Craig James Ostler: Modern buildings and asphalt now obscure the important history of West Lebanon, New Hampshire. As a young boy the Prophet Joseph Smith displayed great courage in a home that once stood here.
After a series of financial setbacks, Joseph Sr. and Lucy Mack Smith moved their family from Vermont across the Connecticut River into New Hampshire, where they resided in what was known then as Lebanon, today known as West Lebanon. They were there from 1811 until 1813. And Lucy wrote… she said, in Lebanon “we settled down, and began to congratulate ourselves upon our prosperity and also to renew our exertions to obtain a greater abundance of this worlds goods…” Then she continued, “We met with success on every hand. But the scene soon changed. In 1813, the typhus fever came into Lebanon and raged there horribly.” 1
All of the Smith children were soon afflicted with this dreaded disease, which threatened to take their lives. When nearly recovered from the typhus fever, Joseph, at the time he was mere seven years old, one day “suddenly screamed out with a severe pain in his shoulder.” 2 So they called a doctor to the Smith home, there in Lebanon, and upon examining the lad they discovered there was a large fever sore.
Dr. LeRoy S. Wirthlin:3 Joseph had been sick with typhus, typhoid fever, and debilitated, and he developed an abscess under his left armpit, axillary abscess. The person who drained that according to Lucy Mack, he drained a quart of puss out of this abscess in the seven year old boy.
Craig James Ostler: They lanced that fever sore and the pain at that time “shot like lightening down his side into the marrow of his leg bone on the same side.”4 Then the leg began to swell and cause this intense pain for about three weeks before the doctor returned and this time he makes an eight inch incision between the knee and the ankle, and it relieved the pain somewhat. Lucy, the mother, then carried her young son Joseph in her arms throughout the day, he is unable to walk or get around, and she is also attempting to calm and to comfort him until eventually she too becomes so ill from exhaustion she cannot do it anymore. Then she records that at that time Hyrum, who is then thirteen years old, this is her words, “was always remarkable for his tenderness and sympathy, desired that he might take my place… We laid Joseph on a low bed, and Hyrum sat beside him almost incessantly day and night grasping the most painful part of the affected leg between his hands and by pressing it closely [enabled] the little sufferer… the better to bear the pain which otherwise seemed almost ready to take his life.”5
Dr. LeRoy S. Wirthlin: Another surgeon made an incision from knee to ankle through the swelling and the pain was relieved but of course the disease was not treated, and the second time he did it he felt the bone was involved so they called in Smith and Perkins and a crew of medical students from Dartmouth.
Craig James Ostler: When the fever settled in Joseph’s leg doctors feared they might have to amputate but Lucy persuaded them to try removing only the infected portion of the bone.
Dr. LeRoy S. Wirthlin: They had to restrain him to do the surgery. Normally they would tie him down full quadrant restraint and he did not like that, but I think his father sat beside him and then these medical students who were there I am sure held him down because you cannot do this without holding him down.
Craig James Ostler: Dr. Nathan Smith performed the delicate surgery on the young Joseph. Pieces of bone were broken loose with the medical tools of the day—trephines or hand drills, bone-grasping forceps.
Dr. LeRoy S. Wirthlin: He had this procedure which was not done anywhere that I could find anywhere in America or Europe, he was the only one doing it, and certainly back in 1797 he is the only one doing this. Nathan Smith was really good, he didn’t need x-rays, no one would attempt that operation without a million x-rays but he would take his finger and feel along the bone and he could fell where it was diseased and then he would go after that part. He used to give his notes and the students would take it down verbatim, they would put down every word he said, and the one student mentioned that as he gave his talk on how to deal with osteo he said, “it occurred to me that I might be able to save some of these legs by going directly to the bone,” it just occurred to him, 1797, it didn’t occur to anyone else. I think you need to know a little bit about the disease he has osteomyelitis which was common in New England among young people in those days. Osteomyelitis forms a death of the bone of the outside, you have the old bone in the center of this new shell. He would make an incision, feel along the bone where the abscess was there and would drain the puss out, so they would drill in the outer bone, take a window of that out, and then go in and pull out the dead part with pinchers.
In- Video Text: Holes were made by using a surgical tool called a trephine. Cuts were made by using a surgical tool called a Heys saw. Dead bone removed by using a surgical tool called a Bone-grasping forcep.
Dr. LeRoy S. Wirthlin: [demonstrating the surgery with 19th century medical tools] But this would be the scalpel and then he would use his finger to expose the bone, and then to get into the bone he’d have to make little drill holes, and then he would take a Heys saw and connect the burr holes, and then with the pinchers remove that; then he would go in with a pair of these bone crushing things and break up the piece that’s contained within, and then reach in and pull it out; and he [Dr. Nathan Smith] describes that and so does his [Joseph Smith] mother. He [Dr. Nathan Smith] said once you remove all the bone you do not touch that wound with anything, you do not probe it, you do not put anything in it, you just let nature heal it, which it would do eventually.
Craig James Ostler: Lucy indicated that she had been sent away from the home. Joseph did not want his mother to see him, but he screams out in pain so loudly that she comes rushing into the home and into the room, bursts through the door, and sees this scene of this little boy lying in bed, his leg exposed, blood everywhere, and it is just more than she can take. Joseph, interestingly to me this little boy is concerned his mother does not see him this way, wants to send her out of the room again and just wants his dad to hold him.6
And so we have an amazing means through these stories to see the life of a young boy, who has some determination, but also has great trust in his father, has great consideration for his mother, who he knows is already exhausted, and maybe we can say loves him to the point of going beyond what even we can imagine today of a mother that would give her life for her child and him being sensitive to her in that situation.
Dr. Nathan Smith’s saddle bags are on display at Dartmouth medical admissions office. Additional saddle bags and a medicine chest belonging to Dr. Smith as well as other medical artifacts are exhibited here at Dartmouth Hitchcock medical center.
The hand of the Lord is evident in the Smiths move here to Lebanon, because at that time Dr. Nathan Smith was the only doctor known to perform such an operation. 7
1 Lucy’s Book: A Critical Edition of Lucy Mack Smith’s Family Memoir, ed. Lavina Fielding Anderson, (Salt Lake City: Signature Books, 2001), 299-300.
2 Lucy’s Book, 303.
3 For Dr. Wirthlin’s landmark article on Nathan Smith and Joseph Smith’s surgery see: LeRoy S. Wirthlin, “Joseph Smith’s Boyhood Operation: An 1813 Surgical Success,” Brigham young University Studies, (Provo, Utah: Brigham Young University Press), Vol. 21, No. 2 [Spring 1981], 131-154. For the entirety of Lucy Mack Smith account regarding the circumstances of the surgery see:Lucy’s Book, 290-310.
4 Lucy’s Book, 304.
5 Lucy’s Book, 305.
6 Lucy’s Book, 308-309.
7 Dr. LeRoy Wirthlin concluded, “When Nathan smith entered the Joseph Smith home, he brought with him a fifteen-year experience with this technique of sequestrectomy and drainage. He had more experience with osteomyelitis than anyone had previously recorded in medical literature in the English language. Although he enjoyed good results, his work and results were not repeated until the early twentieth century.” Wirthlin, 21:2:154.
