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Surgical Approaches to the
Facial Skeleton
THIRD EDITION
Surgical Approaches to the
Facial Skeleton
THIRD EDITION
EDITORS
EDWARD ELLIS III, DDS, MS
Professor, Oral and Maxillofacial Surgery
Director of Residency Training
The University of Texas Southwestern Medical Center and
Chief of Oral and Maxillofacial Surgery
Parkland Memorial Hospital
Dallas, Texas
MICHAEL F. ZIDE, DMD
Associate Director, Oral and Maxillofacial Surgery
John Peter Smith Hospital
Fort Worth, Texas

VIDEO EDITORS
ERIC W. WANG, MD
Associate Professor
Department of Otolaryngology
University of Pittsburgh School of Medicine
Director
Maxillofacial Trauma
UPMC Presbyterian Hospital
Pittsburgh, Pennsylvania
JENNY Y. YU, MD
Vice Chair, Clinical Operations
Department of Ophthalmology
Assistant Professor
Department of Ophthalmology and Otolaryngology
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania

Illustrations by Jennifer Carmichael, MA and Lewis Calver, BFA, MS

Acquisitions Editor: Keith Donnellan
Marketing Manager: Stacy Malyil
Production Project Manager: Kim Cox
Design Coordinator: Stephen Druding
Editorial Coordinator: Dave Murphy
Manufacturing Coordinator: Beth Welsh
Prepress Vendor: SPi Global

Third edition

Copyright © 2019 Wolters Kluwer

Copyright © 2006 by Lippincott Williams & Wilkins. Copyright © 1995 J. B. Lippincott

Company. All rights reserved. This book is protected by copyright. No part of this book
may be reproduced or transmitted in any form or by any means, including as photocopies
or scanned-in or other electronic copies, or utilized by any information storage and retrieval
system without written permission from the copyright owner, except for brief quotations
embodied in critical articles and reviews. Materials appearing in this book prepared by
individuals as part of their official duties as U.S. government employees are not covered by
the above-mentioned copyright. To request permission, please contact Wolters Kluwer at
Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
[email protected], or via our website at lww.com (products and services).

9 8 7 6 5 4 3 2 1

Printed in China (or the United States of America)

Library of Congress Cataloging-in-Publication Data

Names: Ellis, Edward, DDS, author. | Zide, Michael F., author.
Title: Surgical approaches to the facial skeleton / Edward Ellis, III, Michael F. Zide ;
surgical videos by Eric W. Wang, Jenny Y. Yu.
Description: Third edition. | Philadelphia : Wolters Kluwer, [2018] | Includes
bibliographical references and index.
Identifiers: LCCN 2017058293 | ISBN 9781496380418 (hardback)
Subjects: | MESH: Facial Bones—surgery
Classification: LCC RD523 | NLM WE 705 | DDC 617.5/2059—dc23 LC record available
at https://lccn.loc.gov/2017058293

This work is provided “as is,” and the publisher disclaims any and all warranties, express
or implied, including any warranties as to accuracy, comprehensiveness, or currency of the
content of this work.

This work is no substitute for individual patient assessment based upon healthcare
professionals’ examination of each patient and consideration of, among other things, age,
weight, gender, current or prior medical conditions, medication history, laboratory data and
other factors unique to the patient. The publisher does not provide medical advice or
guidance and this work is merely a reference tool. Healthcare professionals, and not the
publisher, are solely responsible for the use of this work including all medical judgments
and for any resulting diagnosis and treatments.

Given continuous, rapid advances in medical science and health information, independent
professional verification of medical diagnoses, indications, appropriate pharmaceutical
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Dedication
Plant a seed and it will grow.
There are many who have unknowingly contributed to this book through the
education
they have provided me. All were my teachers, all are my friends. This book is
dedicated
to these special individuals:

Robert Bruce
Amir El-Attar
W. James Gallo
James Hayward
Kazumas Kaya
Khursheed Moos
Timothy Pickens
Gilbert Small
George Upton
Al Weiss

EDWARD ELLIS III

In gratitude for ageless friendship and counsel. Doug Sinn, DDS, Jack Kent,
DDS,
and Robert V. Walker, DDS.

To Riki: who puts up with me still.

MICHAEL F. ZIDE
PREFACE

There are many reasons for exposing the facial skeleton. Treatment of facial
fractures, management of paranasal sinus disease, esthetic onlay and
recontouring procedures, elective osteotomies, treatment of secondary
traumatic deformities such as enophthalmos, placement of endosteal
implants, and a host of other reconstructive procedures require approaches to
the facial framework. Many approaches to a given skeletal region are
possible. The choice is made usually on the basis of the surgeon's training,
experience, and bias. This book does not advocate one approach over
another, although the advantages and disadvantages of each approach will be
listed. We maintain the age-old belief that “many roads lead to Rome.”
Therefore, the purpose of this book is to describe in detail the anatomical and
technical aspects of most of the commonly used surgical approaches to the
facial skeleton. We have deliberately not presented every approach, because
many of them are not universally used, or are so simple that nothing needs to
be said. However, the approaches presented in this book will allow the
surgeon complete access to the craniofacial skeleton for whatever skeletal
procedure is being performed.
We have attempted, from the beginning, to make Surgical Approaches to
the Facial Skeleton different from the other books that touch on this subject.
Most books that discuss surgical approaches do so in the context of the
surgical procedure that is being presented. For instance, a book on facial
fractures will usually present surgical approaches to a particular facial
fracture. However, the surgical approach is not generally given much
consideration or is it presented in sufficient detail for the novice. The reader
is often left with the question, “How did the author get from the skin to that
point on the skeleton?” We instead avoid consideration of why one is
exposing the skeleton and describe the approaches in great detail so that even
the novice can safely approach the facial skeleton by following the step-by-
step description we have provided.
This book assumes that the reader has some basic understanding of
regional anatomy, especially osteology. However, the anatomic structures of
greatest interest will still be discussed for each surgical approach. This book
also assumes that the reader has developed skills for the careful handling of
soft tissues. We have suggested the use of those instruments that we have
found useful for incising, retracting, and manipulating the tissues involved
with each surgical approach, recognizing that others are also appropriate. The
book also assumes that the reader is skilled in facial soft tissue closure. We
have not discussed skin closure techniques associated with the approaches
unless they differ from routine skin closures.
The first edition of Surgical Approaches to the Facial Skeleton became a
hit with surgeons from several specialties when it was published in 1995.
Oral and maxillofacial surgeons, plastic surgeons, and otolaryngologists all
wanted this book for their collections. The book was most popular, however,
among residents-in-training from these specialties.
The third edition of Surgical Approaches to the Facial Skeleton, like the
first two editions, contains 14 chapters, 13 of which describe a specific
surgical approach. The first chapter discusses basic principles involved in
surgical approaches. The remaining 13 chapters are organized into sections,
predominantly on the basis of the region of the face being exposed. There
will often be more than one surgical approach presented for each region, with
the choice left to the surgeon. We attempt to point out the advantages and
disadvantages of each as they are presented.
The major change in the third edition of Surgical Approaches to the
Facial Skeleton is the addition of videos. Drs. Eric Wang and Jenny Yu
provide narrated videos that demonstrate 12 key approaches as performed on
cadavers.

