when rich returned, shortly after the commencement of the summer term, he was joyfully welcomed by his pupils. in the course of ten days he received a box by the stage, of quite modest proportions, that was instantly transferred to the harness-room, and respecting the reception of which rich seemed very much interested, having been several times to the stage tavern to inquire about it.
this box contained all the bones of the human frame; and no wonder that rich was concerned about their arrival, considering his intense interest in the study of anatomy, and furthermore, the low state of his funds, and that they cost him but five dollars.
it was customary for the lecturer to procure subjects for dissection (in what way was best known to himself), for any students who wished this opportunity of private study and dissection, at twenty dollars apiece. rich clubbed with three more and bought one. after they had dissected[pg 261] and made a study of the different parts in which each felt most specially interested, the bones remained. to secure and put these together properly, so as to form an entire and perfect skeleton, repairing the damages made by the dissecting saw on the skull, to get at the brain, was a great deal of work, and required not only anatomical knowledge, but great patience and no small degree of mechanical skill; and the other students, who were able to purchase skeletons already prepared, and possessed neither the patience nor mechanical ability to perform the work, and, moreover, liked rich, gave him their portion of the bones.
to prepare, classify, and wire them together was a most congenial as well as profitable occupation to rich; it fixed the arrangement, names, and shape of the bones and articulations in his mind, and also gratified his mechanical tastes; and he in the course of the summer accomplished the work, during the performance of which his practice in working iron stood him in good stead, as he replaced the spinal marrow by an iron rod, cut a thread on each end, and made thumb-nuts with which to confine the vertebral column.
the fact of his having attended medical lectures at brunswick, coupled with his previous success in some cases of minor importance, increased very much the confidence of people in general touching his ability as a physician, and he had numerous[pg 262] calls, to all of which he turned a deaf ear, devoting himself entirely to his scholars and studies.
at length circumstances concurred to place him in a position of great perplexity, and one where he was, as it were, compelled to assume a responsibility from which he would gladly have been excused. dan clemens, frank merrill, and horace williams had natural history, in the form of ornithology, "on the brain." if these youngsters didn't sit on eggs, they dreamed of them. it would be difficult to mention anything they would not do for rich when the remuneration was a rare bird, shot and stuffed.
to be soaked to the skin, and so tired they could scarcely put one foot before the other, were pastimes when birds were ahead; and to obtain eggs they would venture life and limb. the fatigue of soldiers on a forced march was trifling in comparison with what they cheerfully endured; and their mothers, during the spring and summer months, were in a state of chronic anxiety, expecting nothing less than their being brought home with broken bones.
one saturday afternoon they were all in swimming with a crowd of boys who took not the least interest in their favorite study; but one of them, while undressing under a leafy elm, at whose roots the boys were accustomed to put their clothes, espied the nest of a baltimore oriole, and told dan, who was in the water with frank and horace.[pg 263] they instantly dressed, and began to look with longing eyes at the nest that was pendent from the extremity of a slender branch near the top of the tree, and on its southern side.
"we can't get that nest," said horace, "for we can't climb the tree, it's so far to a limb. if we could climb it, the limbs won't bear a fellow to reach the nest."
"yes, we can," said dan; "we must have those eggs. you give me a boost. i'll bet i can climb it."
"if you do, you can't reach the nest."
"i can tell better after i get there."
dan did his best, but had to give it up; so did horace. frank was the best climber of the three, though of lighter weight than the others, and less plump—an exceedingly agile and sinewy boy. he did not, however, relinquish his efforts and slide reluctantly down the trunk till he was within three feet of the lowest limb.
"if you could only boost me up that much i fell short, i could go it," said frank, "after i rest and get breath."
"let us," said dan, "pile up a great heap of stones, one of us stand on that, and the rest put frank's feet on his shoulders."
"no; get some nails and a hammer, and nail some pieces of board on the tree," said horace.
"zuckers! i know how you can git up," said a barefooted, red-headed boy of twelve, whose [pg 264]hat-rim was nearly torn off thrashing bumblebees on thistle blossoms, and who didn't go to the academy nor any other school, save a few weeks in the winter, and who lived on a farm three miles from the village, but had the presumption to come there and go in swimming with the academy boys, because it was the best place on the river, and who could swim like a fish.
"you shut up," said frank. "how much do you know about it? and what business have you there in our swimming-place?"
"tain't none of your place, nuther; it's mr. seth hardin's pastur. i've good right here's you have. if you touch me, i'll heave a stone at your head, and i'll tell our sam, and he'll give you a lickin'."
"what is the way, bub?" said dan, too anxious to get the eggs to fling away any chance of success. "what do you know about it?"
