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Biomaterials Principles and Practices 1st Edition Joyce Y.
Wong Digital Instant Download
Author(s): Joyce Y. Wong, Joseph D. Bronzino, Donald R. Peterson, (eds.)
ISBN(s): 9781439872512, 1439872511
Edition: 1
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Year: 2012
Language: english

Edited by
Joyce Y. Wong
Joseph D. Bronzino
Donald R. Peterson
BIOMATERIALS
PRINCIPLES AND PRACTICES

BIOMATERIALS
PRIncIPLES And PRAcTIcES

Edited by
Joyce Y. Wong
Joseph d. Bronzino
donald R. Peterson
BIOMATERIALS
PRIncIPLES And PRAcTIcES

CRC Press
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v
Contents
Introduction...................................................................................................................................vii
Editors............................................................................................................................................. xv
Contributors................................................................................................................................xvii
1 Metallic Biomaterials....................................................................................................1-1
Joon B. Park and Young Kon Kim
2 Ceramic Biomaterials................................................................................................... 2-1
W.G. Billotte
3 Polymeric Biomaterials................................................................................................ 3-1
Hai Bang Lee, Gilson Khang, and Jin Ho Lee
4 Composite Biomaterials............................................................................................... 4-1
Roderic S. Lakes
5 Biodegradable Polymeric Biomaterials: An Updated Overview....................... 5-1
C.C. Chu
6 Biologic Biomaterials: Tissue-Derived Biomaterials (Collagen)...................... 6-1
Shu-Tung Li
7 Biologic Biomaterials: Silk...........................................................................................7-1
Biman Mandal and David L. Kaplan
8 Biofunctional Hydrogels............................................................................................. 8-1
Melissa K. McHale and Jennifer L. West
9 Soft Tissue Replacements............................................................................................ 9-1
K.B. Chandran, K.J.L. Burg, and S.W. Shalaby
10 Hard Tissue Replacements........................................................................................ 10-1
Sang-Hyun Park, Adolfo Llinás, and Vijay K. Goel

vii
Introduction
I.1â•‡ A Brief Note Regarding This Edition
This book has updated chapters from a previous edition and some new chapters added. The content
remains the same, and the following introduction is taken from the previous edition, with minor
changes describing the content of this book. In addition, a number of relevant biomaterials journals
have been added to the list.
Biomaterials are employed to manufacture devices to replace a part or a function of the body in a safe,
reliable, economic, and physiologically acceptable manner (Hench and Erthridge, 1982). A variety of
devices and materials are used in the treatment of disease or injury. Common examples include sutures,
needles, catheters, plates, tooth fillings, and so on. Biomaterials are synthetic materials used to replace part
of a living system or to function in intimate contact with living tissue. The Clemson University Advisory
Board for Biomaterials has formally defined a biomaterial to be “a systemically and pharmacologically
inert substance designed for implantation within or incorporation with living systems.” Black (1992)
defined biomaterials as “nonviable materials used in a medical device, intended to interact with biological
systems.” Others include “materials of synthetic as well as of natural origin in contact with tissue, blood,
and biological fluids, and intended for use for prosthetic, diagnostic, therapeutic, and storage applications
without adversely affecting the living organism and its components” (Bruck, 1980). Another definition
of biomaterials is stated as “any substance (other than drugs) or combination of substances, synthetic
or natural in origin, which can be used for any period of time, as a whole or as a part of a system which
treats, augments, or replaces any tissue, organ, or function of the body” (Williams, 1987) and adds to the
many ways of looking at the same but expressing it in different ways. In contrast, a biological material is
a material, such as skin or artery, produced by a biological system. Artificial materials that simply are in
contact with the skin, such as hearing aids and wearable artificial limbs, are not included in our definition
of biomaterials since the skin acts as a barrier to the external world.
According to these definitions, one must have a vast knowledge or collaborate with different special-
ties in order to develop and use biomaterials in medicine and dentistry as Table I.1 indicates. The uses of
biomaterials, as indicated in Table I.2, include replacement of a body part which has lost its function due
to disease or trauma, to assist in healing, to improve function, and to correct abnormalities. The role of
biomaterials has been influenced considerably by advances in many areas of biotechnology and science.
For example, with the advent of antibiotics, infectious disease is less of a threat than in earlier days so
that degenerative disease assumes a greater importance. Moreover, advances in surgical techniques and
instruments have permitted materials to be used in ways which were not possible previously. This book
is intended to breed familiarity in the reader with the uses of materials in medicine and dentistry and
with some rational basis for these applications.

viii Introduction
The performance of materials in the body can be classified in many ways. First, biomaterials may
be considered from the point of view of the problem area which is to be solved, as shown in Table I.2.
Second, we may consider the body on a tissue level, an organ level (Table I.3), or a system level (Table I.4).
Third, we may consider the classification of materials as polymers, metals, ceramics, and composites,
as shown in Table I.5. In this, the role of such materials as biomaterials is governed by the interaction
between the material and the body, specifically, the effect of the body environment on the material and
the effect of the material on body (Williams and Roaf, 1973; Bruck, 1980; Hench and Erthridge, 1982;
von Recum, 1986; Black, 1992; Park and Lakes, 1992; Greco, 1994).
It should be evident from these perspectives that most current applications of biomaterials involve
structural functions, even in those organs and systems which are not primarily structural in their
nature, or very simple chemical or electrical functions. Complex chemical functions such as those of the
liver and complex electrical or electrochemical functions such as those of the brain and sense organs
cannot be carried out by biomaterials at this time.
TABLE I.2â•… Uses of Biomaterials
Problem Area Examples
Replacement of diseased or damaged part Artificial hip joint, kidney dialysis machine
Assist in healing Sutures, bone plates, and screws
Improve function Cardiac pacemaker, intraocular lens
Correct functional abnormality Cardiac pacemaker
Correct cosmetic problem Augmentation mammoplasty, chin augmentation
Aid to diagnosis Probes and catheters
Aid to treatment Catheters, drains
TABLE I.3â•… Biomaterials in Organs
Organ Examples
Heart Cardiac pacemaker, artificial heart valve, total artificial heart
Lung Oxygenator machine
Eye Contact lens, intraocular lens
Ear Artificial stapes, cochlea implant
Bone Bone plate, intramedullary rod
Kidney Kidney dialysis machine
Bladder Catheter and stent
TABLE I.1â•… Fields of Knowledge to Develop Biomaterials
Discipline Examples
Science and engineering Materials sciences: structure–property relationship of synthetic and
biological materials including metals, ceramics, polymers,
composites, tissues (blood and connective tissues), etc.
Biology and physiology Cell and molecular biology, anatomy, animal and human physiology,
histopathology, experimental surgery, immunology, etc.
Clinical sciences All the clinical specialties: dentistry, maxillofacial, neurosurgery,
obstetrics and gynecology, ophthalmology, orthopedics,
otolaryngology, plastic and reconstructive surgery, thoracic and
cardiovascular surgery, veterinary medicine, surgery, etc.
Source: Modified from von Recum, A.F. 1994. Annual Biomaterials Society Meeting. Boston,
MA: Biomaterials Society.

