Tropical Medicine: A Clinical Text

Tropical Medicine: A Clinical Text

Tropical Medicine: A Clinical Text

Tropical Medicine: A Clinical Text


The history of tropical medicine is as dramatic as the story of mankind - with its own myths and legends, with tales of epidemics destroying whole civilizations; and, still today, with silent stealth, these diseases claim more lives than all the current wars combined. Having had the privilege of working throughout Africa, Asia, and Latin America, as well as in the great medical centers of Europe and the United States, the author presents the essential details for understanding pathogenesis, clinical manifestations, therapy, and prevention of the major tropical diseases. The text, now in its eighth edition, has been used for a half-century by medical students, practicing physicians, and public health workers around the world. This fascinating book should also be of interest to a broad, nonmedical readership interested in world affairs. All royalties from the sale of this book go to the training of humanitarian workers.


Knowledge of clinical tropical medicine is essential for every modern physician. The diseases of warm climates are no longer restricted by geographic boundaries because the scope and speed of air travel and flows of ideas and people have destroyed the barriers of time and space, and the massive increase in international migration in the past half century makes us all part of a global community.

The detection of tropical illnesses is utterly dependent on an awareness of their very existence, and on understanding their pathogenesis, signs, and symptoms. These fundamental facts are rarely taught in any depth in Western medical schools, and the diseases considered in this book—the greatest cripplers and killers of the world—rate only passing attention in most academic curricula in temperate climates.

In some European nations, though, there has been a traditional interest in the diseases of the tropics, an interest developed during the colonial period. In these countries there are still major schools (and hospitals) specializing in tropical medicine. Financial support for these institutions has, however, waned in recent decades as the pressures to treat and investigate domestic ailments steadily escalate. In the United States, an appreciation of tropical medicine has always been far less than in Europe.

There are no American schools or hospitals specializing in this discipline, and only a minuscule percentage of our national research budget is allocated to these major albeit neglected diseases. The economic realities of prolonged postgraduate training in the tropics, and the patterns of insurance payments make it difficult to sustain a cadre of experts in tropical medicine. Almost all those whom I have trained, for example, gravitated toward gastroenterology, where colonoscopies and endoscopies are procedures reimbursed at levels far in excess of what is provided to tropicalists.

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