THE TURN OF THE TIDE.
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
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 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. 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 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 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 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.
[Illustration: 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 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 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."
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; 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."
"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. 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 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 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 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
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.