"i know our sam would git up that tree quick as a cat would lick her ear, i swanny."
"how, bub?"
"arter plantin', dad allers gives sam half a day to go troutin' and git elum rine (elm rind) to string our corn, and me and abigail allers go too. sam takes the axe and starts a strip of bark at the butt of a tree, till he can git his hands hold; then he gives it a twitch, and rips it up clear to the limbs; then he starts another one till he gits enough. arter that he takes hold of one[pg 265] on 'em, and climbs up jist like nothin', and cuts 'em all off but one rope that he saves to come down on. they break off sometimes when there's a knot-hole; they won't run over a knot-hole. abigail and me has jolly times swingin' on the ropes afore he cuts 'em off, and strippin' 'em into twine arter he takes the outside bark off, and windin' 'em into big balls."
the inner bark of the elm, cedar, bass, and willow is very strong and tough; when peeled from the outside layer and soaked in water it makes a very good substitute for twine. our ancestors were taught the value of it by the indians, and used it to string their corn and bind sheaves, and some old-fashioned people have not yet abandoned the practice. getting elm rind and cutting withe rods were always popular with the boys, as it gave them part of a holiday.
"that's it," said dan; "i see it all now. here, bub."
he gave him three cents, upon which little red-head put his bare feet to the ground and went off at a killing pace.
an axe was procured at seth harding's, and a strip of bark peeled from the butt of the tree to one of the lower limbs.
"let us all go up," said horace. "we will stay in the tree and take the nest from frank. he's the lightest to go out on the limb."
frank, taking hold of the piece of bark, put his[pg 266] legs around the tree, and pulled himself up, ascending in this way quite easily. too impatient to wait, dan and horace followed suit, all three ascending at the same time.
in their haste and anxiety to run the bark as far up as possible, in order to reach one of the lower limbs easily, they ran it too far, within a few inches of the place where the branch joined the tree. the result of this was, that when they were pretty well up the trunk, frank incautiously pressing the bark from the tree with his knees, it started the second time and ran out on the limb. away swung the boys, far off from the trunk, in mid-air. the bark kept running narrower and narrower, as the limb grew smaller, till, its farther progress being suddenly arrested by a number of small limbs, it divided up and broke, while the boys came down into the water, amid the shouts and laughter of the rest, who were either swimming or putting on their clothes.
a slippery elm
a slippery elm. page 266.
frank escaped without hurt, but he gave dan a bloody nose with the heels of his shoes, while horace, who was undermost, barked both shins on a rock that just broke the surface of the water.
learning wisdom from experience, they stripped the bark at the next trial farther from the limb, ascending one at a time, and met with no difficulty. the branch on which the nest hung bent over the river. frank, grasping the branch, put his feet on the one directly beneath it, and thus[pg 267] gradually worked his way till he came very near the nest, and the parent birds began to fly around his head.
but the branch now bent so much that dan, who had been the most anxious to obtain the nest and its contents, begged him to desist and give it up; so did horace; but frank's blood was up and his pride roused, for there was a crowd of boys looking at him.
"if i fall," he said, "i shall fall into the water, and i can swim ashore."
at length he could touch the outside of the nest with the tips of his fingers.
"o, if my arm was only two inches longer!"
"don't, frank," said dan, "go any farther. it frightens me to see the limb bend so."
scarcely were the words uttered, when the limb upon which he stood broke as he was holding to the branch above by only one hand. reaching after the nest with the other, he fell feet foremost into the river, catching by the limbs as he went. there were boys still in the water, who, instantly swam to him, while dan and horace, hurrying down the tree, plunged in. frank kept himself on top of the water, after rising, but when the boys reached him, said,—
"i can't swim; i believe my leg is broke. i struck something under water, and heard it snap."
it was on a saturday afternoon that this accident occurred, and rich had embraced the opportunity[pg 268] to work upon his bones. he was busily engaged in the harness-room, with the door fastened, when he was startled by a rousing rap, and the voice of dan clamoring for admittance. opening the door, he beheld dan pale and excited, and the face of mrs. clemens over his shoulder, who manifested no less alarm.
"o, mr. richardson!" cried dan, "frank's fell off a tree and broke his leg. horace and mr. harding have carried him home, and dr. ryan has gone down there, and wants you to come right down. mr. harding said be expected they'd cut his leg off. mr. richardson, don't let 'em cut poor frank's leg off—will you?"
"i hope it won't be necessary," said rich, as he locked the door; "but the doctors will do what they think is for the best."
