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Hazzard’s
Geriatric Medicine and
Gerontology
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Seventh Edition
Hazzard’s
Geriatric Medicine and
Gerontology
Editors
Jeffrey B. Halter, MD
Professor Emeritus of Internal Medicine
Division of Geriatric and Palliative Medicine
University of Michigan
Ann Arbor, Michigan
Parkway Visiting Professor in Geriatrics
Department of Medicine
Yong Loo Lin School of Medicine
National University of Singapore
Joseph G. Ouslander, MD
Professor and Senior Associate Dean for Geriatric Programs
Chair, Department of Integrated Medical Sciences
Charles E. Schmidt College of Medicine
Professor (Courtesy), Christine E. Lynn College of Nursing
Florida Atlantic University
Boca Raton, Florida
Stephanie Studenski, MD, MPH
Chief, Longitudinal Studies Section
Intramural Research Program
National Institute on Aging
Baltimore, Maryland
Kevin P. High, MD, MS
Executive Vice President, Health System Affairs
Wake Forest Baptist Health
Professor of Internal Medicine–Infectious Diseases
Wake Forest School of Medicine
Winston-Salem, North Carolina
Sanjay Asthana, MD, FACP
Associate Dean for Gerontology
Professor and Head, Division of Geriatrics and Gerontology
Director, NIA/NIH Wisconsin Alzheimer Disease Research Center (ADRC)
Director, Madison VAMC Geriatric Research, Education and Clinical Center (GRECC)
Duncan G. and Lottie H. Ballantine Endowed Chair in Geriatrics
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin
Mark A. Supiano, MD
D. Keith Barnes, MD and Dottie Barnes Presidential Endowed Chair in Medicine
Professor and Chief, Division of Geriatrics
University of Utah School of Medicine
Director, VA Salt Lake City Geriatric Research, Education, and Clinical Center
Executive Director, University of Utah Center on Aging
Salt Lake City, Utah
Christine Ritchie, MD, MSPH
Harris Fishbon Distinguished Professor of Medicine
University of California San Francisco
Department of Medicine, Division of Geriatrics
The Jewish Home of San Francisco
Center for Research on Aging
San Francisco, California
New York Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
Hazzard’s Geriatric Medicine and Gerontology, Seventh Edition
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Contents
Contributors
Foreword
Preface
Part I
Principles of Gerontology
1 Biology of Aging and Longevity
David B. Lombard, Richard A. Miller, Scott D. Pletcher
2 Genetics of Age-Dependent Human Disease
Lital Sharvit, Danielle Gutman, Huda Adwan, Rotem Vered, Gil Atzmon
3 Immunology of Aging
Albert C. Shaw, Thilinie Bandaranayake
4 Chronic Inflammation
Jeremy D. Walston
5 Demography and Epidemiology
Bonnielin Swenor, Jack M. Guralnik, Luigi Ferrucci
6 International Gerontology and Geriatric Medicine
Leonard C. Gray, Graziano Onder, Maysa S. Cendoroglo, AB Dey, Ana Beatriz G. Di Tommaso, Brant E. Fries, Rowan H.
Harwood, Jean Claude Henrard, John Hirdes, Naoki Ikegami, Palmi V. Jonsson, Bruce Leff, John N. Morris, Xiaomei Pei,
Naganath Narasimhan Prem, Roberto Bernabei
7 Psychosocial Aspects of Aging
Steven M. Albert, Daphna Gans
8 Sex Differences in Health and Longevity
Steven N. Austad
Part II
Principles of Geriatrics
SECTION A: Assessment
9 Evaluation, Management, and Decision Making
Daniel D. Matlock, Carmen L. Lewis
10 Principles of Geriatric Assessment
David B. Reuben, Sonja Rosen, Heather B. Schickedanz
11 Mental Status and Neurologic Examination
James E. Galvin
12 Assessment of Decisional Capacity and Competencies
Margaret A. Drickamer
13 Prevention and Screening
Sei J. Lee, Louise C. Walter
SECTION E : Nutrition
34 Nutrition and Obesity
Dennis H. Sullivan, Larry E. Johnson
35 Malnutrition and Enteral/Parenteral Alimentation
Jeffrey I. Wallace
36 Disorders of Swallowing
Nicole Rogus-Pulia, Steven Barczi, JoAnne Robbins
37 Oral Health
Joseph M. Calabrese, Judith A. Jones
Part III
Geriatric Syndromes
45 Aging and Homeostatic Regulation
George A. Kuchel
46 Frailty
Luigi Ferrucci, Elisa Fabbri, Jeremy D. Walston
47 Delirium
Sharon K. Inouye, Matthew Growdon, Tamara Fong
48 Falls
Stephen R. Lord
49 Sleep Disorders
Armand Ryden, Cathy Alessi
50 Dizziness
Aman Nanda, Richard W. Besdine
