21 November 2010

Mastectomy without anaesthesia

Frances Burney, an English novelist and diarist, transcribed her experience undergoing a mastectomy for breast cancer in the era before anaesthesia:
“In September 1811 the Herschels’ old friend Fanny Burney, by then the married Madame d’Arblay, underwent an agonizing operation for breast cancer without anaesthetic. It was carried out by an outstanding French military surgeon, Dominique Larrey, in Paris, and so successfully concluded that she lived for another twenty years. What is even more remarkable, Fanny Burney remained conscious throughout the entire operation, and subsequently wrote a detailed account of this experience, watching pats of the surgical procedure through the thin cambric cloth that had been placed over her face. At the time the surgeon did not realise that the material was semi-transparent. “I refused to be held; but when, bright through the cambric, I saw the glitter of polished steel – I closed my eyes. I would not trust to convulsive fear the sight of the terrible incision.”…

Indeed, she screamed throughout the operation. “When the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunction not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision - & agony… All description would be baffled… I felt the Knife rackling against the breast bone – scraping it!” (p. 305-6)
Some modern clinicians would note the twenty-year survival and suspect that her excised lesion was probably a fibroadenoma rather than a carcinoma, but that wouldn't detract from her amazing fortitude.

The text is an excerpt from The Age of Wonder: How the Romantic Generation Discovered the Beauty and Terror of Science. Richard Holmes. Pantheon Books, New York, 2008.

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