659

TROPICAL MEDICINE.

OUR knowledge of tropical diseases has assumed so pro- Iminent a place in medical literature during the past ten years rthat it has been found necessary to devote special teaching Ito the subject. To include the diseases more or less peculiar Ito the tropics in the course of general medicine taught at our a

medical schools would be to expect the teachers of that sub- c

ject to prolong their course of instruction to an inordinate c

length. Moreover, the diseases met with in tropical and c

temperate climates differ in many ways so pronouncedly that 1it requires the teacher to be acquainted clinically with the "!

subject of tropical ailments before he can excite any but an tacademic interest in this important branch of medicine. i

To medical students in Great Britain more than in any other i

country is a knowledge of tropical diseases well-nighessential, for not only do one-fifth of the graduates 1of our universities and colleges take up the practice 1

of their profession abroad but, in addition, many medical men, when qualified, very wisely take a voyage as

medical officer on board ship and thereby come into im- 1

mediate contact with ailments more or less peculiar to thetropics. Nor do those in practice in any part of Great Britain,however remote, find that an acquaintance with tropicaldiseases is unnecessary. So many men, women, and childrenreturn from the tropics to seek change and benefit in theirnative air, or take up permanent residence at home, andbring with them diseases unusual in this country, that themedical practitioner finds himself handicapped throughignorance of even many of the unfamiliar names bestowedupon tropical diseases. To mention a few : Sprue, undulantfever, trypanosomiasis, filariasis, dhobie’s itch, beri-beri,bilharzia, pellagra, kala-azar, anchylostomiasis, &c.; thesecases are not met with in the course of ordinary homepractice, yet persons suffering from such complaints arescattered over the towns and villages of the land and comeunder the care of local practitioners with considerable andincreasing regularity. It would appear, therefore, thatall students of medicine in this country require some

acquaintance with tropical diseases, and to those goingabroad it is imperative. All medical men enteringthe army, navy, and colonial medical services requirespecial training in this branch of medicine, and medicalmissionaries sent out by religious bodies are under the samenecessity. Medical officers of health in the numerous portsof the kingdom connected with the tropics find an acquaint-ance with tropical ailments requisite when they have todeal with ships’ crews and passengers coming from the

tropics. So evident has the necessity for teaching intropical medicine become that in very many of our medicalschools lectureships in tropical medicine have been estab-lished. These fulfil an excellent and useful purpose, andalthough clinical experience in the subject matters of thelectures delivered by the lecturers is obtainable only at butone or two places, chiefly London and Liverpool, usefulinstruction is conveyed by lectures, microscopic specimens,diagrams, museum specimens, &c. It is therefore incumbent

upon every medical student, whatever may be his intentionas to where he may settle in practice, to avail himself ofthe instruction afforded in tropical diseases by his medicalschool.

Schools of tropical medicine were established in Londonand Liverpool in 1899. Since they opened their doors tostudents the necessity for their existence has been amplyjustified if we are to judge by the number of men andwomen who have availed themselves of the instruction theygive. In the London School of Tropical Medicine since itsinitiation over 500 medical men have taken out a courseof instruction. The staff of teachers comprehends manymen who have spent the greater part of their professionalcareer in warm climates and are familiar with the subjectsthey teach. In addition to lecturers on purely tropicalmedicine instruction is given by other teachers in the

surgery specially appertaining to tropical diseases, in

tropical parasitology, in bacteriology, in tropical hygiene, indermatology, in ophthalmology, and so on. In short, thediseases peculiar to particular regions of the tropics aretaught by lecturers specially acquainted with them.The lectures, however, are but a small part of the system

of teaching followed at either of the great schools. Thestudents spend most of their time in the laboratory ofthe school where, under the superintendent of the schooland his staff, individual instruction is given in micro-

scopic work, in bacteriology, in pathology, and in

parasitology appertaining to tropical diseases. Attachedto the London school is a hospital of 60 beds, a branchhospital of the Seamen’s Hospital Society situated at theRoyal Victoria and Albert Docks, London, E. In this

hospital cases of tropical diseases arriving in the Port ofLondon are treated, and the students attached to theLondon School of Tropical Medicine have the opportunity ofactually acquiring clinical experience of the majority ofdiseases they are likely to encounter in practice in warmclimates. For students who wish to do so quarters are

obtainable at the school, a saving in time going to and frobeing thus accomplished. The session lasts three months.There are three sessions in the year, commencing duringthe first weeks of January, May, and October of each yearrespectively. The fees for the full course are .616 16s.,irrespective of board and lodging at the school.

In Liverpool the school of tropical medicine attachedto the university has acquired a wide reputation forthe active part those connected with it have taken in

sending out numerous expeditions from the school to

study disease in West Africa, and by the earnest endeavourthey have made to stamp out malaria in several of our

colonies. The excellently appointed laboratories attachedto the school-the Thompson Yates and Johnston labora-tories-afford every opportunity for study and for experi-mental research. Under the able teachers of the schoolcareful individual training is given and in the wards of thegeneral hospitals of Liverpool, as would be expected fromthe geographical and commercial position of this city, manytropical diseases are to be seen and splendid opportunitiesof clinical experience are afforded. In the schools of Londonand Liverpool the student can obtain a thorough trainingin tropical medicine and thus become acquainted with th&diseases he is likely to meet with in the daily routine ofpractice in warm climates.A diploma in tropical medicine has been recently instituted

by the University of Cambridge. The first examination washeld in August, 1904, when 11 men presented themselves forexamination. The examination consisted of papers on

tropical medicine and hygiene, practical laboratory work,and a clinical examination in the wards of the Seamen’sHospital, Albert Docks. The examiners are Sir PatrickManson, K.C.M.G., F.R.S., Dr. George Nuttall, F.R.S., andMajor Ronald Ross, C.B., F.R.S. The conditions required ofthose intending to present themselves for examination can beobtained by application to the Dean of the Medical Facultyat Cambridge.

Looking Back.FROM

THE LANCET, SATURDAY, SEPT. 2, 1826.THE LANCET.

London, Saturday, Sept. 2, 1826.

, As the commencement of another medical session fast

approaches, it may not be amiss to direct pupils entering ontheir studies, how to employ their time and their monies tothe greatest advantage. A well educated and diligent pupilcan never make a bad practitioner ; but he must be welleducated, or his future success in life will be, at the best,fortuitous, and, generally, deplorable. To perfect a surgicaleducation, there are essentially necessary, lst. To the

teacher, a complete knowledge of the subject he professes-kind, conciliating, candid manners—a desire, as well as thepower, of giving instruction, and an energy that never flags ;2dly. To the Hospitals—CONSTANT ACCESS; and, lastly, tothe pupil, determined and unwearied attention, and, morethan all, OPPORTUNITY.1

It is with deep regret that we announce the death of theonce celebrated LAENNEC. It is an event which has been

long dreaded by his friends in Paris, although it would

appear from his own observations not at all anticipated byhimself. In an early Number, we will present our readerswith a biographical sketch of this illustrious physician.2

1 Excerpt from editorial observations.2 Vide "Looking Back" in THE LANCET, August 20th, 1904. The

biographical sketch referred to appeared in THE LANCET of Oct. 14th,1826.