"just what i have been expecting all the spring, ever since this egg-hunting began. i hope it will be a solemn warning to you, daniel," said his mother.
it happened very opportunely that this was a day fixed upon by dr. ryan and his friend, dr. slaughter, to remove a tumor, the person being one of dr. ryan's patients. they had returned, having performed the operation, and were at the house in a few moments after the boy was brought home, and richardson was not far behind them.
"you had better strip the limb, mr. richardson," said dr. ryan; "he is more familiar with you."
[pg 269]
rich bared the leg by ripping the clothes at the seam, and the two physicians commenced their examination. in his fall the boy had struck on the end of a sunken log, the remaining portion being imbedded in the bank, and both bones were broken. the tibia (or larger bone) was fractured obliquely, the sharp point of the upper end protruding through the skin; and the fibula (or smaller bone) probably with a pipe-stem fracture (square across.)
the physicians now went into a room apart for consultation, and rich, whom they did not invite to accompany them, employed himself in examining the leg, and endeavoring to soothe and encourage the boy.
dr. slaughter gave it as his opinion, that the limb must be amputated at once.
dr. ryan shrank from this, referred to the age and firm constitution of the patient, thought "it was a pity that the boy should be made a cripple at his time of life; that, though one of the fractures was oblique, the bone was not comminuted, and hoped it might be set, and the patient do well."
his brother physician, on the other hand, was positive.
"it was a compound fracture, and it was a settled principle in anatomy always to amputate in a compound fracture. air had been admitted, the muscles and integuments lacerated and bruised;[pg 270] mortification would take place, the leg would have to be amputated higher up after all, with scarcely a chance for life."
dr. ryan, accustomed for years to look to his companion for direction in all surgical operations, was obliged to yield the point; and the parents were informed it was the opinion of the physicians that amputation was necessary. mr. merrill, who reposed the greatest confidence in dr. ryan, and was not aware that he had hesitated in the matter, acquiesced at once, though with tears, for frank was their only child.
but it was very different with the mother, who was a woman of excellent judgment, great penetration, and decision of character. she utterly refused, divined that dr. ryan secretly cherished a different opinion and did not act freely, and entreated the physicians to set the bones, and bind up the wound. but this dr. slaughter refused to do. they then informed their son of the doctors' decision.
"mother," said frank, "i had rather die than have my leg cut off, and be a cripple for life."
they then asked the opinion of rich, but he declined to advance any.
"well, wife," said the husband, "we must say something; the doctors are waiting. i'll do as you think best."
"i," replied she, firmly, "will not give my consent to amputation."
[pg 271]
"well, abide the consequences, then," said dr. slaughter; and he left the house in a huff, followed reluctantly by his companion and richardson.
the parents looked at each other, after they had gone, in doubt and dread. there lay the boy, nothing done as yet, and every moment of delay, increasing the difficulty of cure and augmenting the danger.
"shall i harness up, wife, and go to b. after dr. loring, or to m. after dr. blake?"
"they will probably refuse to do anything but amputate. no, husband. let us send for mr. richardson."
"o, do, mother," said frank; "he's better than all the other doctors in this world, and he loves me."
"it is not likely he would do anything," replied the father. "we asked his opinion, and he wouldn't give any."
"to be sure he wouldn't before them. i know that he didn't think the limb ought to be taken off—saw it in his looks. i don't believe dr. ryan did, either, only dr. slaughter has got him under his thumb."
rich was eating his supper when mr. merrill came for him, and shoving back his plate, went with him directly.
"mr. richardson," said the mother, "there is no one here but ourselves. please to speak freely.[pg 272] do you think it is necessary or best to cut off frank's leg?"
"i do not. i think there is as great a chance for the boy to live with the limb on as off—that the bones may be set, and the limb saved as good as ever."
"will you give me your reasons, and tell me what dr. slaughter meant by a compound fracture, and why doctors always amputate in that case; and do it in language that his father and i can understand?"
"a simple fracture is where the bones are broken, but there is no external wound, and when the bones are set they heal for the most part readily. but a compound fracture is one in which the bone pushes through the skin, the muscles are lacerated, or, by the agent that breaks the bone, an external wound made, and air admitted. the laceration of the muscles and the admission of air, especially the presence of air, causes inflammation, the wound suppurates, sloughs, instead of healing, and ulceration is produced; it then becomes necessary to amputate, and the patient, being reduced, often dies. the old physicians thought less of saving the limb than the modern ones, and in case of compound fracture always amputated."
"is not this a compound fracture?"