51 Syncope
R. A. Kenny, Conal Cunningham
52 Pressure Ulcers
Barbara M. Bates-Jensen, Anabel Patlan
53 Incontinence
Camille P. Vaughan, Theodore M. Johnson, II
54 Elder Mistreatment
Mark S. Lachs, Tony Rosen
Part IV
Principles of Palliative Medicine and Ethics
55 Palliative Care and Special Management Issues
Paul Tatum, Shaida Talebreza, Jeanette S. Ross, Eric Widera
56 Pain Management
Bruce A. Ferrell
57 Common Nonpain Symptoms
Christine Ritchie, Alexander K. Smith, Christine Miaskowski
58 Effective Communication Strategies for Patients With Advanced Illness
Brook Calton, Wendy Anderson
59 Palliative Medicine Across the Continuum of Care Including Hospice
Nelia Jain, Alexander K. Smith
60 Spiritual Care
Najmeh Jafari, Katalin Roth, Christina Puchalski
61 Ethics
Elizabeth Vig, Christina Bell, Caroline Vitale
Part V
Organ Systems and Diseases
SECTION D: Nephrology
86 Aging of the Kidney
Jocelyn Wiggins, Sanjeevkumar R. Patel
87 Renal Disease
Markus Bitzer
88 End-Stage Renal Disease
Mark L. Unruh, Pooja Singh
89 Disorders of Fluid and Electrolyte Balance
Eleanor Lederer, Vibha Nayak
SECTION E : Gastroenterology
90 Aging of the Gastrointestinal System
Karen E. Hall
91 Hepatic Disease
Sean G. Kelly, Courtney Barancin, Michael R. Lucey
92 Biliary and Pancreatic Disease
Sean G. Kelly, Justin C. Rice, Mark Benson, Michael R. Lucey
93 Upper Gastrointestinal Disorders
Alberto Pilotto, Marilisa Franceschi
94 Common Large Intestinal Disorders
David A. Greenwald
95 Constipation
Andres Acosta, Eric G. Tangalos, Danielle Harari
SECTION F : Oncology
96 Oncology and Aging: General Principles
Arati V. Rao, Harvey Jay Cohen
97 Breast Disease
Rachel A. Freedman, Hyman B. Muss
98 Prostate Cancer
Mark C. Markowski, Kenneth J. Pienta
99 Lung Cancer
Carolyn Presley, Ronald Maggiore, Ajeet Gajra
100 Gastrointestinal Malignancies
Ryan Nipp, Nadine J. McCleary
101 Intracranial Neoplasms
Clayton L. Haldeman, Robert J. Dempsey
102 Skin Cancer
Kelly L. Harms, Amy Orsini, Timothy M. Johnson,Alison B. Durham
SECTION G : Hematology
103 Aging of the Hematopoietic System
William Tse, Maxwell M. Krem, Jino Park,Nathan A. Berger, Scot C. Remick
104 White Cell Disorders
Heidi D. Klepin, Bayard L. Powell
105 Non-Hodgkin and Hodgkin Lymphomas
Paul A. Hamlin, Colette Owens
106 Coagulation Disorders
Stacy A. Johnson, Matthew T. Rondina
107 Plasma Cell Disorders
Tanya M. Wildes
Index
Contributors
CHAPTER AUTHORS
Numbers in brackets refer to the chapters written or cowritten by the contributor
Cathy Alessi, MD
Director, Geriatric Research, Education and Clinical Center (GRECC)
Chief, Division of Geriatrics; VA Greater Los Angeles Healthcare System
Professor, David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California [49]
Karen P. Alexander, MD
Professor of Cardiovascular Medicine
Duke University Medical Center
Duke Clinical Research Institute
Durham, North Carolina [77]
Neil B. Alexander, MD
Professor, Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan
Director, VA Ann Arbor Health Care System GRECC
Ann Arbor, Michigan [114]
Danielle L. Anderson, MD
Assistant Professor of Psychiatry and Behavioral Sciences
Division of Geriatric Psychiatry and Neuropsychiatry
Northwestern University
Chicago, Illinois [72]
Jacqueline V. Aredo, BS
Clinical Research Assistant
Rehabilitation Medicine Department
National Institutes of Health
Bethesda, Maryland [124]
Courtney Barancin, MD
Gastroenterologist
Minnesota Gastroenterology
St. Paul, Minnesota [91]
Steven R. Barczi, MD
Professor of Medicine
Division of Geriatrics and Gerontology
Medical Director for Division; Director of Education for GRECC
University of Wisconsin School of Medicine and Public Health
Wm. S. Middleton VA GRECC-Madison
Madison, Wisconsin [36]
Mark Benson, MD
Assistant Professor
Department of Internal Medicine
Division of Gastroenterology and Hepatology
University of Wisconsin
Madison, Wisconsin [92]
Nathan A. Berger, MD
Distinguished University Professor
Hanna-Payne Professor of Experimental Medicine
Professor of Medicine, Biochemistry, Oncology and Genetics
Director, Center for Science, Health and Society
Case Western Reserve University School of Medicine
Cleveland, Ohio [103]
