The American Journal of Tropical Medicine and Hygiene - Volume 7, Issue 5, September 1958

The experiences of the first woman physician in primitive, poverty-stricken Kuwait from 1912 to 1929 are high-lighted by contrasts seen on a recent visit to this now oil-rich country. A personal account of the struggle to introduce Western medicine to Moslem women reveals many interesting glimpses of their family life, although most of the customs described will be familiar to those who have read at all widely in this field. Little of technical value in Tropical Medicine is included beyond mention of the various diseases encountered.

The author, whose husband opened a Mission school for boys, had to practice independently and in a separate part of the building from that used by the other Mission doctor who treated the men. From a description of preparing in trepidation for her first major operation with only uneducated assistants, the story progresses with many an aside about raising a family, social visits with Arab and British officials, and warfare among desert tribes, to an account of practice in a hospital assisted by a trained nurse.

This book offers the reader a wealth of information concerning the tubercle bacillus and experimental tuberculosis. The subject matter is organized in a logical fashion. It begins with a description of the tubercle bacillus and its growth requirements. It reviews methods of isolation and identification of tubercle bacilli and describes their effects on experimental animals. The material is presented in historical perspective and is well documented.

Those interested in basic bacteriology will find a comprehensive description of the biological, chemical and physical factors associated with identification of cell structures. Those interested in diagnostic methods will find a thorough review of the microscopic and cultural techniques for isolation and identification of the tubercle bacillus. Those interested in experimenting with the tubercle bacillus will find reference to the fundamental techniques currently employed in studying tuberculosis in animals. The reader will find the section on hazards and precautions in the laboratory of great practical value.

The authors have reviewed the literature dealing with the transmission of various pathogenic organisms and parasites by cockroaches. There is an impressive list of such organisms that have been associated with these insects; the associations have been established by experimental infections and by recovery of the organisms from wild cockroaches. The authors conclude, “There is no question about the ability of cockroaches to carry pathogens in or on their bodies”, but that there is “… some question about the epidemiological significance of the fact.” As is true of flies, the filthy habits of the pest cockroaches, especially their inhabiting of sewerage systems, make them potential carriers of pathogens from feces to food destined for human consumption.

The organisms associated with cockroaches include viruses, bacteria, fungi, protozoa, and helminths. The review includes sections on allergy, cockroach bites, accidental invasion of man, cockroaches as human food, and cockroaches in medicine and folklore.

From the time of Hippocrates to the etiological discoveries of the last quarter of the 19th century the epidemiology of malaria, without knowledge of parasite or vector, concerned itself perforce with the circumstances under which the disease occurred and spread. When the discoveries of Laveran and Ross disclosed the full cycle of transmission, the old “circumstantial” epidemiology gave way to the studies of the parasite and the vector which constitute the great advance of the last half century. Nevertheless, the mass of detailed knowledge accumulated by this “biological” approach to epidemiology has not provided a satisfactory understanding of the diverse manifestations of the disease under the almost infinite number of possible combinations of biological and circumstantial variables. Professor Macdonald now attempts to identify and evaluate the measurable factors influencing the transmission and endemicity of malaria, and thus to provide a scientific basis for the explanation of the differences in the malaria picture under varying ecologic conditions.