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 NETTER’S
Surgical
Anatomy
Review
P.R.N. 2nd Edition

Robert B. Trelease, PhD

Professor
Division of Integrative Anatomy
Department of Pathology and
Laboratory Medicine
David Geffen School of Medicine
University of California, Los
Angeles
Los Angeles, California

Illustrations by
Frank H. Netter, MD

Contributing Illustrators
Carlos A.G. Machado, MD
Kristen Wienandt Marzejon, MS,
MFA
Tiffany DaVanzo, MA, CMI
John A. Craig, MD
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
NETTER’S SURGICAL ANATOMY REVIEW P.R.N. ISBN: 978-0-323-44727-0
Copyright © 2017 by Elsevier Inc. All rights reserved.
Previous edition copyrighted 2011.
No part of this book may be produced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording or any
information storage and retrieval system, without permission in writing from
the publishers.
Permissions for Netter Art figures may be sought directly from Elsevier’s Health
Science Licensing Department in Philadelphia, PA, USA: phone 1-800-523-1649,
ext. 3276 or (215) 239-3276; or email [email protected].

Notice
Neither the Publisher nor the Author assumes any responsibility for any loss or
injury and/or damage to persons or property arising out of or related to any use
of the material contained in this book. It is the responsibility of the treating
practitioner, relying on independent expertise and knowledge of the patient, to
determine the best treatment and method of application for the patient.
The Publisher

Library of Congress Cataloging-in-Publication Data

Names: Trelease, Robert Bernard, author. | Netter, Frank H. (Frank Henry),
1906-1991, illustrator.
Title: Netter’s surgical anatomy review P.R.N. / Robert B. Trelease ;
illustrations by Frank H. Netter ; contributing Illustrators, Carlos A.G.
Machado, Kristen Wienandt Marzejon, Tiffany DaVanzo, John A. Craig.
Other titles: Netter’s surgical anatomy review pro re nata | Surgical anatomy
review PRN
Description: Second edition. | Philadelphia, PA : Elsevier, [2017] | Includes
index.
Identifiers: LCCN 2015047555 | ISBN 9780323447270 (pbk.)
Subjects: | MESH: Surgical Procedures, Operative | Anatomy | Atlases
Classification: LCC QM531 | NLM WO 517 | DDC 611/.9–dc23 LC record
available at http://lccn.loc.gov/2015047555
Content Strategist: Elyse O’Grady
Content Development Specialist: Marybeth Thiel
Publishing Services Manager: Patricia Tannian
Project Manager: Ted Rodgers
Designer: Julia Dummitt
Working together to grow
libraries in developing countries
www.elsevier.com | www.bookaid.org | www.sabre.org

Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
 This book is dedicated to
My parents, Florence and Robert Trelease (Sr.),
who always supported my pursuit of learning
and science;
My wife, Barbara, and our daughters, Cristin
and Heather, who have motivated all my work;
My students, who will put their anatomical
knowledge to good use in caring for their
patients.
This page intentionally left blank
 About the Author

Robert B. Trelease, PhD, is Professor in the

Division of Integrative Anatomy, Department of
Pathology and Laboratory Medicine, in the David
Geffen School of Medicine (DGSOM) at UCLA. In
1996, Dr. Trelease became a founding member of
and Faculty Advisor to the Instructional Design
and Technology Unit (IDTU), part of the DGSOM
Dean’s Office established to develop online learn-
ing resources for medical education. IDTU cur-
rently provides and manages a broad range of web
server– and mobile device–based educational
resources for all 4 years of the medical school cur-
riculum, as well as developing new multimedia
teaching tools and course management applica-
tions. Dr. Trelease currently serves as Associate
Director of IDTU, in addition to teaching medical
gross anatomy, embryology, and neuroanatomy.
This page intentionally left blank
 Preface

Netter’s Surgical Anatomy Review P.R.N. is a just-

in-time, point-of-contact review of anatomy for the
most common of the surgically treated diseases
and diagnoses encountered during medical student
clerkships and general surgery residencies.
This second edition includes new chapters on
Heart Diseases and Lungs and Respiratory Dis-
eases, content requested by users of the first
edition and its electronic versions. This extends
the coverage of material from general surgery into
thoracic surgery. There are also new updated
Netter Figures contributed by Dr. Carlos Machado,
Kristen Wienandt Marzejon, and Tiffany DaVanzo.
I thank the prior readers and institutional adopt-
ers for their confidence and support. In particular,
special thanks go out to Dr. David Chen, Associate
Professor of Clinical Surgery, and the medical stu-
dents and residents of the David Geffen School of
Medicine at UCLA (DGSOM) for their ongoing use
of the Web-based version for surgical clerkships
and in-service learning.
I am also grateful for the continuing support and
good counsel of my Department Chair, Dr. Jonathan
Braun, and feedback from former Senior Associate
Dean of Medical Education, Dr. LuAnn Wilkerson,
who originally suggested that I develop a PDA-based
learning resource for surgical clerkships.
viii Preface

Great appreciation is due to my colleagues at

DGSOM’s Instructional Design and Technology
Unit, directed by Dr. Anju Relan and including
master developers Zhen Gu, Katherine Wigan, Sam
Payne, and Jason Rock. Their continuing multime-
dia learning projects and dedicated support of the
online medical school curriculum have provided
many practical lessons on the complexities of
development and what really works in educational
technology.
Most of all, I thank my Editor, Elyse O’Grady, for
her continuing dedication to the distribution and
improvement of Netter’s Surgical Anatomy Review
P.R.N. I am especially grateful to Marybeth Thiel,
original Development Editor, for providing con-
tinuing editorial review and oversight for second
edition updates, including all the new artwork.
Their expert team at Elsevier worked skillfully to
produce the new, redesigned content that you are
using.