Roberto Bernabei, MD
Professor of Internal Medicine
Director of the Department on Aging,
Neurosciences, Head and Neck, Orthopaedics
Policlinico A. Gemelli, Universita’ Cattolica del Sacro Cuore
Rome, Italy [6]
Cheryl D. Bernstein, MD
Associate Professor
University of Pittsburgh
Department of Anesthesiology and Neurology
Division of Pain Medicine
Pittsburgh, Pennsylvania [124]
Richard W. Besdine, MD
Professor of Medicine
Director, Division of Geriatrics and Palliative Medicine (Medicine)
Greer Professor of Geriatric Medicine
Alpert Medical School of Brown University
Professor of Health Services Policy and Practice
Director, Center for Gerontology and Health Care Research
Brown University School of Public Health
Providence, Rhode Island [50]
Ellen F. Binder, MD
Professor of Medicine
Division of Geriatrics and Nutritional Science
Fellowship Program Director
Washington University School of Medicine
St. Louis, Missouri [119]
Markus Bitzer, MD
Associate Professor of Internal Medicine Division of Nephrology
Director, Geriatric Nephrology Clinic
University of Michigan
Ann Arbor, Michigan [87]
Jacob B. Blumenthal, MD
Assistant Professor of Internal Medicine
Division of Gerontology and Geriatric Medicine
Associate Director (Acting) for Education and Evaluation/Baltimore GRECC
University of Maryland, Baltimore VAMC
Baltimore, Maryland [111]
Kenneth Brummel-Smith, MD
Charlotte Edwards Maguire Professor
Department of Geriatrics
Florida State University
College of Medicine
Tallahassee, Florida [22]
Chandler Caufield, BA
Research Technician
Dorothy P. & Richard P. Simmons Center for Interstitial Lung Diseases Division of Pulmonary Medicine,
Allergy and Critical Care Medicine
McGowan Institute for Regenerative Medicine
University of Pittsburgh
Pittsburgh, Pennsylvania [83]
Jessica L. Colburn, MD
Assistant Professor of Medicine
Division of Geriatric Medicine and Gerontology
Johns Hopkins University School of Medicine
Baltimore, Maryland [21]
A. B. Dey, MD
Professor and Head
Department of Geriatric Medicine
All India Institute of Medical Sciences
New Delhi, India [6]
Margaret A. Drickamer, MD
Clinical Professor
Division of Geriatrics
University of North Carolina School of Medicine
Chapel Hill, North Carolina
Professor Emeritus
Yale School of Medicine
New Haven, Connecticut [12]
Catherine E. DuBeau, MD
Professor of Medicine
Division of Geriatric Medicine
University of Massachusetts Medical School
UMass Memorial Medical Center
Worcester, Massachusetts [44]
Alison B. Durham, MD
Assistant Professor of Dermatology
Division of Cutaneous Surgery and Oncology
University of Michigan
Ann Arbor, Michigan [102]
Elisa Fabbri, MD
PhD Fellow and Resident in Geriatrics
University of Bologna
Bologna, Italy
Special Volunteer, National Institute on Aging (NIH)
Baltimore, Maryland [46]
Bruce A. Ferrell, MD
Professor of Clinical Medicine
Division of Geriatrics
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California [56]
Joseph H. Flaherty, MD
Professor of Internal Medicine
Division of Geriatric Medicine
Associate Chair for Clinical Affairs
Saint Louis University School of Medicine
St. Louis, Missouri [25]
Scott A. Flanders, MD
Professor of Medicine
Director, Hospital Medicine Program
Associate Chief, Division of General Medicine
Associate Chair, Quality and Innovation
Department of Medicine
University of Michigan
Ann Arbor, Michigan [16]
Daniel E. Forman, MD
Professor of Medicine
Chair, Geriatric Cardiology Section, University of Pittsburgh Medical Center (Divisions of Geriatrics and Cardiology)
Physician Scientist, Pittsburgh Geriatric, Research, Education, and Clinical Center
University of Pittsburgh
Pittsburgh, Pennsylvania [76]
Kaitlyn Fruin, BS
Research Specialist
Department of Obstetrics and Gynecology
The University of Chicago
Chicago, Illinois [41]
Andrew P. Goldberg, MD
Professor Emeritus
Division of Gerontology and Geriatric Medicine
University of Maryland School of Medicine
Baltimore, Maryland [111]
Paul J. Grant, MD
Assistant Professor of Medicine
Director, Perioperative and Consultative Medicine
Division of General Medicine
Department of Internal Medicine
University of Michigan Health System
Ann Arbor, Michigan [31]