Edward Ellis III, DDS, MS

Michael F. Zide, DMD
Inhalt

Preface

Section 1 Basic Principles for Approaches to the Facial

Skeleton
1 Basic Principles for Approaches to the Facial Skeleton

Section 2 Periorbital Incisions

2 Transcutaneous Approaches Through the Lower Eyelid
3 Transconjunctival Approaches
4 Supraorbital Eyebrow Approach
5 Upper Eyelid Approach

Section 3 Coronal Approach

6 Coronal Approach

Section 4 Transoral Approaches to the Facial Skeleton

7 Approaches to the Maxilla
8 Mandibular Vestibular Approach

Section 5 Transfacial Approaches to the Mandible

9 Submandibular Approach
 10 Retromandibular Approach
11 Rhytidectomy Approach

Section 6 Approaches to the Temporomandibular Joint

12 Preauricular Approach

Section 7 Surgical Approaches to the Nasal Skeleton

13 External (Open) Approach
14 Endonasal Approach

Index
Surgical Approaches to the
Facial Skeleton
THIRD EDITION
 SECTION 1

Basic Principles for Approaches to

the Facial Skeleton
 1 Basic Principles for
Approaches to the Facial
Skeleton

Maximum success in skeletal surgery depends on adequate access to and

exposure of the skeleton. Skeletal surgery is simplified and expedited when
the involved parts are sufficiently exposed. In orthopaedic surgery, especially
of the appendicular skeleton, the basic rule is to select the most direct
approach possible to the underlying bone. Therefore, incisions are usually
placed very near the area of interest while major nerves and blood vessels are
retracted. This involves little regard for esthetics but allows the orthopaedic
surgeon greater leeway in the location, direction, and length of the incision.
Surgery of the facial skeleton, however, differs from general orthopaedic
surgery in several important ways. The first factor in incision placement is
not surgical convenience but facial esthetics. The face is plainly visible to
everyone, and a conspicuous scar may create a cosmetic deformity that can
be as troubling to the individual as the reason for which the surgery was
performed. Cosmetic considerations are critical in light of the emphasis that
most societies place on facial appearance. Therefore, as we will see in this
book, all the incisions made on the face must be placed in inconspicuous
areas, sometimes distant from the underlying osseous skeleton on which the
surgery is being performed. For instance, placement of incisions in the oral
cavity allows superb exposure of most of the facial skeleton, with a
completely hidden scar.
The second factor that differentiates incision placement on the face from
incisions placed anywhere else on the body is the presence of the muscles and
nerve (cranial nerve VII) of facial expression. The muscles are subcutaneous
structures, and the branches of the facial nerve that supply them can be
traumatized if incisions are made in their path. This can result in a
“paralyzed” face, which is not only a severe cosmetic deformity but can also
have great functional ramifications. For instance, if the ability to close the eye
is lost, corneal damage can ensue, affecting vision. Therefore, placement of
incisions and dissections that expose the facial skeleton must ensure that
damage to the facial nerve is minimized. Many dissections to expose the
skeleton require care and electrical nerve stimulation to identify and protect
the nerve. Approaches using incisions in the facial skin must also take into
consideration the muscles of facial expression. This is especially important
for approaches to the orbit, where the orbicularis oculi muscle must be
traversed. Closure of some incisions also affects the muscles of facial
expression. For instance, if a maxillary vestibular incision is closed without
proper reorientation of the perinasal muscles, the nasal base will widen.
The third factor in facial incision placement is the presence of many
important sensory nerves exiting the skull at multiple locations. The facial
soft tissues have more sensory input per unit area than soft tissues anywhere
else in the body. Loss of this sensory input can be a great inconvenience to
the individual. Therefore, the incisions and approaches used must avoid
injury to the sensory nerves. An example is dissection of the supraorbital
nerve from its foramen/notch in the coronal approach.
Other important factors are the patient’s age, existing unique anatomy,
and expectations. The age of the patient is important because of the possible
presence of the wrinkles that come with age. Skin wrinkles serve as a guide
and offer the surgeon the opportunity to place incisions within or parallel to
them. Existing anatomic features that are unique to the individual can also
facilitate or hamper incision placement. For instance, pre-existent lacerations
can be used or extended to provide surgical exposure of the underlying
skeleton. The position, direction, and depth of a laceration are important
variables in determining its utility. The presence of old scars may also direct
incision placement; the old scar may be excised and used to approach the
skeleton. Sometimes, an old scar may not lend itself to use and may even
cause the new incision to be positioned such that the old scar is avoided. Hair
distribution may also direct the position of incisions. For instance, the
incision for the coronal approach is largely determined by the patient’s
hairline. Ethnic characteristics also have a bearing on whether an incision will
be placed in a conspicuous area. History or ethnic propensity for hypertrophic
scarring, keloid formation, and hyper- or hypopigmentation may alter the
decision as to whether or where to place an incision.
The patient’s expectations and wishes must always be considered in any
decision about location of an incision. For instance, patients who repeatedly
require treatment of facial injuries may not be concerned with local cutaneous
approaches to the naso-orbito-ethmoid region, whereas other individuals may
be very concerned about the location of incisions. Therefore, the choice of
surgical approach depends at least partly on the patient.

Principles of Incision Placement

Incisions placed in areas that are not readily visible, such as within the oral
cavity or far behind the hairline, are not of esthetic concern. Incisions placed
on exposed surfaces of the face, however, must follow some basic principles
so that the scar will be less conspicuous. These principles are outlined in the
following text.

