History of the Liverpool School of Tropical Medicine.

I AM often asked why there should be a tropical school in Liverpool and whether there is a place for such a school in the modem developing world. The simplest way of answering these questions is to sketch the history of the school. In my view history includes the present as well as the past and in this case should deal with the philosophy of the school as well as the people who have served in it. I shall attempt to deal superficially with the history of the Liverpool School in this way. The first question is-Why have a tropical school in Liverpool? The factual answer is, of course, that the school was founded in Liverpool. The first of its kind in the world, it was started at the height of the Colonial Empire, when streams of doctors were going from England to the tropical colonial empire to practise clinical medicine and to deal with indigenous problems of public health. (I separate clinical medicine and health at this stage because this was the unfortunate habit in colonial administration.) At the time the school was created the British Empire needed large numbers of doctors skilled in the specific disciplines of the tropics, but had not provided any central facilities for training them. It was not until 1898 that the British Government realized for the first time that it was sending untrained doctors to work in the colonies. There was no place in Britain which was dedicated to the necessary disciplines and there was no specific reference to them included in the medical curriculum, apart from the elementary parasitology. Moreover, there were no opportunities offered for refresher courses for those returning on leave. Doctors who went to tropical colonies had to learn the hard way by long experience. This reduced their immediate efficiency and generally lowered the standard of their work. Pressed by Manson, who had become Medical Adviser to the Colonial Office, Joseph Chamberlain, then Secretary of State for the Colonial Office, wrote a letter to the General Medical Council and to the main medical schools suggesting that adequate emphasis should be given in the ordinary medical curriculum to tropical medicine and related subjects, in order to help the many doctors who would subsequently go overseas. The G.M.C. replied, as might be expected, that it agreed in principle with the need for such training but no action was forthcoming, as the medical schools clearly considered there was no need to change existing teaching programmes for the sake of a relatively small minority who would eventually learn their tropical medicine in the tropics. Chamberlain then addressed a letter to the Governors of all Colonies, pointing out the great mortality and morbidity arising from endemic tropical diseases such