ROBERT B. TRELEASE, PHD

 Contents

Section I Head and Neck

1 Skull and Face Fractures   3
2 Thyroid Diseases   17

Section II Back and Spinal Cord

3 Vertebral Fractures   27

Section III Thorax

4 Breast Diseases   45
5 Heart Diseases   61
6 Lung Diseases   91
7 Esophageal Diseases   115
8 Ribs and Thorax Fractures   129

Section IV Abdomen
9 Appendix Diseases   139
10 Biliary Diseases   149
11 Colon Diseases   163
12 Gastroduodenal Diseases   181
13 Hernias   201
x Contents

14 Kidney Diseases   217

15 Liver Diseases   233
16 Pancreatic Diseases   253
17 Small Intestine Diseases   265

Section V Pelvis and Perineum

18 Anorectal Diseases   285
19 Pelvic Fractures   297
20 Prostate Diseases   311
21 Uterus and Adnexal Diseases   325

Section VI Upper Limb

22 Pectoral Girdle Fractures   343
23 Humerus Fractures   353
24 Forearm Fractures   367
25 Wrist and Hand Fractures   381

Section VII Lower Limb

26 Hip and Thigh Fractures   397
27 Knee and Leg Fractures   413
28 Ankle and Foot Fractures   429

Index   443
Head and Neck

Head and Neck

This page intentionally left blank
1 Skull and Face Fractures
ANATOMY OF THE SKULL AND
FACIAL SKELETON
Skull and Facial Bones
• Neurocranium (cranial vault): frontal, ethmoid,
sphenoid, temporal, parietal, occipital bones
• Viscerocranium (facial skeleton): maxilla, nasal,
lacrimal, zygomatic, vomer, palatine, mandible
bones
• Base of skull: occipital, sphenoid, temporal,
palatine, maxilla bones
• Most of the bones of the skull are flat (type), with
inner and outer “tables” (layers) of compact
(cortical) bone surrounding trabecular bone and
marrow space (diploë).
• Emissary veins connect diploic spaces with
cerebral veins/sinuses (intracranial) and scalp
and superficial veins: potential route for intra-
cranial spread of infection.
• Sutures
n Thin fibrous joints found only between skull

and facial bones

n Produced by intramembranous ossification

n May be indented (e.g., coronal suture), planar,

or squamous
• Most cranial and facial bones are pharyngeal
arch derivatives.
• Occipital, sphenoid, and ethmoid bones develop
from paraxial mesoderm, comparable to vertebrae.
4 Skull and Face Fractures

Frontal bone

Nasal
bone

Maxilla

Parietal bone Temporal bone

Pterion Squamous part
Zygomatic
Sphenoid bone process
Greater wing

Zygomatic
bone Mandible
Head of condylar
process

Ramus

Body

Anterior and Lateral Aspects

Scalp Layers
• Skin: thin (thicker in occipital region); well sup-
plied with arteries, veins, lymphatic drainage
• Connective tissue: dense subcutaneous layer
with rich neurovascular supply
• Aponeurosis of occipitofrontalis muscle, with
lateral attachments of temporoparietalis and
posterior auricular muscles (collectively the
epicranius)
• Loose areolar tissue: allows aponeurosis move-
ment; danger space for infections owing to
emissary vein drainage into diploic spaces of
cranium
• Pericranium: external periosteum, fibrously
fused to sutures

NEUROVASCULAR SUPPLY
Arteries of Face and Cranium
External Carotid (Proximal to Distal)
• Lingual: to tongue and floor of mouth, may have
common origin with facial
• Facial: superior, inferior labial, lateral nasal,
angular branches; to anteromedial face
• Posterior auricular: posterior to ear and mastoid
regions
• Occipital: lateral aspect of head behind ear
• Maxillary: deep auricular, anterior tympanic,
deep temporal, middle meningeal, inferior alveo-
lar, posterior alveolar, infraorbital branches; to
deep face
• Transverse facial: lateral face, parallel to parotid
duct
• Superficial temporal: anterior, lateral aspect of
crania

5 Skull and Face Fractures

6 Skull and Face Fractures

Branches of
Frontal
Transverse facial superficial temporal
Parietal artery and vein
artery and vein
Parietal
emissary vein
Supraorbital
artery and vein
Supratrochlear
artery
and vein

Angular
artery
and vein

Facial artery Posterior

and vein auricular
artery and
External carotid artery vein
Common
facial vein Retromandibular
vein
Internal
jugular vein

Sources of arterial supply of face

Black: from internal carotid artery
(via ophthalmic artery)
Red: from external carotid artery

Superficial Arteries and Veins of Face and Scalp

Internal Carotid
• Anterior cerebral
n Ophthalmic artery: supraorbital, supratroch-

lear, anterior and posterior ethmoid branches

• Middle cerebral
Other
• Vertebral: basilar, pontine, posterior and infe-
rior cerebellar, posterior cerebral, posterior
communicating branches
• Facial: face richly perfused, with anastomoses
across midline, anterior to posterior, and
between intra- and extracranial branches
• Kiesselbach’s area/plexus: anterior inferior nasal
septal region, anastomoses between superior
labial (facial), sphenopalatine, palatine (maxil-
lary), and anterior ethmoid (anterior cerebral via
ophthalmic) branches; frequent site of epistaxis
Venous Drainage
Internal Jugular Vein
Common Facial Vein
• Tributaries
n Facial: superior, inferior labial, deep facial,

external nasal, angular ← orbital, inferior and

superior palpebral
n Submental

n Retromandibular: superficial temporal, middle

temporal, maxillary
• Pterygoid venous plexus of deep face connects
with deep facial and maxillary veins and with
cavernous sinus via connections through
foramen ovale.
• Facial veins have no valves: potential route for
spread of infection from face and deep venous

7 Skull and Face Fractures

8 Skull and Face Fractures

From maxillary division

of trigeminal nerve (V2)
Zygomaticofacial nerve
Zygomaticotemporal nerve
Infraorbital nerve

From ophthalmic division

of trigeminal nerve (V1) Medial branches of dorsal
rami of cervical spinal nerves
Supraorbital nerve
Greater occipital nerve (C2)
Supratrochlear nerve
Palpebral branch of
lacrimal nerve
Infratrochlear nerve
External nasal
branch of anterior
ethmoidal nerve

From mandibular Branches from

division of cervical plexus
trigeminal nerve Lesser occipital
(V3) nerve (C2)
Mental nerve Great auricular
Buccal nerve nerve (C2, 3)
Auriculotemporal nerve

