A Clinical Lecture on Tropical Diarrh a
Authors: J. Fayrer
Journal: BMJ (1884)

As it has been intimated to me that it would be agreeable, and perhaps useful, to you, were I, when occasion offers, to make some practical observations on the clinical aspects of certain diseases which have originated in, or are due to, the influences of a tropical climate, I have much pleasure in complying with the wish, and in placing such information and experience as I possess at your disposal.I can well imagine that clinical instruction of this character may be serviceable in a school of medicine which con- tributes so largely as this does to the various departments of the public service, the mercantile navy, and the civil medical establish- ments of our foreign possessions.The opportunities for clinical instruction about the various, especially the acute, forms of tropical disease which would, doubtless, most interest you, are not so frequent as to give promise of a continuous or complete series of lectures ; but still as, from time to time, cases occur, which illustrate some of the more important and characteristic features of tropical disease, I would gladly take advantage of them for your benefit; and I trust that I may be able to direct your attention to certain points of interest which will be of service not only to those among you who look forward to a career in the public service, or in the colonies, but also to those who contemplate professional work at home.As you all know, our rapidly extending intercommuni- cation with India, China, the colonies, and other foreign, tropical, or subtropical countries, whilst bringing us into closer and more rapid intercourse, is also making medical men at home more familiar with, and more directly interested in, various forms, phases, and sequele of exotic disease, which are by no means of uncommon occurrence in many parts of our own country.The subject I have selected for consideration to-day is one of con- siderable interest, and it is essentially a form of disease due to tropical influences, frequently very grave in its character, and, if not carefully and judiciously dealt with, very prejudicial to health, even to life itself.Through the kindness of Dr. Bruce I am enabled to illustrate clinically, in the case of a person recently returned from India, the symptoms of tropical diarrhcea, the complaint to which I propose to direct your attention to-day; and whilst considering this case, and directing your attention to its clinical history and peculiarities, I shall take advantage of the opportunity it gives me of describing in some detail the disease as it usually presents itself; giving you also some hints as to the method of dealing with it.I do not propose to dwell on the subject of diarrhcea generally, but on that special form of it which has received the designation of tropical, from being so frequently seen in persons who have resided in India, China, Java, Ceylon, or other tropical or subtropical countries.Chronic dysentery, with which it is often complicated, I reserve for a future occasion.I need hardly remind you that diarrhcea is a symptom of disease rather than a disease itself, and may depend on a variety of causes.