David A. Greenwald, MD
Professor of Medicine
Department of Medicine, Division of Gastroenterology
Icahn School of Medicine at Mount Sinai
Director of Clinical Gastroenterology and Endoscopy
Mount Sinai Hospital
New York, New York [94]
Ryan Greytak, MD
Board-Certified Geriatric Psychiatrist
Private Practice
San Diego, California [73]
David A. Gruenewald, MD
Associate Professor of Medicine
Department of Medicine
Division of Gerontology and Geriatric Medicine
University of Washington School of Medicine
VA Puget Sound Health Care System
Seattle, Washington [108]
Jerry H. Gurwitz, MD
The Dr. John Meyers Professor of Primary Care Medicine
Professor of Medicine, Family Medicine and Community Health, and Quantitative Health Sciences
Chief, Division of Geriatric Medicine
Executive Director, Meyers Primary Care Institute
University of Massachusetts Medical School
Worcester, Massachusetts [24]
Jeffrey B. Halter, MD
Professor Emeritus of Internal Medicine
Division of Geriatric and Palliative Medicine
University of Michigan
Ann Arbor, Michigan
Parkway Visiting Professor in Geriatrics
Department of Medicine
Yong Loo Lin School of Medicine
National University of Singapore [110]
Paul A. Hamlin, MD
Associate Member, Department of Medicine, Lymphoma Service
Division of Hematologic Oncology
Chief, Basking Ridge Medical Oncology Service
Memorial Sloan Kettering Cancer Center,Associate Professor in Medicine
Weill Cornell Medical College
New York Presbyterian Hospital
Department of Medicine
New York, New York [105]
Danielle Harari, MD
Consultant Physician and Senior Lecturer
Kings College London
Department of Ageing and Health
Guy’s and St. Thomas’ NHS Foundation Trust
London, England [95]
Rowan H. Harwood, MD
Consultant Geriatrician and Professor of Geriatric Medicine
Nottingham University Hospitals NHS Trust
Queen’s Medical Centre
Nottingham, United Kingdom [6]
Jennifer L. Hayashi, MD
MedStar Total Elder Care
Baltimore, Maryland [21]
Jean-Claude Henrard MD
Emeritus Professor of Public Health Versailles-Saint-Quentin en Yvelines University
Versailles, France [6]
Kerry L. Hildreth, MD
Assistant Professor
Division of Geriatric Medicine
Department of Medicine
University of Colorado School of Medicine
Aurora, Colorado [115]
“I really maist dinna ken what to do wi’ mysel the day,” said
William; “I can neither settle to work, nor yet sit still; ’od, by-the-by,
I’ll gang an’ ’oup my fishing rod, to be ready for the neist shower.”
Sae he taks it doun an’ begins working at it, and presently he sees
James rise and put on his bonnet.
“Whaur are ye gaun, James,” says he.
“I was thinking,” says James, “o’ gaun up to Wattie Simpson’s to
see if they want ony potatoes.”
“Just as if they didna get a bow o’ them last Tuesday!” said
William.
“Weel, I can stap in an’ speir how they like them.”
“Are ye sure, James, you’re gaun there?” asked William, a wee
slily.
“Where’er I’m gaun, William,” said James, “I’m gaun for nae
harm.”
“I’ve gane far eneugh wi’ Samson,” thought William; “sae I’ll say
nae mair.” An’ sae he keeps tying his fishing-rod; but no muckle
minding what he’s doing, the string plays snap in twa.
“Toots!” says William, a wee angered, “and me sae near dune!” Sae
he begins ower again, wi’ mair care; but he sune forgets himsel again,
an’ snap gangs the twine a second time.
“The deil tak the string and the whaun too!” cried he, “I’ll meddle
nae mair wi’t the day.” Sae he hangs it up, and then draws out his
watch and examines it again. “It’s really a grand siller watch, an’ a
grand siller chain too, an’ mony a ane will be asking to look at it;—
and I think Elie Allison wad like to see it;—and now that I mind o’t,
gif I didna promise to ca’ and tell her a’ the news, and me to forget it
a’ this time!”
Sae awa William fares to Elie’s, and there he sits crackin’ and
laughin’ at an unco rate, and never thinking o’ the time o’ day. And
Elie’s auntie, she says to him, “And now, William, are ye for takin’ a
potato wi’ us, or are ye gaun hame?”
An’ his face turned a wee red, for he thought she wantit him awa;
and he said he was gaun hame, to be sure.
“But dinna tak it amiss,” said the auntie, “for I thought ye wad be
ower late for hame.”
