I
Sir Penniston Crisp was a man of some sixty active years, whose ruddy
cheeks, twinkling blue eyes, and convincingly innocent smile suggested
forty. At thirty he had been accounted the most promising young surgeon
in London; at forty he had become one of the three leading members of
his profession; at fifty he had amassed a fortune and had begun to
accept only those cases which involved complications of true scientific
interest, or which came to him on the personal application of other
distinguished physicians.
Like many another in the medical world whose material wants are
guaranteed, he found solace and amusement only in experimentation along
new lines of his peculiar hobbies. His days were spent between his
book-lined study with its cheery sea-coal fire and his adjacent
laboratory, where three assistants, all trained Bachelors of Science,
conducted experiments under his personal direction.
His daily life was as well ordered as his career had been. Rising at
seven, Sir Penniston partook of a meager breakfast, attended to his
trifling personal affairs, read his newspaper, dictated his letters, and
by nine was ready to don his uniform and receive his sterilized
instruments from his young associate, Scalscope Jermyn, a capable and
cheerful soul after Crisp's own heart. An operating theater adjoined the
laboratory, and here the baronet made it a point to perform once each
week, in the presence of various surgeons who attended by invitation, a
few difficult and dangerous operations upon patients sent to him from
the City Hospital.
When Jermyn was with his familiars he was wont to refer to his master as
the "howlingist cheese in surgery." This was putting it mildly, for,
although Sir Penniston was indubitably, if you choose, quite the
"howlingist cheese" in surgery, he was also a pathfinder, an explorer
into the mysteries of the body and the essence of vitality in bone and
tissue. He could do more things to a cat in twenty minutes than would
naturally occur in the combined history of a thousand felines. He could
handle the hidden arteries and vessels of the body as confidently and
accurately as you or I would tie a shoe string. He had housed a tramp
for thirteen months and inserted a plate-glass window in that
gentleman's exterior in order that he might with the greater certainty
study the complicated processes of a digestion stimulated after a
chronic lack of food. He experimented on men, women, children,
elephants, apes, ostriches, guinea pigs, rabbits, turtles, frogs, and
goldfish. He could alter the shape of a nose, or perfect an irregular
ear in the twinkling of an instrument; remove a human heart and insert
it still beating without inconvenience to its owner; and was as much at
home among the vessels of Thebesius as he was on Piccadilly Circus.
He was single, kept but one servant--a Jap--neither smoked nor drank,
attended the worst play he could find every Saturday night, and gave
ponderous dinners to his professional brethren on Wednesdays. He was the
dean of his order, and bade fair to remain so for a long time to come--a
calm, passionless craftsman in flesh and bone. His rivals frequently
were heard to say that there was nothing surgical in heaven or earth
that Crisp would not undertake. A faint odor of chloroform followed his
well-regulated progress through existence.
On the morning upon which this narrative opens Sir Penniston had entered
his laboratory with that urbanity so characteristic of him. A white
frock hung jauntily upon his well-filled, if slenderly nourished,
proportions, his blue eyes sparkled with good-natured activity, and his
long, muscular hands rubbed themselves together in a manner which
signified that they were anxious to be at the skilled work in which
their owner took so keen a pleasure. Scalscope was already on hand, and
with a bundle of dripping instruments in his grasp met his master
halfway between the minor operating table and the antiseptic bath.
"Ah, good morning, Scalscope! How is the Marchioness of Cheshire this
fine morning?"
Scalscope smiled deferentially at the little joke.
"I presume you mean Lady Tabitha? Her ladyship is doing
splendidly--better, I fancy, than could be expected under the
circumstances."
"Excellent, Scalscope! Delightful! Where is she?"
At that moment a large Maltese cat, cognizant by some unknown instinct
that she was the subject of this matutinal conversation, stalked slowly
out of a patch of sunshine and rubbed herself between Sir Penniston's
broadcloth-covered calves. The surgeon bent over and felt carefully of
her foreleg, but the feline did not flinch; on the contrary, she
screwed round her head and thrust it into the doctor's hand.
"Perfect!" exclaimed Sir Penniston, his face lighting with a smile of
scientific satisfaction. "Absolutely perfect! Scalscope, you have lived
to participate in the highest achievement of modern surgery! Is the
patient in the operating room? Very good. The gentlemen assembled?
Excellent! While you are administering the somni-chloride I will
announce our success."
He bowed to the other assistants and, followed by the Marchioness of
Cheshire, opened the door which led to the platform of the operating
theater. Some dozen or fifteen professional-looking gentlemen rose as he
made his appearance and bowed. A young woman with her arm in a sling sat
by the table attended by a couple of women nurses.
"Good morning, gentlemen! Good morning!" remarked Sir Penniston. "Mr.
Jermyn, will you kindly prepare the patient? My friends, I have the
pleasure of being able to announce to you, and thus permitting you in a
measure to share in, what I regard as the most extraordinary achievement
of our profession."
A murmur of interest and appreciation made itself audible from the
physicians who had resumed their seats upon the benches. If Sir
Penniston regarded anything as remarkable, it must indeed be so, and
they awaited his next words expectantly.
