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Gordon C. Cook and Alimuddin I. Zumla (editors), 2002. Edinburgh, United Kingdom: Elsevier Science Limited and W. B. Saunders. 1,847 pages, 119 contributors.
For a relatively exotic specialty, tropical medicine and its affiliated disciplines are endowed with a relatively large library. Then there is Manson’s Tropical Diseases, which is in a class by itself. Since 1898, through 20 editions (six by Sir Patrick Manson and ten by his son-in-law, Sir Philip Manson-Bahr), it has been the Baedeker for the clinicians and researchers who dare explore the diseases of the torrid zone. Now comes the 21st edition edited by Gordon C. Cook and Alimuddin I. Zumla with chapters contributed by the distinguished experts that we have come to expect of the Manson editions. However this Baedeker is no vade mecum; it is an elephant edition of 1,864 pages, 1,007 illustrations, 87 chapters, and 5 appendices weighing 12 pounds by my bathroom scales, which, admittedly, is adjusted on the light side.
This is a very different book than former editions. For example, my old 1972 17th edition (1,164 pages, 45 chapters, 4 appendices, 4 pounds) was organized into concise chapters on specific, mainly infectious, diseases epidemiologically associated with the tropics and subtropics. Thirty years have witnessed a profound change in what has been, for the past century, called tropical medicine. Indeed, early in the book the editors question whether in this era of disease globalization the term "tropical medicine" is still valid. And in their chapter on primary care, N. and P. S. Shelty remind the reader that since 1973, 17 pathogenic, globally distributed, microbes, including human immunodeficiency virus and Cryptosporidium, have been identified as causative agents of human disease.
This new Manson seems to be several text books under one cover. The first section comprises a group of chapters dealing with such diverse topics as immunology, economics, ethics, epidemiology, and traditional medicine. Generalist students in schools of public health might be the most appropriate audience for this section "textbook". The second section is a system-oriented "textbook" with chapters on gastroenterologic problems in the tropics, dermatologic problems in the tropics, hematologic problems, renal problems, etc. Medical school faculty whose school has adopted the organ-system instructional format will be familiar with its strengths and weaknesses.
A third part returns to the familiar Manson text of etiologically oriented chapters. Most deal with diseases caused by viral, bacterial, parasitic, and mycotic pathogens, but there are chapters on non-infectious diseases such as malnutrition and poisoning by plant and animal toxins. There is an uneven emphasis; a very good chapter by Nick White tells you everything you need to know about malaria in 92 pages with 680 references. But everything you need to know about African trypanosomiasis is compacted into 22 pages with 94 references. Finally, there are the customary appendices that comprise, essentially, a book on medical zoology.
For those who like their information in a unified package, this Manson is not their cup of tea. Malaria, for example, is covered in the malaria chapter with other, or repeated, aspects in organ-system chapters, specialized-section chapters (e.g., immunology, economics, epidemiology) and in the parasitology, entomology, and laboratory diagnosis appendices. The information is all there, but not in user-friendly fashion. However, the book is comprehensively indexed for the reader who doesn’t object to some page-turning. Still, Manson’s Tropical Diseases in not only the biggest but remains the best. It is a book that has been evolving, like its subject, for the past 100 years. I look forward to reviewing the 22nd edition.
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