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 thusgradually 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 opportunityto 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 thebone 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 regularsteps; 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 oflaceration, 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 theyhad 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 aremyboy 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.
Two or three times before midnight Frank started spasmodically, and once would have risen up in bed if Rich had not held him down; as it was, he clasped his physician convulsively around the neck with great force.
"What is the matter, Frank?"
"I thought I was falling out of the tree. I suppose I was dreaming."
In one respect Rich was favorably situated. He had but one patient, and every moment he could spare from his school he either spent at the bedside of the boy, or in studying his case by the aid of books; he availed himself of the experience of Dr. Ryan, who knew the constitution of the lad, sympathized with Rich, and, in the exercise of a noble generosity, told him he was glad he had taken charge of the case, and believed he would succeed.
The means resorted to by Rich to prevent inflammation were crowned with success; the swelling of the muscles, never excessive, soon subsided,and he found the wound was healing by the first intention, which far exceeded his most sanguine hopes, as he feared some air might have entered, or some splinter of bone be lying loose in the wound that would cause suppuration.
It was time for new bone to begin to form, and consequently the shape the limb now assumed it would retain through life. Rich knew several persons in town whose limbs had been broken and set by Dr. Ryan, and he could hardly recall a single instance in which the operation had been entirely successful; nearly all walked with a hitch in their gait, many used a staff, or wore a peculiarly-shaped shoe. He also noticed that most of the persons thus partially crippled lived at a long distance from Dr. Ryan, and concluded that it arose in a good degree either from a mistaken economy on the part of the patient, anxious to save the cost of a visit, or from careless bandaging on the part of the doctor.
Excited to the highest degree by the brilliant success thus far attained, and knowledge that the boy's life was safe, he longed, O, how ardently! to make aperfectcure, and restore the leg to its original form and efficiency.
He reflected that less discretion and regard to future consequences were to be expected from a lad like Frank than from a grown person; didn't feel satisfied with the old splints, was afraid that, unless he bandaged the leg so tight as to impedethe circulation, the restless boy would, just at the critical period when the bone was forming, get the parts out of place.
"I know," said Rich to himself, "that I am mechanic enough toplacethose bones as they should be, and I'll see if I cannot contrive some way tokeepthem there in spite of this wide-awake youngster."
He went to bed in order to think about it, and in the morning at the breakfast table said to Mrs. Clemens,—
"Where did you get that blue clay the girl was putting on the floor yesterday to take out a grease-spot? It had no more grit than tailors'-chalk."
"Daniel got it somewhere."
"I got it down in Milliken's Gully, Mr. Richardson. You might cut it with a razor, and not dull the razor; there's not a stone or one mite of grit in it. I got it to make marbles."
Richardson procured a quantity of the clay, dried, pounded, sifted, and made it into a very thin mortar. He then took the splints from Frank's leg, placed the bones precisely as he wanted them, put the leg in a box, fastened the upper portion of his body to the bed that he could not move, and poured the clay mortar into the box till it completely enveloped the leg and foot. He then pulled the bed under the window, where the sun shone full on the clay, took hold of Frank's foot, and sat down.
"How long are you going to keep me lashed down so, Mr. Richardson?"
"Till this clay dries. And I shall hold your foot just where it is till then."
"Why, Mr. Richardson," said Mrs. Merrill, "it will take all day for that clay to dry."
"No, it won't, with the warmth of the leg on one side, and that of the sun on the other, it won't takehalfa day."
"But the academy bell will ring in about fifteen minutes."
"Parson Meek is going to take my place this forenoon; so you may prepare to give me some dinner, for I shall sit here till the clay hardens, if it is till to-morrow evening."
The clay was stiff, though not dry, before noon, and Frank's leg immovably fixed in the position Rich had placed it.
"Now, Frank, you have behaved so well, I am going to put you in a chair."
Rich and Mr. Merrill took Frank up, placed him in a chair, and put the leg, box and all, on two others.
"Now, my boy, you may sit at the table and eat dinner with us, if you will eat only what I prescribe; and you may thank the blue clay in Milliken's Gully for that. Blue clay, forever, Frank. Were it not for that you would have had to lie on your back twenty days or more."
After the meal was ended, Rich, with a saw,cut out a portion of the clay, in order to be able to get at that part of the leg the bone had penetrated. The box was also lined with paper, that the clay might not stick to it, and put together with screws, in order that it might be taken to pieces. This was Rich's fracture box, not very elegant, and for which he never took out any patent; being made, the sides, of the cover of an old herring box; but it answered the purpose completely, fastening the limb as firmly in the box as though it grew there, and as effectually preventing any motion of the ankle or toes, by which the bones might be displaced.
When Rich went to the academy in the afternoon, he returned Frank to his bed; and the next morning he was taken up again, and, as the cure progressed, sat up more and more. He could now read, play checkers with Dan and Horace, and the time passed less tediously. He now importuned his physician to take his leg out of the box; but Rich peremptorily refused, though he allowed him a more generous diet.
When a full month had elapsed, Rich took the box apart, sawed through the coating of clay the whole length, and peeled it off, removed the bandage, washed the leg, gave it a smart rubbing, and compared it with the other. After examining the limb a long time very carefully, he said,—
"If those two legs are not as well matched as they were before, I am very much mistaken."
"Shall I be lame any, Mr. Richardson?" said Frank.
"If you are, it will be your own fault. If you are careless now, you will rue it as long as you live, for the parts are not consolidated yet, and the oblique fracture in the large bone requires a longer time to heal than the square break in the other."
Rich put on the clay again, but without the box, and in less quantity, confining it by a bandage, slung the patient's leg to his neck, and permitted him to take exercise by walking about the house on crutches, some one accompanying him; and when he permitted him to put his injured leg to the floor, it was found to be of the same length as the other.
