17th and 18th Century Operations or My Deep Respect for Anaesthesia

I’ve been gone for a while. The first reason for this is “mommybloggers”. The good women of mumsnet made me cry, quite hysterically, for a whole day and they scared me off the internet for a bit longer than that. After an exhaustive session of alliterative insult-creation with friends – vicious viragos, back-biting behemoths, matza-minded mushbags – I feel much better. I understand this is not a very grown-up way of dealing with bullies, but it worked. I stopped crying and started laughing again.

The second reason is my son’s hernia repair. The poor little guy is just 8 and it was his first operation. He did remarkably well, despite a less than ideal reaction to the anaesthetic, and he was playing Red Rover again within days of the operation. He is now a legend at school. War stories of guts and stitches and scalpels are gold to the reputation of an 8 year-old.

I was allowed to go into theatre with him until he went to sleep. Watching his eyes roll back and then flicker closed mid-sentence was very disturbing indeed. My extreme discomfort was not helped by the theatre nurse who then asked me if I would like to kiss his unconscious body goodbye before I was ushered out of the room. Discomfort aside, I was so very very pleased we live in time where you can sleep through the pain.

17th century surgeons – men in black.

An operation without anaesthetic is almost impossible for me to imagine but they were performed for hundreds of years; they were performed on battlefields and in barber’s chairs. In the 17th century Samuel Pepys had an operation to extract his bladder stone, the description of which gives me the shivers. From Claire Tomalin’s biography:

“The surgeon got to work. First he inserted a thin silver instrument, the itinerarium, through the penis into the bladder to help position the stone. Then he made the incision, about three inches long and a finger’s breadth from the line running between scrotum and anus, and into the neck of the bladder, or just below it. The patient’s face was sponged as the incision was made. The stone was sought, found and grasped with pincers; the more speedily it could be got out the better. Once out, the wound was not stitched—it was thought best to let it drain and cicatrize itself—but simply washed and covered with a dressing, or even kept open at first with a small roll of soft cloth known as a tent, dipped in egg white. A plaster of egg yolk, rose vinegar and anointing oils was then applied.”

During these lithotomies, the patient’s arms and legs were strapped to a high chair. At least one assistant would stand over the patient and hold his shoulders back while the barber-surgeon went to work.

Bladder stone operation in progress. Picture source: The Wellcome Collection

A paper written in 1650 by John Evelyn, describes the surgery of an 8 or 9 year-old boy:

“with much cherefullnesse, going through the operation with extraordinary patience, & expressing greate joy, when he saw the stone was drawn”

There was much blood-loss during these lithotomies and I can almost not believe that more patients did not simply die of shock. In their favour, however, was the time it took to extract the bladder stones. Good surgeons were able to perform this operation in under a minute. Your risk of death increased after the operation when infections and then gangrene set in. Samuel Pepys was lucky to suffer neither. He lived for many years after his bladder stone operation, celebrating the day each year with a party for his friends. Not so lucky were the women who underwent mastectomies in the same period.

I was first introduced to the story of Frances “Fanny” Burney by Barb Drummond in her wonderful blog Text History. Since reading the most harrowing few paragraphs of autobiography I have ever come across, I think of Fanny quite often.

Frances Burney's (1752–1840) last novel before...

Frances Burney was born in King’s Lynn (just around the corner from my family’s ancestral home of Great Walsingham) in June of 1752. Her father Dr Charles Burney was a musical historian and composer. When he moved his family to London, their lives were a whirlwind of trendy parties and suitable connections. Society thought Dr Burney was utterly charming. He sounds like a bit of a bastard to me, however – constantly criticising Frances; ignoring her education to focus on that of his “prettier and more intelligent” daughters. His son James became an admiral and sailed with Thomas Cook to the far ends of the earth.

Despite the challenges of being the least favoured child and only learning her letters when she was 8, Fanny grew up to be a well-respected and very popular author. Jane Austen bought and read her books. William Makepeace Thackeray and Samuel Johnson were admirers.

I’m an admirer too. I admire her spirit. She married against her father’s wishes, to a French General – Alexandre D’Arblay. He was penniless, a Catholic and leaned towards support of the French revolutionaries and was thus considered wholly unsuitable. Fanny married him anyway. While living in Paris with her husband in 1810, Fanny was diagnosed with breast cancer. What follows is her description of her mastectomy, which quite unbelievably, she survived. The operation was performed by 7 leading surgeons dressed all in black, among them the “best doctor in France”, Dr Dubois.

[I] mounted, therefore, unbidden, the Bed stead – & M. Dubois placed me upon the Mattress, & spread a cambric handkerchief upon my face. It was transparent, however, & I saw, through it, that the Bed stead was instantly surrounded by the 7 men & my nurse. 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. Yet — when the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision – & I almost marvel that it rings not in my Ears still? so excruciating was the agony. When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound. I concluded the operation was over – Oh no! presently the terrible cutting was renewed – & worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered – Again all description would be baffled – yet again all was not over, – Dr. Larry rested but his own hand, & — Oh heaven! – I then felt the knife (rack)ling against the breast bone – scraping it!