“Nae fear o’ that,” said William, “for we dinna dine till twa o’clock.”
“I kent that,” said she, “but it’s past it already.”
“The deuce it is!” cried William, jumping up; “then fareweel—I’ll
maybe see ye the morn.”
As he’s hurrying hame, he sees somebody coming frae the road to
the Hope, and walking unco fast.
“’Od,” thought he, “can that be Jeanie?—’deed is’t, an’ I’ll lay my
lugs she hasna been hame yet. But I maun get before her, and then
see if I dinna gie her’t, for what she said to me the day.”
Sae awa he sets wi’ a’ his might, an’ as he gets near the mill, aff wi’
his coat, an’ up wi’ a spade, an’ begins delving; an’ keeking ower his
shouther, he sees Jeanie turning the corner o’ the plantin’, but he
never lets on, nor looks round, till she’s just beside him, an’ speaks to
him.
“Hech!” says he, “I’m glad he’s ready at last;—’od, I really thought
we were to get nae dinner the day.”
“Is my father in the house?” says Jeanie.
“Is your father in the house!” repeated William, “’odsake, lassie,
hae ye no been hame yet?”
“I was taigled,” answered Jeanie, looking a wee foolish.
“An’ the kail will no be on yet,” cried he; “I was sure o’t now—quite
sure o’t!”
“An’ what for did ye no gang in and put them on yoursel, then, if ye
was sae sure o’t?”
“An’ sae I wad, if you hadna threepit, and better threepit, that ye
was gaun nae farer than the lane. But dinna put aff time here, for I’se
warrant my father’s in a bonny kippidge already.”
“I’m no fear’t for that,” says Jeanie but she wasna very easy for a’
that.
Sae when she comes in at the kitchen door, she sees the kail-pat
standin’ on the floor, and her father gien a bit pick to the robin.
“Did ever mortal ken the like o’ this?” cried she: “naething to be
dune, and my gude auld father sitting just as contentit there as if the
dinner was ready to be put on the table; but we’ll no be lang o’ makin’
something.” An’ she up wi’ the stoup, and aff wi’ the lid o’ the pat,
when the miller cries to her, “Tak care, Jeanie, an’ no spoil the kail!”
“Weel, I declare,” she exclaimed, “if that callant shouldna get his
paiks, for gauring me believe that the kail wasna ready: but it was
thoughtfu’ o’ him, after a’, to pit them on; and troth,” says she,
“they’re uncommon gude.”
“An’ what for no, Jeanie?” asked the miller. “Did ye think that your
father had forgotten how to mak a patfu’ o’ kail?”
“Did ye mak them, father?”
“Troth did I; wha else was there to do it?”
“But couldna ye hae cried in William, father? I’m sure it wad hae
been better for him to hae been in the house, than puttin’ himsel into
sic a terrible heat wi’ delving this warm day.”
“If William’s in a heat,” quoth the miller, “it’s no wi’ delving, for I
haena seen him near the house the hale day, an’ I was out twa or
three times.”
“Then I’ll lay onything I ken whaur he’s been,” said Jeanie; “and
him to hae the impudence to speak to me yon gate—but I’se gie
him’t;—an’ yet what right hae I to be angry wi’ him, me that’s
forgotten mysel sae muckle?”
“Dinna vex yoursel about that, my bairn,” quoth the miller; “what
has happened the day’s enough to put us a’ out o’ sorts; but we’ll a
come to oursels belyve. An’ now, Jeanie, gang ye out an’ look if ye can
see James coming hame, an’ then we’ll hae our dinner.”
Sae awa she gangs, and when William sees her coming, he
pretends to be unco busy working.
“William,” cries she, “ken ye whaur James is gane?”
“Me!” said William, “how should I ken whaur folk stravaig to? I
might rather hae askit you gif ye had fa’en in wi’ him, I think.”
“Aye, aye, my man, but ye’re speaking rather crouse. And whaur
hae ye been yoursel a’ day, I wonder? No delvin’, I’m sure, gif ane
may judge by the wee pickle yird that’s turned up.”
“An’ do ye think,” said William, “that after a’ my racing and
rinnin’, I should hae been delving a’ day, and lighter wark to do
about the farm?”
“An’ whaur was ye, then, that father couldna see you when he was
out?”
“Did my father cry on me?” asked William.
“No,” said Jeanie; “at least he didna say’t.”
“Then that’s it,—just it; for he cries sae loud, that it wad hae
wakened a man wi’ the hale haystack abune him, forbye lyin’ at the
side o’t.”
“An’ sae ye’ll hae me to believe,” says Jeanie, “that ye was sleepin’;
but I’m thinking ye was anither gate. I’se find it out yet.”
“Women’s tongues, women’s tongues!” said William, beating a
piece yird as if he wad mak pouther o’t; “they’re aye either fleechin’
or flytin’.”
