As living standards in what are now the industrial countries have improved, many conditions, which once occurred everywhere, are now confined to the tropics. Although they often thought of as being specifically tropical, they are in fact the ''surgery of poverty'. Surgical tuberculosis (Chapter 29), surgical leprosy (Chapter 30), vesicovaginal fistulae (18.18), perforated typhoid ulcers (31.8), and enormous hernias (14.4) are a few of the conditions which were once seen everywhere. There are also a few specifically tropical infections, such as mycetoma (31.3) and filariasis (31.6) which may need surgery. Schistosoma haematobium causes much surgical disease of the urinary tract, but none of the procedures that are possible are sufficiently easy or effective to be mentioned here, apart from a plea for the early diagnosis of the bladder cancer that it may cause (32.31), a note on schistosomal granulomas of the vulva (20.14), and on the occasional usefulness of nephrostomy (23.13).
Tropical ulcers are one of the classical tasks of tropical surgery, so we will start with them.