Dorsal rami
cervical spinal
Ophthalmic nerves
nerve (V1)
Note: Auricular
branch of vagus
Trigeminal Maxillary nerve to external
nerve (V) nerve (V2) acoustic meatus
and small area
on posteromedial
Mandibular surface of auricle
nerve (V3)
Branches from
cervical plexus

Cutaneous Nerves of Head and Neck

 sinuses to intracranial sinuses (e.g., cavernous
sinus via angular and orbital veins)
• Common facial connects to external jugular vein
External Jugular Vein
• Drains posterior auricular
Innervation of the Head and Neck
• Cranial nerve deficits may be associated with
specific regional fractures, trauma
• Olfactory (I): special somatic sensory to superior
nasal cavity; foramina: cribriform plate of
ethmoid; intranasal CSF leakage, anosmia with
ethmoid fracture
• Optic (II): foramen–optic canal (sphenoid)
• Oculomotor (III), trochlear (IV): motor to extra-
ocular muscles, travel through cavernous sinus,
superior orbital fissure (sphenoid bone), and orbit
• Trigeminal nerve (V): sensory to most of face
and head, superficial and deep, including sinuses
and supratentorial dura; motor to muscles of
mastication, tensor palati, and tensor tympani
n Ophthalmic division: foramen—superior orbi­

tal fissure (sphenoid bone)

n Maxillary division: foramen rotundum (sphe-

noid bone)
n Mandibular division: foramen ovale (sphenoid

bone)
• Abducens (VI): runs along clivus and through
cavernous sinus and superior orbital fissure to
lateral rectus; clival fracture can cause lateral
gaze paralysis
• Facial (VII)
n Supplies muscles of facial expression and

stapedius

9 Skull and Face Fractures

10 Skull and Face Fractures

n Carries visceromotor fibers to lacrimal and

submandibular and sublingual salivary glands
n Taste afferents for anterior 2/3 of tongue

n Exits stylomastoid foramen (temporal bone)

• Acousticovestibular (vestibuloacoustic, audi-

tory) (VIII): from cochlea and vestibular appara-
tus (labyrinth) in temporal bone; nerve enters
internal acoustic meatus (temporal bone)
• Glossopharyngeal (IX): taste and common sen-
sation from posterior third of tongue and ton­
sillar fossa; exits jugular foramen (between
temporal and occipital bones)
• Vagus (X): motor to palate, pharynx and larynx,
thoracoabdominal viscera; exits jugular foramen
(between temporal and occipital bones)
• (Spinal) accessory (XI): motor to sternomastoid
and trapezius muscles; exits jugular foramen
(between temporal and occipital bones)
• Hypoglossal (XII): motor to tongue muscles
except for palatoglossus (X); exits hypoglossal
canal (anterior supracondylar occipital bone)
• Cervical nerves
n No C1 dermatome exists.

n C2 spinal nerve: sensory to skull, skin from

vertex down, infratentorial dura, parotid (auric­

ulotemporal nerve), and infratemporal skin
n C3 spinal nerve: sensory to suboccipital region

CLINICAL CORRELATES
Skull Fractures
Classification
• Linear: fracture line is distinct
• Comminuted: multiple fragments, may be depressed
with compression of dura and brain (image)
 Compound depressed
skull fracture. Note hair
impacted into wound

Compound Depressed Skull Fractures

11 Skull and Face Fractures

Another random document with
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people and the place, without thinking and talking too much about
how things are in England.”
“All this is easy, Sir, for the sake of plenty and independence.”
“I trust you will find it so. But, Frank, there are other things to be
considered, both for your own sake and Ellen’s. You probably see
that in the present state of the colony, particular sobriety and
discretion are required in all the young women that go there.”
Frank was quite ready to answer for his sister; and hoped that a
settlement with a respectable husband would soon place her out of
reach of temptation. He perceived that he would find it less easy to
marry than he might wish; and this seemed the greatest drawback to
the plan: but, perhaps, when he should be prosperous enough to
marry, he might send over for a wife, as he heard some settlers did;
or might be fortunate enough to find one that he would like among
the new emigrants who would be coming over from time to time.
Mr. Jackson advised him not to think much about this at present, if
he really intended to go; and agreed with him that there appeared
still less chance of his marrying in England, if he continued to be too
conscientious to form such a pauper marriage as many of his
neighbours were venturing upon.
From this day, Frank began tutoring himself and his sister for the
new way of life they hoped to enter upon. They learned all they
could, from books and persons, about the changes they might look
for out of their own country. They inured themselves purposely to toil
and heat and cold, and strove to bear with patience the trials of
temper which continually arose. There was only one thing which they
did not try to bear patiently; and that was, receiving parish-pay. Their
father was as much disgusted at it as themselves; and this assisted
his reconcilement to the emigration plan. He would not give his
children the satisfaction of saying that he liked it, or hoped any thing
from it; but he vowed he would not stay where he was; and as there
was no other place to go to, this implied assent. He looked with
sullenness on the preparations that were made; but he did nothing in
the way of hinderance; nor did he contradict his neighbours when
they took for granted that he was going. So Frank and Ellen
considered the matter settled as far as he was concerned; and rather
expected to see him much disappointed if any thing should occur to
overthrow the plan. His wife seemed utterly indifferent whether she
went or staid, or what became of her; and the whole business
seemed to rest upon the two young people and their friend, Mr.
Jackson.
 Chapter II.

HOMES ON THE WASTE.

