Joseph's leg infection


mikbone

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I recently did some research into Joseph Smith's lower leg bone infection.  Including the original journals.  The snippets that we get in the Sunday School lessons don't do the illness its due justice.  Merry Christmas.  It is my gift to you.  Enjoy.  It brought me to tears.  I did the footwork of linking the original articles and journals.  The second citation is from a medical journal from 1827 and the material is just as good if not better than what I learned in my modern day residency.  It is heartbreaking as you read the description of the horrible illness and empathize with young Joseph attempting to understand the exhaustion and pain that he graciously endured.  

 

Young Joseph was an amazingly brave and hardy child.  As an Orthopaedic surgeon I can appreciate the ordeal that he experienced when he developed a serious illness.  When Joseph was seven years of age, the Smith family had settled in Lebanon, New Hampshire, and in 1812 a Typhoid fever epidemic swept through the upper Connecticut River Valley resulting in over 6,000 deaths.  All the children in the Smith household were affected and Sophronia almost died.  After Joseph recovered from the initial fever, a secondary infection settled into his left shoulder area.  The local physician, Dr. Parker, diagnosed the shoulder pain as a sprain despite Joseph denying any injury…  Two weeks later the physician was recalled to the home and as he re-examined Joseph, he identified an obvious axillary abscess and copious amounts of purulence required surgical drainage.  Soon after the shoulder improved, Joseph felt the pain and fever radiate into his left lower leg with an agonizing swelling that persisted for another three weeks.  Dr. Parker was sent for a third time and decided to perform a superficial debridement with an eight-inch long longitudinal incision between the knee and ankle.  Joseph improved slightly but as the skin began to heal a week later, the pain became worse and a deep debridement down to the bone was undertaken.  As the skin of the leg began to heal for a second time the swelling and pain became even worse.  Eventually a surgical consultation was requested, and Doctors Smith, Stone, and Perkins from Dartmouth Medical College concluded that the infection had settled into the tibia.[1] Dr. Nathan Smith later wrote a detailed journal article describing the method of trepanning the bone, with the disclaimer that a “majority of patients survive its attack, though often with long confinement, protracted suffering and great emaciation”.[2]  Joseph was either very lucky or under the protection of divine providence as Dr. Smith (the only physician in the world at that time who knew how to correctly treat the infection) worked only five miles from the Smith home. 

I have operated on patients with osteomyelitis (bone infection), it is a horribly painful infection that is difficult to treat with modern day procedures and antibiotics.  I cannot imagine performing this surgery on a child without anesthesia.  The initial surgical recommendation was amputation, but Joseph’s mother implored the doctors to save the extremity.  The senior consultant, Doctor Nathan Smith (founder of the Dartmouth Medical School and president of the New Hampshire Medical Society) had, just a few years previous, developed the technique of drilling, sawing, and removing dead bone.[3]  The following is Lucy Mack Smith’s recollection of the final surgery, and “about a year of sickness and distress”[4] 

Quote

The principal surgeon, after a moment’s conversation, ordered cords to be brought to bind Joseph fast to a bedstead; but to this Joseph objected.  The doctor, however, insisted that he must be confined, upon which Joseph said very decidedly, “No, doctor, I will not be bound, for I can bear the operation much better if I have my liberty.” “Then,” said Dr. Stone, “will you drink some brandy?”

“No,” said Joseph “not one drop.”

“Will you take some wine?” rejoined the doctor. “You must take something, or you can never endure the severe operation to which you must be subjected.”

“No,” exclaimed Joseph, “I will not touch one particle of liquor, neither will I be tied down; but I will tell you what I will do­­–I will have my father sit on the bed and hold me in his arms, and then I will do whatever is necessary in order to have the bone taken out.”  Looking at me, he said, “Mother, I want you to leave the room, for I know that you cannot bear to see me suffer so; father can stand it, but you have carried me so much, and watched over me so long, you are almost worn out.” Then looking up into my face, his eyes swimming in tears, he continued, “Now, mother, promise me that you will not stay, will you? The Lord will help me, and I shall get through with it”

To this request I consented, and getting a number of folded sheets, and laying them under his leg, I retired, going several hundred yards from the house in order to be out of hearing.

The surgeons commenced operating by boring into the bone of his leg, first on the one side of the bone where it was affected, then on the other side, after which they broke it off with a pair of forceps or pincers.  They thus took away large pieces of the bone.  When they broke off the first piece, Joseph screamed out so loudly, that I could not forbear running to him.  On my entering the room, he cried out, “Oh, mother, go back, go back; I do not want you to come in–I will try to tough it out, if you will go away.”

When the third piece was taken away, I burst into the room again–and oh, my God! What a spectacle for a mother’s eye! The wound torn open, the blood still gushing from it, and the bed literally covered with blood.  Joseph was pale as a corpse, and large drops of sweat were rolling down his face, whilst upon every feature was depicted the most agony!

I was immediately forced from the room, and detained until the operation was completed; but when the act was accomplished, Joseph put upon a clean bed, the room cleared of every appearance of blood, and the instruments which were used in the operation removed, I was permitted again to enter. 

Joseph went on to heal after a protracted recovery that required bedrest and frequent dressing changes to allow the wound to heal from the inside out.  Joseph used crutches for the next three years and walked with a limp for the remainder of his life. 