ix
Introduction
I.2â•‡ Historical Background
The use of biomaterials did not become practical until the advent of an aseptic surgical technique
developed by Dr. J. Lister in the 1860s. Earlier, surgical procedures, whether they involved biomaterials
or not, were generally unsuccessful as a result of infection. Problems of infection tend to be exacerbated
in the presence of biomaterials, since the implant can provide a region inaccessible to immunologically
competent cells of the body. The earliest successful implants, as well as a large fraction of modern ones,
were in the skeletal system. Bone plates were introduced in the early 1900s to aid in the fixation of long-
bone fractures. Many of these early plates broke as a result of unsophisticated mechanical design; they
were too thin and had stress-concentrating corners. Also, materials such as vanadium steel that was
chosen for its good mechanical properties corroded rapidly in the body and caused adverse effects on
the healing processes. Better designs and materials soon followed. Following the introduction of stain-
less steels and cobalt chromium alloys in the 1930s, greater success was achieved in fracture fixation,
and the first joint-replacement surgeries were performed. As for polymers, it was found that warplane
pilots in World War II who were injured by fragments of plastic polymethyl methacrylate (PMMA) air-
craft canopies did not suffer adverse chronic reactions from the presence of the fragments in the body.
PMMA became widely used after that time for corneal replacement and for replacements of sections of
damaged skull bones. Following further advances in materials and in surgical technique, blood vessel
replacements were tried in the 1950s and heart valve replacements and cemented joint replacements
in the 1960s. Table I.6 lists notable developments relating to implants. Recent years have seen many
further advances.
TABLE I.4â•… Biomaterials in Body Systems
System Examples
Skeletal Bone plate, total joint replacements
Muscular Sutures, muscle stimulator
Circulatory Artificial heart valves, blood vessels
Respiratory Oxygenator machine
Integumentary Sutures, burn dressings, artificial skin
Urinary Catheters, stent, kidney dialysis machine
Nervous Hydrocephalus drain, cardiac pacemaker, nerve stimulator
Endocrine Microencapsulated pancreatic islet cells
Reproductive Augmentation mammoplasty, other cosmetic replacements
TABLE I.5â•… Materials for Use in the Body
Materials Advantages Disadvantages Examples
Polymers (nylon, silicone
rubber, polyester,
polytetrafluoroethylene, etc.)
Resilient
Easy to fabricate
Not strong
Deforms with time
May degrade
Sutures, blood vessels, hip socket,
ear, nose, other soft tissues, sutures
Metals (Ti and its alloys, Co–Cr alloys,
stainless steels, Au, Ag, Pt, etc.)
Strong, tough,
ductile
May corrode
Dense
Difficult to make
Joint replacements, bone plates and
screws, dental root implants, pacer
and suture wires
Ceramics (aluminum oxide, calcium
phosphates including
hydroxyapatite, carbon)
Very biocompatible,
inert, strong in
compression
Brittle
Not resilient
Difficult to make
Dental, femoral head of hip
replacement, coating of dental
and orthopedic implants
Composites (carbon–carbon, wire, or
fiber-reinforced bone cement)
Strong, tailor-made Difficult to make Joint implants, heart valves

x Introduction
I.3â•‡ Performance of Biomaterials
The success of biomaterials in the body depends on factors such as the material properties, design, and
biocompatibility of the material used, as well as other factors not under the control of the engineer,
including the technique used by the surgeon, the health and condition of the patient, and the activities
of the patient. If we assign a numerical value f to the probability of failure of an implant, then the reli-
ability can be expressed as
r f.
= −
1
(I.1)
If, as is usually the case, there are multiple modes of failure, then the total reliability rt â•›is given by the
product of the individual reliabilities r1â•–=â•–(1â•›–â•›f1), and so on:
r r r rn
t = ⋅ ⋅ ⋅ ⋅
1 2 .
(I.2)
Consequently, even if one failure mode such as implant fracture is perfectly controlled so that the
corresponding reliability is unity, other failure modes such as infection could severely limit the utility
TABLE I.6â•… Notable Developments Relating to Implants
Year Investigators Development
Late eighteenth to
nineteenth century
Various metal devices to fix bone fractures; wires and pins from
Fe, Au, Ag, and Pt
1860–1870 J. Lister Aseptic surgical techniques
1886 H. Hansmann Ni-plated steel bone fracture plates
1893–1912 W.A. Lane Steel screws and plates (Lane fracture plate)
1912 W.D. Sherman Vanadium steel plates, first developed for medical use; lesser
stress concentration and corrosion (Sherman plate)
1924 A.A. Zierold Introduced Stellites® (CoCrMo alloy)
1926 M.Z. Lange Introduced 18-8sMo stainless steel, better than 18-8 stainless steel
1926 E.W. Hey-Groves Used Carpenter’s screw for femoral neck fracture
1931 M.N. Smith-Petersen First femoral neck fracture fixation device made of stainless steel
1936 C.S. Venable, W.G. Stuck Introduced Vitallium® (19-9 stainless steel), later changed the
material to CoCr alloys
1938 P. Wiles First total hip replacement prosthesis
1939 J.C. Burch, H.M Carney Introduced tantalum (Ta)
1946 J. Judet and R. Judet First biomechanically designed femoral head replacement
prosthesis; first plastics (PMMA) used in joint replacements
1940s M.J. Dorzee,
A. Franceschetti
First used acrylics (PMMA) for corneal replacement
1947 J. Cotton Introduced Ti and its alloys
1952 A.B. Voorhees,
A. Jaretzta, A.B. Blackmore
First successful blood vessel replacement made of cloth for tissue
ingrowth
1958 S. Furman, G. Robinson First successful direct heart stimulation
1958 J. Charnley First use of acrylic bone cement in total hip replacement on the
advice of Dr. D. Smith
1960 A. Starr, M.L. Edwards First commercial heart valves
1970s W.J. Kolff Total heart replacement
Source: Adapted from Park, J.B. 1984. Biomaterials Science and Engineering. New York: Plenum Press.

xi
Introduction
represented by the total reliability of the implant. One mode of failure which can occur in a biomate-
rial, but not in engineering materials used in other contexts, is an attack by the immune system of the
body on the implant. Another such failure mode is an unwanted effect of the implant on the body;
for example, toxicity, inducing allergic reactions, or causing cancer. Consequently, biocompatibility is
included as a material requirement in addition to those requirements associated directly with the func-
tion of the implant.
Biocompatibility involves the acceptance of an artificial implant by the surrounding tissues and by
the body as a whole. Biocompatible materials do not irritate the surrounding structures, do not provoke
an abnormal inflammatory response, do not incite allergic or immunologic reactions, and do not cause
cancer. Other compatibility characteristics that may be important in the function of an implant device
made of biomaterials include (1) adequate mechanical properties such as strength, stiffness, and fatigue
properties; (2) appropriate optical properties if the material is to be used in the eye, skin, or tooth; and
(3) appropriate density. Sterilizability, manufacturability, long-term storage, and appropriate engineer-
ing design are also to be considered.
The failure modes may differ in importance as time passes following the implant surgery. For exam-
ple, consider the case of a total joint replacement in which infection is most likely soon after surgery,
while loosening and implant fracture become progressively more important as time goes on. Failure
modes also depend on the type of implant and its location and function in the body. For example, an
artificial blood vessel is more likely to cause problems by inducing a clot or becoming clogged with
thrombus than by breaking or tearing mechanically.
With these basic concepts in mind, the chapters in this book focus on biomaterials consisting of dif-
ferent materials such as metallic, ceramic, polymeric, and composite.
Defining Terms
Biocompatibility: Acceptance of an artificial implant by the surrounding tissues and by the body as a
whole.
Biological material: A material produced by a biological system.
Biomaterial: A synthetic material used to make devices to replace part of a living system or to function
in intimate contact with living tissue.
References
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xii Introduction
Further Information
(Most important publications relating to the biomaterials area are given for further reference.)
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xiii
Introduction
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Williams, D.F., Ed. 1981. Fundamental Aspects of Biocompatibility, vols I and II, CRC Press, Boca Raton, FL.
Williams, D.F., Ed. 1981. Systemic Aspects of Blood Compatibility, CRC Press, Boca Raton, FL.
Williams, D.F., Ed. 1982. Biocompatibility in Clinical Practice, vols I and II, CRC Press, Boca Raton, FL.
Williams, D.F. and Roaf, R. 1973. Implants in Surgery, W.B. Saunders, London.
Wright, V., Ed. 1969. Lubrication and Wear in Joints, J.B. Lippincott, Philadelphia, PA.
Yamamuro, T., Hench, L.L., and Wilson J., Eds. 1990. CRC Handbook of Bioactive Ceramics, vols I and II,
CRC Press, Boca Raton, FL.
Journals of Interest
Acta Biomaterialia
Acta Orthopaedica Scandanavica
American Association of Artificial Internal Organs: Transactions
Annals of Biomedical Engineering
Bioconjugate Chemistry
Biomacromolecules
Biomaterials