"it must be defined as such technically. but the muscles are not lacerated; and though the[pg 273] bone protrudes, i have not the least doubt that it was done by the sharp point of the bone pricking through in consequence of the foot's falling back when they took him up, and that it was not forced through by the violence of the blow. it is therefore so near to a simple fracture that it may be considered and treated as one, with a fair chance of success, especially considering the patient's age, health, and the time of year (for the weather is not hot as yet), and that he is at home, where he will have the best of nursing."
"mr. richardson," said the father, "i know in these matters the state of a patient's mind has much to do with the final results. the boy will not submit to amputation except by compulsion. that we cannot think of. but he loves you, and has the most perfect confidence in your ability. will you set the bones, and do as you think best?"
"mr. merrill, i am a young man, without experience to guide me. i have no guide other than what i have gathered from books, a few weeks' instruction, and practice of dissection at brunswick, and my own unmatured judgment; but i also know that before you can get a physician here from another town, swelling will take place, and the chance of recovery be greatly diminished. i will do it on condition that you take upon yourselves all the responsibility. if a regular physician should amputate the limb, and the result be unfavorable, it would be said he took the regular[pg 274] steps; he would have the authority of precedent, and the approval of other physicians; and the ill success would be attributed to the providence of god; whereas in my case it would be said, 'he is a rash, ignorant upstart and pretender, puffed up with conceit to trifle with human life.' it would destroy confidence in me for the future, and prove a poor introduction to practice."
"we will do that, and, moreover, make it public, let the event be what it may."
rich now manifested as much despatch as he had previously displayed reluctance.
"frank," he said, "i shall be obliged to give you some pain, but i will not do it unnecessarily, nor to any great extent."
the bone completely filled the wound it had made, the point protruding slightly, and a little blood trickled down the leg from a slight flesh wound in the upper part of the thigh. rich in the first place removed the protruding point of ragged bone with the saw, and then, dipping a bunch of lint in the blood that issued from the flesh wound, gave it to dan to hold. he then gently returned the bone, dan applying the lint, and lightly pressing it to the wound as the bone receded. rich then applied a sticking plaster, spread only at the edges, over the whole, sponged, and bound up the flesh wound. thus, no air having been admitted to the wound, the fracture, in that respect, and on account of the absence of [pg 275]laceration, might be considered as virtually a simple one. then, with the aid of assistants, he flexed the thigh on the abdomen and the leg on the thigh, thus relaxing the muscles, by which he was enabled to put the bones in place, and, retaining them with his hands, brought the leg gently down and straightened it.
one assistant, now taking hold of the heel, extended the leg, while another held the thigh, and rich manipulated the ends of the bones. by bringing the heels and toes of both feet in line, and sighting across, they assured themselves that the legs were of equal length, and the foot in the right position; that there was no twist, no turning of the foot out or in. he then applied the splints, and, in order to preserve extension, by reason of the contraction of the muscles, put a shoe on the foot and attached half of a brick to it with a string. it requires a good deal of force to counteract the contraction of a muscle, if exerted at once, but much less when applied gradually and constantly.
although progress was now the watchword among the younger portion of the medical fraternity, and a decided improvement had been made in surgical instruments, still very few of the appliances now in common use were then known in this country (starch and plaster of paris, and dextrine bandages for broken bones, fracture-beds and boxes, cutting-forceps to remove bone, &c.,) and richardson could not have obtained them if they[pg 276] had been, and, like his grandfather, under the stimulus of a determined purpose, invented the appliances he felt to be needful.
"it's all over now, frank," said rich, sitting down by him and patting his cheek; "the leg is set, and you have borne it like a hero. remember you are my boy after this, and when your leg gets well i shall expect you to run all my errands. this dressing is only temporary, because the limb will swell, and the bandages perhaps, require to be loosened. it will be five or six days before the bones will begin to knit, and then i shall put on a permanent fixture. i am going to take care of you myself to-night, as to-morrow is sunday, no school, and i can sleep. after that i must be in school."
having requested the family to retire, he placed the light in the next room, administered a sedative to the patient, and resumed his seat beside him. never had rich such cause for anxiety before. in addition to his affection for the lad, who was in truth a noble-minded, lovable boy, he felt that he had ventured upon an innovation in surgical practice, and taken a bold step, which success alone could justify. the confidence reposed in him by the parents in thus placing their only child in his hands touched him to the quick, and he felt that it was with him the turning-point, the decisive step in professional life.
kneeling down by the bedside, he offered a heartfelt petition to god for direction and support.
"mr. richardson," said frank.
"what is it, my boy?"
"i begin to feel drowsy, and my leg don't pain me much. i want to kiss you before i go to sleep."
rich bent over him, and the grateful boy, putting his arms around his teacher's neck, kissed him, and dropped asleep.