Mr. Merrill rewarded Rich most liberally, being abundantly able, and with expressions of grateful feeling that were more gratifying to the recipient than even the money. It was a proud and glad morning to him when Frank Merrill came to school with his books under his arm, escorted by Dan and Horace Williams, and with as firm a tread as his companions.
Scarcely had Frank's case been disposed of, when a younger sister of Mrs. Merrill, a member of the choir, and a most lovely girl as far as personal attractions, correct principles, and amiability of disposition went, was taken down with a lung fever; and the patient, with her parents and Mrs.Merrill, insisted that Rich should manage the case. This was more practice than Rich either desired or felt himself qualified to assume, and he told them so, and that he should pursue quite a different method from the ordinary practice, which was, in that disease, to bleed patients till they fainted, give them antimony to reduce the action of the heart, till, in reducing the inflammation, they often made an end of the patient. The young lady's relatives informed him they were not at all concerned about that, and to adopt the course his judgment dictated. In so doing, Rich drew no blood, and pursued a course calculated to support the strength of the patient as much as possible, and was successful in this case also.
At the conclusion of the summer term Rich resolved to make another visit to his parents, but felt that in his present circumstances he could afford to ride; and, what was very singular, he spent a night at farmer Conant's, taking the stage from his door the next afternoon. It certainly could not have been from fatigue, as on the former occasion. It was probably to thank the hospitable farmer for his kindness then, and it was a noble thing in Rich not to forget, in the moment of success, those who had been his friends in adversity.
With the fall term commenced another year of the academical course, when it was necessary for Rich to make a new arrangement with the trustees, who were very anxious to retain him, and offeredto increase his salary. On the other hand, Dr. Ryan wanted him to give up the academy, devote himself entirely to the study of medicine, obtain a medical diploma, go into practice with him and finally take his place, as he did not care to practise any more.
The doctor said he loved him as a son, and that if he did not improve the opening, some other young man would certainly come who might be very objectionable.
Rich replied that he would at the expiration of two years, and then agreed to keep the academy one year longer; thus affording himself a year of uninterrupted study, in addition to what he could accomplish while teaching, and resolutely refused all invitations to take charge of patients.
The fall term had been going on but a week when he received a visit from Morton. The inhabitants of the village showed great attention to Morton, as a compliment to Rich, and especially Mr. Merrill's family, and that of Mr. George Litchfield, the father of the young lady Rich had attended during a course of lung fever.
As the two friends were walking one evening, Morton said,—
"Rich, why don't you make up to that Miss Litchfield? She's a beautiful girl, intelligent, accomplished, and of most amiable disposition, I know, for she shows it in her very looks. You are about to jump into a fat practice, that willgive you a handsome living at once, and it is time you were thinking of such matters. I know she likes you, and her father is wealthy, which, though I know it would weigh little with you, is not to be despised."
"Mort, why did not you take Miss T., whom you used to like to escort to exhibitions and commencements, and walk with, and who was more beautiful than Harriet Litchfield, and in preference engaged yourself to Eliza Longley?"
"Because I wanted a wife, not a doll, a woman who would make for me a happy home."
"Now you have answered your own question. Miss Litchfield is beautiful and of a sweet temper, for I have seen her when sick, and sickness developes character. She is well educated, sings finely, plays well, is not vain, and is sincerely pious, but has neither industry, energy, nor a single domestic trait. She cannot make or mend, get a meal's victuals, or tell anybody else how to do it. Her counsel in the emergencies of life, which you and I have known something about even at our age, would not be worth the asking. Why, Mort, she is as hollow as the stalk of a seed onion; no resources in herself, and for all the practical duties of life utterly useless. How could I respect a woman who, if she has not a piano to amuse, or some gossip to engage her attention, sits and folds her hands, and resembles a wooden clock, the face the best part of it? You saw how my mother stoodup under the load, and took her share of it, when father's property was swept into the Atlantic; and it will be a long day before a boy who has such a mother marries a doll."
"I rather think, Rich, such a woman as you want is not easily found."
"Neither are diamonds. But you found such a one, and so have I."
"Indeed! I congratulate you. But who and where is she? Is she handsome?"
"She is not beautiful, but as handsome as good health, regular features, and a perfect form can render a woman."
"Is she accomplished?"
"To the highest degree. She can spin and weave, wash and mend, make butter, and make clothes; and when she's tired, or has a leisure hour, can sit down and obtain both profit and pleasure from a thoughtful book."
"It is little you would have thought of falling in love with such a woman when we first knew each other. What has become of all the poetry that was in you then, and, I had almost said, the froth on the top of the liquor?"
"It went to sea when the boom broke."
"I long to see her."
"You shall Sunday, and eat a dinner of her cooking. We will ride over there Saturday. She is a farmer's daughter. There is nopropertyinthe matter, of the kind you referred to just now. It is all inher."
"You know what I told you, Rich, so long ago, when we were sitting on the steps of your old house, and the cat shoved her nose into your bosom. It was deadlow waterthen; but now the tide has not only turned, but it is young flood, and the tide will continue to flow till, at high water it will lift the strawberry leaves on the edge of the bank."
"True, Mort; but I do not regret the trial. I have gained more than I lost by it. Have you heard anything from college lately, or from our old class?"
"No. All our acquaintances are gone, and there is a new set in Radcliffe. But they are only going to keep it during the fall term; after that it is to be made into a dwelling-house. Charlie Longley wrote me that the dam at the Glen had washed away in the fall rains, and the pond had run out."
Their conversation was interrupted by meeting Dr. Ryan, who invited them to go home with him, enjoy a sing, and take tea.
The next volume of the series is entitled,A Stout Heart, or, the Student from over the Sea.