xiv Introduction
Biomedical Materials and Engineering
Clinical Orthopaedics and Related Research
CRC Critical Review in Bioengineering
International Orthopaedics
Journal of Applied Biomaterials
Journal of Arthroplasty
Journal of Biomaterials Science, Polymer Edition
Journal of Biomechanics
Journal of Biomedical Engineering
Journal of Biomedical Materials Research
Journal of Bone and Joint Surgery
Journal of Controlled Release
Journal of Medical Engineering and Technology
Journal of Orthopaedic Research
Langmuir
Medical Engineering and Physics
Tissue Engineering
Transactions of the American Society of Artificial Internal Organs (annually held in spring): Extended
Abstracts Society for Biomaterials: http://www.biomaterials.org/index.html.
Transactions of the Orthopaedic Research Society Meeting (annually held during February): Abstracts
Transactions of the Society for Biomaterials (annually held during April and May): Abstracts

xv
Editors
Joyce Y. Wong received a BS from the Massachusetts Institute of Technology (MIT), Cambridge,
Massachusetts, in 1988 and a PhD from MIT in 1994. She is presently an associate professor of bio-
medical engineering and a College of Engineering Distinguished Faculty Fellow at Boston University
(BU) in Boston, Massachusetts. At BU she currently is a co-director of an Affinity Research
Collaborative in Nanotheranostics and is a faculty of the Division of Graduate Medical Sciences and
of the Biomolecular Pharmacology Program in the BU School of Medicine. She is also a member of
BU’s Whitaker Cardiovascular Institute, Center for Regenerative Medicine, and Center for Nanoscience
and Nanobiotechnology. She currently serves on the board of directors of the Biomedical Engineering
Society.
Dr. Wong is the author of over 60 publications, and her research focuses on the development of
biomaterials to probe how structure, material properties, and composition of the cell–biomaterial
interface affect fundamental cellular processes. Her current research interests include pediatric vas-
cular tissue engineering and intravascular pharmacology, development of targeted nano- and micro-
particle contrast agents for combined therapeutics and diagnostics (theranostics) of atherosclerotic
and vulnerable plaque, and engineering biomimetic systems to study restenosis and cancer metas-
tasis. Her research has been funded by NIH (National Institutes of Health), NSF (National Science
Foundation), NASA (National Aeronautics and Space Administration), DOE (Department of Energy),
and industry. The awards she has received include a NSF CAREER Award, Clare Boothe Luce Assistant
Professorship, Dupont Young Professor Award, and Hartwell Individual Biomedical Research Award.
Dr. Wong is a fellow of the American Institute of Medical and Biological Engineering (AIMBE). She
also chaired the Gordon Research Conference on Biomaterials and Tissue Engineering in 2011. She was
also selected for participation in the National Academy of Science Frontiers in Engineering, National
Academies Keck Futures Initiative Conference, German–American Frontiers in Polymer Science,
and Japan–America Frontiers in Engineering. She serves on the editorial advisory boards of Polymer
Reviews, Biointerphases, Cellular and Molecular Bioengineering, and Biomatter.
Joseph D. Bronzino earned a BSEE degree from Worcester Polytechnic Institute, Worcester,
Massachusetts, in 1959, a MSEE degree from the Naval Postgraduate School, Monterey, California, in
1961, and a PhD in electrical engineering from Worcester Polytechnic Institute in 1968. He is pres-
ently the Vernon Roosa Professor of Applied Science, an endowed chair at Trinity College, Hartford,
Connecticut, and president of the Biomedical Engineering Alliance and Consortium (BEACON), which
is a nonprofit organization consisting of academic and medical institutions as well as corporations ded-
icated to the development of new medical technology. To accomplish this goal, BEACON facilitates
Â�
collaborative research, industrial partnering, and the development of emerging companies.
Dr. Bronzino is the author of over 200 journal articles and 15 books, including Technology for Patient
Care (C.V. Mosby, 1977), Computer Applications for Patient Care (Addison-Wesley, 1982), Biomedical
Engineering: Basic Concepts and Instrumentation (PWS Publishing Co., 1986), Expert Systems: Basic

xvi Editors
Concepts (Research Foundation of State University of New York, 1989), Medical Technology and Society:
An Interdisciplinary Perspective (MIT Press and McGraw-Hill, 1990), Management of Medical Technology
(Butterworth/Heinemann, 1992), The Biomedical Engineering Handbook (CRC Press, 1st Edition,
1995; 2nd Edition, 2000; 3rd Edition, 2006), Introduction to Biomedical Engineering (Academic Press,
1st Edition, 1999; 2nd Edition, 2006), Biomechanics: Principles and Applications (CRC Press, 2002),
Biomaterials: Principles and Applications (CRC Press, 2002), Tissue Engineering (CRC Press, 2002), and
Biomedical Imaging (CRC Press, 2002).
Dr. Bronzino is a fellow of IEEE and the American Institute of Medical and Biological Engineering
(AIMBE), an honorary member of the Italian Society of Experimental Biology, past chairman of the
Biomedical Engineering Division of the American Society for Engineering Education (ASEE), a charter
member of the Connecticut Academy of Science and Engineering (CASE), a charter member of the
American College of Clinical Engineering (ACCE), a member of the Association for the Advancement
of Medical Instrumentation (AAMI), past president of the IEEE-Engineering in Medicine and Biology
Society (EMBS), past chairman of the IEEE Health Care Engineering Policy Committee (HCEPC), and
past chairman of the IEEE Technical Policy Council in Washington, DC. He is a member of Eta Kappa
Nu, Sigma Xi, and Tau Beta Pi. He is also a recipient of the IEEE Millennium Medal for “his con-
tributions to biomedical engineering research and education” and the Goddard Award from WPI for
Outstanding Professional Achievement in 2005. He is presently editor-in-chief of the Academic Press/
Elsevier BME Book Series.
Donald R. Peterson earned his PhD in biomedical engineering and his MS in mechanical engineering
at the University of Connecticut. Dr. Peterson has been an active member of the Biomedical Engineering
(BME) faculty since 1999, offering courses in biomechanics, biodynamics, biofluid mechanics, and ergo-
nomics, and during the past year he has served as BME Graduate Program Committee chair. He is an
assistant professor in the School of Medicine, where he is the director of the Biodynamics Laboratory
and the Bioengineering Center at the University of Connecticut Health Center. His research involves
the modeling of human interactions with existing and developmental devices such as powered and
nonpowered tools, dental instruments, computer input devices, musical instruments, sports equipment,
and spacesuit and space tool development for NASA. Dr. Peterson has written more than 45 scholarly
publications appearing in journals and textbooks.