While the deliberations were going forwards, some rumours which

arose out of them reached the ears of a very influential gentleman in
the neighbourhood, to whom they were not at all agreeable. Mr.
Fellowes was a young man of large property, who had just come of
age, and whose kindly disposition and activity of observation equally
inclined him to make the condition of the surrounding poor one of his
first objects of interest. He had for some time been investigating their
state and its causes, with a view to doing something for their relief
when he should have the control of his fortune. He had fully satisfied
himself of the evils of the poor-law system, and that the one thing
wanted was an increased production of food,—an object, in his
belief, very easy of accomplishment. This he intended to prove by an
experiment of his own; or that which his friends called an
experiment,—and he a demonstration. His plan became known to
Mr. Jackson in due time, as well as to many others less willing to
listen to what he had to say, and to regard his exertions with the
seriousness and kindness which their importance, and the
benevolence of their motives deserved. It was with equal good will
that these two gentlemen met at the parsonage-door one day, each
having questions to put to the other.
“Pray is it true,” inquired Mr. Fellowes, “that you are encouraging
the Castles and others of your parishioners to emigrate?”
“Perfectly true; and I was coming to you to make a request as to
something I wish you to do as soon as they are gone.”
“Let us see first whether it is necessary for them to go. Is it quite
settled? Are they past being persuaded?”
 “Their passage is not taken, but their minds are made up, and
Ellen Castle’s name is sent in to government.”
“It may be refused; and in that case there is time to save them
yet.”
“Save them from what?”
“From what! From the manifold woes of the emigrant. Is it no evil
to leave the country, and the kindred, and the father’s house? Is it no
evil to be severed from old connexions, and wrenched from all that
has been beloved from birth? Is it no evil to be set down in a
wilderness, where climate, soil, the habits of the people where there
are any, and the solitude where there are not, are all uncongenial,
and whatever happens is new and strange? Is it no evil to be
banished?”
“All these are great evils, I grant: but from which of them are the
Castles likely to suffer so much as by remaining here? Their country
affords no kindly home for them. They will be disgraced in the eyes
of their kindred by becoming a public burden; and their father’s
house long ago passed into hands better able to keep it up than
theirs. They leave little behind that they love; for want has chilled
their affections towards their country, and hardship is fast breeding
hatred to the powers which have not hitherto succeeded in securing
the happiness of the people. As for the rest,—they are going to a fine
climate a fertile soil, and among inhabitants who speak their
language, and are under the same government with themselves.
While they have plenty and independence before them, and leave
only want and woe behind, I cannot think there is any cruelty in
assisting them to go whither they wish.”
“But, Sir, you are assuming that they must prosper abroad and be
destitute at home; whereas I assert that neither the one nor the other
need be the case. Look at the Swan-river settlement! There was no
end of the praise we heard of the climate, and the soil, and the
facilities of every kind; and yet where was there ever a more
complete failure?”
“Through these very facilities the failure happened,” replied Mr.
Jackson. “Land was so cheap, and required so little capital to be laid
out on it at first, that every labourer chose to have land, instead of
letting his labour to capitalists. The consequence was, that capitalists
could do nothing for want of labourers; and by the time their goods
were rotted on the beach, and their cattle had strayed or died for
want of proper care, the provisions they took out with them were
consumed, the new crops had not come up, and all were reduced to
equal distress. It was because all would be capitalists at first that all
became labourers,—and very poor labourers, at last. This need not
be the case again; and, in fact, the Castles hire themselves by
contract to capitalists long settled in the parts they are going to.—
And now tell me why it need not be that these people should be
exposed to want and woe at home.”
“Simply because they might be colonized here instead of abroad. I
am sure we have waste land enough and to spare for all our
population.”
“As to space, undoubtedly; but what say you to its quality? Why is
it still waste in the midst of a hungry population, if it is worth being
tilled?”
“Let us try whether it is not; that is all I ask. Send the Castles, and
twenty other families to me, and let us see whether corn will not
come up upon well-dug ground, as it has ever done till now.—
Remember that the condition of land varies under the influences of
nature, and that soil once barren need not remain barren for ever.
Nature works,—more slowly it is true,—but not less surely than man,
in preparing the waste for his support; and there is always a point of
time, sooner or later, when he may take the work out of her hands
and feed upon the fruits of her ministrations. Wherever there are
furrows, wherever there are mounds, there is a growth of fertile soil.
Particles of sand are brought by the winds to mix with decaying
herbage. Minute seeds of plants and the decomposed elements of
vegetable substances float in the atmosphere, are arrested by the
first elevation they come in contact with, and settle down to enrich
the land. The vegetation which springs up attracts the moisture of
the air, and thus is fertility again promoted. It spreads and spreads till
a desert becomes a field, or in a condition to be made one. O, you
may trust to nature to provide for man!”
“I question nothing of what you have said,” replied Mr. Jackson.
“On the contrary, when I preach of Providence, I use as arguments
whatever processes of co-operation and amelioration we can
distinguish among the workings of nature, from the counteracting
forces by which the planets are retained in their orbits, to the method
by which the crevice of the rock exchanges, in due time, its carpet of
moss for a crest of branching oaks. But nature is slow in her
workings; and since the life of man is short, his business is to work
with her, not to wait for her. Every acre of ground may in course of
ages become capable of tillage; but our business meanwhile is to
place our hungry brethren where nature’s work is forwardest. Among
the many grades of fertility prepared by her, it is our wisdom to
choose the highest. This is what I preach as the truest gratitude to
Providence.”
“I have rather wondered, I own, at the style of your preaching
lately. It would strike a stranger as unusual.”
“I do not preach for strangers, but for my own flock; and if they are
not enlightened enough to apply abstract principles, I must help them
to do so. I must not only tell them to be honest, but show that
honesty can scarcely subsist under overwhelming temptations to
theft and fraud. I must not only recommend the domestic affections,
but warn against turning them to bitterness by rashly incurring the
risk of that destitution under which parents and children learn to look
coldly on each other. I must not only speak of gratitude to God, but
show how it may be made to spring up by distributing to all a share
of his gifts, instead of being starved out by want and woe. If, as I
believe, it be true that hardness of the lot brings hardness of the
heart, and that blasphemy is a disease of the spirit-broken, how can I
and other ministers of the gospel promote its influences so well as by
teaching how to bring about that state of society which is most
congenial to those influences?”
“Yours is a more likely way to gain your object than theirs who
carefully separate the interests of the other world from those of the
