Tinnitus. Ciba Foundation Symposium 85

The very first edition of this classic text in tropical diseases appeared in 1898 under the authorship of the legendary "father of tropical medicine," Sir Patrick Manson, who nurtured this book through six editions until his death in 1922. For over eighty years students of tropical diseases have turned to its previous editions to familiarize themselves with these important disease entities. The eighteenth edition promises once again to serve that purpose admirably. As the editors indicate in their preface, the 1982 edition contains substantially new or rewritten sections on haemoglobinopathies, animal poisons, ophthalmology in the tropics, drugs, and medical entomology. They are timely and welcome additions. The book itself is compact, readily transportable to remote areas, and thoroughly readable. Many excellent diagrams, charts, and photographs are retained from the previous editions and bear historical witness to the advances of twentieth-century tropical medicine. I can think of no more enjoyable way to foray into this wealth of material. However, in reviewing this latest edition of Manson's Tropical Diseases I found myself increasingly concerned about the ability of this edition to transmit the advances made in the immunology, diagnosis, and treatment of these diseases. This task demands updating and revisions for nearly every chapter in a text whose last edition appeared ten years ago. In chapter 31, on lymphogranuloma venereum, I was surprised to find it still referred to as a "generalized viral infection" when it is now known to be associated with distinct strains of Chlamydia, which are not viruses. The discussion of hepatitis barely covers three pages, with hepatitis B receiving a few cursory paragraphs in which there is no mention of its relation to hepatocellular carcinoma, a topic of particular relevance to workers in developing tropical countries. Non-A, non-B hepatitis receives ten lines, and the reader is referred to a 1978 editorial in the British Medical Journal for review. The reader is often referred to primary sources for additional material but this could place the text in an awkward position. Whereas Man-son's Tropical Diseases is an excellent historical introduction and reference work, it is in danger of losing practical relevance for workers in the tropics who require the presentation of fairly current material without the need to refer to primary sources which are often expensive and unavailable. Manson's Tropical Diseases should not be allowed to go that route. It is a priceless resource, having been there at the beginning, …