xvii
Contributors
W.G. Billotte
Department of Biology
University of Dayton
Dayton, Ohio
K.J.L. Burg
Department of Bioengineering
Clemson University
Clemson, South Carolina
K.B. Chandran
Department of Biomedical Engineering
University of Iowa
Iowa City, Iowa
C.C. Chu
Department of Fiber Science and Apparel Design
Cornell University
Ithaca, New York
Vijay K. Goel
University of Toledo
Toledo, Ohio
David L. Kaplan
Tufts University
Medford, Massachusetts
Gilson Khang
Department of BIN Fusion Technology
Chonbuk National University
Duckjin, Korea
Young Kon Kim
Inje University
Gimhae, Korea
Roderic S. Lakes
Departments of Engineering Physics, Materials
Science, and Biomedical Engineering
University of Wisconsin, Madison
Madison, Wisconsin
Hai Bang Lee
Biomaterials Laboratory
Korea Research Institute of Chemical Technology
Daejeon, South Korea
Jin Ho Lee
Department of Advanced Materials
Hannam University
Daejeon, South Korea
Shu-Tung Li
Collagen Matrix, Inc.
Oakland, New Jersey
Adolfo Llinás
Department of Orthopaedics and Traumatology
Fundacion Santafé de Bogota University
Hospital
Fundacion Cosme and Damián
and
Universidad de los Andes
Bogota, Colombia
Biman Mandal
Tufts University
Medford, Massachusetts
Melissa K. McHale
Rice University
Houston, Texas

xviii Contributors
Joon B. Park
University of Iowa
Iowa City, Iowa
Sang-Hyun Park
Tissue Healing Laboratory
Orthopedic Hospital
and
Department of Orthopaedics
University of California, Los Angeles
Los Angeles, California
S.W. Shalaby (deceased)
Poly-Med, Inc.
Anderson, South Carolina
Jennifer L. West
Rice University
Houston, Texas

1-1
1.1â•‡Introduction
Metals are used as biomaterials because of their excellent electrical and thermal conductivity and
mechanical properties. Since some electrons are independent in metals, they can quickly transfer an
electric charge and thermal energy. The mobile free electrons act as the binding force to hold the positive
metal ions together. This attraction is strong, as evidenced by the closely packed atomic arrangement
resulting in high specific gravity and high melting points of most metals. Since the metallic bond is
essentially nondirectional, the position of the metal ions can be altered without destroying the crystal
structure resulting in a plastically deformable solid.
Some metals are used as passive substitutes for hard tissue replacement such as total hip and knee
joints, for fracture healing aids as bone plates and screws, spinal fixation devices, and dental implants
because of their excellent mechanical properties and corrosion resistance. Some metallic alloys are used
for more active roles in devices such as vascular stents, catheter guide wires, orthodontic archwires, and
cochlea implants.
The first metal alloy developed specifically for human use was the “vanadium steel,” which was used
to manufacture bone fracture plates (Sherman plates) and screws. Most metals such as iron (Fe), chro-
mium (Cr), cobalt (Co), nickel (Ni), titanium (Ti), tantalum (Ta), niobium (Nb), molybdenum (Mo), and
tungsten (W) that were used to make alloys for manufacturing implants can only be tolerated by the
body in minute amounts. Sometimes these metallic elements, in naturally occurring forms, are essential
for the function of red blood cells (Fe) or synthesis of vitamin B12 (Co), but cannot be tolerated in large
amounts in the body (Black, 1992). The biocompatibility of the metallic implant is of considerable con-
cern because these implants can corrode in an in vivo environment (Williams, 1982). The consequences
1
Metallic Biomaterials
Joon B. Park
University of Iowa
Young Kon Kim
Inje University
1.1 Introduction....................................................................................... 1-1
1.2 Stainless Steels.................................................................................... 1-2
1.3 CoCr Alloys........................................................................................1-4
1.4 Ti Alloys..............................................................................................1-6
Pure Ti and Ti6Al4Vâ•‡ •â•‡ TiNi Alloys
1.5 Dental Metals................................................................................... 1-12
1.6 Other Metals..................................................................................... 1-13
1.7 Corrosion of Metallic Implants......................................................1-14
Electrochemical Aspectsâ•‡ •â•‡ Pourbaix Diagrams in Corrosionâ•‡ •â•‡ Rate
of Corrosion and Polarization Curvesâ•‡ •â•‡ Corrosion of Available
Metalsâ•‡ •â•‡ Stress Corrosion Cracking
1.8 Manufacturing of Implants.............................................................1-18
Stainless Steelsâ•‡ •â•‡ Co–Cr Alloysâ•‡ •â•‡ Ti and Its Alloys
Defining Terms............................................................................................ 1-19
References..................................................................................................... 1-20
Further Reading........................................................................................... 1-22

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The Princess Casamassima
A Novel
by Henry James
1886
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I
“Oh yes, I dare say I can find the child, if you would like to see
him,” Miss Pynsent said; she had a fluttering wish to assent to every
suggestion made by her visitor, whom she regarded as a high and
rather terrible personage. To look for the little boy she came out of
her small parlour, which she had been ashamed to exhibit in so
untidy a state, with paper ‘patterns’ lying about on the furniture and
snippings of stuff scattered over the carpet—she came out of this
somewhat stuffy sanctuary, dedicated at once to social intercourse
and to the ingenious art to which her life had been devoted, and,
opening the house-door, turned her eyes up and down the little
street. It would presently be tea-time, and she knew that at that
solemn hour Hyacinth narrowed the circle of his wanderings. She
was anxious and impatient, and in a fever of excitement and
complacency, not wanting to keep Mrs Bowerbank waiting, though
she sat there, heavily and consideringly, as if she meant to stay; and
wondering not a little whether the object of her quest would have a
dirty face. Mrs Bowerbank had intimated so definitely that she
thought it remarkable on Miss Pynsent’s part to have taken care of
him gratuitously for so many years, that the humble dressmaker,
whose imagination took flights about every one but herself, and who
had never been conscious of an exemplary benevolence, suddenly
aspired to appear, throughout, as devoted to the child as she had
struck her solemn, substantial guest as being, and felt how much
she should like him to come in fresh and frank, and looking as pretty
as he sometimes did. Miss Pynsent, who blinked confusedly as she
surveyed the outer prospect, was very much flushed, partly with the
agitation of what Mrs Bowerbank had told her, and partly because,
when she offered that lady a drop of something refreshing, at the
end of so long an expedition, she had said she couldn’t think of

