the order of bulla; and that four orders still remain unpublished, viz. pustules, vesicles, tubercles, and spots. The principal features of the arrangement, as originally announced by Dr. Willan, are entirely preserved by Dr. Bateman, and very nearly all the subordinate divisions: but a few alterations and some additions occur; and, although it is obvious that the author has been unwilling to deviate from the method of his predecessor, we think that he has shewn great judgment and discretion in this respect. His work differs essentially from that of Dr. Willan. While the latter is to be regarded as a complete treatise on cutaneous diseases, including an accurate investigation of their nature and origin, adjusting their nomenclature, comparing their phænomena with the descriptions of other writers, antient and modern, and discussing the merits of the various means proposed for their cure, Dr. Bateman presents us with no more than a practical synopsis ;' in which these topics are treated in a brief and cursory manner; and the main point to which the attention is directed is to lay down a correct diagnosis, and to establish general principles on which the treatment ought to be conducted. In accomplishing his object, we think that he has been remarkably successful; and we have very seldom perused a medical work with more complete satisfaction.

In our remarks on this volume, we shall principally confine ourselves to the last four orders, being those which were left unfinished by Dr. Willan; viz. pustules, vesicles, tubercles, and spots. A pustule is defined to be an elevation of the cuticle, with an inflamed base, containing pus.' There are five genera of pustular diseases; impetigo, porrigo, ecthyma, variola, and scabies. It is evident that the order of pustule is to be considered as quite artificial, in which the diseases are characterized solely by the formation of purulent matter; and perhaps a doubt may arise how far this circumstance is a convenient basis on which a nosological arrangement should be built. In well marked cases, and at certain periods of the disease, the existence of pus is an obvious and striking occurrence, that cannot be easily overlooked or mistaken: but we conceive that in many diseases, which according to Dr. Bateman's system are to be ranked as pustular, no proper pustules will be discoverable; and, on the other hand, we shall often meet with the semblance of pustules, in cases which, in this system, are placed among the vesicles.

The impetigo, which is intended to include the different kinds of moist tetters, and the porrigo, which includes ringworms, scald heads, &c. are well defined genera, and probably are intitled to the appellation of pustular diseases; although, as

we

we have just remarked, the proper pustular appearance is often not to be recognized. The directions for the cure of the. different species of porrigo seem to be judicious, and present a candid account of the effects of the principal remedies that have been proposed for the removal of these disagreeable complaints.

The word ecthyma is used to denote an eruption of large, hard, inflamed pustules, which are scattered over the body, not attended by fever, and not contagious. It is an affection of little importance in itself: but, as the author observes, the diagnosis of this eruption from the contagious pustular diseases, as well as from some of the secondary appearances of syphilis, is of considerable importance in practice, and renders it necessary to notice this genus.'

Though the scabies, or common itch, is a disease in most cases very easily known and discriminated, yet it does not readily find its proper place in a nosological arrangement:

This troublesome disease, which, from its affinity with three orders of eruptive appearances, pustules, vesicles, and papulæ, almost bids defiance to any attempt to reduce it to an artificial classification, is not easily characterized in few words. An extreme latitude in the acceptation of the term has indeed been assumed by writers, from Celsus downwards; and no distinct or limited view of the disease has been given, until near our own times. Celsus has in cluded other forms of pustular disease among the different species of Scabies; and some of the earlier writers, after the revival of learning, considered almost all the eruptions, to which the skin is liable, as modifications of this disease: even our countryman, Willis, to whom the contagious nature of true Scabies, as well as its specific remedy, was well known, has not sufficiently separated it from some other pustular and pruriginous affections.'

The lower classes of people, who from obvious causes have the best opportunity of becoming acquainted with this disease, have noticed four different varieties; and these have been introduced into Dr. Bateman's arrangement, under the specific names of papuliformis, lymphatica, purulenta, and cachectica. While, however, he admits the propriety of this division, he observes that the practical discrimination, in many of these cases, is more difficult than in any other order of cutaneous disease.' It is well known that some naturalists have contended for the existence of a peculiar species of insect as the cause of scabies, and that delineations of it have been published with marks of accuracy and authenticity. Yet Dr. Bateman was never able to detect any thing of the kind; and he is disposed to regard their presence, when they do exist, rather as an accidental occurrence than as being essentially connected with the formation of the pustules.

The

The order of vesicles comprehends seven genera. A vesicle is defined to be a small orbicular elevation of the cuticle, containing lymph, which is sometimes clear and colourless, but often opaque, and whitish or pearl coloured. It is succeeded either by scurf, or by a laminated scab.' This definition is, we believe, nosologically correct: but, practically, it will often be impossible to detect the distinction between the pustule and the vesicle; since an elevation of the cuticle containing whitish or pearl coloured lymph must, in its external characters, be very nearly allied to a pustule. The seven genera of vesicles are the chicken-pox, cow-pox, herpes, rupia, miliaria, eczema, and aphtha. The term herpes, which has been frequently employed in a very vague manner, is restricted by Dr. Bateman' to a vesicular disease, which, in most of its forms, passes through a regular course of increase, maturation, and decliné, and terminates in about ten, twelve, or fourteen days.'

Doctor B. notices six varieties of herpes, which appear to be distinguished from each other with considerable accuracy: but we confess that we are not competent, from our own observation, to determine how far the descriptions accord with the actual phænomena of the disease, or are capable of being included under the generic definitions.

