Rainbows in washtubs

OVERALL RATING Good

STRENGTHS Easy and enjoyable read; provides a useful approach to agromedicine

WEAKNESSES Not a practical reference guide

AUDIENCE Anyone interested in the links between agriculture and health

Rainbows in Washtubs. Diagnostic Mysteries in Agromedicine is a reflective collection of fascinating agromedicine vignettes. Dr Schuman, a pediatrician who became an epidemiologist and later an investigative public health physician, presents a variety of clinical challenges that are solved as clinical riddles—almost like a rural practice “CSI.” The first story, “Finding Rainbows in Washtubs,” begins with an infant, a 6-year-old, a 9-year-old, and their parents presenting to a rural doctor in an emergency department with a variety of symptoms: stiff neck, ataxia, muscular twitching, blurred vision, cramps, and diarrhea. The mystery is later solved on a public health home investigation that reveals a rainbow in the washtub, which is actually the effect of a toxic oil-soluble organophosphate pesticide. Another vignette traces an outbreak of pneumonia in schoolchildren to playground soil contaminated with histoplasmosis spores. And yet another links a rash of rashes in floral shops to a new, highly allergic imported plant that causes severe contact dermatitis. This book is an enjoyable read and, collectively, the vignettes present an approach to agromedicine challenges that will complement reference textbooks, especially for physicians who care for rural families.

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