touching anything unless Miss Pynsent would keep her company.
The cheffonier (as Amanda was always careful to call it), beside the
fireplace, yielded up a small bottle which had formerly contained
eau-de-cologne and which now exhibited half a pint of a rich gold-
coloured liquid. Miss Pynsent was very delicate; she lived on tea and
watercress, and she kept the little bottle in the cheffonier only for
great emergencies. She didn’t like hot brandy and water, with a lump
or two of sugar, but she partook of half a tumbler on the present
occasion, which was of a highly exceptional kind. At this time of day
the boy was often planted in front of the little sweet-shop on the
other side of the street, an establishment where periodical literature,
as well as tough toffy and hard lollipops, was dispensed, and where
song-books and pictorial sheets were attractively exhibited in the
small-paned, dirty window. He used to stand there for half an hour
at a time, spelling out the first page of the romances in the Family
Herald and the London Journal, and admiring the obligatory
illustration in which the noble characters (they were always of the
highest birth) were presented to the carnal eye. When he had a
penny he spent only a fraction of it on stale sugar-candy; with the
remaining halfpenny he always bought a ballad, with a vivid woodcut
at the top. Now, however, he was not at his post of contemplation;
nor was he visible anywhere to Miss Pynsent’s impatient glance.
“Millicent Henning, tell me quickly, have you seen my child?”
These words were addressed by Miss Pynsent to a little girl who sat
on the doorstep of the adjacent house, nursing a dingy doll, and
who had an extraordinary luxuriance of dark brown hair, surmounted
by a torn straw hat. Miss Pynsent pronounced her name Enning.
The child looked up from her dandling and patting, and after a
stare of which the blankness was somewhat exaggerated, replied:
“Law no, Miss Pynsent, I never see him.”
“Aren’t you always messing about with him, you naughty little
girl?” the dressmaker returned, with sharpness. “Isn’t he round the
corner, playing marbles, or—or some jumping game?” Miss Pynsent
went on, trying to be suggestive.

“I assure you, he never plays nothing,” said Millicent Henning, with
a mature manner which she bore out by adding, “And I don’t know
why I should be called naughty, neither.”
“Well, if you want to be called good, please go and find him and
tell him there’s a lady here come on purpose to see him, this very
instant.” Miss Pynsent waited a moment, to see if her injunction
would be obeyed, but she got no satisfaction beyond another gaze
of deliberation, which made her feel that the child’s perversity was
as great as the beauty, somewhat soiled and dimmed, of her
insolent little face. She turned back into the house, with an
exclamation of despair, and as soon as she had disappeared Millicent
Henning sprang erect and began to race down the street in the
direction of another, which crossed it. I take no unfair advantage of
the innocence of childhood in saying that the motive of this young
lady’s flight was not a desire to be agreeable to Miss Pynsent, but an
extreme curiosity on the subject of the visitor who wanted to see
Hyacinth Robinson. She wished to participate, if only in imagination,
in the interview that might take place, and she was moved also by a
quick revival of friendly feeling for the boy, from whom she had
parted only half an hour before with considerable asperity. She was
not a very clinging little creature, and there was no one in her own
domestic circle to whom she was much attached; but she liked to
kiss Hyacinth when he didn’t push her away and tell her she was
tiresome. It was in this action and epithet he had indulged half an
hour ago; but she had reflected rapidly (while she stared at Miss
Pynsent) that this was the worst he had ever done. Millicent Henning
was only eight years of age, but she knew there was worse in the
world than that.
Mrs Bowerbank, in a leisurely, roundabout way, wandered off to
her sister, Mrs Chipperfield, whom she had come into that part of the
world to see, and the whole history of the dropsical tendencies of
whose husband, an undertaker with a business that had been a
blessing because you could always count on it, she unfolded to Miss
Pynsent between the sips of a second glass. She was a high-
shouldered, towering woman, and suggested squareness as well as

a pervasion of the upper air, so that Amanda reflected that she must
be very difficult to fit, and had a sinking at the idea of the number of
pins she would take. Her sister had nine children and she herself had
seven, the eldest of whom she left in charge of the others when she
went to her service. She was on duty at the prison only during the
day; she had to be there at seven in the morning, but she got her
evenings at home, quite regular and comfortable. Miss Pynsent
thought it wonderful she could talk of comfort in such a life as that,
but could easily imagine she should be glad to get away at night, for
at that time the place must be much more terrible.
“And aren’t you frightened of them—ever?” she inquired, looking
up at her visitor with her little heated face.
Mrs Bowerbank was very slow, and considered her so long before
replying, that she felt herself to be, in an alarming degree, in the
eye of the law; for who could be more closely connected with the
administration of justice than a female turnkey, especially so big and
majestic a one? “I expect they are more frightened of me,” she
replied at last; and it was an idea into which Miss Pynsent could
easily enter.
“And at night I suppose they rave, quite awful,” the little
dressmaker suggested, feeling vaguely that prisons and madhouses
came very much to the same.
“Well, if they do, we hush ’em up,” Mrs Bowerbank remarked,
rather portentously; while Miss Pynsent fidgeted to the door again,
without results, to see if the child had become visible. She observed
to her guest that she couldn’t call it anything but contrary that he
should not turn up, when he knew so well, most days in the week,
when his tea was ready. To which Mrs Bowerbank rejoined, fixing
her companion again with the steady orb of justice, “And do he have
his tea, that way, by himself, like a little gentleman?”
“Well, I try to give it to him tidy-like, at a suitable hour,” said Miss
Pynsent, guiltily. “And there might be some who would say that, for
the matter of that, he is a little gentleman,” she added, with an

effort at mitigation which, as she immediately became conscious,
only involved her more deeply.
“There are people silly enough to say anything. If it’s your parents
that settle your station, the child hasn’t much to be thankful for,” Mrs
Bowerbank went on, in the manner of a woman accustomed to
looking facts in the face.
Miss Pynsent was very timid, but she adored the aristocracy, and
there were elements in the boy’s life which she was not prepared to
sacrifice even to a person who represented such a possibility of
grating bolts and clanking chains. “I suppose we oughtn’t to forget
that his father was very high,” she suggested, appealingly, with her
hands clasped tightly in her lap.
“His father? Who knows who he was? He doesn’t set up for having
a father, does he?”
“But, surely, wasn’t it proved that Lord Frederick—?”
“My dear woman, nothing was proved except that she stabbed his
lordship in the back with a very long knife, that he died of the blow,
and that she got the full sentence. What does such a piece as that
know about fathers? The less said about the poor child’s ancestors
the better!”
This view of the case caused Miss Pynsent fairly to gasp, for it
pushed over with a touch a certain tall imaginative structure which
she had been piling up for years. Even as she heard it crash around
her she couldn’t forbear the attempt to save at least some of the
material. “Really—really,” she panted, “she never had to do with any
one but the nobility!”
Mrs Bowerbank surveyed her hostess with an expressionless eye.
“My dear young lady, what does a respectable little body like you,
that sits all day with her needle and scissors, know about the doings
of a wicked low foreigner that carries a knife? I was there when she
came in, and I know to what she had sunk. Her conversation was
choice, I assure you.”
“Oh, it’s very dreadful, and of course I know nothing in particular,”
Miss Pynsent quavered. “But she wasn’t low when I worked at the