Avoid Important Neurovascular Structures

Although this is an obvious consideration, avoiding anatomic hazards during
placement of incisions is only a secondary consideration in the face. Instead,
placing the incision in a cosmetically acceptable location takes priority.
Important neurovascular structures encountered during the dissection must be
dealt with by dissecting around them or by retracting them.

Use as Long an Incision as Necessary

Many surgeons tend to use short incisions. If the soft tissues around a short
incision are stretched to obtain sufficient exposure of the skeleton, the
additional trauma from retraction may create a less satisfactory scar than a
longer incision would. A well-placed long incision may be less perceptible
than a short incision that is placed poorly or requires great retraction. A long
incision heals as quickly as a short one.
Place Incisions Perpendicular to the Surface of Non–
hair-bearing Skin
Except in some very specific regions, an incision perpendicular to the skin
surface permits the wound margins to be reapproximated in an accurate,
layer-to-layer manner. Incisions performed obliquely to the surface of the
skin are susceptible to marginal necrosis and to overlapping of the edges
during closure. Incisions in hair-bearing tissue, however, should be parallel to
the direction of the hair so that fewer follicles are transected. An oblique
incision requires a more meticulous closure because of the tendency of the
margins to overlap during suturing. Subcutaneous sutures may have to be
placed more deeply to avoid necrosis of an oblique edge.

Place Incisions in the Lines of Minimal Tension

The lines of minimal tension, also called relaxed skin tension lines, are the
result of the skin’s adaptation to function and are also related to the elastic
nature of the underlying dermis (see Fig. 1.1). The intermittent and chronic
contractions of the muscles of facial expression create depressed creases in
the skin of the face. These creases become more visible and depressed with
age. For instance, the supraorbital wrinkle lines and the transverse lines of the
forehead are caused by the contraction of the frontalis muscles, which insert
into the skin of the lower forehead. In the upper eyelids, many fine
perpendicular strands of fibers of the levator aponeurosis terminate in the
dermis of the skin and along the tarsus to form the supratarsal fold. Similar
insertions in the lower eyelid create fine horizontal lines, which are
accentuated by the circumferential contraction of the orbicularis oculi muscle.
FIGURE 1.1 Lines of minimal tension (relaxed skin
tension lines) are conspicuous in the aged face. These lines
or creases are good choices for incision placement because
the scars resulting from the incision will be imperceptible.

Incisions should be made within the lines of minimal tension. Incisions

made within or parallel to such a line or crease will become inconspicuous if
they are closed carefully. Any incision or portion of an incision that crosses
such a crease, however, is often conspicuous.

Seek Other Favorable Sites for Incision Placement

If incisions cannot be placed within the lines of minimal tension, they can be
made inconspicuous by placement inside an orifice, such as the mouth, nose,
or eyelid; within hair-bearing areas or locations that can be covered by hair;
or at the junction of two anatomic landmarks, such as the esthetic units of the
face.
 SECTION 2

Periorbital Incisions

A standard series of incisions have been used extensively to approach the

inferior, lateral, and medial orbital rims. Properly placed incisions offer
excellent access with minimal morbidity and scarring. The most commonly
used approaches are those made on the external surface of the lower eyelid,
the conjunctival side of the lower eyelid, the skin of the lateral brow, and the
skin of the upper eyelid. This section describes these approaches. Other
periorbital approaches exist and can be useful. Existing lacerations of 2 cm or
longer may also be used or extended to access the orbit.
 2 Transcutaneous Approaches
Through the Lower Eyelid

Approaches through the external side of the lower eyelid offer superb
exposure to the inferior orbital rim, the floor of the orbit, the lateral orbit, and
the inferior portion of the medial orbital rim and wall. These approaches are
given many names in the literature (e.g., blepharoplasty, subciliary, lower- or
mid-eyelid, subtarsal, infraorbital rim), based primarily on the position of the
skin incision in the lower eyelid. Because of the natural skin creases in the
lower eyelid and the thinness of eyelid skin, scars become inconspicuous
with time and do not form keloids. The infraorbital incision, however, is
almost always noticeable to some degree (see Fig. 2.1).
FIGURE 2.1 Photograph showing poor cosmetic result
from the use of an infraorbital incision. Incisions placed at
this level often heal poorly for two reasons: (a) the lateral
extension of the incision usually crosses the resting skin
tension lines (dots) that cause widening of the scar (arrows)
and (b) the incision is in the thicker skin of the cheek rather
than the thin skin of the eyelid.

Surgical Anatomy
Lower Eyelid
In the sagittal section, the lower eyelid (1) consists of at least four distinct
layers: the skin and subcutaneous tissue, the orbicularis oculi muscle, the
tarsus (upper 4 to 5 mm of the eyelid) or orbital septum, and the conjunctiva
(see Fig. 2.2).
FIGURE 2.2 Sagittal section through the orbit and globe.
Another random document with
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 “Here we are,” said Lindsay, triumphantly. “How you may feel on the
matter, I can’t tell, Mr. Muir, but this seems very fine to me; and the
windows behind look out on the Forth.”
Harry was half-ashamed of his ill-humour, but for the moment he
could not conquer it.
“We’ll give this room to the bonniest ane,” said the Dragon, with his
feeble smile. “Whilk ane’s that, Mr. Hairy? and you’ll no be for ony
mair windows for your Lady Rose,” added the old man, turning
sharply round on Cuthbert.
Cuthbert had been investigating the apartment behind.
“The very brightest of drawing-rooms,” said the advocate, with a
warmth which made Harry still more ashamed of himself. “You have
nothing to do but take down this partition, and throw the two into one
room.”
The poor old guardian of these dim walls clenched his hand, and
shook it with feeble vehemence in Cuthbert’s face:
“Would ye put such radical notions into the innocent lad’s head?
Would ye daur?”
 CHAPTER II.

