DISCARD PILE: Field Guide to Disease: A Handbook for World Travelers

Discard Pile reviews books that were recently withdrawn from the collection at the Barstow School in Kansas City, Missouri.

Field Guide to Disease: A Handbook for World Travelers

By Berton Roueché

Little, Brown and Co., 1967

$4.95

Entered Barstow School Library: Feb. 15, 1968

In his disgustingly riveting Field Guide to Disease, Berton Roueché suggests that travelers stricken with diseases “near [their] natural dwelling place…have every chance of receiving prompt and proper treatment.” As an example he uses, “histoplasmosis in Kansas City.” I live and work in Kansas City. Roueché says I have probably had this fungus invasion that he deems endemic to this part of the United States. The good news: the disease is mostly relatively benign. The not-so-good-news: the “conspicuous manifestation” proves fatal.

Normally I worry about (mostly in order) my family, the general state of American culture, geo-political conflict, the NSA, getting smushed by an asteroid, and globe-hopping strains of Ebola. Roueché provides me with a menagerie of new fears and horrorshow descriptions of tapeworms, fungi, and spirochetes, mosquitoes, midges, and microbes.

Roueché documents the history of 27 different and often unpronounceable diseases with the ruthless efficiency of a virus. Each section begins with a general overview of the disease, followed by a recounting of its linage, usually to ancient times. He catalogs names of scientific pioneers and quotes from their work; he writes of Roman encyclopedists and their takes on malaria. He tells us that Darwin probably suffered from Chagas’ disease, that yellow fever inspired Wagner and Coleridge. Roueché gives us Boccaccio on the plague, Virgil musing on anthrax, Aristotle holding court on rabies.

For all his fascinating history, though, Roueché revels in the gnarliness of symptoms, as though he wants to craft the physiological version of Naked Lunch — worms that slither out of people’s feet, furuncles of parasites, hallucinatory fevers, so so much swelling, and the occasional blood vomit. To wit, Roueché calls the L. loa, the carrier of loiasis, “a restlessly peripatetic” worm that prowls the human body. He continues, “Victims of loisas frequently first become aware of their condition when standing at a mirror. An adult L. loa is around an inch in length and its passage across the eyeball takes about a minute. The pain experienced by the victim during that moments is generally both physically and psychologically exquisite.”

Such macabre glee provides an uncanny level of unintentional humor not normally found in field guides to disease. Those who fall victim to brucellosis (an undulant fever), “frequently become neurotic and are considered as pests by their relatives and friends.” He argues that the growing numbers of types of diseases “are triumphant evidence of progress.” Diphyllobothriasis, a fish tapeworm disease has a life cycle of “baroque complexity.” And his simple advice for those adventuring in exotic locales, “These are not, like diseases of degeneration, the result of constitutional decline and decay, but of parasitical invasion, and their avoidance is thus not completely a matter of chance. The prudent traveler can avoid the woods or streams or crowded streets and stores in which some of them are most frequently found.”

While nightmares will certainly follow, I rather enjoyed the naughty schoolboy voice of Roueché in his Field Guide to Disease, and remember, as he tells us in the first line of the book, “This book is not intended to alarm.”

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