present.—Well! I am about to preach to the same effect by my
actions as you from your pulpit.”
“Then, if you would second my doctrines, you must do the thing I
told you I meant to ask of you. You must take down the cottages
inhabited by those about to emigrate; and it must be done
immediately on their departure, or I shall have to publish the banns
of nobody knows how many young couples the very next Sunday.
Unless you have inquired into the fact, you will hardly believe how
many marry just because there is a house ready. We have too many
dwellings in proportion to our food.”
“I have had thoughts already of removing to my new farm some
cottages that belong to me, and of buying others from the
speculators in our parish funds, who are far too ready to build in our
neighbourhood. There will be little encouragement for them to build
again when all the surplus population of the parish is located on my
pauper farm, where no strangers may intermeddle. You must come
and see the ground I have laid out.”
Mr. Jackson readily agreed to go, but had great doubts about the
final results of the scheme. This seemed to Mr. Fellowes very
strange, as they agreed upon the extent of relief at present wanted,
and upon the capability of this farm to supply it.
“It was you yourself who told me, Jackson, that it is not the whole
of the people now distressed that it is necessary to relieve. It is only
the redundancy that we have to take care of.”
“Certainly: but it should be so relieved as not to produce a further
redundancy.—We have among us, as we agree, sixty labourers
more than we want. Of these none actually starve, and they
therefore deprive some others of a portion of necessaries. It appears
accordingly that three hundred are insufficiently fed and clothed
because there is a redundancy of sixty.”
“Well! my district farm will take off sixty at once, and more
afterwards.”
“And will therefore produce an immediate relief, restoring to the
remainder of the three hundred their proper share of necessaries; so
would the emigration of sixty. But mark the difference three
generations hence. Our young people who emigrate carry their
descendants with them to a land where they are wanted. The
descendants of your pauper cultivators must be turned out upon
society after all, in greater numbers than you now abstract from it. It
will be well if the grandchildren of your present dependants have not
to emigrate at last, after the expenditure of much capital that might
have been better employed, and at a much greater ultimate cost
than at present.”
 “You seem to forget, Jackson, that the capital I am laying out is all
to be reproduced, and that the people on my farm are to work
themselves free. If any reliance is to be placed on calculations which
have been conducted with the utmost care, if experience is to be
trusted, if I may believe what I saw last month with my own eyes in
the Belgian colonies (which it is worth a long journey to see), a good
deal more than the cost of settling my paupers and providing for
them will be raised by their labour upon the ground. The best of them
will in time repay me, and go out with money in their pockets to make
room for others.”
“And where are they to go? To carry more labour and new families
into a market which is already overstocked. How much easier to
remove them at once to a labour market where they and their
children will be permanently welcome!”
“I am for ever met with objections about raising rents and
overstocking the labour-market,” cried Mr. Fellowes—“I that take no
rent, and bind myself to employ all the labour!”
“I said nothing about rent,” replied the clergyman. “I am quite
aware that a farm like yours, made out of a forced application of
capital, bears no relation to the natural process of rent. But I do not
see how you can escape the charge of ultimately obliging a portion
of society to pay too dear for their food.”
“What can you mean, when the very essence of my plan is——”
“Tell me your plan, and then I will tell you my meaning.”
“My plan is to show, on a small scale, how the charity-funds of this
country might be employed productively, and therefore so as to fulfil
the ends of charity. I would have the unappropriated wastes of Great
Britain, amounting to, some say, 15,000,000 of acres, (and some say
much more,) set apart to be the People’s Farm. It should be
cultivated by means of public funds, say our present poor-rates; and
it should be so portioned out as that every pauper should have the
interest of private property in his allotment.—The further internal
arrangements should be made according to the judgment of the
directors. Mine are to be as like as I can make them to those
adopted in the pauper farms in the Netherlands. Each family shall
have its portion of ground and its cottage, with food and clothing till
these can be procured by themselves. The soil shall be improved to
the utmost by spade-husbandry, and by preparations of manure
requiring more labour than can be devoted to the object in a general
way. The productiveness of the ground being usually very great
under these methods, I expect a considerable surplus every harvest;
of which a part will go to repay the original expenses, and a part to
set forward the family when they re-enter the world. Meanwhile, the
women and children will spin and weave, and we shall produce
within our own bounds all that we want. We shall not even need
money: for the people will pay one another in commodities.”
“That is, you are about to carry back a portion of society to a
primitive condition;—to delving, and a state of barter. If there was no
choice between the starvation of a number and this state of society, I
might be brought to look upon it with some degree of complacency:
but when other ways are open,—when the question is,—not whether
all shall relapse into barbarism or some starve,—but whether
multitudes shall pass their lives in unassisted digging at home, or a
few wander to distant parts of this fair earth to leave the many in
possession of the blessings of advanced civilization,—I am for
applying labour to its highest purposes, and for elevating instead of
depressing the pursuits of society. No one doubts that if every hand
was employed in tillage there would be food enough for all: the
question is whether it be not thus obtained at too great a cost,—
every higher pursuit being sacrificed to it. Only convey to fertile
regions abroad the half of those who are eager to go, and there will
be abundance of food for all,—and of many more things equally
essential to the full enjoyment of life. If the Greeks had not done so,
what would have become of all that they did to enlighten and bless
the world? If they had fed their surplus numbers by employing more
and more in tillage at home, as their numbers increased and the
produce required was greater, there would now have been little of
the philosophy, the literature, the fine arts, which have spread from
their country over the world; while, after all, fewer would have lived,
and fewer of the living would have been fed than under their system
of emigration.”
“They seem indeed never to have thought of the more obvious
mode of providing for the people. Away they sent them, as fast as
they overflowed their bounds.”
 “Because they were so circumstanced as to perceive at once the
fallacy of the supposed remedies which you and other benevolent
persons here are advocating. The great body of the people among
the Greeks were slaves, maintained by masters, and not, as with us,
free labourers supported by their own toil. The deficiency of food was
there first felt by the masters, in the cost of supporting their slaves.
Here, it is felt mainly by the labourers in the fall of the real value of
wages. In Greece, there was no dispute about the fact, from the
moment that food became deficient. Here, such a deficiency is even
now questioned by multitudes who declare that we have not a
redundant, but only a poor population; that nobody wants food who
has enough to give for it; and that therefore it is money, or work that
