The year is 1873 when on a late October night, Grace Wickham is called to an accident at the local tannery. Recently returned from a year of medical school, Miss Wickham is the person people turn to as they once did her late father, the local doctor.

The body floating in a steaming tannery vat is the owner, Truman Reed, and the men who rush to answer the emergency bell each have reason to wish him dead. With the constable out of town, the coroner asks Gracie to look into things, for this was no accident. Is the murderer the manager himself whom Reed threatened to fire? Was it his partner, Phineas Pierce, who wanted to sell? Troublemaker Wash Baker, whose pay had been cut? Recently fired night watchman Orrin Rooney? Reed's embittered wife? Or Chester Owens, who believes his son died following Reed's unreasonable orders? And why was a peddler hanging around the tannery that night?

As Gracie sees patients in her herbal practice and talks with neighbors, she puzzles over motives and evidence with Adirondack hotel owner and friend, Ambrose Baldoon, (the only man taller than Gracie's six feet). Another suspicious death complicates her investigation until clues converge and Gracie comes up with some surprising answers.