THE STUDY OF TROPICAL
The
increasing
interest
taken
DISEASES.
by
the
people
of England in everything concerning India, and indeed in everything concerning the tropics, is significant and full of promise. It is in part due
mind-expanding effect of travel upon the annually increasing number of our cold-weather to the
visitors,
but it is also in
due to the restless retired tropical resi-
part
energy of the returned dents. Men retire at an earlier age and with better health than formerly, and are less willing to settle down to a quiet club life for the rest of or
their more
days. A run possible, and
home on short leave is also the result of all this is that
the
galling neglect and careless indifference of former days is giving way to an almost feverish interest in
political.
Indian affairs?scientific as well as provided that half assimilated
And
views do not replace the the change can only be far is one to be warmly
facts, or even erroneous ignorance that existed, for the better, and welcomed.
so
One of the chief evidences of this awakening interest in matters scientific is the formation
344
of
THE
section of
a
nual
of
meeting
MKDIOAL GAZKTTE.
medicine at the anMedical Associa-
tropical the
INDIAN
British
tion held in
1898.
[Sept.
metropolitan school, and few students will regularly visit either of tliese institutions. Sir Henry Burdett is sanguine that tropical diseases can be thoroughly studied at the Docks, and on behalf of the Seamen's
Edinburgh in July last. Another attempt to start a school of- tropical Hospital appeals to the public for ?10,000 and a net medicine at Greenwich, and a third is the income of ? 2,000 a year, in addition to a capital grant new Journal of Tropical Medicine, the first of ?3,550 from the Colonial Office and the fees from Colonial student, estimated at ?1,000 per annum. We number of which has just been published in see no statement as to the number of cases is
the
London.
Men who
in the troto see the results
working
are
will
probably still prefer of their labours appear without delay in medical journals published near the seat of their labours, but for work in tropical diseases, such as can be carried on in temperate climes, the new form a suitable doubt will no journal pics
medium of
publication.
temporary
a
warm
open to it. As regards the
We offer
our
new con-
welcome in the wide
tropical
admitted into the hospitals of the Seamen's Hospital Society. Chronic dysentery, beri-beri, and chronic malaria make up almost entirely the tropical which
diseases which
a student may expect to see during a of three or four month's study, and acute cases must be extremely rare, judging from the annual reMr. W. Johnson Smith has ports of the Society. published the records of the cases of hepatic abscess course
during twenty-five
teaching
and
they only amount to in tropical diseases well-appointed laboratories of
years,
sphere fifty. Bacteriological investigation can
of
are
tropical diseases
in
London, it appears from the Lancet that the Committee of the Seamen's Hospital at Green-
be taught
in
the
many of our medical schools and is a
part of the Netley curriculum. Phthisis, cardiac disease, rheumatism, and renal disease figure amongst the most common cases of illness at the Seamen's as well as at other hospitals. If
placed before Mr. Chamberlain a compulsion is exercised on appli cants for Colonial medienlarging the branch hospital at the cal appointments, as seems to be implied in Mr. ChamAlbert Docks from eighteen to forty-five beds, berlain's letter, of course a regular supply of students compulin order to supply the material necessary for will be at once forthcoming ; but if there is sion we question whether many will attend at such has written to Sir The Burdett, Henry teaching. an inaccessible situation as the Albert Docks, and we Times (July 11th) supporting the scheme, and doubt whether the variety of cases is sufficient to interest wich
has
scheme for
no
that paper has also a leading article upon his letter. In addition to the enlargment of the branch
of the
hospital
cludes, according
to the
docks,
the scheme in-
Lancet:?
"
The building of school premises, museum, and laboratory, with accommodation for from twenty to twentyfive students, of whom ten would be able to sleep 011 the establishment. A medical tutor is to supervise the instruction for six hours daily, whilst the staff of the Seamen's Hospital as well as of the branch hospital, with selected additional teachers, are to attend and teach for four hours a day during four days a week. We see 110 provisions in Sir Henry Burdett's letter for the payment of this staff of teachers. It can scarcely be expected that the physicians and surgeons attached to
specially
the Seamen's Hospital Society can undertake any more gratuitous work than they have at present. The Albert Docks is not a very accessible place and a visit there, with four hours' teaching, will make a serious inroad into a or surgeon's daily work. The study of
physician's
tropical
diseases is of the utmost practical importance for colonial and military surgeons and practitioners, and deHitherto it has been best serves every encouragement. out at Netley, and the amount of practical
carried material in that
be study disposal of the medical officers. Sporadic courses of are eminently unpractical, because the
hospital
ignored, although Indian and army lectures in London
for such
it is
only
at
a
must not
the
students cannot watch the course and treatment of the illustrating the lectures. Few patients can be brought from Greenwich or the Albert Docks to a cases
and instruct them for such
a
long period
as
three
or
four
months."