“Did ye ever say that to Elie Allison? Ye’ve been there, I’ve a
notion. But we’ll say nae mair about it enow, for yonder’s James; sae
pit ye on your coat, and bring in your spade; or if ye’ll wait, James
will carry it for ye, for your arms maun be unco wearit!”
When William saw James coming alang, as grave-like as frae a
preaching, and thought on whaur he had been, he kent he wad laugh
in his face downright if he met him, and that might anger Samson;
sae he set aff by himsel an’ put by his spade. An’ when he saw him
fairly in the house, an’ had his laugh out alane, he composed himsel,
and walked into the kitchen as if naething had happened.
Chapter V.
Neist day the miller spoke to James anent his marriage, an’ tell’t
him, as they were no to move frae the mill, it needna be putten aff
ony langer; sae it was settled to be in a fortnight, an’ that created an
unco bustle in the house. An’ Jeanie was every now and then speakin’
o’ how they were a’ to manage, but the miller ne’er seemed to mind
her.
So ae day, when they’re in the kitchen by themsels, she begins on’t
again: “An’ James an’ his wife will hae to get the room that he an’
William are in; an’ then William he maun either get mine, or sleep
outby, for there’ll be nae puttin’ him in yon cauld, damp bed, unless
we want him to gang like a cripple; sae I dinna ken what’s to be
dune.”
“Ye forget, Jeanie,” said the miller, “that John Murdoch sleepit
there, an’ he didna seem to be the waur o’t.”
“Aye, for ae night, nae doubt, and in fine weather; but how lang
will that last?”
The miller gies her nae answer; but after sittin’ thinking a wee, he
rises and taks down his bonnet.
“It’s a fine day for being out,” says Jeanie; “but are ye gaun far,
father?”
“Nae farer than the Hope,” said the miller.
“The Hope!” exclaimed Jeanie, as her face reddened.
“Ay,” says the miller; “and I’m thinking o’ speirin’ if there’s room
there for ane o’ ye.”
“Now God bless my gude auld father,” said Jeanie; “he sees brawly
what I wanted, and wadna even look me in the face to confuse me.”
“Geordie Wilson,” cries the miller, “when will it suit you to marry
my dochter?”
“The day—the morn—ony day,” answers Geordie, as happy’s a
prince.
“Because I was thinking,” says the miller, “that it might be as weel
to pit James’s waddin’ and yours ower thegither.”
“Wi’ a’ my heart,” says Geordie, “wi’ a’ my heart!”
“Weel, then,” quoth the miller, “I’ll awa hame and see what our
Jeanie says to’t.”
“And I’ll gang wi’ you,” cries Geordie.
“Come your wa’s then, my man,” says the miller.
And sae as they’re gaun down the road thegither, they meets
William, an’ Geordie tells him how matters stood. An’ when William
hears o’t, he shakes Geordie by the hand, an’ awa he flees ower ditch
and dyke, an’ is hame in nae time. An’ after resting himsel a minute,
an’ to tak breath, in he gangs to the kitchen; an’ when Jeanie sees
him, she says, “Ye’re warm-like, William,—ye’ve surely been
running?”
“Is onything wrang wi’ my father?” asked he.
“Gude forbid!” said Jeanie; “but what maks ye speir?”
“Ou, naething ava, amaist; but only I met him walking unco grave-
like, an’ he scarcely spak to me; an’ I met wi’ Geordie Wilson too, and
he didna say muckle either.”
“Preserve us a’!” cries Jeanie; “if onything has happened atween
the twa!”
“What could put that nonsense in your head, lassie?” said William.
“By-the-by,” continues he, after a pause, “Geordie’s at the end o’ the
lane, an’ wishing muckle to speak to ye.”
“An’ what for did ye no tell me that at first, ye haverel?” cried
Jeanie; and out she flees. An’ just as she’s turning the corner, she
runs against her father wi’ a great drive.
“The lassie’s in a creel, I think!” quoth the miller; “but it’s the same
wi’ them a’.”
“Jeanie! my ain Jeanie!” whispers Geordie, “an’ it’s a’ settled for
neist week, and we’ll be sae happy!”
Jeanie held him at arm’s length frae her, that she might look him
in the face.
“I see it’s true! I see it’s true!” she said, “an’ ye’re no joking me! An’
that wicked callant, to gang and gie me sic a fright! Hech! I haena
gotten the better o’t yet!”
“An’ now, Jeanie, that I hae seen ye,” says Geordie, “I maun rin
awa hame and tell my gude auld mither that it’s a’ fixed; for she
wasna in when your father cam to the Hope; and then I maun awa to
the toun for things. An’ what’ll I bring ye, Jeanie? what’ll I bring?”