Lord what a nothing is this little span

We call a man!
How slight and short are his resolves at longest,
How weak at strongest!

quarles.
Cuthbert Charteris returned to Edinburgh that night, but not until
he had first made a rude outline—he was no artist, but could use his
pencil enough for this—of Allenders, with its eccentric turret and
shady mall, and the boat—a very crazy, incompetent boat as it
turned out—lying under the saugh tree upon the quiet water. He
showed it to Harry, as they eagerly consulted about the necessary
improvements, and Harry thought it quite a remarkable production;
but Cuthbert greatly doubted as he enclosed it to Martha Muir. The
deed almost lost its original intention of simple kindness, as he
pondered over it, and feared that they might think his drawing a very
poor affair; but it was sent at last.
Harry remained with Lindsay in Stirling. It was necessary to see the
family of Allenders residing there, who, failing Harry and his
household, were next heirs; and some legal forms had also to be
gone through. Harry had recovered his usual spirits; he was, excited
with his new position, with his proposed improvements, and even
with his inn lodgings; and while Lindsay laboured through some
necessary processes for his enfeoffment, Harry strayed out to see
the town. He saw the town, it was very true. He climbed to the
bastions of the lofty castle, and looked round him east and west. To
the blue Highland hills in the distance—to Demeyet and his brother
Ochils, glooming in brown shadows over the country at his feet—to
the silvery maze of the Forth, wantoning in and out between those
verdant banks as if he were fain of a pretext to linger at every corner,
because he loved the way so well—and to the broad strath of
Bannockburn, stealing away into those great lines of cloud, which
seemed to carry its gently sloping plain into the distant sky. Harry
looked upon them all, and mused and lingered, thinking pleasant
thoughts. Then he saw the lights begin to gleam, one after another,
in the town below, and he sauntered down to walk through the
streets with their pleasant, quiet, leisurely stir, and then to return to
his hotel.
But it was very late when Harry returned to his hotel—and he was
“indisposed,” and would not see the wondering Lindsay, who only left
his papers for the supper he had ordered, when he heard that Mr.
Muir had already gone to his room, and was “indisposed.” Lindsay
was puzzled and offended. He could not make out what this sudden
indisposition could mean.
Poor Harry! next morning he rose late, with an aching head and a
pained heart. He forgot at first when he woke how he had concluded
the last evening; but as the remembrance dawned upon him, he
wrung his hands and groaned aloud. What could he do? how could
he defend himself against this overpowering weakness? He threw
himself upon his face, and prayed in an agony of self-reproach and
shame, for strength, for deliverance. Alas! this great inheritance, this
fair new life—had he put the stain of his infirmity upon its promise
already.
Lindsay had breakfasted some time before Harry made his
appearance in their sitting-room; and now sat at a window, reading a
newspaper, and looking very grave and stately. A ceremonious
salutation passed between them; and Harry, sick, despondent, and
miserable, sat down at the table. As he loitered over his coffee, and
pushed his plate away from him with loathing, there was perfect
silence in the room, except for the rustling of Lindsay’s paper, and
his own restless motions.
Poor Harry was utterly cast down, but his humiliation struggled with
a fierce irritability; and Lindsay never moved his paper, but his
companion felt the strongest impulse to snatch it from his hand, and
trample on it, as if the indifference, which could content itself with a
newspaper, while he was suffering thus, was a positive injury to him.
When he had finished breakfast, he remained still leaning his head
upon his hand, and idly brooding over the disordered table. He did
not feel any inclination to go out, he had indeed nothing present
before him, but a diseased image of himself overspread with blank
despondency, and clouded with rising ill-humour. He had never felt
this so much before; for always before he had to justify himself, or to
melt in sympathy with those tears of yearning love and pity which
had been wept over him so often. He scarcely had known till now
how bitterly and harshly the soul can condemn itself, alone.
“When you are at leisure, Mr. Muir,” said Lindsay, coldly, “I shall be
glad if you will accompany me to call on Dr. Allenders. He was here
last night, having received a note I wrote him from Edinburgh; and as
he did not see you then—”
“Of course, I am ready—of course,” said Harry, starting up hastily.
“It was impossible I could know when Dr. Allenders intended to call.
But I am quite at your command, Mr. Lindsay. Does this man mean
to dispute my claim?”
“This man is a person of the highest character,” said Lindsay, with
his stiff gravity. “Having seen the documents, he does not intend to
put any obstacle in your way, Mr. Muir. By the bye, I do not know
whether you mean to assume the name of the family which you
succeed. It is not a condition of the will certainly, but it was implied.
Shall I present you to the Doctor as Mr. Allenders?”
“No, no, not yet,” said the conscience-stricken Harry. “Not yet—not
to-day. No, no—let it be a better time.”
These words were spoken incoherently, but Lindsay understood
them, and his heart was softened.
They went out, and the conversation gradually became less
constrained and more familiar; but Harry painfully recognised the
places which he had passed during the ramble of the previous night,
and vowed in his heart, as the bright day without restored in some
degree his failing spirit and courage, that never more, never again,
should these inanimate things remind him of temptations yielded to,
and resolutions broken. Poor Harry! a very short time makes him as
confident as ever; and when they have reached the doctor’s door, he
has again begun to look forward fearlessly into the future, and to
bring no self-distrust or trembling out of the past.
The doctor’s house is on the outskirts of the town, a square,
comfortable habitation, with a radiant glimpse from its windows of the
mazes of the river and the far-off hills. Upon the door glitters a brass
plate, bearing the name of John Allenders, M.D.; and Dr. John
Allenders seems to be in comfortable circumstances, for a spruce
boy in buttons opens the door, and they are shown into a handsome
library, which a strong, peculiar fragrance, and a suspicious glass
door with little red curtains, proclaims to be near the surgery; but Dr.