Since the appearance of Sir Henry Burdett's letter in the Times, the Visiting Physicians, Drs. John Curnow and John Anderson, C.I.E., and the Visiting Surgeon, Mr. Or. R. Turner, have written to the Lancet, saying that the letter in the Times was the first intimation of any kind they received that such a scheme was on foot, and that the statement was made without their
authority Branch
or
consent.
Hospital
The
of 18 beds
visiting staff of the (the Seaman's Hospi-
tal contains 235 beds) are : Physician, Dr. P. Manson, and Surgeons, Mr. W. J. Smith and Mr. W. Turner. The state of affairs hinted at in our London Letter of this issue seems therefore to exist. In a question of this kind, how-
personalities should be ignored and the abstract question?is or is not a school of tropical medicine possible or necessary in London ?? ever,
should alone be considered. In the truly modest appeal to the public quoted above, the fact that the proper place to study tropical diseases is in the tropics seems to be lost sight of. It may be said, and we are quite
prepared
for the
hot climates have
reproach,
that medical
not done
men
in
very much to ad-
Sept.
LONDON LETTER.
1898.]
3^5
pathology. This is true and yet not true.opportunity of learning of what stuff the new True of the majority of men who are overwork-arrivals were made, and the men themselves often formed friendships of lifelong value, fostered and have no time or superfluous energy for have but ing an esprit de corps which is even more desirwho untrue of those original work, either. The names of Lewis, Cunningham, Van- able to-day than ever it was. dyke Carter, Maitland, Ross and many others will Under the conditions that will obtain at Greenwich if the school is started, men will learn and were time as well as vance
live,
opportunity given,
what the}" should have learned before they how to examine blood and faeces for qualified, Acute rheumatism is a disease prevailing in the malarial and other parasites and for worms. England and its after-effects are commonly seen Beyond that and obtaining a practical knowin India. Yet no one dreams of coming from ledge of a few chronic tropical diseases with a England to India to study acute' rheumatism. theoretical knowledge of the rest, we cannot Even a profound acquaintance with chronic see what advantage a man will gain from his dysentery, enlarged spleen and tropical' diar- three months' residence at the Albert Docks. rhoea at home will avail one little in treating acute dysentery, heatstroke, cholera or remittent malarial fever as met with daily in the tropics. The material in London is, we hold, too small in amount and of the wrong quality for teaching were not, however, the purposes. Even if it a school remains to be of such proved. necessity the lish would be
rapidly
added to.
O
'
Similar material is to be found in even greater abundance in the Royal Victoria Hospital at Netley, where too there exist a medical school with well-equipped laboratories and a teaching staff well acquainted with tropical diseases of all
is an excellent museum with of every disease prevailing in warm specimens in addition the hygiene teaching and climates, There
kinds.
and
laboratory
as
are
The cost
anywhere.
individual would
to
good
as are
to be found
the State and to the
probably
be less also than in
Nothing need be said far-reaching advantages of the professional
the Albert Dock School. of the
and social intercourse between the future members of the R. A. M. C., the I. M. S. and the Colonial Medical Services. They are obvious. As we have already urged, however, the best place to study tropical diseases is in the tropics, and
we
would like to
see men
sent to convenient-
ly situated cities possessing large hospitals and, if
medical
possible,
Calcutta,
Jamaica,
schools,
such
as
Bombay,
Hong-Kong, &c. before proceeding
Three
to join months spent there their appointments would be invaluable. For the British and Indian Medical Services also a return to the old system of months in the presidency-towns
spending on
a
few
first arrival
has very much to recommend it.
ing
a
great
medicine time to
in
Besides learndeal practically about tropical the time so spent, men gained
study the language
of official life.
i
and know something The heads of the service had an
'