Rupia is a genus introduced by this author, and takes its appellation from the sordid condition of the diseased parts; it is thus described:

The rupia is characterized by an appearance of broad and flattish vesicles, in different parts of the body, which do not become con. fluent they are slightly inflamed at the base, slow in their progress, and succeeded by an ill-conditioned discharge, which concretes into thin and superficial scabs, that are easily rubbed off, and presently regenerated.'-

The eczema is characterized by an eruption of small vesicles, on various parts of the skin, usually set close or crowded together, with little or no inflammation round their bases, and unattended by fever. It is not contagious.'

The most important species of eczema is that which arises from the irritation of mercury, and has lately been described under the appellations of erythema mercuriale, hydrargyria, &c. It is remarkable that an affection which is of considerable violence, and not of very rare occurrence, should until lately have been little noticed.

The 7th order of tubercle is defined to be a small, hard superficial tumour, circumscribed, and permanent, or suppurating partially.' It comprehends eight genera: but, as Dr. Bateman observes that some of them require surgical treatment and

some

some are not often seen, we shall remark on only two of them, the acne and the elephantiasis:

The acne is characterized by an eruption of distinct hard tubercles, which are sometimes permanent for a considerable length of time, and sometimes suppurate very slowly and partially. They usually appear on the face, especially on the forehead, temples, and chin, and sometimes also on the neck, shoulders, and upper part of the breast; but never descend to the lower parts of the trunk, or to the extremities. As the progress of each tubercle is slow, and they appear in succession, they are generally seen at the same time in the various stages of growth and decline; and, in the more violent cases, are intermixed likewise with the marks or vestiges of those which have subsided. The eruption occurs almost exclusively in persons of the sanguine temperament, and in the early part of life, from the age of puberty to thirty or thirty-five; but, in those of more exquisite temperament, even later. It is common to both sexes; but the most, severe forms of it are seen in young men.'

The

This disease, which includes the different varieties of what are usually called scorbutic eruptions in the face, is divided into four species, simplex, punctata, indurata, and rosacea. last species constitutes the red face, which is either the effect of hereditary temperament or of the immoderate use of spirituous liquors. The following remarks on the cure of this unpleasant and obstinate complaint may be interesting to some of our readers :

The perfect cure of acne rosacea is, in fact, seldom accom, plished; for, whether it originate in a strong hereditary predisposi tion, or from habitual intemperance, the difficulties in the way of correcting the habit of body are almost insurmountable. The regula tion of the diet, in both cases, is important: and when the stomach or liver is disordered, in the latter, the symptoms may be sometimes palliated by the liquor potasse, or other antacids, which seem also to have some influence in lessening inflammatory action in the skin. The gentlest restringents should be used externally to the patches of reticulated veins; such as very dilute spirituous or acetous lotions, with or without a small proportion of the acetate of lead; or simple ointments combined with alum, acetate of lead, &c. in small quanti ties. The more purely local and primary the eruption appears to be, the more active may be the astringency of the substances applied to it.'

In the section on Elephantiasis we have a favourable specimen of the author's learning and discrimination. The term elephantiasis appearing to have been used in the most inaccurate manner, and indeed to have been applied to quite different diseases, Dr. Bateman attempts to clear up these difficulties, and to ascertain precisely the train of symptoms to which the name is strictly applicable.-The last order, macula, although necessary

to

to complete the system, consists of affections generally of little moment, and such as scarcely require medical treatment.

Before any person could venture to give a decided opinion respecting the merit of the arrangement of cutaneous diseases which is here presented to the public, by the joint labours of Dr. Willan and Dr. Bateman, it would be necessary that a more minute degree of attention should be paid to this class of complaints than ordinary practice excites or requires: but it is easy to pronounce that these gentlemen are intitled to one great and important commendation, viz. that the terms employed by them are all well defined, and may be readily comprehended. We have no hesitation, therefore, in saying that every practitioner would do well to adopt Dr. Bateman's nomenclature, as a standard by which he should regulate his proceedings; and he will, in the course of his experience, perceive by degrees whether it be founded on just principles, and is sufficient to guide him in all the variety of cases that fall under his notice, or whether it be defective in any of its parts. Should this latter prove to be the result, the precise defect may be easily pointed out, and the requisite alteration be applied, without introducing in this branch of medicine any more of that confusion which has rendered our practice so doubtful and inefficient, in consequence of the uncertainty which has always attached to our language.

ART. VI. Shipwrecks and Disasters at Sea; or Historical Narratives of the most noted Calamities and Providential Deliverances, which have resulted from Maritime Enterprize: with a Sketch of various Expedients for preserving the Lives of Mariners. 8vo. 3 Vols. pp. 1479. 11. 16s. Boards. Longman and Co.

THI

HIS narrative of nautical disasters is compiled from the records of a period of somewhat more than two centuries; and the examples are selected from the history of various nations, but more particularly from the maritime annals of the English, Dutch, and French. Of our countrymen, the first whose fate is related is Sir Humphrey Gilbert, who was wrecked in 1583; and the long and gloomy catalogue is closed by an account of the loss of the Nautilus sloop of war in the Archipelago, in 1807. Two out of the three volumes are occupied with details of events belonging to the eighteenth century; and those readers, who find their attention interested by such subjects, will here see a full narrative of the fate of the Grosvenor Indiaman in 1772, of the Winterton in 1792, and of the extraordinary but less melancholy adventures of Captain Bligh, who traversed the Indian ocean in an open boat in 1789. The

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