A 19Th CENTURY MASTECTOMY
FANNY (FRANCES) BURNEY was born in 1752, the fourth child and second daughter of Dr Charles Burney and his wife Ester. When her first novel "Evelina" was published in 1778 it became an instant best seller and remains in print today. Aged 41 she married a French refugee M. D'Arblay and in 1794 gave birth to her only child Alexandre. M. D'Arblay went back to France in 1810 and Fanny, with the baby, joined him in Paris the same year. In the summer of 1811 she noticed an inflammation and the appearance of a lump in the right breast. By 1812, when she was 50, the lump had become cruelly painful and, she could hardly use her right arm. Dr Dubois, a doctor to the Empress Josephine, was of the opinion that surgery to remove the lump was unavoidable if she were to live. Months afterwards Fanny wrote a narrative describing the ordeal in a long letter to her sister Hetty.
The operation was performed at home; permission from the local police had to be obtained for straw to be placed in the road outside the house to ease the noise of the horses and carriage wheels during the period of "danger and fever to the invalid." Fanny had to give a formal signed permission to the surgeon, Baron Larrey. She was told to prepare an armchair and provide a supply of towels and await his arrival at 1.00 o'clock . At 3 o'clock four carriages drew up outside and Fanny was given a "wine cordial to drink" when 7 men in black burst into her room insisting that her maid and newly engaged nurses should leave. Ignoring the armchair they began to move a bedstead into the centre of the room.
"..........Astonished I turned to Dr Larry (the surgeon), who had promised that an armchair would suffice; but he hung his head and would not look at me. Two old mattresses M. Dubois then demanded and an old sheet. I now began to tremble violently., more with distaste and horror of the preparation even then of the pain. These arranged to his liking, he desired me to mount the Bed stead. I stood suspended for a moment, whether I should not abruptly escape - I looked at the door, the windows - I felt desperate........."
M. Dubois tried to calm his patient and allowed one of the nurses to stay in the room. Knowing throughout her terror that there was no real alternative if she was to survive - and indeed that there was no guarantee of success anyway - she took off her robe de Chambre and ...........
"....... 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 and 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 that terrible incision......."
Fanny also saw the surgeon draw a cross and a circle upon the breast and realised that the intention was to.......
"......take off the WHOLE. Excited by this idea I started up and threw off my veil........& explained the nature of my sufferings.......I was heard attentively but in utter silence, and M. Dubois then replaced me as before and spread my veil over my face........Hopeless then, desperate, & self-given up, I closed once more my eyes, relinquishing all watching, all resistance, all interference......."
"Yet--when that 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 poinards, 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 and 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 which remained hermetically shut......."
"........I concluded that 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 it was not over. Dr Larry rested but his own hand, & - Oh heaven - I then felt the knife rackling against the breast bone, scraping it. This performed while I yet remained in utterly speechless torture.....".
The operation lasted seventeen and a half minutes, Fanny fainted twice. On being lifted from her bed she was conscious and looked into Dr Larry's face.
".......I saw my good Dr Larry, pale nearly as myself, his face streaked with blood, & its expression depicting grief, apprehension, and almost horrour.....".
That night the expected fever struck and Fanny vomited dreadfully. She suffered "violent spasm" and was given "des potions calmantes anti-spasmodique." But on visiting his patient the following morning Dr Larry found that the fever had departed; on the evening of the same day Fanny was able to".......take a little chicken broth."
It was over.
****************
Fanny Burney survived her mastectomy. The family D'Arblay returned to England in 1812, but were back in Belgium during the Battle of Waterloo. In 1815 she returned to London and then lived in Bath until her death, aged 88, in 1840.
She lived a further 28 years after her operation.
Thanks to "Fanny Burney, Her Life," by Kate Chisholm (pub Chatto & Windus, regretfully out of print.)
Faculty of Medicine, University of Manitoba.
From The Old Dyke 4, September 2000
Back to: