The BookBrowse Review

Published June 9, 2021

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The Girl in His Shadow
The Girl in His Shadow
by Audrey Blake

Hardcover (4 May 2021), 384 pages.
Publisher: Sourcebooks Landmark
ISBN-13: 9781728228723
Genres
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The story of one woman who believed in scientific medicine before the world believed in her.

Raised by the eccentric surgeon Dr. Horace Croft after losing her parents to a deadly pandemic, the orphan Nora Beady knows little about conventional life. While other young ladies were raised to busy themselves with needlework and watercolors, Nora was trained to perfect her suturing and anatomical illustrations of dissections.

Women face dire consequences if caught practicing medicine, but in Croft's private clinic Nora is his most trusted―and secret―assistant. That is until the new surgical resident Dr. Daniel Gibson arrives. Dr. Gibson has no idea that Horace's bright and quiet young ward is a surgeon more qualified and ingenuitive than even himself. In order to protect Dr. Croft and his practice from scandal and collapse Nora must learn to play a new and uncomfortable role―that of a proper young lady.

But pretense has its limits. Nora cannot turn away and ignore the suffering of patients even if it means giving Gibson the power to ruin everything she's worked for. And when she makes a discovery that could change the field forever, Nora faces an impossible choice. Remain invisible and let the men around her take credit for her work, or let the world see her for what she is―even if it means being destroyed by her own legacy.

Paperback Original

PROLOGUE

Hefting his black bag, Dr. Horace Croft stumped down the uneven pavement. Despite the afternoon sunshine, the street was silent and the air thick with fear. Shop doors were shut and bolted, and too many anxious faces watched from the windows. For fifteen years London had dreaded the cholera. Now it had come.

Croft had tried to prepare, studying initial reports of the epidemic from India, Russia, and Japan. An irreligious man, he gave silent prayers of relief when the outbreak of 1827 died in the Caucasus before reaching Europe. Foolish of him. Four years later, the deadly disease advanced from the dark forests of the East into the shadowy Balkans. The following year it breached England's rocky shores. Miraculously, the outbreak was contained in Sunderland, but this was respite, not reprieve. Three months later, the disease erupted in London.

He'd paid ten calls already today, all within a mile of each other. He frowned, still troubled by the last.

Jemmy Watt had first sent for him yesterday to tend his feverish wife. Today, she was dead. So were her children, and Jemmy was failing rapidly. It would be a miracle if Croft found him alive tomorrow. This disease was too strong to fight. Even worse, the lads at the parish were cowards, unwilling to come for the bodies of Jemmy's family. Croft had shouted and cursed, warning them against leaving corpses harboring contagion until they'd finally cleared them away, but not before binding linen around their faces as a shield against the miasma of disease. All the shouting left Croft's throat dry as pasteboard.

One more stop before he could go home. With this patient, at least, he had some hope. Francis Beady, a stationer, was gone already, buried in quicklime a week ago, but the wife, Margaret, ignored grief with an iron will. Yesterday, though terse and thin-lipped, she'd been determined to keep her ailing mother-in- law alive. Better yet, her child and baby were still healthy. He had left Margaret Beady with a tincture of willow bark for fever and instructions to get help with her mother-in- law's care, though they knew no one would come.

"I'll try, Doctor," Margaret said, spooning water between the dry lips of her mother-in- law, while the little girl—a mere eight or nine—bounced the baby on her knee. The old woman seemed to be turning the corner.

Yes, he expected to see improvements in the Beady house. The shop was closed, naturally, so he knocked loudly on the door. No answer. He checked his watch. Mrs. Beady knew to expect him.

"Mrs. Beady!" Still no sound. Worried now, he rattled the handle. It moved beneath his hand. Unlocked. Horace frowned. It wasn't like Mrs. Beady, but there was little danger of invasion. The neighbors all knew of their affliction. Croft stepped inside, past the dimly lit shelves of notebooks and paper. In only a week, the counters had acquired a film of dust.

It was a small shop, but the Beadys made a better living than Jemmy Watt. Not that money dissuaded cholera or made it any less lethal. He made his way up the stairs to the family's rooms on the second floor. "Mrs. Beady?" It was too quiet, and the telltale stench hovered on the landing. Resigned to what he would find, Croft walked in, stepping over the toy blocks abandoned on the floor.

He found the mother-in- law's wasted body in the bedroom, but Mrs. Beady had been well enough then to cover her with a sheet. Mrs. Beady was curled up on the sitting room floor, her hair still damp, her lips cracked. The baby lay beside her. It must have died after, for it lay uncovered in a pool of filth, and Croft knew Margaret was not a woman to leave her child untended. He sighed and straightened, tugging at his coat. As for the older child…

Croft looked around. He couldn't see her. "Miss Beady?" He didn't know the girl's name. "Miss Beady!"

He felt more than heard a faint exhalation. She was behind him, huddled deep in a shabby armchair. He tilted back her chin—still alive, her skin hot, her eyes unfocused. He reached to take her pulse, frowning as he counted the slow, thready beats, noting the tremor in her fingers. In her other hand, cradled against her stomach, she clutched a dipper. The basin beside her was empty. Her lips moved, and though she failed to produce any sound, he could almost hear the crackling of her flaked skin.

Full Excerpt

Excerpted from The Girl in His Shadow by Audrey Blake. Copyright © 2021 by Audrey Blake. Excerpted by permission of Sourcebooks Landmark. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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Please be aware that this discussion guide may contain spoilers!

  1. Though she's more qualified, Nora worries about being replaced by Daniel. Have you ever found yourself in a similar situation? What did you do about it?
  2. Dr. Croft often resorts to disreputable methods of getting subjects, such as paying grave robbers or taking advantage of grieving family members. For him, the ends justify the means. Do you agree with him? To what extent?
  3. Throughout the story, Nora conducts a series of experiments and independent studies. What was she hoping to learn?
  4. We get to see nineteenth century medical techniques through Nora's eyes. Which treatments surprised you the most? Are there any techniques that carried over into modern medicine?
  5. Nora is one of only a few women in a field dominated by men. Do you see any parallels between her situation in the nineteenth century and today?
  6. Dr. Harry Trimble finds himself in a difficult situation when Dr. Silas Vickery blackmails him into speaking at the trial. Do you think Harry really had a choice in betraying Nora? What would you have done?
  7. Compare Daniel's relationship with Mae and his relationship with Nora. How are they different? Are they similar in any way?
  8. Daniel comes from an upper-class family while Nora and Harry come from the working class. How does socioeconomic background affect how they are treated by other people?
  9. While Nora originally disliked Daniel, the two eventually grow to love each other. What brought them together, and why?
  10. What did you think about Nora's decision to speak up for herself, though it results in public disgrace and punishment?

 

Unless otherwise stated, this discussion guide is reprinted with the permission of Sourcebooks Landmark. Any page references refer to a USA edition of the book, usually the trade paperback version, and may vary in other editions.

Here are some of the recent comments posted about The Girl in His Shadow.
You can read the full discussion here, and please do participate if you wish.
Be aware that this discussion will contain spoilers!

Can the respect of a mentor and care of a devoted housekeeper supplant parental affection?
I agree that they were family but still with a sense of loss of Nora's parents and siblings. - bill

Can you disapprove of a person without disapproving of their upbringing?
As a child, your upbringing is not within your control - how could you hold that against someone? You can however disapprove of the adult’s behavior - upbringing is not an excuse for bad behavior - you can be sympathetic and understanding ... - christinec

Compare Daniel's relationship with Mae and his relationship with Nora. How are they different? Are they similar in any way?
Based on her looks and social standing, Daniel appeared to be in love with Mae and, based on her letters, it appeared that Mae was in love with Daniel. However, it appeared that Mae was controlled by her parents, who like Daniel's parents, were... - bill

Do you see any parallels between Nora's situation in the nineteenth century and today?
Yes for many of the reason above but definite improvement from actions taken by women and men with actions such as the suffragette movement and in the courts with Ruth Bader Ginsburg and other male and female lawyers and judges. - bill

Do you think "disciple" is the right word to describe what Nora is to Croft? Do you think it’s better to pledge yourself to an ideal or to another person?
Don’t like word disciple - devoted to and respected and loved him - believed in his work and felt he was selfless in wanting to help people - - christinec

Do you think Mrs. Phipps’ religious nature inclines her to needing Nora, while Dr. Croft's non-religious outlook inclines him to detachment?
I agree that personality and not religion accounts for the relationships between Nora and Mrs. Phipps. I also do not believe that Dr. Croft is totally detached as it was he that brought her to his house and gave her a home and also involved her in ... - bill

Does Nora's "stubbornness" account for her resilience? Have you found the greatest successes in your life from being stubborn or from being flexible?
I agree with the general consensus Women who are smart, dedicated and have opinions are almost always described in negative ways. I like to think of Nora as an incredible smart woman who was seriously committed to learning medicine! - jos

Dr. Croft often resorts to disreputable methods to get subjects. For him, the ends justify the means. Do you agree with him? To what extent?
It was probably necessary at the time but it was most upsetting when Dr. Croft made the arrangements to dig up the body of a young female patient of his because he knew that her parents would not have agreed. - bill

Have you ever used any activity as a distraction, as Nora and Daniel do with their work? Do you see parallels between this kind of behavior and the recreational use of mind-altering substances?
I can’t relate to using mind altering drugs. I do think most people use distractions like social media, TV, music,etc. - catherynez

How does Nora and Harry’s socioeconomic background affect how they are treated by other people?
I didn't see any class distinction at all--except maybe when Daniel's parents met Nora. Actually, I was sort of amazed that Dr Croft's practice seemed to cater only to the working class - katherinep

Is Daniel's difficulty in accepting Nora's agency and expertise rooted in a lack of humility? Has a lack of humility ever kept you from developing yourself?
I believe that Daniel's position was more driven by the fact that he was suppose to report Nora's "illegal" practice of medicine. - bill

Is Nora's motivation to obtain her medical license a truly self-satisfying impulse, or has the influence of Daniel's career arc artificially given her something to prove?
Nora always denied to go as far in the medical field as she could. At first, it looked to be as much as she can do in Dr. Croft's practice and subsequently in Daniel's practice. However, when Dr. Pena came along, she ... - bill

Is removing the memory of pain the same as preventing it? If you had the ability to alter the memory of someone you had hurt so they didn't remember you doing it, would you?
I choose to prevent pain and if I have even if I did not realize how sensitive someone may have been I recognize it immediately and make amends. - carriem

Is sacrifice necessary to prove loyalty? Are such sacrifices fundamental to romantic love?
I agree with Paulak and Katherine but, unlike Jody, I think Mae would have sacrificed in her social standing and parental relationship if she had defended Daniel. - bill

Overall, what do you think of The Girl in His Shadow? (no spoilers in this thread, please)
I enjoyed this book very much. Although I had book club books to read, I would not start them until I finished this one!! As many of the above comments, I very much enjoy reading historical fiction as well as non-fiction... - bill

There had to have been many Noras that were practicing and learning in secret. Do you think historical fiction gives them a deserved voice and is it adequate?
I agree with all of you, these women’s stories in history are so important and even though we know they must exist I feel their stories are still under represented and needs all our attention readers, authors, and publishers alike. - jos

Though she's more qualified, Nora worries about being replaced by Daniel. Have you ever found yourself in a similar situation? What did you do about it?
Despite being more qualified, Nora had the problem that she was prohibited from performing the job. However, in many situations, it is not always the most qualified who gets the job. Besides gender (female over male also)... - bill

Throughout the story, Nora conducts a series of experiments and independent studies. What does it seem like she is hoping to learn?
I think she was trying to learn everything she could about the human body! She had a thirst and desire to find the best techniques to improve medicine and the way it was practiced. I honestly can't imagine the barbaric ways they treated... - beckys

What did you think about Nora's decision to speak up for herself, despite it resulting in public disgrace and punishment?
I agree with Katherine's response. Nora knew she must reveal the truth and weighed the consequences before speaking. She knew she was on the right side, societal practices of the time "be damned"! - judyw

What do you think about Harry’s betrayal of Nora and Daniel, in light of the fact that his betrayal amounts to telling the truth, rather than committing to an agreed-upon lie? To whom or what do you owe the greatest loyalty?
Agree that Harry should have talked to Dr. Croft, Nora, and Daniel about his situation. I agree I liked how the author unraveled his story. - Janet Smith

When two people experience the same event, how much of their understanding of it is based on their lived experiences, and how much on the event itself?
I think that Daniel's comment was more of a put-down of what he did not think Nora knew at that time. - bill

Which treatments surprised you the most? Can you identify any techniques that have carried over into modern medicine?
There are a number of treatments that would be surprising to people who had not studied history. The lack of antiseptics and ways to sedate for surgery were several of the things that show how far medicine and science have come. It is unbelievable to... - Loveslife

While Nora originally dislikes Daniel, the two eventually grow to love each other. What does it appear brings them together, and why?
Passion for their work - something in common that will bind them - they will understand each other - christinec

An intriguing and suspenseful tale of mid-1800s medical science.

Print Article Publisher's View   

The Girl in His Shadow by Audrey Blake is a fast-paced historical novel set in Victorian-era England. With both romance and thriller-esque elements, Blake — a pseudonym for co-authors Jaima Fixsen and Regina Sirois — creates a convincing tale of legal and medical suspense, all in the midst of period-accurate gory descriptions of surgeries, home births and autopsies. Tying this background color together with the book's plot-driven qualities is an exploration of the medical advances and experimentation of the time.

The novel aims to follow these subjects from a feminist angle; the protagonist, Nora Beady, is a young woman practicing medicine without a license who must contend with the misogynistic society around her. Having been taken in by Dr. Horace Croft as a child after her family died of cholera, she has, under the doctor's tutelage, developed skills befitting a medical professional. However, as women are not allowed to openly use such skills, she assists Dr. Croft in secret. The doctor himself is one for bending or outright ignoring the rules: His thirst for scientific knowledge leads him to pay grave robbers for dead bodies to study, and his pragmatism leads him to respect Nora's intellect and not view her gender as any kind of impediment to her capabilities.

The harmony of the life and work Nora and the doctor share is disrupted when Croft decides to take on an additional assistant, a young physician named Daniel Gibson. This puts Nora in an uncomfortable position, as she is obligated to hide from Daniel the crucial role she plays in Croft's practice, at least initially. Romance between Daniel and Nora is hinted at early on, and as all three of the main characters endeavor to provide the highest possible level of care for their patients, they run into legal troubles that stretch beyond the scope of Nora's activities.

In The Girl in His Shadow, historical detail blends artfully with a compelling plot. Rather than leaning too heavily on any one aesthetic or device, it maintains a light, shifting balance: There is a romance but it doesn't unfold or tie up as neatly as might be expected; there is a somber focus on matters of life and death but also humor, including an incident with a faulty door connecting Daniel's room with Dr. Croft's; the action of the novel is meticulously constructed but so are the descriptions.

While the authors successfully mix different aspects of story and genre, the novel falls short in its feminist ambitions. Nora is an embodiment of the fairly simplistic modern fantasy of a "strong woman" type overcoming obstacles, and not particularly interesting. This is all the more disappointing because, as an orphan raised by a man who keeps body parts in jars, she is set up to be a fantastically specific and captivating character, but she doesn't have much of a personality outside of the predicaments she encounters and her determination to persevere. This has the effect of muddying the waters of feminism and romance; rather than presenting a story with real elements of both, the novel ends up romanticizing feminism through a rather surface-level idea of female independence.

Of course, this should not be a problem for those looking for lighter reading combined with substantial historical fact, and The Girl in His Shadow still has much to recommend it. The real star of the book is the burgeoning scientific knowledge of the day, which is woven seamlessly into the plot, such that the reader feels caught up in the excitement of the possibilities that surround the characters as they experiment with emerging treatments and battle limitations imposed by the traditional medical establishment, all against a drearily romantic background that those drawn to Victorian-era suspense will surely appreciate.

Reviewed by Elisabeth Cook

Historical Novel Society
Assured, engaging, and full of fascinating detail and richly realized characters.

Library Journal
With its strong woman protagonist and authentic period detail, this is the best kind of historical fiction, transporting readers to a place and time peopled with memorable characters. Readers who enjoy medical drama will gravitate to this book.

Author Blurb Tracey Enerson Wood, international bestselling author of The Engineer's Wife
In The Girl in His Shadow, Audrey Blake takes the reader on an exquisitely detailed journey through the harrowing field of medicine in mid-19th century London. Nora, the ward of the eccentric and brilliant surgeon Horace Croft, learns far more than any woman is allowed. Bravely saving lives while risking her own, she defies the law to pioneer breakthroughs in medicine.

Author Blurb Gloria Goldreich, author of The Paris Children
A suspenseful story of a courageous young woman determined to become a surgeon in repressive Victorian England. Fluidly written, impeccably researched, The Girl in His Shadow is a memorable literary gift to be read, reread, and treasured.

Write your own review

Rated 5 of 5 of 5 by Sonia Francis
The audacity of a female
Nora, an orphan in 19th century London has lost her parents to cholera and is raised by Dr. Croft . The tenacity and persistence of Nora to risk it all in a Victorian society where women’s role in medicine is zero is absolutely shunned on to the point of criminality. Nora is defiant that she she won’t be the homemaker: not knitting, not baking cookies. She follows Dr Croft around, she reads, learns her anatomy, practices on the cadavers, learns to do sutures and mend wounds - all of this done clandestinely, because she is not supposed to be in this role.
This novel hooked me right in and didn’t let me go. I totally enjoyed the medical aspect especially the surgery performed on a patient with gangrenous bowel. Even if you were not in the health field, you were awed by the surgical settings. It was made better with a little romance thrown in by a doctor (Daniel) who at first had issues with Nora being “ in the way” until she proved herself knowledgeable and capable.
An absolute gem of a book with characters ranging from hero to villains. I loved it because of the enlightenment towards women in the 19th century and thinking how far women has come. I wished that Nora did not have to leave Daniel and I would always wonder if they will ever meet again. There should be a sequel.

Rated 5 of 5 of 5 by Katherine Pond
Women Cannot Practice Medicine!
Received a copy of this book to discuss on BookBrowse. I found it incredibly interesting for many reasons. As a pre-med grad and a teacher of Anatomy and Physiology for about 30 years the history of women in science and the restrictions on their opportunities to study and practice medicine, while not unfamiliar to me, was presented in a very personable way. It was very easy to identify with Nora and her interest in and fascination with the human body and its diseases. To have a mentor such as Dr Croft was such a gift to her. And yet, though she is as talented and bright as any male med student she could not legally apply her knowledge nor be certified to practice medicine. In this regard, Italy was far ahead of its time in being supportive of the life of a woman in a professional capacity, beyond the kitchen and nursery. That actually was a hallmark of Italian society well before the 19th century!
Besides the story of Nora and women's place in society, is the revelation of the rudimentary practice called medicine only a bit more than a century ago. Sometimes, we forget just how far the knowledge of the human body and its functions has come in a relatively short time. The conflict of egos among the men practicing is also interesting to learn. Though, truth be told, that hasn't change d much as evidenced by all the doctors, epidemiologists etc that have come out of the woodwork during this latest pandemic. Each of them sure of their positions and each of them happy to grandstand and proclaim them loudly--despite the confusion their cacophony has produced among the people of the world.
The characters are all very well drawn and the personality of each is easy to envision. From the housekeeper who is the only mother Nora has really known to the young doctors who find her appealing, each of them is three dimensional and relatable. Considering the story could have been bogged down in textbook style presentation of the experiments and surgeries and treatments described, it is a joy to say, none of it is boring or overly descriptive--just enough for reality but not so much to repel. Well done, ladies!

Rated 5 of 5 of 5 by carriem
The Girl in His Shadow
An engaging historical fiction about one woman’s struggle to use her abilities and knowledge in medicine and science during Victorian times in London and the societal roadblocks she faced. Nora has mentors that support and encourage her but there are obstacles and decisions she must reach including going beyond boundaries set for her and breaking of an agreed upon confidence. One of her initial skeptics and later supporters develops into a mutual romantic interest. An excellent book for book groups because there are many points and views to discuss.

Rated 4 of 5 of 5 by Jos
Girl Power
Good historical Fiction on women and medicine set in the mid 1800s London. The book examines how women were band from practicing medicine and ethical situations in discovering lifesaving techniques. There is a big romance set in this book,
but enough medical experiments and surgeries to keep this geeky science girl interested! The Historical references were good and interesting and the characters were complex and endearing. In some ways the romance was important in context to demonstrate the difficulties of women trying to break that glass ceiling and all the rules of convention it involved but I felt it was too predictable and was tiresome at times. I really adore Nora the main character who is adopted by a distracted but brilliant Doctor and his housekeeper. The Doctor is inclined to step out of “the box,” when it comes to how and who is practicing medicine, so Nora is not denied a brilliant education in science however impractical it will be to her. Nora is bright, compassionate and has strong moral values yet she is totally unconventional for her time throwing many people in her life off guard! However, this never stops Nora from pushing forward to obtain her dreams and I felt akin to her right away. A book I would recommend to fellow historical fiction lovers. Interesting note about the author Audrey Blake, which is a pseudonym of Jaime Fixsen of Canada and Regina Sirois of Kansas! Being from Kansas, I loved this book involved a local author How fun!!

Rated 4 of 5 of 5 by Susan P
An Unexpected Ending
The story of a young woman who has a talent for medicine during a time when women were not allowed to practice as doctors has been told before. But, this time, the story has an unexpected twist at the end. The story in between beginning and end is entertaining, has good character development and captured this reader's imagination. A most enjoyable read and I recommend it as a good book club discussion book.

Rated 4 of 5 of 5 by Christine
Thoroughly Enjoyed!
Thoroughly enjoyed this book. Handled the subject really well without being patronizing - even the romance was done well without making the woman “weak” and “lose” herself.

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Early Anesthetics

Oil painting of dentist W.T.G. Morton using an ether-soaked rag to anesthetize a patient by Ernest BoardIn The Girl in His Shadow by Audrey Blake, Nora and Daniel use diethyl ether, referred to simply as "ether," to render a patient unconscious in order to perform a surgical procedure on him. While the procedure is ultimately successful, the characters are still unsure of the exact effects of the drug. Nora and Daniel's study of and experimentation with ether is reflective of the murky medical knowledge of the substance available to physicians at the time. Ether ultimately became the first general anesthetic to see wide recorded use in surgery.

Before general anesthetics, or drugs that allow for the controlled induction of total unconsciousness, those performing invasive medical procedures such as surgery relied on sedatives (substances that promote relaxation) and analgesics (pain relievers) — including alcohol, opium and various herbal medicines — to reduce pain and discomfort in patients. The first known use of a general anesthesic during surgery took place in Japan in 1804. The anesthetic was an herbal mixture containing the plants monkshood and thorn apple that physician Seishu Hanaoka gave to a patient undergoing a partial mastectomy. However, this form of anesthesia never came into use outside of Japan.

Diethyl ether was first prepared as a chemical compound by the Prussian botanist Valerius Cordus in 1540. Its potential as an analgesic and sedative was explored in a report by English scientist Michael Faraday in 1818, but during the first half of the 19th century it was mainly used as a recreational drug. It was sold as an alternative to alcohol, and people attended "ether frolics," parties where the substance was inhaled. Inhalation could eventually lead to unconsciousness, but it produced a feeling of euphoria before that point was reached.

Crawford Williamson Long, a physician practicing in Georgia in the United States, was the first to employ ether as a general anesthetic for the purpose of performing surgery in 1842, when he used the substance to anesthetize a patient, James M. Venable, before removing a tumor from his neck. Long and Venable were both familiar with the recreational use of ether, which may have been why they agreed to try it for this purpose. However, Long delayed publishing the results of the procedure until 1848, by which time a Boston dentist named William T.G. Morton had already demonstrated the use of ether as an anesthetic in public in 1846. For this reason, Morton is commonly (though inaccurately) credited with being the first to use ether to anesthetize a patient.

Ether subsequently began to see wide use in medical procedures, including on wounded soldiers during the American Civil War. It remained a standard form of general anesthesia until it was replaced in the 1960s by fluorinated hydrocarbons, which are safer for use in a medical setting and less likely to produce certain side effects, such as nausea and vomiting.

While ether is no longer typically used as an anesthetic in the United States, Britain and many other countries that have reliable access to modern medicine, it is still sometimes employed for this purpose in poorer regions because it is relatively cheap to produce. The main drawback to its use is that it is highly flammable and explosive, and can therefore be dangerous.

The first use of ether in dental surgery, painting by Ernest Board, 1846

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By Elisabeth Cook

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