John has a good collection of books, and altogether appears to
Harry an exceedingly creditable relation, and one with whom even
the heir of Allenders may be sufficiently well pleased to count kin.
It is some time before Dr. John makes his appearance; but Lindsay,
who stands opposite the glass door, catches a glimpse of a
dissipated-looking head, in great shirt collars, stealthily peeping
through the red curtains at Harry, and making faces with an
expression of unmitigated disgust. But he has scarcely time to notice
this, when a shadow falls upon the door, and, with a solemn step, Dr.
Allenders enters the library.
He is a common-place looking man, with great dark eyes, which
project almost their whole round from under the puckered eyelid. It is
curious to notice how those eyes move, as if they were touched by
strings or wires behind; but the rest of his face is very tolerable, and
he looks what he is, a thoroughly respectable person, driving his gig,
and having money in the bank; and understanding himself to be a
responsible man, owing society, in right of his position in it, ever so
many observances and proprieties.
Close behind Dr. Allenders, comes the dissipated head and the
shirt collars, which just now made faces at Harry Muir. The owner of
the head stumbles up the two steps which connect the lower level of
the surgery with that of this more dignified apartment, and enters the
room with a swagger. He has eyes like the doctor’s, and a long,
sallow face, encircled by the luxuriant brushwood which repeats
under his chin the shaggy forest of hair which is the crown and glory
on his head. He wears a very short grey coat, a coloured shirt, and
an immense neck-cloth; and there enters with him into the room an
atmosphere of smoke, tinted with many harmonizing odours, which
envelopes his whole person like a separate world.
Harry turned round with slightly nervous haste as the doctor made
his appearance. The Doctor bowed, and held out his hand with a
frankness half real, half assumed; but Harry’s hand fell as it
advanced to meet that of Dr. Allenders, while Dr. Allenders’ son
uttered a coarse exclamation of surprise and recognition. Poor
Harry! his face became purple with very shame and anger—for this
coarse prodigal had been one of his boon companions on the
previous night.
“Met before?” said the doctor, inquiringly, as Harry stimulated by the
rude laugh of young Allenders, and the serious wonder of Lindsay,
made a strong effort to recover himself. “Seen my son in some other
place, Mr. Muir? I am glad of that, for blood is thicker than water; and
though we have lost an estate through your means, my young friend,
I hope we’ll have grace given us not to be envious, but to rejoice in
your exaltation as if it were our own; besides that, it would have been
very inconvenient to me—extremely inconvenient for my professional
duties—to have lived five miles out of town; and then the house is
such an old tumble-down affair. So I wish you joy, most heartily, Mr.
Muir. The income of Allenders’ estate would have been small
compensation to me, and Gilbert here has not settled to the harness
yet; so we’ve no reason to complain—not a shadow. Pray sit down—
or will you come up-stairs and see my wife and my daughters? Oh,
we’ll not disturb them; and being relations, they have heard of you,
Mr. Muir—I told them myself yesterday—and would like to see the
new heir.”
“I say Muir, my boy, I’m delighted it’s you,” said Mr. Gilbert
Allenders, thrusting forward a great bony, tanned hand, ornamented
with a large ring. “Pleasant night, last night, wasn’t it? Glad to see
we’ve got another good fellow among us. Come along up-stairs and
see the girls.”
Mr. Gilbert Allenders had a rough voice, with the coarsest of
provincial accents; and to mend the matter, Mr. Gilbert put himself to
quite extraordinary pains to speak English, omitting his r’s with
painful distinctness, and now and then dropping a necessary h. It
had been a matter of considerable study to him, and he was very
complacent about his success.
Harry submitted with a bad grace to shake hands, and
unconsciously drew nearer to Lindsay.
But Lindsay, who only smiled at the vulgar Mr. Gilbert, instinctively
drew himself up, and turned his face from Harry. Harry Muir for
himself was nothing to the young lawyer; but Lindsay felt personal
offence mingle in the contempt with which he perceived how his
client chose his company—leaving himself solitary in their inn, to go
and seek out a party which could admit this Gilbert Allenders.
Henceforth, Mr. Lindsay might be man of business to the new heir—
friend he could never be.
“I must be in Edinburgh this afternoon,” said Lindsay coldly. “Do you
accompany me Mr. Muir? for if you do not, I have accomplished all
that is necessary here, I fancy, and may take my leave.”
Harry hesitated for a moment, his better feelings struggling with
false shame and pride; but lifting his eyes suddenly, he encountered
the derisive smile of Gilbert Allenders, and took in with one rapid
glance all the characteristics of his new-found kinsman. These had
more effect on his susceptibility than either reason or repentance. He
did not decide on returning in the lawyer’s respectable society,
because he feared for his own weakness, if he permitted himself to
remain here alone. No, often though Harry’s weakness had been
demonstrated even to his own conviction, it was not this; but what a
knowledge of himself could not do, disgust with Gilbert Allenders did.
He answered hastily that he too would return at once, and
persuading Lindsay to remain and accompany him up-stairs to the
drawing-room where Mrs. Allenders and her daughters sat in state
expecting their visit, they at length left the house together, declining
the preferred escort of Mr. Gilbert.
But Harry did not escape without a galling punishment for the
previous night’s folly. Gilbert Allenders, seeing how he winced under
it, plied him with allusion after allusion. “Last night, you recollect?”
and with the most malicious perseverance recalled its speeches, its
laughter, its jokes and its noise, assuming too an ostentation of
familiarity and good-fellowship which Harry could scarcely restrain
his fury at. The effect was good and bad; on the one hand, Harry
vowed to himself fiercely that he never would put himself in the
power of such a man again: on the other, he forgot how he himself
had wasted the fair summer night begun with pleasant thoughts and
blessings; how he had desecrated and polluted what should have
been its pure and healthful close. He forgot his repentance. He felt
himself an ill-used man.
But he left Stirling that night with the half-mollified Lindsay. So much
at least was gained.
 CHAPTER III.

