Principles and Methods of Plant Biosystematics

Failure is the word that best describes human effort to master schistosomiasis. In 1000 B.C. schistosomes infected man, proof being recovery of calcified ova from dated Egyptian mummies. Earlier by a thousand years, vesical schistosomiasis was prevalent, to judge from references to hematuria by the local medical profession. By A.D. 1969 the world incidence of schistosomiasis was at least 150 millions. Three to four thousand. years of work by the medical and public health; professions produced this most unimpressive result. Complacency in regard to the "control of communicable diseases" is widespread, but it should be realized that the medical and allied professions are presently incapable of dealing effectively with a large number of infectious diseases. Schistosomiasis, with its documented millenial history and composite of social and scientific difficulties which impede progress, provides a particularly rich case history of an unsolved problem. The present book is a highly condensed survey of present knowledge, said to be intended for "the man in the field." Accordingly it is strong in breadth. The wide representation of viewpoints and findings and the description of the complexities of the control problem are of special value. The section on chemotherapy enumerates the compounds now available, the variable results obtained, suggests reasons for these variations and cites associated dangers. Apparently the authors do not consider that there is any one best drug, and the interested reader will have to consult elsewhere. There is an interesting section on the concept of "suppressive management" with potassium antimony dimercaptosuccinate (Astiban). This involves a period of monthly spacing of injections during which the patient is improved, possibly cured, toxic reactions reduced and transmission interrupted. Niridazole (Ambilhar) is considered a great advance in the therapy of Schistosoma haematobium; local physicians will be interested that, "In the treatment of S. mansoni, acute confusional states and epileptic form attacks have been reported in adults in most trials." Related doses and incidence rates are not given. Cancer of the bladder associated with S. haematobium infection of the same organ is observed in abnormally high incidence in Egypt. Whether the relationship is causal has been undecided for about 60 years. It still is, and the reports of lack of correlation in other areas of Africa suggest that multiple factors may play a part in Egypt. Speculations concerning chemical carcinogens in the helminths or in patients are mentioned, no experimental work dealing with the problem is cited. In summary, the book does well what it sets out to do: review succinctly the literature on the subject. Those who need more will have to look elsewhere, which they can do with the aid of the extensive bibliographies. DAVID WEINMAN