The Imaging of Tropical Diseasesedited by Philip E.S. Palmer and Maurice M. Reeder. Springer-Verlag, 2001. (hbk, 2 Vols) £344(Vol. 1, xi + 879 pages) ISBN 3-540 56028 9(Vol. 2, xi + 895 pages) ISBN 3 540 6247 6One of the most spectacular developments in medical diagnosis in recent years has been the growth of novel methods for imaging the human body. Computer-assisted tomography, magnetic resonance (MR) imaging and ultrasonography are now well established in many medical centres, and various other refinements and applications of biophysical principles are being steadily added to the list. The extraordinarily detailed views of the interior of the living body provided by these techniques are transforming clinical investigations, although one must remember the more important revolution that occurred over 100 years ago, when Roentgen introduced X-radiology as a diagnostic tool.Tropical medicine has benefited much from radiology, although, of course, has often been severely hampered by poverty of equipment and trained operators. This book is the second edition of a monument to those who have laboured long and hard to chart the radiological changes caused by a wide range of parasitic diseases, bacterial and fungal infections, tumours, cardiovascular diseases and other conditions that are common in tropical regions. Published in two volumes, Palmer and Reeder have assembled an impressive team of contributors from radiological centres worldwide, systematically providing radiological images of various kinds for each disease, enriched by brief accounts of their history, pathobiology, epidemiology, clinical manifestations and current treatment. Some chapters could be books in their own right; for example, those on amoebiasis, schistosomiasis and hydatid disease are each over 100 pages long, all have impressive sets of illustrations drawn from conventional and recent imaging techniques and all contain valuable bibliographies. There is a chapter devoted entirely to ultrasonographic images and another on how to set up and run a field X-ray unit, an interesting touch that emphasizes the practical nature of the book. Although there are inevitable variations in the quality of the older images, and the photographs of gross and microscopic pathology would have benefitted from colour, on the whole, the illustrations are excellent.Although the book is clearly aimed at practicing radiologists, the breadth and depth of information is fascinating, and there is much for the parasitologist to ponder; for example, the variety of sites affected in the body, and the extent to which life can be sustained in gross, untreated chronic infections, such as those seen in MR images of advanced cranial hydatid cysts. Dipping into various chapters, the reader is also rewarded with fascinating snippets of information, such as arthropodal infections of the nose and throat, picked up from contact with snakes, where larvae of the tongue worm, Pentastoma, disport themselves in the respiratory tract. There is also the message that many tropical diseases are poorly understood and new ones will probably be discovered. For example, in 1963, the cause of an outbreak of gastroenteritis in the Philippines was found to be a previously unknown nematode, Capillaria phillipinensis. Another example is the intriguing disease in West Africa called ainhum (of unknown cause), which involves spontaneous auto-amputation of toes.In conclusion, this is an impressive book that will be of much value and interest to radiologists and others concerned with tropical disease, a discipline that is likely to expand as global warming and movements of populations progress. As expected of its publisher, Springer-Verlag, the volumes are beautifully produced, and will grace the shelves of those lucky enough to be able to afford them. The wealth of images also reflects the tremendous impact of infectious diseases on human populations, and the reader is again reminded that: in much of our world, infectious agents of many kinds are responsible for widespread suffering and death; medical help is mostly scarce and effective treatment is scarcer; and many of these diseases are easily preventable, given appropriate socio-economic and political conditions, whereas others require vigorous pharmaceutical research and development just to contain them. These are uncomfortable thoughts and make one ponder our priorities as we plan for the coming high-tech postgenomic era.