Fair gladsome waking thoughts, and joyous dreams more fair!

castle of indolence.
In the parlour at Port Dundas the window is open, the little muslin
blind waves in the soft air, and sounds steal in drowsily through the
sunshine from without. At the table sits Agnes, in her best gown,
writing a letter to Harry. Violet, in a corner, stands erect with her
hands behind her, defying Rose, who sits with great dignity in the
arm-chair to puzzle her with that spelling-book. Little Harry, now
beginning to walk, creeps about the floor at his own sweet will; and
indeed they are all idling but Martha, who still works at the “opening,”
though you perceive she does it slowly, and has not the keen interest
in “getting on” which she had a week ago.
Agnes writes rather laboriously—she is no penwoman; and what
she writes is just about nothing at all—a domestic letter, full of
implied tenderness and exuberant hopes, through which you can
scarcely see the sober and solemn solicitude which has made
Harry’s wife a woman deeper than her nature, and elder than her
years. But the heart of the young wife is very light now, and she
looks at the sleeve of her best gown with a smile, as she pauses to
arrange the next sentence, and beats upon her hand with the feather
of her pen. Little Harry seated at her feet, which he makes a half-way
house between two corners, tears away with appetite at a great
orange, refreshing himself, before, on hands and knees, he starts
upon another circumnavigation.
Looking down upon him lovingly, the young mother concocts her
next sentence with triumphant success; and you can guess, without
looking over her shoulder, what a pretty outline grows upon her
paper, under that inspired pen, which can write so quickly now. It is
not a daguerreotype of little Harry which his mother will send to his
father; but indeed one cannot tell what height of excellence and
warm expression this very daguerreotype can attain to, when the
sunshine which makes the portraiture is not the light of common day,
but of love.
Nor are you working either, little dark-haired Violet! Alas, it is no
sensible educational purpose which has carried you into the corner,
with one defiant foot planted firmly before the other, and those
restless hands crossed demurely behind. Not a respectable lesson
gravely administered and received, as lessons should be, but a
challenge proudly given to Rose to “fickle” you, who are very
confident in this particular of spelling, that you cannot be “fickled.” A
slight curve upon the brow of Rose, as she hunts up and down
through all those pages for hard words, intimates that she is a little
“fickled” herself; and Violet raises her head more proudly, and Rose
laughs with greater mirth as each successive word is achieved,
though now and then the elder trifler discovers that she is idle, and
wonders why it is, and remembers the cause which has made their
industry less urgent, with new smiles and joy.
But Martha still works at her “opening.” This, the last which they are
ever to do, Harry says, is a collar very elaborately embroidered,
which Martha resolves shall be bestowed on Agnes, as one
memorial of those toilsome days when they are past. The sterner
lines in Martha’s face have relaxed, and her eyelids droop softly with
a grateful pleasant weariness over her subdued eyes. Sometimes
the curves about her mouth move with a momentary quiver, as
though a few tears were about to fall; but the tears never fall. And
sometimes she lays down her work on her knee, and droops her
head forward, and looks up under her eyelashes with a smile at the
young mother, or at the two household flowers. These are long,
loving, lingering glances, not bright but dim with the unusual
gentleness of this unusual rest.
The sounds without do not strike upon your ear harshly, as sounds
do in winter, for this April day is warm and genial, like a day in June,
and has in it a natural hush and calm, which softens every distant
voice. Chief of all passing voices come gaily through the sunshine
and the open window, the song of Maggie McGillivray. She is sitting
again on her mother’s step, with the full sunshine, which she does
not at all heed, streaming upon her brown, wholesome, comely face.
Her scissors flash in the sun, her yellow hair burns; but Maggie only
throws over her head the finished end of her web, and clips and
sings with unfailing cheerfulness. This time it is not the “Lea Rig,” but
“Kelvin Grove,” to which the shears march and keep time; but it is
impossible to tell what a zest it gives to idleness, when one can look
out upon industry so sunshiny and alert as this.
“Perfunctory—p, e, r, f, u, n, c, t—Eh! Rose, yonder’s Postie, with a
letter,” cried Violet, out of breath.
“It’s sure to be from Harry, he’s always so thoughtful,” said the
young wife; “run and get it, Violet. I wonder if he has seen the house
yet—I wonder if he has settled when we’re all to go—I wonder—but
to think of him writing again to-day! Poor Harry! he would think we
would be anxious, Martha.”
“Here’s three; everybody but me gets a letter,” cried Violet, entering
with her hands full. “Martha, Postie says this should have come
yesterday, but it had no number; and here’s one from my uncle. May
I open Uncle Sandy’s letter, Martha?”
But Violet’s question was not answered. Harry’s letter was a large
one, a family epistle addressed to Martha, enclosed within the love-
letter which Harry’s still fresh and delicate affection sent to his wife.
But while Agnes ran over her’s alone, a flush of delight and
expectation making her smile radiant, Rose looking over Martha’s
shoulder, and Violet standing at her knee, possessed themselves of
the contents of the larger letter; so that Agnes, roused at the end of
her own to kindred eagerness about this, started up to join them, as
Rose exclaimed: “A boat on the water,” and Violet cried “Eh, Agnes,
a wee burn,” in the same breath.
And then Martha smilingly commanded the little crowd which
pressed around her to sit down quietly, and hear her read; and Violet
added with authority:
 “Agnes, Rose, you’re to go away. Martha will read it out loud;” but,
notwithstanding still obtruded her own small head between the letter
of Harry and the eyes of her elder sister.
And Martha did read “out loud,” all the others still continuing to bend
over her shoulder, and to utter suppressed exclamations as their
eyes ran, faster than Martha’s voice, over the full page. The mall, the
boat, the burn, the partitions to be thrown down, the windows to be
opened, the painting and gilding and furnishing which filled Harry’s
mind with occupation, produced the pleasantest excitement in the
family. Those two girls, Agnes and Rose—for the wife was little more
mature than her young sister—paused at the end of every sentence
to clap their hands, and exclaim with pleasure; but Violet’s small
head remained steady under shadow of Martha’s shoulder, and she
read on.
“I have the accumulated rents of two years—nine hundred pounds
—to begin with,” wrote Harry; “you may fancy how much
improvement we may get out of such a sum as that; and I am
resolved that the house shall be a pleasant house to us all, and like
what a home should be, if anything I can do, will make it so. We
must have a new boat, instead of this old crazy one, and will be
obliged to have a vehicle of some kind. Violet must go to Stirling to
school, so we’ll need a pony for her (Violet laughed aloud), and
Agnes and Rose and you, my dear Martha, must have some kind of
carriage; however, you shall decide yourselves about that. But this
thousand pounds, you see, will enable us to begin in proper style,
and that is a great matter.
I have just seen a family of Allenders in Stirling, respectable vulgar
people, with a dissipated son, who took upon him to be more
intimate with me than I was at all disposed for. I am afraid I shall be
rude to this Gilbert Allenders, if he continues to press himself upon
me; however, when you are all yonder, everything will go well.”
Poor Harry! It was a consolation to him to condemn Gilbert
Allenders: it seemed to take a weight from his own conscience;
disgust for his dissipated kinsman stood Harry in stead as disgust for
dissipation itself, and he took the salve to his heart, and was
comforted.
“Martha, will a pony carry two folk?” asked Violet, anxiously. “Yes, I
mind—for ladies rode upon a pillion langsyne.”
“And what two folk would you have it carry, Lettie?” asked Rose.
“Me and Katie Calder. Martha, will you let Katie come?—for Auntie
Jean’s ill to her; my uncle told Harry that, Martha.”
“Ask Agnes,” said Martha, with a smile; “I am only Harry’s sister and
your sister, Lettie; but Agnes is lady of Allenders now; you must ask
Agnes.”
The little wife grew red and white, and laughed hysterically; then
she sank down on the floor at Martha’s feet, and clasped her arms
round the elder sister’s waist, and wept quietly with her face hidden.
It was too much for them all.
“And it’s an enchanted castle, and there’s a Dragon in it,” cried
Violet joyously; “but, Rosie, Rosie, there should be a knight. Oh! I
ken who it is—I ken who it is; it’s Mr. Charteris!”
“Lettie, what nonsense!” exclaimed Rose, who at that moment
became extremely upright and proper.
“I ken; you’re the princess, Rosie, and Mr. Charteris is the knight;
and maybe there’s fairies about the burn! Oh! I wish I was there!—
me and little Katie Calder!”
Martha lifted the other letters from the table; they had been
forgotten in the interest of this. One of them was from Uncle Sandy;
the other was a note from Cuthbert, enclosing his sketch—an
extremely brief note, saying little—yet Rose examined it over her
sister’s shoulder stealthily, while the others looked at the drawing.
There was nothing peculiar about the hand; and Rose did not
understand the art of gleaning traits of character out of hair-strokes
—yet her eyes went over it slowly, tracing the form of every letter.
Poor Cuthbert! he thought this same Rose would be very much
interested about his drawing; it seemed for the moment that these
plain characters occupied her more.
 CHAPTER IV.

A pair of friends—though I was young

And Matthew seventy-three.

wordsworth.
“Eh, wee Hairy!” cried Miss Aggie Rodger, “your faither’s a muckle
man noo; do you ken that, my pet? and you’ll ride in a coach, and
get a grand powney o’ your ain, and eat grossets and pu’ flowers a’
the simmer through; do you hear that, my wee boy? But ye’ll have to
gang away, Hairy, and what’ll we a’ do wanting ye?”
“It’s me that’s to get the pony,” said Violet. “I’m to ride into Stirling to
the school every day, and I want Martha to buy a pillion for Katie
Calder, and then, Miss Aggie, I can sit before, and Katie behind, like
the lady in Lochinvar; but it’s me that’s to get the pony.”
“Preserve me, what a grand lady!” said Miss Aggie, throwing up
little Harry in her arms; “but the wee boy’s the heir for a’ that—are ye
no, Hairy?”
“But I want to ken how we’re to get to Stirling,” said Violet. “I ken
about the Castle and the Ladies’ Rock, and all the places where the
Douglas played, and where Lufra chased the deer, and King James
coming down the High Street, too; but Mr. John, will you tell me how
we’re to get to Stirling?”
“I never was there myself, Lettie,” said the idle man; “but there’s a
map of Scotland in that auld book—see, down yonder in the corner,
behind ‘Hervey’s Meditations’—that’s it—and we’ll look and see.”
The book was a dingy and tattered one, and beside it lay a very old
copy of Young’s “Night Thoughts,” which Violet brought with her in
her hand.
 “See now, this is the road,” said the poor, good-natured Johnnie,
with whom Lettie was an especial favourite, as he spread out the
worn map on his knee, and taking a pin from the lappel of his coat,
traced with it the route. “But your brother, you know, Lettie, went to
Edinburgh first, and then sailed up here—and this is Stirling.”
“Eh, how the water runs out and in!” exclaimed Violet; “and we have
a boat all to ourselves. Mr. John, will you tell me what this book is—
is it good for reading?” and Violet contemplated, with a slightly
puzzled expression, the dense pages of blank verse in which there
appeared no story to catch her eye, or interest.
“Very good for reading,” answered the oracular Mr. John; “but now,
Lettie, put the books back, and run down to Mrs. McGarvie’s like a
good girl, and bring me a new pipe—run, Lettie!”
There was a strange alliance between the child and the man. Lettie,
not always very tolerant of messages, put down the books without a
murmur, and obeyed.
It was now May, and the day was hot and slumbrous. Miss Jeanie
Rodger was at the warehouse, carrying back the work; Miss Aggie
making boisterous fun with little Harry at the window; while proud,
pensive, faded Miss Rodger sat very unpresentable in another room,
repairing worn finery, which never could have been suitable for her,
and was suitable for no one now.
The mother, worn out by two or three successive encounters with
tax-gatherers, whose visits she bitterly resented at all times, and
among whom she classed the collectors of those innocent water and
gas accounts, which lay upon the “bunker” in the kitchen, was
sleeping away her wrath and fatigue; everything was still in the
house, except the crowing of little Harry. And little Harry’s mother and
aunts were making a new frock for him in the parlour—a work which,
for very joy, made slow progress: they had so many other things to
think and talk about.
Looking into this pleasant work-room to see that all was right,
before she obeyed the command of Mr. John, Violet went bounding
down the stair, and out into the street.
 Mrs. McGarvie’s Tiger sat painfully on the very narrow step of the
door, where he could be shaded from the sun; sat very upright and
prim, poor fellow, compelled by this circumscribed space. Mrs.
McGarvie’s pretty Helen, with her beautiful hair and her bare feet, on
short time at the mill, lovingly clipped with Maggie McGillivray across
the way, but was very languid under the full sunshine, and grew quite
ashamed of herself as she watched with awe and admiration the
vigorous shears of her companion; while Mrs. McGarvie in the easy
dishabille of a loose short gown, shook her clenched hand at her
daughter from the threshold, and called her an idle cuttie at the top
of her voice.
It was a drowsy day, and some one looking very brown and dusty,
came toiling down the sunny, unshaded road,
“Eh, it’s Harry!” cried Violet Muir—and affectionately grasping the
pipe in one hand, she ran up the road to secure Harry with the other.
“Who’s to smoke the pipe? Lettie, you must go no more messages
like this, for you’re a young lady now,” said Harry, drawing himself
up. “Is it for that idle fellow, John Rodger? What a shame, Lettie!”
“He’s my friend; I like him best,” said Violet, decidedly.
“He’s a mean fellow!” said Harry. “See that you don’t go anywhere
for him again!”
For Harry had just now been a little irritated. Some one had met
him, who did not know his new dignity, and who in the old days had
been the superior of Mr. Buchanan’s clerk; but having extinguished
his wrath by this condemnation of poor John Rodger, and highly
amused to notice the violent flush of anger which rose upon the little
defiant face of Lettie, Harry entered the house in great spirits.
“He’s turning steady, that lad,” said Mrs. McGarvie, looking after him
with a sigh. “I’m sure it’s a great blessing; and a’ body mends o’ their
ill courses but our guid man.”
Harry had come by the coach; the economic tardiness of the canal
was not necessary to Harry now; and except that he was sunburnt,
and hot, and dusty, the quick inquisitive eye of Rose decided in a
moment that there was nothing in his appearance to-day to rouse
Martha’s suspicions.
“Don’t let Lettie run about so,” said Harry, when their first greetings
were over. “It is great presumption of those Rodgers; don’t let her go
errands for them. Lettie is clever, Martha; we must make something
of her. And now, when will you all go home?”
“Is that all that remains now, Harry?” exclaimed Agnes, clapping her