“Ou, just onything ye like,” said she; “bring back yoursel, that’s a’
Jeanie cares about.”
An’ she stands an’ looks after him till he’s out o’ sight; an’ as she
turns about, “Jeanie! my ain Jeanie!” says James, takin’ her in his
arms.
“My ain gude and aye kind brither!” said Jeanie, resting her head
on his shouther.
“She’ll no speak to me, nae doubt,” says William, his voice shakin’
a wee.
“Ah, ye wicked callant!” says Jeanie, kissing his cheek. “But ye
mauna plague me nae mair; na, ye’ll no daur do’t!”
“No!” cries William, “I’m sure I’m fit for a’ that Geordie Wilson can
do ony day, an’ maybe mair.”
Jeanie was gaun to answer, but she got her ee on the miller
standing at the door.
“I maun hae his blessing first,” she cries, “and then Jeanie’s heart
will be at peace.”
When the miller saw her coming, he gaes slowly back to his ain
room, an’ in she comes after him, and, “Bless me, bless your bairn,
my gude auld father!—you that’s been father an’ mither, an’ a’ to her
since before she could guide hersel! Bless your Jeanie, an’ she’ll hae
naething mair to wish for!”
“How like she’s to her mither!” said the miller in a low voice; “but
ye’ll no mind her sae weel, Jeanie. I mind weel, that on the night
before she dee’t, an’ when I was like ane distrackit, ‘It’s the will o’
Providence, John,’ says she, ‘and we maun a’ bow till’t; but dinna ye
grieve sae sair for my loss, John; for young as she is yet, my heart
tells me that I’m leaving ane ahint me, wha’ll be a blessing an’ a
comfort to ye when I’m awa;’ and ne’er were truer words spoken,”
continued the miller, “for ne’er frae that day to this was her father’s
heart wae for Jeanie; sae bless you, my bairn, an’ may a’ that’s gude
attend ye, an’ may ye be spared to be a comfort and an example to a’
around ye, lang, lang after your auld father’s head’s laid low.” An’ as
he raised her frae her knees he kissed her, an’ then turned slowly frae
her, an’ Jeanie slippit saftly awa.
On the neist Friday the twa marriages took place, an’ a’ the folk sat
down to a gude an’ a plentifu’ dinner, an’ there was an unco deal o’
fun an’ laughing gaed on. An’ when dinner was ower and thanks
returned, the miller cried for a’ to fill a fu’, fu’ bumper. “An’ now,”
says he, “we’ll dring King James’s health, an’ lang may he and his
rule ower us.”
This led them to speak o’ his coming there as John Murdoch; and
some o’ them that hadna heard the hale story, askit the miller to
tell’t.
“Wi’ a’ my heart,” quoth the miller; “but first open that cage-door,
Jeanie, for it’s no fitting that it, wha had sae muckle share in’t,
should be a prisoner at sic a time.”
An’ the robin cam fleein’ out to the miller’s whistle, an’ lightit on
the table beside him.
When the miller was dune wi’ the story, “An’ now, frien’s,” said he,
“ye may learn this frae it, that it’s aye best to do as muckle gude and
as little ill as we can. But there’s a time for a’thing,” continued he;
“sae here, Jeanie, my dawtie, put ye by the robin again; and now,
lads, round wi’ the whisky.”
They a’ sat crackin’ an’ laughin’ thegither, till it was time for
Geordie an’ his wife to be settin’ aff for the Hope, and the rest o’ the
folk gaed wi’ them, an’ a’ was quiet at the mill again.
In twa year after that, William was married to Elie Allison. And
when he was three score and ten, the miller yielded up his spirit to
Him that gied it; an’ when King James heard that he was dead, he
said publicly, that he had lost a gude subject and an honest man, and
that he wished there was mair folk in the kintra like John Marshall.
And James succeeded to his father; an’ after James cam James’s
sons, and their sons after them for never sae lang; and, for aught I
ken to the contrair, there’s a Marshall in the Mill o’ Doune at this
day.—“The Odd Volume.”
THE HEADLESS CUMINS.
The Lady Isabel was a Scottish baron’s daughter, and far was she
famed. Were others fair, she was fairer; were others rich, she was
richer. In short, all perfections were said to be centred in the Lady
Isabel, and yet that quality for which she ought to have been most
prized, seemed the one which made the least noise in the world,—
this was her devoted duty to her father. She was his only child—the
child of his old age, the idol of his heart, and the lamp of his life. But
still was he a cruel father; for in return for her duteous affection, he
had determined to wed her to a man she had never seen, while he
knew that her heart was another’s.