same place with her, and she often told me she would do nothing for
any one that wasn’t at the very top.”
“She might have talked to you of something that would have done
you both more good,” Mrs Bowerbank remarked, while the
dressmaker felt rebuked in the past as well as in the present. “At the
very top, poor thing! Well, she’s at the very bottom now. If she
wasn’t low when she worked, it’s a pity she didn’t stick to her work;
and as for pride of birth, that’s an article I recommend your young
friend to leave to others. You had better believe what I say, because
I’m a woman of the world.”
Indeed she was, as Miss Pynsent felt, to whom all this was very
terrible, letting in the cold light of the penal system on a dear, dim
little theory. She had cared for the child because maternity was in
her nature, and this was the only manner in which fortune had put it
in her path to become a mother. She had as few belongings as the
baby, and it had seemed to her that he would add to her importance
in the little world of Lomax Place (if she kept it a secret how she
came by him), quite in the proportion in which she should contribute
to his maintenance. Her weakness and loneliness went out to his,
and in the course of time this united desolation was peopled by the
dressmaker’s romantic mind with a hundred consoling evocations.
The boy proved neither a dunce nor a reprobate; but what endeared
him to her most was her conviction that he belonged, ‘by the left
hand’, as she had read in a novel, to an ancient and exalted race,
the list of whose representatives and the record of whose alliances
she had once (when she took home some work and was made to
wait, alone, in a lady’s boudoir) had the opportunity of reading in a
fat red book, eagerly and tremblingly consulted. She bent her head
before Mrs Bowerbank’s overwhelming logic, but she felt in her heart
that she shouldn’t give the child up for all that, that she believed in
him still, and that she recognised, as distinctly as she revered, the
quality of her betters. To believe in Hyacinth, for Miss Pynsent, was
to believe that he was the son of the extremely immoral Lord
Frederick. She had, from his earliest age, made him feel that there
was a grandeur in his past, and as Mrs Bowerbank would be sure

not to approve of such aberrations Miss Pynsent prayed she might
not question her on that part of the business. It was not that, when
it was necessary, the little dressmaker had any scruple about using
the arts of prevarication; she was a kind and innocent creature, but
she told fibs as freely as she invented trimmings. She had, however,
not yet been questioned by an emissary of the law, and her heart
beat faster when Mrs Bowerbank said to her, in deep tones, with an
effect of abruptness, “And pray, Miss Pynsent, does the child know
it?”
“Know about Lord Frederick?” Miss Pynsent palpitated.
“Bother Lord Frederick! Know about his mother.”
“Oh, I can’t say that. I have never told him.”
“But has any one else told him?”
To this inquiry Miss Pynsent’s answer was more prompt and more
proud; it was with an agreeable sense of having conducted herself
with extraordinary wisdom and propriety that she replied, “How
could any one know? I have never breathed it to a creature!”
Mrs Bowerbank gave utterance to no commendation; she only put
down her empty glass and wiped her large mouth with much
thoroughness and deliberation. Then she said, as if it were as
cheerful an idea as, in the premises, she was capable of expressing,
“Ah, well, there’ll be plenty, later on, to give him all information!”
“I pray God he may live and die without knowing it!” Miss Pynsent
cried, with eagerness.
Her companion gazed at her with a kind of professional patience.
“You don’t keep your ideas together. How can he go to her, then, if
he’s never to know?”
“Oh, did you mean she would tell him?” Miss Pynsent responded,
plaintively.
“Tell him! He won’t need to be told, once she gets hold of him and
gives him—what she told me.”
“What she told you?” Miss Pynsent repeated, open-eyed.
“The kiss her lips have been famished for, for years.”

“Ah, poor desolate woman!” the little dressmaker murmured, with
her pity gushing up again. “Of course he’ll see she’s fond of him,”
she pursued, simply. Then she added, with an inspiration more
brilliant, “We might tell him she’s his aunt!”
“You may tell him she’s his grandmother, if you like. But it’s all in
the family.”
“Yes, on that side,” said Miss Pynsent, musingly and irrepressibly.
“And will she speak French?” she inquired. “In that case he won’t
understand.”
“Oh, a child will understand its own mother, whatever she speaks,”
Mrs Bowerbank returned, declining to administer a superficial
comfort. But she subjoined, opening the door for escape from a
prospect which bristled with dangers, “Of course, it’s just according
to your own conscience. You needn’t bring the child at all, unless
you like. There’s many a one that wouldn’t. There’s no compulsion.”
“And would nothing be done to me, if I didn’t?” poor Miss Pynsent
asked, unable to rid herself of the impression that it was somehow
the arm of the law that was stretched out to touch her.
“The only thing that could happen to you would be that he might
throw it up against you later,” the lady from the prison observed,
with a gloomy impartiality.
“Yes, indeed, if he were to know that I had kept him back.”
“Oh, he’d be sure to know, one of these days. We see a great deal
of that—the way things come out,” said Mrs Bowerbank, whose view
of life seemed to abound in cheerless contingencies. “You must
remember that it is her dying wish, and that you may have it on
your conscience.”
“That’s a thing I never could abide!” the little dressmaker
exclaimed, with great emphasis and a visible shiver; after which she
picked up various scattered remnants of muslin and cut paper and
began to roll them together with a desperate and mechanical haste.
“It’s quite awful, to know what to do—if you are very sure she is
dying.”

“Do you mean she’s shamming? we have plenty of that—but we
know how to treat ’em.”
“Lord, I suppose so,” murmured Miss Pynsent; while her visitor
went on to say that the unfortunate person on whose behalf she had
undertaken this solemn pilgrimage might live a week and might live
a fortnight, but if she lived a month, would violate (as Mrs
Bowerbank might express herself) every established law of nature,
being reduced to skin and bone, with nothing left of her but the
main desire to see her child.
“If you’re afraid of her talking, it isn’t much she’d be able to say.
And we shouldn’t allow you more than about eight minutes,” Mrs
Bowerbank pursued, in a tone that seemed to refer itself to an iron
discipline.
“I’m sure I shouldn’t want more; that would be enough to last me
many a year,” said Miss Pynsent, accommodatingly. And then she
added, with another illumination, “Don’t you think he might throw it
up against me that I did take him? People might tell him about her
in later years; but if he hadn’t seen her he wouldn’t be obliged to
believe them.”
Mrs Bowerbank considered this a moment, as if it were rather a
super-subtle argument, and then answered, quite in the spirit of her
official pessimism, “There is one thing you may be sure of: whatever
you decide to do, as soon as ever he grows up he will make you
wish you had done the opposite.” Mrs Bowerbank called it opposite.
“Oh, dear, then, I’m glad it will be a long time.”
“It will be ever so long, if once he gets it into his head! At any
rate, you must do as you think best. Only, if you come, you mustn’t
come when it’s all over.”
“It’s too impossible to decide.”
“It is, indeed,” said Mrs Bowerbank, with superior consistency. And
she seemed more placidly grim than ever when she remarked,
gathering up her loosened shawl, that she was much obliged to Miss
Pynsent for her civility, and had been quite freshened up: her visit
had so completely deprived her hostess of that sort of calm. Miss