"The problem, gentlemen, of limb-grafting has been solved!" he announced
modestly.
The assembled surgeons gazed at one another in amazement.
"You may perhaps recall," continued the baronet, "that it has for years
been my particular hobby, or, I should more properly say, theory, that
there was no reason in the world why, if a severed finger or a nose
could be replaced by surgery, the same should not be true of a major
part, such as a hand or leg; and why, if a limb once severed could be
replaced upon its stump, another person's might not be used.
"Many gentlemen eminent in our profession, some of whom I believe I see
before me, gave it as their opinion that such an operation was
impossible. A few--and most of these, I regret to say, were upon the
other side of the Atlantic--agreed with me that it could and would
ultimately be accomplished. I studied the problem for years. Was it our
inability to nourish a part once severed or so to reënervate it as to
unite tendons, muscles, or bone? The latter surely gave no trouble.
Tendons were sutured every day, and under favorable circumstances their
functions were restored, while nerves were frequently sutured and
functional restoration recorded.
"The question, therefore, seemed to narrow itself down to whether or not
it was impossible to restore an arterial supply once cut off. Veins, of
course, were frequently cut and sutured, and performed perfectly
afterwards. Was there no way to restore an artery? In other words, could
a limb once severed be sufficiently nourished to restore it? This, then,
became my special study--a fascinating study indeed, involving as it did
the possibilities of untold benefit to mankind."
Sir Penniston paused and glanced toward the table upon which was
extended the now almost unconscious form of the patient. There was still
plenty of time for him to conclude his remarks.
"With a view, therefore, to observing whether a thin glass tube would be
tolerated in a sterilized state within an artery (the only possible
means I could devise to allow a continued flow of blood and
contemporaneous restoration), I made a number of half-inch pieces to
suit the caliber of a dog's femoral, constricted them very slightly to
an hour-glass shape, and smoothed their ends by heat, so that no surface
roughness should induce clotting. Cutting the femorals across, I tied
each end on the tube by a fine silk thread, and tied the thread ends
together. Primary union resulted, and the dog's legs were as good as
ever! The first step had been successfully accomplished."
The assembled surgeons clapped their hands faintly in token of
appreciation, and one or two murmured, "My word!-- Extraordinary!--
Marvelous!" Sir Penniston bowed slightly and resumed:
"I now added one more step to my experiments. I dissected out the
trachial artery and vein near the axilla of a dog's forelimb, and,
holding these apart, amputated the limb through the shoulder muscles and
sawed through the bone, leaving the limb attached only by the vessels. I
then sutured the bone with a silver wire and the nerves with fine silk.
Each muscle I sutured by itself with catgut, making a separate series of
continuous suturing of the _fascia lata_ and skin. The leg was then
enveloped in sterilized dressing, a liberal use of iodoform gauze being
the essential part. Over all, cotton and a plaster jacket were placed,
leaving him three legs to walk on. The dog's leg united perfectly."
The assembled gentlemen broke into loud applause. The patient was lying
motionless, her deep inspirations showing that she was under the
anæsthetic. But Sir Penniston was now lost in the enthusiasm of his
subject.
"Thus, gentlemen, I demonstrated that, if in an amputated limb an
artery could be left, the limb would survive the division and reuniting
of everything else, and had good ground for the belief that if an
arterial supply could be restored to a completely amputated limb, _that_
limb also might be grafted back to its original or to a corresponding
stump.
"The final experiment only remained--the complete amputation of a limb
and its restoration--a combination of all the others--difficult,
dangerous, delicate--and requiring much preparation, assistance, and
time. I finally selected a healthy cat, amputated its foreleg, inserted
a glass tube in the artery, and sutured bone, muscles, nerves, and skin.
Complete restoration occurred! And after four months you have here
before you this morning the cat herself, fat, well, and strong, and as
good as ever!--Here, kitty, kitty, kitty!"
The Marchioness of Cheshire ran quickly to Sir Penniston and leaped into
his lap, while the gentlemen left the benches and hastened forward to
seize the master's hand and to examine the cat in wonder.
"There is nothing, therefore, in the way of grafting which cannot be
successfully undertaken. A human arm or leg crushed at thigh or
shoulder, and requiring amputation, would admit of Esmarch's bandage
being applied to expel its blood and of being used after amputation. Why
not another man's blood as well as its owner's? No reason in the world!
Had we here a suitable forearm ready to be applied I have no doubt but
that I could successfully replace it upon the stump of the one I am now
about to remove. Hereafter, so long as there are limbs enough to go
round--so long as the demand does not transcend the supply--none of our
patients need fear the permanent loss of a member!"
The surgeons overwhelmed him with their congratulations, but Sir
Penniston modestly waived them aside. His triumph was the triumph of
science--and its purity was not marred by any thought of personal
glorification.
"The Crispan operation," some one whispered. The others caught it up.
"The Crispan operation," they repeated. A slight look of gratification
made itself apparent upon Sir Penniston's rosy countenance.
"Thank you, gentlemen! Thank you! Mr. Jermyn, is the patient quite
ready? Yes? We will proceed, gentlemen. My instruments, if you please."
Among those who left the operating theater an hour later was Sir Richard
Mortmain.