The Lord of Ormisdale was the son of his ancient friend, and the
possessor of broad lands in a distant part of Scotland. The two old
men had sworn to each other that their children should be united,
but ere this paction, the youth had been sent abroad to be initiated in
the art of war—an art but too much practised in his native country at
that time; for be it known that our peerless beauty bloomed in the
15th century, when the feuds of the Scottish nobility were frequent
and deadly. Much was bruited abroad of the goodly person and brave
qualities of the young earl, but of this Lady Isabel had no opportunity
of judging, for never, as has been told, had she seen him. She had,
however, but too often seen his cousin Roderick, and to him was her
heart devoted. It was true he had neither title, nor lands, nor vassals;
but he was a handsome, a noble, and a gallant youth, and he had
knelt at her feet, confessed his love, and swore eternal constancy;
and though, when she thought of her father, she turned coldly away,
it was but to treasure his image in her heart, and to weep most bitter
tears for the hapless fate which doomed her to wed another.
Roderick, by-and-by, went away to a foreign land, distraught by his
passion for the Lady Isabel; and the time was long, and he returned
not, and none spoke of him, or seemed to think of him, save his
disconsolate love. But it was not so; for the old Baron loved him for
his worth and manly bearing; and when he saw his daughter
drooping her head like a lily, he too was unhappy, and repented him
of his rash vow, though he would rather have sacrificed his own life,
and hers too, than have broken his oath. And so time passed on, and
many were the suitors that sought the hand of the Lady Isabel. Some
loved her for herself, some for her great possessions, and some for
both; but all were sent hopeless away.
And now the time was at hand when the sun was to shine upon the
nineteenth birthday of the baron’s daughter, and multitudes were
invited to his castle to celebrate the festival with mirth and revelry.
Many were the reasons on which he had thrown wide his castle gates
and welcomed numerous guests, and ample the hospitable provision
he had made for them; but never, during his life, or that of his
forefathers, had there been such doings as now. Whole hecatombs of
sheep and oxen bled on the occasion, with wain-loads of deer, wild
and tame fowl, and other creatures. Every country seemed to have
been taxed for fruit and other delicacies, while beer of the strongest,
and wines of the richest, seemed, by the quantities provided, to be
intended absolutely to flow in rivers. The birthday of the Lady Isabel
had been celebrated, as it came round, ever since that on which she
first drew her breath, but never had there been even imagined such
preparations as this. The tongues of all the gossiping old dowagers in
the kingdom were set a-going on the occasion: some assigned one
reason for this extraordinary entertainment, and some another.
There were several whose eager curiosity caused them so much
uneasiness, that they went so far as to ask an explanation of the old
baron himself. They were all, however, foiled in the attempt to
penetrate the mystery, and therefore settled in their own minds that
the old man had either lost his wits altogether, or was in his dotage.
Nor, to speak the truth, did the young lady, on whose account was
all this turmoil, feel less surprised than other people at her father’s
unbounded extravagance, especially as there arrived from the capital
chest after chest, packed with the richest vestments, cut in the
approved fashion of the day, and boxes filled with jewellery, which,
added to the family gems she already possessed, might have
furnished the dowry of a princess.
The day at length arrived for which all this extraordinary
preparation had been made; and the baron, not content with
charging his daughter to apparel herself in a suit which, by its
exceeding splendour, seemed to have been particularly intended for
the occasion, and to wear her most costly jewels, also commanded
her maidens to tax their wits in ornamenting and setting off, to the
best advantage, the charms of their young mistress.
And now, after having arranged all things, and being promised
implicit obedience by his daughter, the mystery of all his magnificent
proceedings was partly unravelled by his telling her that they were
that night to expect the arrival of the Earl of Ormisdale. He moreover
presented her with a mask, and informed her that he had taken order
that each of his guests should put on a visor before they enter the
ball-room, after they left the banqueting-hall, and that he had done
this for her sake, that the eye of idle curiosity should not read in her
features what was passing in her mind when she first met her
betrothed. It was in vain that the afflicted Lady Isabel pled most
movingly for a more private meeting, for her father was deaf to her
entreaties, while he affirmed that his precaution of the visor would
do away all objections, and was so peremptory in the matter, that, as
usual, she acquiesced; and having thanked and kissed his dutiful
daughter, he withdrew from her with renewed youth in his step, and
joy in his eye. How different, however, were the feelings of his
daughter on this momentous subject! and sore averse was she to
meet the man she was sure that she could never love; and many were
the tears shed, and many the resolves she made to retract all her
promises, and live and die in solitude. But then she bethought her of
the despair of her poor old father—of his tender, though mistaken
love—of the few remaining years of his life embittered by
disappointment—and his death probably hurried on through her
means. All this was too much when laid in the balance with only her
own happiness, and she still sustained the character of a dutiful
daughter, by heroically determining to sacrifice all selfishness at the
altar of filial duty and affection.
But though this was her ultimate resolve, we need not be surprised
that, when decked in her splendid attire, and presiding in the