Pynsent gave the fullest expression to her perplexity in the supreme
exclamation—
“If you could only wait and see the child, I’m sure it would help
you to judge!”
“My dear woman, I don’t want to judge—it’s none of our
business!” Mrs Bowerbank exclaimed; and she had no sooner uttered
the words than the door of the room creaked open and a small boy
stood there gazing at her. Her eyes rested on him a moment, and
then, most unexpectedly, she gave an inconsequent cry. “Is that the
child? Oh, Lord o’ mercy, don’t take him!”
“Now ain’t he shrinking and sensitive?” demanded Miss Pynsent,
who had pounced upon him, and, holding him an instant at arm’s
length, appealed eagerly to her visitor. “Ain’t he delicate and high-
bred, and wouldn’t he be thrown into a state?” Delicate as he might
be the little dressmaker shook him smartly for his naughtiness in
being out of the way when he was wanted, and brought him to the
big, square-faced, deep-voiced lady who took up, as it were, all that
side of the room. But Mrs Bowerbank laid no hand upon him; she
only dropped her gaze from a tremendous height, and her
forbearance seemed a tribute to that fragility of constitution on
which Miss Pynsent desired to insist, just as her continued gravity
was an implication that this scrupulous woman might well not know
what to do.
“Speak to the lady nicely, and tell her you are very sorry to have
kept her waiting.”
The child hesitated a moment, while he reciprocated Mrs
Bowerbank’s inspection, and then he said, with a strange, cool,
conscious indifference (Miss Pynsent instantly recognised it as his
aristocratic manner), “I don’t think she can have been in a very
great hurry.”
There was irony in the words, for it is a remarkable fact that even
at the age of ten Hyacinth Robinson was ironical; but the subject of
his allusion, who was not nimble withal, appeared not to interpret it;

so that she rejoined only by remarking, over his head, to Miss
Pynsent, “It’s the very face of her over again!”
“Of her? But what do you say to Lord Frederick?”
“I have seen lords that wasn’t so dainty!”
Miss Pynsent had seen very few lords, but she entered, with a
passionate thrill, into this generalisation; controlling herself, however,
for she remembered the child was tremendously sharp, sufficiently
to declare, in an edifying tone, that he would look more like what he
ought to if his face were a little cleaner.
“It was probably Millicent Henning dirtied my face, when she
kissed me,” the boy announced, with slow gravity, looking all the
while at Mrs Bowerbank. He exhibited not a symptom of shyness.
“Millicent Henning is a very bad little girl; she’ll come to no good,”
said Miss Pynsent, with familiar decision, and also, considering that
the young lady in question had been her effective messenger, with
marked ingratitude.
Against this qualification the child instantly protested. “Why is she
bad? I don’t think she is bad; I like her very much.” It came over
him that he had too hastily shifted to her shoulders the responsibility
of his unseemly appearance, and he wished to make up to her for
that betrayal. He dimly felt that nothing but that particular
accusation could have pushed him to it, for he hated people who
were not fresh, who had smutches and streaks. Millicent Henning
generally had two or three, which she borrowed from her doll, into
whom she was always rubbing her nose and whose dinginess was
contagious. It was quite inevitable she should have left her mark
under his own nose when she claimed her reward for coming to tell
him about the lady who wanted him.
Miss Pynsent held the boy against her knee, trying to present him
so that Mrs Bowerbank should agree with her about his having the
air of race. He was exceedingly diminutive, even for his years, and
though his appearance was not positively sickly it seemed written in
his attenuated little person that he would never be either tall or
strong. His dark blue eyes were separated by a wide interval, which

increased the fairness and sweetness of his face, and his abundant
curly hair, which grew thick and long, had the golden brownness
predestined to elicit exclamations of delight from ladies when they
take the inventory of a child. His features were smooth and pretty;
his head was set upon a slim little neck; his expression, grave and
clear, showed a quick perception as well as a great credulity; and he
was altogether, in his innocent smallness, a refined and interesting
figure.
“Yes, he’s one that would be sure to remember,” said Mrs
Bowerbank, mentally contrasting him with the undeveloped
members of her own brood, who had never been retentive of
anything but the halfpence which they occasionally contrived to filch
from her. Her eyes descended to the details of his toilet: the careful
mending of his short breeches and his long, coloured stockings,
which she was in a position to appreciate, as well as the knot of
bright ribbon which the dressmaker had passed into his collar,
slightly crumpled by Miss Henning’s embrace. Of course Miss
Pynsent had only one to look after, but her visitor was obliged to
recognise that she had the highest standard in respect to buttons.
“And you do turn him out so it’s a pleasure,” she went on, noting the
ingenious patches in the child’s shoes, which, to her mind, were
repaired for all the world like those of a little nobleman.
“I’m sure you’re very civil,” said Miss Pynsent, in a state of severe
exaltation. “There’s never a needle but mine has come near him.
That’s exactly what I think: the impression would go so deep.”
“Do you want to see me only to look at me?” Hyacinth inquired,
with a candour which, though unstudied, had again much of the
force of satire.
“I’m sure it’s very kind of the lady to notice you at all!” cried his
protectress, giving him an ineffectual jerk. “You’re no bigger than a
flea; there are many that wouldn’t spy you out.”
“You’ll find he’s big enough, I expect, when he begins to go,” Mrs
Bowerbank remarked, tranquilly; and she added that now she saw
how he was turned out she couldn’t but feel that the other side was

to be considered. In her effort to be discreet, on account of his
being present (and so precociously attentive), she became slightly
enigmatical; but Miss Pynsent gathered her meaning, which was that
it was very true the child would take everything in and keep it: but
at the same time it was precisely his being so attractive that made it
a kind of sin not to gratify the poor woman, who, if she knew what
he looked like to-day, wouldn’t forgive his adoptive mamma for not
producing him. “Certainly, in her place, I should go off easier if I had
seen them curls,” Mrs Bowerbank declared, with a flight of maternal
imagination which brought her to her feet, while Miss Pynsent felt
that she was leaving her dreadfully ploughed up, and without any
really fertilising seed having been sown. The little dressmaker
packed the child upstairs to tidy himself for his tea, and while she
accompanied her visitor to the door told her that if she would have a
little more patience with her she would think a day or two longer
what was best and write to her when she should have decided. Mrs
Bowerbank continued to move in a realm superior to poor Miss
Pynsent’s vacillations and timidities, and her impartiality gave her
hostess a high idea of her respectability; but the way was a little
smoothed when, after Amanda had moaned once more, on the
threshold, helplessly and irrelevantly, “Ain’t it a pity she’s so bad?”
the ponderous lady from the prison rejoined, in those tones which
seemed meant to resound through corridors of stone, “I assure you
there’s a many that’s much worse!”

II
Miss Pynsent, when she found herself alone, felt that she was
really quite upside down; for the event that had just occurred had
never entered into her calculations: the very nature of the case had
seemed to preclude it. All she knew, and all she wished to know,
was that in one of the dreadful institutions constructed for such
purposes her quondam comrade was serving out the sentence that
had been substituted for the other (the unspeakable horror) almost
when the halter was already round her neck. As there was no
question of that concession being stretched any further, poor
Florentine seemed only a little more dead than other people, having
no decent tombstone to mark the place where she lay. Miss Pynsent
had therefore never thought of her dying again; she had no idea to
what prison she had been committed on being removed from
Newgate (she wished to keep her mind a blank about the matter, in
the interest of the child), and it could not occur to her that out of
such silence and darkness a second voice would reach her, especially
a voice that she should really have to listen to. Miss Pynsent would
have said, before Mrs Bowerbank’s visit, that she had no account to
render to any one; that she had taken up the child (who might have
starved in the gutter) out of charity, and had brought him up, poor
and precarious as her own subsistence had been, without a penny’s
help from another source; that the mother had forfeited every right
and title; and that this had been understood between them—if
anything, in so dreadful an hour, could have been said to be
understood—when she went to see her at Newgate (that terrible
episode, nine years before, overshadowed all Miss Pynsent’s other
memories): went to see her because Florentine had sent for her (a
name, face and address coming up out of the still recent but sharply
separated past of their working-girl years) as the one friend to