hands. “May we go at once? Is it so near as that?”
“Well, I don’t think you should,” said Harry. “Let me get all the
alterations made, and the place furnished, and then you can come.
But Charteris said he was sure you would like better to be there at
once, and have a hand in the improvements; so I promised him to
give you your choice.”
“Oh, surely! Let us go now,” said Agnes.
“Eh, I would like!” echoed little Violet.
“But I should not like,” said Harry. “I want you to go when the place
is complete and worthy of you. If you saw it now, you would think it a
dingy, melancholy desert; but just wait for a month or so! There is a
good deal of wood to be cut down, and they tell me the estate may
be much improved; and to have a thousand pounds to begin with,
you know, is great good fortune. There is a new church building
close by—I think of giving them a hundred pounds, Martha.”
“A hundred pounds!” exclaimed Agnes and Rose.
The eyes of both were wet. It was so great a gladness to be able to
give such a gift, and then to propose it was so good of Harry! They
were both overpowered with his liberality.
“A Syrian ready to perish was my father,” said Martha, slowly. “Yes,
it is very fit you should bring the handful of first-fruits; but bring it
justly, Harry. Spare it. Do not give it to the church and spend it too.”
“Martha is thinking of our old fifteen pounds a quarter,” said Harry,
gaily. “Martha forgets that you don’t need to put off an account to pay
your seat-rent now, Agnes. Why, only think of a thousand pounds—
what a sum it is! It seems to me as if we could never spend it. Look
here, Lettie.”
And Harry triumphantly exhibited a hundred-pound note. No one
present had ever seen such a one before; and simple Harry, with a
touch of most innocent pride, had preferred this one piece of paper
to the more useful smaller notes, simply to let them see it, and to
dazzle their eyes with a whole hundred pounds of their own.
“Eh, Harry!” exclaimed Violet, with reverential eyes fixed on Harry’s
new pocket-book, “is’t a’ there?”
Harry laughed, and closed the book; but they all looked at it a little
curiously, and even Agnes felt a momentary doubt as to whether a
thousand—ay, or even a hundred—pounds were very safe in Harry’s
keeping.
“No, it’s not all here,” answered the heir; “it’s all in the bank but this.
Now, Agnes, am I not to have any tea? And we must consult about it
all. The improvements will cost some two hundred pounds; then we’ll
say a hundred and fifty to furnish the drawing-room—that’s very
moderate. Then—there are already some things in the dining-room
—say a hundred for that, and another hundred for the rest of the
house. How much is that, Lettie?”
Lettie was counting it up on her fingers.
“Eh, Harry, what a heap of siller!”
“Five hundred and fifty; and this,” said Harry, complacently laying
his finger on his pocket-book, “six; and a hundred to the kirk, seven
hundred and fifty; and say fifty pounds for a good horse and Lettie’s
pony, and somewhere near a hundred for a carriage, and then—
whew! there’s nothing left. I must begin to calculate again—a
thousand pounds—”
“But, Harry, you said it was only nine hundred,” said Rose.
“Well, so it is—it’s all the same. What’s a hundred here or there?”
said Harry the Magnificent. “I must just make my calculations over
again—that’s all.”
 “But can people encumbered as you are afford to keep a carriage
on four hundred and fifty pounds a-year?” asked Martha.
“Oh, not in the town, of course; but the country is quite different.
Besides, Allenders will improve to any extent; and I suppose I may
double my income very soon. Don’t fear, Martha, we’ll be very
careful—oh, don’t be afraid.”
And Harry sincerely believing that no one need be afraid, went on in
his joyous calculations—beginning always, not a whit discouraged,
when he discovered again and again that he was calculating on a
greater sum than he possessed; but it soon became very apparent,
even with Harry’s sanguine arithmetic, that it was by no means a
difficult thing to spend a thousand pounds, and a slight feeling of
discontent that it was not another thousand suddenly crossed the
minds of all.
“I see,” said Harry, slowly, “it’ll have to be fifty to the church, Martha.
Fifty is as much as I can afford. It would not be just, to myself and to
you all, to give more.”
Poor Harry! The magnificence of liberality was easier to give up
than the other magnificences on which he had set his heart.
 CHAPTER V.

But hark you, Kate,

Whither I go, thither shall you go too;
To-day will I set forth, to-morrow you.

henry iv.
“What could you do in Allenders? one never knows how to deal
with you capricious women. Stay at home, Agnes, and manage your
own department—it is impossible you could assist me, and you
would only be a hindrance to work. Stay at home, I say, till the place
is ready for you.”
Agnes laid down the child softly upon the sofa where she was
sitting, and answered nothing; but her face wore a look of resignation
which Harry thought ostentatious, and which irritated him greatly, as
indeed his little wife partly knew.
He started hastily from his seat with a contracted brow, and began
to walk about the room, muttering something to himself about the
impossibility of pleasing everybody. Poor little Agnes was
desperately exerting herself to swallow a sob; she did feel a little
fretful and peevish, it was very true, but at the same time she
honestly struggled to keep it down.
“Martha, say something,” whispered Rose. “Harry is angry—speak
to him, Martha.”
But Martha sat still and said nothing—for Harry’s magnificent
intentions troubled his sister with an uneasy sense of dependence. It
is oftentimes a greater exercise of generosity to receive than to
bestow. Labouring for Harry would have seemed to Martha a thing
so natural as never to disturb her every-day life for a moment; to be
supported by Harry, called for a stronger exertion. But Harry’s sister