Casesshould be removedto hospital and isolated’, when ‘Admit the patient and isolatehim’ would be better? Whv write ‘The mental health problemsof the commun&y are stratified in termsof ageand sex’whenwhat is meantis that ‘Each age and sex has its own problems’?Sentencesare often long. What about some case histories and anecdotesin smallprint to enliven the next edition? A textbook needsa picture on every double page spread.This hasone slightly lessthan one per every other doublepage.Somepageshaveno numbers.The figures on what is presumablypage274 are barely informative. The iceberg in Fig. 2.2 grows up from the bottom of the sea. Health educationis relegatedto three pagesnear the end: a textbook of preventive medicine either needsmoreor none. The headingsarecuriousin some places,as on page 187 when chloroquine resistance appearsasa subheadingof chloroquinesensitivity. I can find no factual errors. The feeling it gives is that its very distinguished authorsthought they could write a short textbook in a short time. I can seemany medical students, and many auxiliaries,all over the developingworld trying to learnit by heart. If they aregoingto learnthis way, this may perhapsbe the book for them. Altogether, it is a usefulpreparationfor a dry-as-dustexamination. Maurice
King
Medicine: a clinical text. K. M. Cahill & W. O’Brien. Oxford, etc.: Heinemann Medical Books. 1990. x+~~ODD. . . Price cl4.95. ISBN 0-43300430:3* The authors’begintheir prefacewith wisewords: ‘A knowledgeof clinical tropical medicineis essentialfor every modern physician.’ This reviewer wholeheartedlv endorsesthat sentiment. The book represents,we are told, the ‘third edition of a text which waswritten bv oneof us (K.M.C.) in 1964.and completely revised-in 1975.’ ‘Does this then have significant advantagesover other tropical medicine texts-both large and small-which are widely read by many varied sectionsof the medical profession? There is a very strong emphasison parasitoses; separatechaptersare devoted to malaria, amoebiasis,
Tropical
HYGIENE
(1991)
85, BOOK
REVIEWS
411
the Trypanosomatidae (the trypanosomiasesand leishmaniases),filariasis, schistosomiasis, intestinal helminthic, and larval helminthic infections. Viral infections and bacterial and rickettsial diseasesare each allocated their own chapters, and leprosy and funeal infections a further two. Tronical diarrhoeal diseases are given a separatechapter, &id to complete the coveragethere are contributions on malnutrition (3.5 pagesonly), hereditary anaemias,and miscellaneousconditions(‘tropical tumours’, snakebite, eye diseases, and heart diseases). But where, for example, are tuberculosis(arguably the mostcommonbacterial diseaseof the trbprcs), pneumonia,and meningitis? The authorshave therefore electedto write about the classical‘tropical diseases’;this is an antiquated approachbecausemost physicianswould agreethat ‘tropical (colonial) medicine’is now a compartment within the specialismdevoted to communicable(infectious) disease. Someof my criticismsareasfollows. The arrangement of chapters is bizarre; it follows neither a taxonomic nor clinical classification.Why is familial Mediterraneanfever (recurrent hereditary polyserositis) included in the chapter on anaemias? The section on malaria prophylaxis and treatment gives scant coverageof a verv difficult area:nrimaauineCD. 13) is missp& andits doseis not given: There areaLo other spellingerrors(including benznidazole,p. 30). There is no mention of C or E viral hepatitis. Fascioliasis does not get a mention! There is no reference to paromomycin (in leishmaniasis)or albendazole(in strongyloidiasis).Why do the authorsnot recommend diloxanide furoate (in addition to metronidazoleor tinidazole) in the treatment of colonic and hepatic amoebiasis?Emetine really is an tmnecessarychemotherapeuticagent in these days of 5-nitroimidazoles. There is only scant mention of antibiotic resistancein Salmonella typhi. Serology,ultrasonography and computerized tomography scanning are underplayed. Coverage of immunization is weak. Most of the figuresare badly producedin an erawhen excellent reproduction is possible;also the book is under-illustrated.The 17 pagesof referencesinclude a number which are somewhatdated and exclude many more recent onesof importance.The index is barely adequate. Severalrecent texts on generalmedicine contain sectionson infectiousdiseases which include the more exotic infections covered in the book. In addition there arenow a numberof similarlysized(andpriced) paper-backedvolumeswhich cover both communicableand ‘tropical’ diseases. I thereforefind it curious that a well-established publishershouldstepback two or three decadesand nroducea book which is sim~lv outdatedin its approachand coverage;it might have sold well in the 1950sand 196Os!I certainlv do not recommendthat my studentwither undergraduate or postgraduat+buy this text and, for someone working in the developingworld, the disease coverage in this book would prove exceedinglyunsatisfactory. G. C. Cook Modem Vaccines-Current Practice and New Approaches: a Lancet review. Moxon, E. R. (editor).
London. Melbourne. Auckland: Edward Arnold. 1990, x&lliOpp. Price f9.95. ISBN 0-340-52960-l: The editor of this bargain purchase(a superbly
1Book
OF THE ROYAL
SOCIETY
OF TROPICAL
MEDICINE
AND
Reviews1
A New Short Textbook of Preventive Medicine for the Tropics, 3rd edition. A. 0. Lucas and H. M.