whom she could appeal with some chance of a pitying answer. The
effect of violent emotion, with Miss Pynsent, was not to make her sit
with idle hands or fidget about to no purpose; under its influence, on
the contrary, she threw herself into little jobs, as a fugitive takes to
by-paths, and clipped and cut, and stitched and basted, as if she
were running a race with hysterics. And while her hands, her
scissors, her needle flew, an infinite succession of fantastic
possibilities trotted through her confused little head; she had a
furious imagination, and the act of reflection, in her mind, was
always a panorama of figures and scenes. She had had her picture
of the future, painted in rather rosy hues, hung up before her now
for a good many years; but it seemed to her that Mrs Bowerbank’s
heavy hand had suddenly punched a hole in the canvas. It must be
added, however, that if Amanda’s thoughts were apt to be
bewildering visions they sometimes led her to make up her mind,
and on this particular September evening she arrived at a
momentous decision. What she made up her mind to was to take
advice, and in pursuance of this view she rushed downstairs, and,
jerking Hyacinth away from his simple but unfinished repast, packed
him across the street to tell Mr Vetch (if he had not yet started for
the theatre) that she begged he would come in to see her when he
came home that night, as she had something very particular she
wished to say to him. It didn’t matter if he should be very late, he
could come in at any hour—he would see her light in the window—
and he would do her a real mercy. Miss Pynsent knew it would be of
no use for her to go to bed; she felt as if she should never close her
eyes again. Mr Vetch was her most distinguished friend; she had an
immense appreciation of his cleverness and knowledge of the world,
as well as of the purity of his taste in matters of conduct and
opinion; and she had already consulted him about Hyacinth’s
education. The boy needed no urging to go on such an errand, for
he, too, had his ideas about the little fiddler, the second violin in the
orchestra of the Bloomsbury Theatre. Mr Vetch had once obtained
for the pair an order for two seats at a pantomime, and for Hyacinth
the impression of that ecstatic evening had consecrated him, placed
him for ever in the golden glow of the footlights. There were things

in life of which, even at the age of ten, it was a conviction of the
boy’s that it would be his fate never to see enough, and one of them
was the wonder-world illuminated by those playhouse lamps. But
there would be chances, perhaps, if one didn’t lose sight of Mr
Vetch; he might open the door again; he was a privileged, magical
mortal, who went to the play every night.
He came in to see Miss Pynsent about midnight; as soon as she
heard the lame tinkle of the bell she went to the door to let him in.
He was an original, in the fullest sense of the word: a lonely,
disappointed, embittered, cynical little man, whose musical
organisation had been sterile, who had the nerves, the sensibilities,
of a gentleman, and whose fate had condemned him, for the last ten
years, to play a fiddle at a second-rate theatre for a few shillings a
week. He had ideas of his own about everything, and they were not
always very improving. For Amanda Pynsent he represented art,
literature (the literature of the play-bill) and philosophy, and she
always felt about him as if he belonged to a higher social sphere,
though his earnings were hardly greater than her own and he lived
in a single back-room, in a house where she had never seen a
window washed. He had, for her, the glamour of reduced gentility
and fallen fortunes; she was conscious that he spoke a different
language (though she couldn’t have said in what the difference
consisted) from the other members of her humble, almost suburban
circle; and the shape of his hands was distinctly aristocratic. (Miss
Pynsent, as I have intimated, was immensely preoccupied with that
element in life.) Mr Vetch displeased her only by one of the facets of
his character—his blasphemous republican, radical views, and the
contemptuous manner in which he expressed himself about the
nobility. On that ground he worried her extremely, though he never
seemed to her so clever as when he horrified her most. These
dreadful theories (expressed so brilliantly that, really, they might
have been dangerous if Miss Pynsent had not known her own place
so well) constituted no presumption against his refined origin; they
were explained, rather, to a certain extent, by a just resentment at
finding himself excluded from his proper place. Mr Vetch was short,

fat and bald, though he was not much older than Miss Pynsent, who
was not much older than some people who called themselves forty-
five; he always went to the theatre in evening-dress, with a flower in
his button-hole, and wore a glass in one eye. He looked placid and
genial, and as if he would fidget at the most about the ‘get up’ of his
linen; you would have thought him finical but superficial, and never
have suspected that he was a revolutionist, or even a critic of life.
Sometimes, when he could get away from the theatre early enough,
he went with a pianist, a friend of his, to play dance-music at small
parties; and after such expeditions he was particularly cynical and
startling; he indulged in diatribes against the British middle-class, its
Philistinism, its snobbery. He seldom had much conversation with
Miss Pynsent without telling her that she had the intellectual outlook
of a caterpillar; but this was his privilege after a friendship now of
seven years’ standing, which had begun (the year after he came to
live in Lomax Place) with her going over to nurse him, on learning
from the milk-woman that he was alone at Number 17—laid up with
an attack of gastritis. He always compared her to an insect or a bird,
and she didn’t mind, because she knew he liked her, and she herself
liked all winged creatures. How indeed could she complain, after
hearing him call the Queen a superannuated form and the
Archbishop of Canterbury a grotesque superstition?
He laid his violin-case on the table, which was covered with a
confusion of fashion-plates and pincushions, and glanced toward the
fire, where a kettle was gently hissing. Miss Pynsent, who had put it
on half an hour before, read his glance, and reflected with
complacency that Mrs Bowerbank had not absolutely drained the
little bottle in the cheffonier. She placed it on the table again, this
time with a single glass, and told her visitor that, as a great
exception, he might light his pipe. In fact, she always made the
exception, and he always replied to the gracious speech by inquiring
whether she supposed the greengrocers’ wives, the butchers’
daughters, for whom she worked, had fine enough noses to smell, in
the garments she sent home, the fumes of his tobacco. He knew her
‘connection’ was confined to small shopkeepers, but she didn’t wish

others to know it, and would have liked them to believe it was
important that the poor little stuffs she made up (into very queer
fashions, I am afraid) should not surprise the feminine nostril. But it
had always been impossible to impose on Mr Vetch; he guessed the
truth, the untrimmed truth, about everything in a moment. She was
sure he would do so now, in regard to this solemn question which
had come up about Hyacinth; he would see that though she was
agreeably flurried at finding herself whirled in the last eddies of a
case that had been so celebrated in its day, her secret wish was to
shirk her duty (if it was a duty): to keep the child from ever knowing
his mother’s unmentionable history, the shame that attached to his
origin, the opportunity she had had of letting him see the wretched
woman before she died. She knew Mr Vetch would read her troubled
thoughts, but she hoped he would say they were natural and just;
she reflected that as he took an interest in Hyacinth he wouldn’t
desire him to be subjected to a mortification that might rankle for
ever and perhaps even crush him to the earth. She related Mrs
Bowerbank’s visit, while he sat upon the sofa in the very place where
that majestic woman had reposed, and puffed his smoke-wreaths
into the dusky little room. He knew the story of the child’s birth, had
known it years before, so she had no startling revelation to make.
He was not in the least agitated at learning that Florentine was
dying in prison and had managed to get a message conveyed to
Amanda; he thought this so much in the usual course that he said to
Miss Pynsent, “Did you expect her to live on there for ever, working
out her terrible sentence, just to spare you the annoyance of a
dilemma, or any reminder of her miserable existence, which you
have preferred to forget?” That was just the sort of question Mr
Vetch was sure to ask, and he inquired, further, of his dismayed
hostess, whether she were sure her friend’s message (he called the
unhappy creature her friend) had come to her in the regular way.
The warders, surely, had no authority to introduce visitors to their
captives; and was it a question of her going off to the prison on the
sole authority of Mrs Bowerbank? The little dressmaker explained
that this lady had merely come to sound her, Florentine had begged
so hard. She had been in Mrs Bowerbank’s ward before her removal

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