is wanted, and not food. Such observers give alms, or pay their poor
neighbours for digging holes and filling them up again, or doing
things equally useless; never dreaming that all the while they are
taking food from somebody who has earned it by a better kind of toil.
Such follies as this could never be suggested by the state of things
in Greece; and I see no reason why, because our lower orders are
not slaves, we should not abjure our errors, and adopt such parts of
the Grecian policy as were wise.”
“Well, but, the long and short of the matter is this. If the quantity of
food in Great Britain is too small, cannot it be increased?”
“To be sure it can. If ten thousand individuals can live this year
only by taking a portion from their neighbours, we may raise as much
food in addition next year as may feed ten thousand people; but if
the people at the same time increase still faster, how are we better
off than we were before?”
“But cannot we raise enough that year for twenty thousand people
instead of ten thousand, to meet the difficulty? The People’s Farm
would admit of this.”
“It would: but here the question recurs, whether it will not answer
better to send the ten or twenty thousand people where they may
obtain food at much less cost of toil and capital, and where their
descendants will not be liable to tax the mother country for food for
generations yet unborn. At home it is only by a considerable sacrifice
that the growth of food can be made for any length of time to equal,
—or by any extraordinary effort to outstrip the demands upon it;
while, abroad, it spontaneously keeps ahead of population, and will
do so in many parts, till men have grown wise enough to regulate
population. Our best present policy, then, is to send our surplus
numbers abroad to eat and prosper, instead of obliging more and
more of our multitudes to dig at home. It is on your wish to make
them do so much labour for a lesser instead of a greater production,
that I founded my charge of your ultimately making a part of society
pay too dear for their food.”
“You mean because labour is the price of food?”
“Yes; and food would be almost as much too dear under your
system as under the present. At present, the competition for food is
so excessive that men bid their labour against each other to
desperation. Under your pauper-farm system, the same thing would
take place in time; and in the meanwhile, every bushel of wheat
would cost twice or thrice as much labour as in Van Diemen’s Land;
so that both immediately and ultimately, you oblige a certain number
to pay higher for their food than they need do and therefore ought to
do.—And this without taking into consideration the change in the
proportion of capital to population which is caused by emigration,—a
change most beneficial to the mother country.”
“And how extensive do you conceive that change to be? There is
very little difference between the cost of conveying persons to Van
Diemen’s Land, and settling them on a pauper farm,—too small a
difference to warrant such an expression as yours.”
“In addition to this difference, there is all the increase of production
which will take place abroad, and which is so much gained to the
mother country, since it maintains her people. Besides this, all that
would have been unproductively consumed by the pauper
descendants of these emigrants may be considered as so much
clear gain to the community. Again,—the thriving population of our
colonies will want more and more of our manufactures, and will send
us their agricultural produce in exchange; and I suppose you will not
question the advantage of investing our capital in manufactures, and
receiving wool and wheat of the best quality in return, instead of
laying it out on lands of inferior fertility at home, while the people
scantily supply themselves with the coarse manufactures of their
own firesides? You will not question the duty of availing ourselves of
the advantages of division of labour in the case of our greatest
need? Yet you would, by your plan of home colonization, deprive the
people of this reciprocity of benefits. You would set up new
manufactures instead of a new market for them; and all for the sake
of producing food at a greater cost than under the emigration
system. You are clearly wrong, Fellowes, depend upon it. What a pity
that you should not turn your zeal and benevolence and your other
resources to the best account!”
“The fact is,” replied Fellowes, “that on a matter of so much
importance as this, I am anxious to go on sure ground. I have heard
so much on good authority of the miseries of emigrants in Canada
and elsewhere, and I have seen so much with my own eyes of the
benefits of the Home-Colonization system in the Netherlands, that I
am induced to do that which I know will produce great and
immediate good, instead of that whose consequences I cannot
witness or calculate. I want to give our poor neighbours food; and I
dare not run the risk of having them perish with cold and hunger in
the woods before they can get any.”
“If you mix up the abuses of a system with its principles,—if you
take the conduct of a few ignorant adventurers as an example of
what is to be done by all emigrants,” continued Mr. Jackson, “I do not
wonder at our differing as we do. It is true that too many of our poor
neighbours, heartsick at their condition here, have wandered forth
with nothing but the clothes on their backs and a hatchet in their
hands, without the guidance and assistance which are necessary to
their very lives in a new climate and condition of society; but this
folly, and the consequent hardship, have nothing to do with
emigration. It is to preclude such evils that I would have benefactors
like you demonstrate to the people what is essential to a successful
emigration, and that emigration is sure to be successful if well
conducted. As for its ultimate results, time will teach them to all; but
you, my dear Sir, with your objects and your resources, will be
inexcusable if you do not endeavour to anticipate them. It will be
unpardonable in you to adopt a manifestly short-sighted policy while
the philosophy of principles and the evidence of facts lie open before
you.”
 “Fact is enough for me, romantic as many of my friends think me,”
replied Fellowes, smiling. “The fact will be, as you will witness, if we
both live, that two years hence our sixty superabundant labourers
with their families will have food without burthening the parish. This
is enough for me.”
“It will not always be enough. If you should live to see the
multiplied descendants of these sixty persons either suffering
themselves under pauperism, or displacing an equal number from
the ranks of employed labourers, you may wish that they had been
located where there was room for all without any arbitrary direction
of capital, or factitious employment of labour. If, in your old age, you
do not witness this, it will be because others have repaired your
mistake by conveying elsewhere the surplus you have created.”
“If we both live ten years, friend, you shall come and see how I
send forth those who once were paupers, with money in their hands,
ready to establish themselves reputably in society. There will be
nothing in this to make me repent.”
“No; your time for repentance will be when each of these monied
men sends two paupers to your gates;—when you find poverty
growing up round you, which you can relieve,—if at all,—only by a
late emigration. I am sure you will make your confessions to me
honestly, if that day should ever come.”
“I will, if you will give me faithful tidings of the Castles, and the
others who are going with them. Let me hear of all their struggles
and trials, from the outset till the end.”
“You shall, as far as I know them myself. Meanwhile, let us help
one another where we agree. Do you be on the watch to lessen the
number of dwellings as much as you can, and I will use my pastoral
influence in inducing the young folks to delay the publication of their
banns till they have secured something besides a bare shelter to
begin with.”
 Chapter III.