To conclude, the evil was so profound the case so delicate, and the precautions necessary for preventing a return too numerous, that the operation, including the treatment and dressing lasted 20 minutes! A time, for sufferings so acute, that it was hardly supportable – However, I bore it with all the courage I could exert, and never moved, nor stopt them, nor remonstrated, nor spoke, except once or twice during the dressings to say “Ah, Messieurs! que je vous plains” – for indeed I was sensible to the concern with which they saw what I had endured, though  my speech was meant principally, very principally,for Dr Larry … Twice, I believe, I fainted, at least I have two total chasms in my memory of the transaction, that impede me tying together what passed. When all was done, and they lifted me up that I might be put to bed, my strength was so totally annihilated, that I was obliged to be carried, and could not even sustain my hands and arms, which hung as if I had been lifeless; while my face, as the Nurse has told me, was utterly colourless. This removal made me open my Eyes – and then I saw my good Dr Larry, pale nearly as myself, his face streaked with blood, and it expression depicting grief, apprehension and almost horror.”

I am pale and horror-filled simply copying these words. My little guy’s operation was, in context, an absolute miracle of modern life. Mean-spirited mommybloggers have done me absolutely no lasting damage. I’ve learnt a valuable lesson about not taking kind words and an open heart to a bear-skinning. The sun is shining. The garden is green. The dogs have recovered from the Diwali fireworks. 23 Thorns, my charming husband, survived turning 40 with the crisis manifesting itself only as a very silly November moustache. My perineum is intact. I’ve never felt a scalpel against my bone. Really, I’ve got rather a lot to be cheerful about. I’m back.

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30 thoughts on “17th and 18th Century Operations or My Deep Respect for Anaesthesia

  1. She felt the knife scraping the breastbone??!! oh my …. this made me feel weak in the knees. My son is an anesthesiologist. I can not imagine surgeons doing their job without him!

  2. I can’t even watch Grey’s Anatomy, and now you’re telling me this! The snakes that haunt my dreams are going to be replaced by a blood soaked man in a mothy wig with an itinerariumin his hand.

    • What with your blog about plague-ridden cute and furries and mine about primal horror, I think neither of us will ever sleep again. Luckily the children will be awake anyway. Do you think our boychild is old enough to make us a glass of hot milk yet?

  3. Firstly, welcome back. You have been missed!
    Yeek! My breasts cramped in sympathy then! Oh the horror. I can’t imagine actually watching my bubba’s being put to sleep, and that comment made about kissing his lifeless body goodbye is utterly unfeeling! 😦 Glad the surgery all went well and that your son is making the most of his brand new battle scar.
    As for the vicious Mumma’s, those that get most defensive and nasty about the perceived faults in others parenting are hiding their own dark and nasty (and probably only in their own minds) parenting imperfections. I’m glad you’ve come back to the blogosphere as you would have been well missed. Hope your hubby isn’t making to big a moan about his encroaching decrepitude either. ;

  4. Eye-opening and watering. Had trouble finishing reading the description of the masectomy. If I was being operated in those days I think I’d have wanted at the very least a bottle of brandy to drink first!

  5. Eeeurrrgh….That’s primarily about the historic operations. Though a weetabix and raw egg smoothie makes a good second.
    Sorry to hear about the mumsnet experience. Fear of something like that happening has held me back from things like blogging for years. If it is any consolation (and I don’t know if it will be because I haven’t seen the context), ‘muppet’ in the UK is generally used as an affectionate, mild way of telling someone they’ve done something daft/been a bit of an idiot.

      • I’ve never had an even vaguely similar experience here on WordPress. Apparently the mumsnet forums that deal with actual health issues etc are hugely supportive. It just so happened that I stumbled onto a board that is known to be for the thick-of-skin; a mommy fight club where you go to get Dr Phil (if he could remain anonymous) ‘tell it like it is’ reflection. I didn’t know that before wading in though. Lesson learnt. I think it’s about where you post. Also, never get into a cyber argument about anything. You simply cannot win!

  6. I used to work in offices and hospitals full of women. always a bitchfest. I tended to hang out with the guys and got all sorts of flack for it. So, condolences and glad you’re back and your family are fine. As for the post, it’s not just the anaesthesia, but decent pain relief. I think it wsa the US killer Gary Gilmour who killed because his teeth hurt him so much and he was too afraid to kill himself. Chronic pain does strange things to people. another great post.

    • Thanks Barb for being the first to tell me about Fanny.

      You’re right about pain relief. The thought of not even having a Panado to pop after somebody had cut off my breast is just unthinkable.

      My housekeeper recently became a sangoma (witch doctor/ traditional healer) and she has to now avoid all “modern” medicine. She is not allowed to visit a chemist and is absolutely forbidden contact with doctors. During her training, she had the worst case of shingles I have ever seen and it was quite painful just watching her trying to cope with the agony without the option of an anti-inflammatory.

  7. Glad to see you’re back, the interweb can be a very mean place 😦

    The thought of operations without anaesthetic is just horrifying. Like you I have been there when number 2 was put to sleep (bad asthma attack, intubated and in ICU) and even though it was an awful thing to be there for I thanked my lucky stars that I live in a country where such care is available. I can’t begin to imagine having to hold yourself still while someone is operating on you.

    Imagine how awful it would have been for the surgeons too, waiting for your patient to move the wrong way and the noises that even the most steadfast patient would make would be a dreadful stress to be under.

  8. Crazy….the surgical stuff and the mommy bloggers.

    I am never going to be “Mother of the Year”, but I laughed my ass off at the post you are referring to when your son fell out of the Range Rover—- clearly I knew he was fine, as your husband wouldn’t have posted it otherwise. People are crazy!

    • I laughed at the post too. Out loud. I’m nervous about his next post though. He has announced that he will be calling me a crack-addict AGAIN. I’m not going to look at a single comment!

      Oh, what am I saying?! Of course I will. I’ve just grown a thicker skin. It’s time I took it for a test-drive.

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