24 



THE HISTORY OF TROPICAL MEDICINE 



tropics. We refer the reader interested in this subject to the classical 

 work of Nuttall on insects as carriers of disease in the Johns 

 Hopkins Hospital Reports, 1899. 



The idea that the house-fly and its allies are capable of spreading disease 

 originates from the time of Mercurialis, who in 1577 suggested that the virus 

 of plague might be disseminated by this means. In 1666 Sydenham remarked 

 that the presence of numerous flies in the summer indicated that there would 

 be much sickness in the autumn, while in 1808 Crawford stated that he 

 believed insects to be the carriers of infection. In 1853 Moore referred to 

 flies as the possible carriers of cholera, typhoid, tuberculosis, anthrax, and 

 leprosy. In i86q Raimbert performed the first experiments, showing that 

 anthrax could be disseminated by flies. Tizzoni and Cattani made observa- 

 tions on the spread of cholera by the same means, Grassi and later Stiles 

 demonstrated the possibility of the carriage of parasitic worms, and one of 

 us the transference of the Treponema pertenue by the same means. Gayon 

 in 1903 indicated the possibility of the dissemination of fungi by flies. 



Toxicology. — Micro-organisms are not the only causes of disease 

 to be found in the tropics, for poisons from plants and animals 

 are also of the greatest importance. 



It has been shown that the most primitive peoples have definite 

 knowledge of poisons, and it has already been mentioned how early 

 the study of snake and other animal venoms began. 



It will suffice here to indicate that the scientific study of snake- 

 venom, begun by Prince Lucien Bonaparte in 1843, has been ex- 

 tended by Fayrer, Martin, Lamb, Calmette,' Noguchi, and many 

 others, and leave a fuller description of this and the history of other 

 poisons to a later chapter. 



Climatology. — Tropical medicine does not confine itself to diseases 

 caused only by parasites and poisons, for there are such conditions 

 as heat-stroke, which are entirely due to physical causes, and also 

 there is the important question of the influence of tropical climates 

 on man, which must be dealt with in a later chapter. 



Dietetics. — But little work has so far been done with regard to 

 this important subject in the tropics, though pioneer struggles have 

 been undertaken most successfully by McCay in India, and his 

 example deserves to be followed. 



Clinical Medicine.— Clinical researches into the diseases affecting 

 Europeans and natives in the tropics began with the earliest modern 

 travellers, non-medical as well as medical, and the earliest references 

 to tropical diseases are to be found in these early works on travel. 

 Thus, as Singer has pointed out, De Oviedo in 1526 gives a reference 

 to a disease bubas, which we now know to include Frambcesia 

 tropica, a form of Leishmaniasis, and probably a form of Blasto- 

 mycosis. In 1558 Thevet described the jigger as a little worm called 

 * Tom,' which entered into the feet, and wrote descriptions of 

 Frambcesia tropica under the term ' Plans.' In 1598 G. W. wrote an 

 account of Calenture (heat-stroke), and Tabardillo, which is derived 

 from the Spanish word Tabardo, a cloak, and was applied to the 

 typhus fever epidemic in Spain in 1557; ^-ud therefore G. W. may 

 have meant typhus by this term, though it is possible that he also 

 included yellow fever under the same name. He also describes 