GOING IN SEARCH OF HOME.

Mr. Jackson’s interest in the subject of emigration to Van Diemen’s

Land first arose out of his friendship with a gentleman and lady who
were appointed by government to superintend the selection and
preparation of the young women who were assisted in their
settlement in the way already related. His recommendations were
received with the confidence naturally resulting from this intimacy;
and he had interest to get arrangements made for Frank’s convict
brothers to be settled near the rest of the family. In course of time,
which seemed very long to impatient paupers, all was settled. Ellen
had a summons to be in London by a certain day, with her 8l. in her
pocket, and a small sum over for the purchase of such necessaries
in the way of clothing as should be provided cheap for her by those
who were to receive her, see her safe on board, and furnish her with
a letter to the governor, stating her family circumstances.
Frank and his parents, with a few more labourers from the parish
of A——, were to sail in another ship about the same time, proposals
having been sent before them to Van Diemen’s Land, to bind
themselves to farmers for a term of years at a certain rate of wages,
out of which the parish was to be repaid for the expenses of their
passage and outfit.
The outfit was much less expensive in their case than in that of
settlers in Canada and the western states of America, both because
the climate of Van Diemen’s Land is more congenial to English
constitutions, and because wearing apparel and other necessaries
are much more easy to be had there, even if not supplied by settlers
as a portion of the wages of labour. Frank was furnished with a
complete set of tools; and the family with a stout suit of clothes each.
A stock of plain substantial provisions for six months was added, and
this was all. There were a few grumblers about the last-mentioned
article. They thought that the parish might, at parting, treat the
people with better cheer than they had been accustomed to; but the
parish authorities were wiser. They had heard how many lives had
been lost on the passage to America from the poor Irish, who had
been accustomed to nothing better than potatoes, being fed with an
abundance of more stimulating diet, under circumstances which
prevented their taking their usual exercise; and when, from having
nothing to do, they were tempted to eat more than they wanted of
good things that they could not get at home. The nearer the diet on
ship-board resembles that in common use, the better for the health
of the emigrant; and if he finds himself less disposed to eat than
when at the hard labour he has been accustomed to, no harm will
come of his temperance.
As the day of departure approached, Frank felt it a positive evil
that every thing was done for himself and his family by the parish, as
too much leisure was left for very unhappy thoughts. He had no idea
till the time came how much there was to be left behind which even
he could not help regretting. He had indeed no beloved cottage to
quit, no favourite stock to sell off, no circle of attached friends and
neighbours to say farewell to; but he would fain have had such
regrets as these to bear, for the sake of something to do at the last.
He envied his sister at her needle, making a gown for her mother
when she had finished her own linen, while he wandered over the
hills that looked towards the sea, or watched for the postman who
was to bring the final tidings for Ellen, or stood with his arms folded,
silently hearing his father’s murmurs or his mother’s taunts. He was
quite angry with himself for selfishly wondering what he should do
with the three days that were to pass between Ellen’s departure and
his own, when he ought to be glad that she would be out of hearing
of the uncomfortable sayings that now met her ears continually.
The hour came when the young people ought to be setting out to
meet the carrier’s cart which was to convey Ellen to London. When
Frank thought he had waited long enough before the door, he went
in to look for her, and found her with her bonnet on, her bundle by
her side, and little Susan on her knee. Her eyes were running over
with tears; but she smiled when he tapped her shoulder as a signal
that they must go.
“It seems like a long parting, just because I am going a long way,”
said she, trying to laugh. “But if we all go to the same place, and
there are meadows and cows, and the same sort of life we have
been accustomed to, there is little to mind in going, except Mr.
Jackson, to be sure, and grandfather, and—and——”
“Where is father?” asked Frank, distressed at her sobs; “surely he
is not gone out just now?”
Ellen ran to the door to look about for him, and saw her father
leaning against the wall.
“Where’s your money?” he asked. “You had need take care of
money when you have got it. All the rest is moonshine, to my
thinking.”
“There is very bright sunshine where we are going, if they all say
true,” said Ellen; “and that you will find, father, before a year is over.
You may trust Frank and Mr. Jackson, I am sure; and so——”
“I trust nobody. I have had enough of trusting people,” cried
Castle. “All this is your doing, remember, both of you; so never cast it
up to me. Go, go. ’Tis getting very late. Where’s your money, I ask
you, child?”
“Safe, father, sewed into my stays. But, father, what can happen to
us so bad as living here, as—as—we have done lately?”
“Go, children, go, and leave off talking about our meeting again at
the other side of the world. If I go to the bottom half-way, Ellen, it will
be none the worse for you, but the better, except that Frank must go
too, and you would not like that so well.”
“O father——!”
“Well, one kiss more; and God bless you, whatever becomes of
me!”
Ellen found her step-mother gossipping with a neighbour as if
nothing was happening. Her farewell words were few.
“Goodbye. If I find you an honest woman next time I see you, it’s
more than I expect, from what people say of the place you are going
to. Come, now, Frank, don’t be in a passion. Better take care of your
sister than look so proud about her.”
 Frank now took care of his sister so far as to remove her while she
had strength to go.
“O Frank!” she cried, as he put her arm within his own, and led her
rapidly on, “what can there be about me that makes them all talk as
they do?”
“Nothing about you, dear, but about the place. It is a dangerous
place for vain, silly girls; but you need only mind your business, and
think of father and mother, and what we have agreed to do for them,
and you will do well enough.”
“And of Mr. Jackson, and grandmother, and how she almost broke
my heart last night. Look, look! do you see how yonder trees stoop
and shiver in the churchyard? What a shower of leaves!”
“’Tis a sudden gust. There have been many such of late.”
“Just so they went when Molly Shepherd’s funeral was going
under them, and grandmother bade me beware of her shame. ’Tis
just like a sign to me now! And here comes Mr. Jackson too.”
Mr. Jackson just stopped her to give her a little book as a
remembrance, and to beg her to write to her grandfather, of whom
he should inquire for her from time to time. It was now really very
late.
“Don’t hurry yourself,” said Frank. “Walk quick if you like, but don’t
be flurried. I’ll overtake the cart for you, I’ll be bound; and you had
better look like yourself as you get in.”
The carrier was just cracking his whip to proceed after a halt,
when the brother and sister made their appearance at the end of the