Gilles. Sevenoaks,UK: Hodder andStoughton, 1990. 322 pp. Price c12.95. ISBN 0-340-53591-l. Short textbookshave a great place,especiallyin the esteemof the student. Knowledge is not all equally useful, but how is the beginnerto know what to begin with? The selectionhastherefore to be done for him. One of my fellow students at Cambridge, who subsequentlybecamea distinguishedhaematologist, prided himself on passinghis tripos on Best and Taylor’s Physiology for Nurses. So humble books can contain most of what matters, and they can alsobe a nleasureto read: this one is not. Its style is dry and factual. It is so brief that it cannot deal with the realitiesand the difficulties of real life, and socannot hold the interestof the reader. Why is medicine still so chary about using the imperative?Why write ‘Casesshould be removedto hospital and isolated’, when ‘Admit the patient and isolatehim’ would be better? Whv write ‘The mental health problemsof the commun&y are stratified in termsof ageand sex’whenwhat is meantis that ‘Each age and sex has its own problems’?Sentencesare often long. What about some case histories and anecdotesin smallprint to enliven the next edition? A textbook needsa picture on every double page spread.This hasone slightly lessthan one per every other doublepage.Somepageshaveno numbers.The figures on what is presumablypage274 are barely informative. The iceberg in Fig. 2.2 grows up from the bottom of the sea. Health educationis relegatedto three pagesnear the end: a textbook of preventive medicine either needsmoreor none. The headingsarecuriousin some places,as on page 187 when chloroquine resistance appearsasa subheadingof chloroquinesensitivity. I can find no factual errors. The feeling it gives is that its very distinguished authorsthought they could write a short textbook in a short time. I can seemany medical students, and many auxiliaries,all over the developingworld trying to learnit by heart. If they aregoingto learnthis way, this may perhapsbe the book for them. Altogether, it is a usefulpreparationfor a dry-as-dustexamination. Maurice
King
Medicine: a clinical text. K. M. Cahill & W. O’Brien. Oxford, etc.: Heinemann Medical Books. 1990. x+~~ODD. . . Price cl4.95. ISBN 0-43300430:3* The authors’begintheir prefacewith wisewords: ‘A knowledgeof clinical tropical medicineis essentialfor every modern physician.’ This reviewer wholeheartedlv endorsesthat sentiment. The book represents,we are told, the ‘third edition of a text which waswritten bv oneof us (K.M.C.) in 1964.and completely revised-in 1975.’ ‘Does this then have significant advantagesover other tropical medicine texts-both large and small-which are widely read by many varied sectionsof the medical profession? There is a very strong emphasison parasitoses; separatechaptersare devoted to malaria, amoebiasis,
Tropical
HYGIENE
(1991)
85, BOOK
REVIEWS
411
the Trypanosomatidae (the trypanosomiasesand leishmaniases),filariasis, schistosomiasis, intestinal helminthic, and larval helminthic infections. Viral infections and bacterial and rickettsial diseasesare each allocated their own chapters, and leprosy and funeal infections a further two. Tronical diarrhoeal diseases are given a separatechapter, &id to complete the coveragethere are contributions on malnutrition (3.5 pagesonly), hereditary anaemias,and miscellaneousconditions(‘tropical tumours’, snakebite, eye diseases, and heart diseases). But where, for example, are tuberculosis(arguably the mostcommonbacterial diseaseof the trbprcs), pneumonia,and meningitis? The authorshave therefore electedto write about the classical‘tropical diseases’;this is an antiquated approachbecausemost physicianswould agreethat ‘tropical (colonial) medicine’is now a compartment within the specialismdevoted to communicable(infectious) disease. Someof my criticismsareasfollows. The arrangement of chapters is bizarre; it follows neither a taxonomic nor clinical classification.Why is familial Mediterraneanfever (recurrent hereditary polyserositis) included in the chapter on anaemias? The section on malaria prophylaxis and treatment gives scant coverageof a verv difficult area:nrimaauineCD. 13) is missp& andits doseis not given: There areaLo other spellingerrors(including benznidazole,p. 30). There is no mention of C or E viral hepatitis. Fascioliasis does not get a mention! There is no reference to paromomycin (in leishmaniasis)or albendazole(in strongyloidiasis).Why do the authorsnot recommend diloxanide furoate (in addition to metronidazoleor tinidazole) in the treatment of colonic and hepatic amoebiasis?Emetine really is an tmnecessarychemotherapeuticagent in these days of 5-nitroimidazoles. There is only scant mention of antibiotic resistancein Salmonella typhi. Serology,ultrasonography and computerized tomography scanning are underplayed. Coverage of immunization is weak. Most of the figuresare badly producedin an erawhen excellent reproduction is possible;also the book is under-illustrated.The 17 pagesof referencesinclude a number which are somewhatdated and exclude many more recent onesof importance.The index is barely adequate. Severalrecent texts on generalmedicine contain sectionson infectiousdiseases which include the more exotic infections covered in the book. In addition there arenow a numberof similarlysized(andpriced) paper-backedvolumeswhich cover both communicableand ‘tropical’ diseases. I thereforefind it curious that a well-established publishershouldstepback two or three decadesand nroducea book which is sim~lv outdatedin its approachand coverage;it might have sold well in the 1950sand 196Os!I certainlv do not recommendthat my studentwither undergraduate or postgraduat+buy this text and, for someone working in the developingworld, the disease coverage in this book would prove exceedinglyunsatisfactory. G. C. Cook Modem Vaccines-Current Practice and New Approaches: a Lancet review. Moxon, E. R. (editor).
London. Melbourne. Auckland: Edward Arnold. 1990, x&lliOpp. Price f9.95. ISBN 0-340-52960-l: The editor of this bargain purchase(a superbly