TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1991) 85, BOOK REVIEWS 411

1 Book Reviews1

A New Short Textbook of Preventive Medicine for the Tropics, 3rd edition. A. 0. Lucas and H. M. Gilles. Sevenoaks, UK: Hodder and Stoughton, 1990. 322 pp. Price c12.95. ISBN 0-340-53591-l.

Short textbooks have a great place, especially in the esteem of the student. Knowledge is not all equally useful, but how is the beginner to know what to begin with? The selection has therefore to be done for him. One of my fellow students at Cambridge, who subsequently became a distinguishedhaematologist, prided himself on passing his tripos on Best and Taylor’s Physiology for Nurses. So humble books can contain most of what matters, and they can also be a nleasure to read: this one is not.

Its style is dry and factual. It is so brief that it cannot deal with the realities and the difficulties of real life, and so cannot hold the interest of the reader. Why is medicine still so chary about using the imperative? Why write ‘Cases should be removed to hospital and isolated’, when ‘Admit the patient and isolate him’ would be better? Whv write ‘The mental health problems of the commun&y are stratified in terms of age and sex’ when what is meant is that ‘Each age and sex has its own problems’? Sentences are often long. What about some case histories and anecdotes in small print to enliven the next edition?

A textbook needs a picture on every double page spread. This has one slightly less than one per every other double page. Some pages have no numbers. The figures on what is presumably page 274 are barely informative. The iceberg in Fig. 2.2 grows up from the bottom of the sea.

Health education is relegated to three pages near the end: a textbook of preventive medicine either needs more or none. The headings are curious in some places, as on page 187 when chloroquine resistance appears as a subheading of chloroquine sensitivity. I can find no factual errors.

The feeling it gives is that its very distinguished authors thought they could write a short textbook in a short time. I can see many medical students, and many auxiliaries, all over the developing world trying to learn it by heart. If they are going to learn this way, this may perhaps be the book for them. Altogether, it is a useful preparation for a dry-as-dust examination.

Maurice King

Tropical Medicine: a clinical text. K. M. Cahill & W. O’Brien. Oxford, etc.: Heinemann Medical Books. 1990. x+~~ODD. Price cl4.95. ISBN 0-433- 00430:3 *

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The authors’begin their preface with wise words: ‘A knowledge of clinical tropical medicine is essential for every modern physician.’ This reviewer wholeheartedlv endorses that sentiment. The book represents, we are told, the ‘third edition of a text which was written bv one of us (K.M.C.) in 1964. and completely revised -in 1975.’ ‘Does this then have significant advantages over other tropical medicine texts-both large and small-which are widely read by many varied sections of the medical profession?

There is a very strong emphasis on parasitoses; separate chapters are devoted to malaria, amoebiasis,

the Trypanosomatidae (the trypanosomiases and leishmaniases), filariasis, schistosomiasis, intestinal helminthic, and larval helminthic infections. Viral infections and bacterial and rickettsial diseases are each allocated their own chapters, and leprosy and funeal infections a further two. Tronical diarrhoeal diseases are given a separate chapter, &id to complete the coverage there are contributions on malnutrition (3.5 pages only), hereditary anaemias, and miscel- laneous conditions (‘tropical tumours’, snake bite, eye diseases, and heart diseases). But where, for example, are tuberculosis (arguably the most common bacterial disease of the trbprcs), pneumonia, and meningitis? The authors have therefore elected to write about the classical ‘tropical diseases’; this is an antiquated approach because most physicians would agree that ‘tropical (colonial) medicine’ is now a compartment within the specialism devoted to communicable (in- fectious) disease.

Some of my criticisms are as follows. The arrange- ment of chapters is bizarre; it follows neither a taxonomic nor clinical classification. Why is familial Mediterranean fever (recurrent hereditary polyserosi- tis) included in the chapter on anaemias? The section on malaria prophylaxis and treatment gives scant coverage of a verv difficult area: nrimaauine CD. 13) is missp& and its dose is not given: There are aLo other spelling errors (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 authors not recommend diloxanide furoate (in addition to metronidazole or tinidazole) in the treatment of colonic and hepatic amoebiasis? Emetine really is an tmnecessary che- motherapeutic agent in these days of 5-nitroimida- zoles. There is only scant mention of antibiotic resistance in Salmonella typhi. Serology, ultrasonogra- phy and computerized tomography scanning are underplayed. Coverage of immunization is weak. Most of the figures are badly produced in an era when excellent reproduction is possible; also the book is under-illustrated. The 17 pages of references include a number which are somewhat dated and exclude many more recent ones of importance. The index is barely adequate.

Several recent texts on general medicine contain sections on infectious diseases which include the more exotic infections covered in the book. In addition there are now a number of similarly sized (and priced) paper-backed volumes which cover both communic- able and ‘tropical’ diseases. I therefore find it curious that a well-established publisher should step back two or three decades and nroduce a book which is sim~lv outdated in its approach and coverage; it might have sold well in the 1950s and 196Os! I certainlv do not recommend that my studentwither undergraduate or postgraduat+buy this text and, for someone working in the developing world, the disease coverage in this book would prove exceedingly unsatisfactory.

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