 


[1] The Joseph Smith Papers, History, 1838–1856, volume A-1 [23 December 1805–30 August 1834], Page 131

Link to the original doc

[2] Smith, Nathan. Observations of the Pathology and Treatment of Necrosis. Philadelphia monthly journal of medicine and surgery, June 1827 p. 11-19, & July 1827 p. 66-75

Digital version of the original journal

[3] Wirthlin, LeRoy S. Nathan Smith (1762-1828) Surgical Consultant to Joseph Smith. BYU Studies Quarterly 1977, Vol 17, Issue 3, p. 319-337

PDF version of the article

[4] Smith, Joseph F. (Editor) The Improvement Era, January 1902, Volume 5, Number 3, Salt Lake City, p. 167-170

Link to digital version of the Improvement Era

Edited by mikbone
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Joseph still suffered (not walking without assistance) as a boy when the family moved to New York.  Something missing from the story is that Joseph made a friend of a boy that was 2 years younger than Joseph.  This boyhood friend was small (not much over 5 feet tall as an adult) and a social misfit that never did well socially (did not get along well with hardly anybody) - in fact he became famous for being anti-social.  This friend was present when the Church was organized but he never held a "leadership" calling but was fearlessly loyal to Joseph - and the Church.  Outside of the Smith family I speculate that this friend was the first to learn of Joseph's vision.  His name was Porter Rockwell.  I also speculate that part of the bound between the two was Joseph's injured leg.

 

The Traveler

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1 hour ago, Traveler said:

I also speculate that part of the bound between the two was Joseph's injured leg.

The Traveler

Thanks, I didn’t know this detail...

Porter Rockwell and Joseph Smith grew up on neighboring farms in Palmyra, New York. Despite their eight years difference in age, both men had a noticeable limp that cemented their close friendship—Joseph’s resulted from a childhood surgery and Rockwell’s resulted from an improperly set bone that left one leg two inches shorter than the other.

Source - http://www.ldsliving.com/Porter-Rockwell-7-Unbelievable-Facts-and-Stories-You-Didn-t-Know/s/77142

 

Mikbone child # 8 is named Porter Rockwell.  When they announced the name from the pulpit there was an audible gasp.  😀

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8 hours ago, mikbone said:

Thanks, I didn’t know this detail...

Porter Rockwell and Joseph Smith grew up on neighboring farms in Palmyra, New York. Despite their eight years difference in age, both men had a noticeable limp that cemented their close friendship—Joseph’s resulted from a childhood surgery and Rockwell’s resulted from an improperly set bone that left one leg two inches shorter than the other.

Source - http://www.ldsliving.com/Porter-Rockwell-7-Unbelievable-Facts-and-Stories-You-Didn-t-Know/s/77142

 

Mikbone child # 8 is named Porter Rockwell.  When they announced the name from the pulpit there was an audible gasp.  😀

side note - Porter Rockwell recruited a small rambunctious kid that at the time was 17 to be a US Marshal.  This person was the only lawman trained by Porter and the only lawman to ride with Porter - He was my Great grandfather.  Both died of old age, never had church callings and were strongly committed to the Church.

 

The Traveler

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1 hour ago, Traveler said:

side note - Porter Rockwell recruited a small rambunctious kid that at the time was 17 to be a US Marshal.  This person was the only lawman trained by Porter and the only lawman to ride with Porter - He was my Great grandfather.  Both died of old age, never had church callings and were strongly committed to the Church.

 

The Traveler

Are you sure Porter never had a church calling?  He was ordained as a High Priest, went on multiple missions, and was a member of the council of fifty.  I have seen mention of him being in the Seventy Quorum but cannot confirm.  

https://history.lds.org/missionary/individual/orrin-porter-rockwell-1814?lang=eng

https://josephsmithpapers.org/person/orrin-porter-rockwell

He may not have had a standard calling...  but he served.

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Although some modern day church members may picture Joseph as someone meek and gentle, he was one physically tough man, and was when he was a child as well.  It is said that he never lost a fist fight and he got in many (including when he was a prophet).

Since Porter Rockwell was mentioned, one of my favorite stories is when Porter Rockwell got arrested in Missouri on one occasion (he was arrested more than once in Missouri).  Joseph Smith wanted to bail him out, but didn't have the money.  The town was hosting a tough man competition and anyone who beat the prized fighter was  promised a sum of money.  In order to get the money to bail Porter out of jail, Joseph entered the contest.  Joseph beat the crap out of the guy and collected the sum of money to bail out Porter.  

Porter was a really tough guy (and seemingly fearless) as well.   When he was arrested under the accusation of an attempted assassination of Governor Boggs, his defense wasn't that he, Porter would never do such a thing, but that if Porter was the one that attempted the assassination that Governor Boggs would have been dead.   

Edited by Scott
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1 hour ago, Scott said:

It is said that he never lost a fist fight and he got in many (including when he was a prophet).

It may be said, but it's baloney. Joseph got beaten up on more than one occasion by his younger brother William, and is thought to have suffered from the effects of one beating for the rest of his life.

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8 hours ago, Vort said:

It may be said, but it's baloney. Joseph got beaten up on more than one occasion by his younger brother William, and is thought to have suffered from the effects of one beating for the rest of his life.

Dang (milkbone shared the link with the story), it must have been quite the fight because Joseph was one tough character.  William was a member of the Quorum of the Twelve Apostles at the time as well.  

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1 hour ago, Scott said:

William was a member of the Quorum of the Twelve Apostles at the time as well.  

My understanding is that William was a troubled soul, which might be PC code for "a real jerk". But I guess we can't look inside a man's heart and see his desires and motivations—especially if the man has been dead for over a century.

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