lane. Ellen cast one glance back upon the familiar spire and
hedgerows and cottage roofs, and summoned up one bright smile
and a few more words for Frank.
“’Tis not as if you were to stay behind, Frank.”
“To be sure not! Leave every thing to me dear, and be steady and
easy, that’s all; and don’t talk of Bob and Jerry, for your own sake.—
All right, carrier?—Well then, good bye!”
And high on the hedge stood Frank, gazing long after he had
ceased to distinguish the bright face looking out at the back of the
cart. Not till the vehicle had disappeared behind the hill did he
descend to the stubble-field below, and pick up straws, and cut hazel
switches like a truant boy, muttering to himself “In three days we
shall be off.”
The second departure was more public and more painful. The two
old folks would come out at the last moment; and their distress
moved the gazers to an outcry against the cruelty of deserting them,
and the unnatural behaviour of leaving one’s country and kindred. A
giddy young couple thanked the Castles for vacating their cottage
just when others were wanting one; and of the rest, some who were
disappointed of going looked on in silent envy, and others were loud
in their reports of the dangers of the sea, and the horrors of savage
life. Frank had seated his charge in the waggon and walked on,
intending to be overtaken out of hearing of these busy tongues. He
looked back from the first corner, and seeing that there was great
confusion, returned. Castle was motioning away the parish officers
and Mr. Jackson, and doggedly refusing to go after all. His wife was
laughing, and little Susan crying.
“You must please yourself, father,” said he firmly. “If you put
yourself out of the way of being helped by your own children, God
help you! I must go, and that this moment.”
“Come along!” cried the wife. “We may as well get out of reach of
these plaguy officers, with their talk of our debt to them. Let’s be off,
and then they may get their money as they can. We shall never drive
our carriage here, as they say my boys may do at Botany Bay. Come
along!”
Frank would allow of no force, His father should choose for
himself. So said Mr. Jackson.
While he was choosing, a ready pauper jumped into his place, and
the waggon drove off. Before it had gone two hundred yards, there
was a cry to the driver to stop, the new candidate was turned out
grumbling, and Castle scrambled in. Twenty times during the journey
to London, he asked how he and his were to pay the seventy pounds
required to send them out; and as often his wife bade him not mind
whether it was paid or not; and Frank assured him that he should not
be burdened with debt, if his children lived and prospered. Tears
came at last to the unhappy man’s relief. As he passed villages and
farmsteads where healthy and cheerful faces looked up at the
waggon as it went by;—as he heard the saw grinding in the saw-pit,
and the hammering at the forge, he wept at being reminded of his
younger and more prosperous days, and at the thought that while so
many were busy and happy in their occupations, there was no room
for him,—once as hearty in his toil, and now as willing to work as any
of them. Frank contrived to gather what was in his thoughts, and
spoke of the saw-pits and forges which are so busy in the land they
were going to, and of the increased dignity and profit of such
occupations in places where artificers are scarce. His own heart was
ready to sink when he fancied, instead of such a busy region as that
under his eye, plains and valleys with scarcely a roof visible from
end to end: but every glimpse of a workhouse, every notice by the
way-side about vagrants, restored his courage, and satisfied him that
it was best, at all events, to be where, whatever other evils might
exist, there was no pauperism.
The departure of Jerry and Bob took place in a somewhat different
style. A stranger would have fancied there was high holiday in
Newgate the day before they went. Parties of convicts from the
country arrived, and were lodged there previous to embarkation, and
the larger proportion were full of congratulations to one another on
their fine prospects. This was done in bravado by some, no doubt;
and a few looked downcast, and were laughed at by their
companions for the shame expressed in their countenances and
manners: but it was actually the belief of most that they were lucky
fellows to be carried free of expense to a country where they should
have little to do but get rich as fast as they liked. Two among them
had been transported before, and so wonderful and tempting were
the tales they had to tell, that they not only found willing listeners
among criminals wherever they went, but had induced more than
one of the present company to commit thefts in order to get
transported and put in fortune’s way. These men, Giles and Green,
held forth in all the vanity of superior experience, and in all the pride
of having cheated the law; and drew an attentive audience round
them while waiting for the cart which was to convey the company to
the convict-ship.
Bob was leaning rather despondingly against the wall, when his
brother clapped him on the shoulder, and asked him why he looked
so black on this the grandest day of his life.
 “You should have said ‘thank’ee’ to the judge, Bob, as I did when
he finished with us; and so you would if you’d known how we were
obliged to him. We’ll have each a house and servants, and all
handsome about us by the time we’re one-and-twenty, and
meanwhile, there are fine pranks to be played. Come and hear
Green, about how he and his set got as much rum in one night as
they could drink in a month, and what frolics they had in the woods,
before he took it into his head to come back without leave.”
Bob shook himself free of his brother, who however would not long
let him alone.
“I say, Bob,” he continued, returning, “they call you sulky; and it will
be the worse for you in the colony if they report you sulky. You may
as well hear what we are to do when we get there.”
Bob listlessly followed, and took his place among the eager
hearers.
“Bet Turner!” cried one. “What is that she that belonged to
Greville’s gang? She that got transported for shop-lifting?”
“The same. Well; she has a large white house just out of Sidney,
on the right hand as you go out of Mount-street. Lord! you should
see her driving out, how grand she looks over her servants, and as
well behaved to her husband as if she had not left another behind
her. They say she sends Turner a bank note every year out of
charity. He has married again to give her satisfaction that he won’t
claim her; so they are both content.”
“Then there is Wilson,” cried Green. “You remember what a poor
ragged creature he was while he worked like other honest men, for
nine shillings a week. He got sent abroad for the first bad shilling he
tried to pass after he joined us; and all for looking like a bungler at a
new trick. He worked his way up into a farm of his own in four years,
and he has got his wife and children over, and is very much
respected. But Jack Lawe is the finest fellow of them all. He’s just
past thirty, and he is as rich as a London banker at sixty.”
“What, he that was within an hour of hanging?”
“Aye. They looked pretty close to him for a long while; but he is as
sharp in his wits as he is clever at whatever you set him to. He
cheated them all round, and got himself free in six years, and now
you should see him out hunting or betting at billiards. He is a good-