The way we were: Under the knife

Two extracts from letters and diaries about 19th-century surgery
September 22, 2010
30th September, 1811. After the diagnosis of breast cancer, Fanny Burney writes to her sister describing her radical mastectomy performed without anaesthetic in Paris

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 When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were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—but when again I felt the instrument—describing a curve—cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose & tire the hand of the operator, who was forced to change from the right to the left—then, indeed, I thought I must have expired.

I attempted no more to open my Eyes, —they felt as if hermetically shut, & so firmly closed, that the Eyelids seemed indented into the Cheeks. The instrument this second time withdrawn, I concluded the operation over—Oh no!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 tackling against the breast bone—scraping it! …not for days, not for Weeks, but for Months I could not speak of this terrible business without nearly again going through it! I could not think of it with impunity! …& this miserable account, which I began 3 Months ago, at least, I dare not revise, nor read, the recollection is still so painful.

24th December, 1847. Charles Greville records in his diary an early use of chloroform

To St George’s Hospital to see the chloroform tried. A boy two years and a half old was cut for a stone. He was put to sleep in a minute; the stone was so large and the bladder so contracted, the operator could not get hold of it, and the operation lasted above twenty minutes, with repeated probings by different instruments; the chloroform was applied from time to time, and the child never exhibited the slightest sign of consciousness, and it was exactly the same as operating upon a dead body.

A curious example was shown of what is called the etiquette of the profession. The operator could not extract the stone, so at last he handed the instrument to Keate, who is the finest operator possible, and he got hold of the stone. When he announced he had done so, the first man begged to have the forceps back… in taking it he let go of the stone, and the whole thing had to be done all over… increasing the local inflammation, and endangering the life of the child. I asked Keate why… He said the other man’s dignity would have been hurt if he had not been allowed to complete what he had begun!