A Mastectomy Without Anesthesia

In September 1811 the Herschels’ old friend Fanny Burney, by then the married Madame d’Arblay, underwent an agonising 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 parts 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.’

On the subject of pain, and Humphry Davy’s failure to pursue anaesthesia, it is worth considering what Fanny Burney wrote about her terror before this mastectomy operation: ‘All hope of escaping this evil being now at an end, I could only console or employ my mind in considering how to render it less dreadful to [my husband] M. d’Arblay. M. Dubois had pronounced: “you must expect to suffer — I do not wish to mislead you — you will suffer — you will suffer very much!” M. Ribe had charged me to cry! To withhold or restrain myself might have seriously bad consequences, he said. M. Moreau, in echoing this injunction, enquired whether I had cried or screamed at the birth of Alexandre. Alas, I told him, it had not been possible to do otherwise. “Oh then,” he answered, “there is no fear!” — What terrible inferences were here to be drawn!’

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 — & I almost marvel that it rings not in my ears still! So excruciating was the agony … All description would be baffled … I felt the Knife rackling against the breast bone — scraping it!’

One of Burney’s many extraordinary reflections was whether extreme physical pain could not only induce unconsciousness — ‘I have two total chasms in my memory of this transaction’ — but actually force the soul out of the body. She also found that the act of recollection carried its own pain, and that she had taken three months to complete the account, as a letter of nearly 10,000 words to her sister Esther. She had severe headaches every time she tried to go on with it. Once finished, she could not look back over what she had written. ‘I dare not revise, nor read, the recollection is still so painful.’ It is an astonishing record of courage, not least in Fanny’s determination to protect her husband from the trauma of the operation. But it also recalls what the real conditions of surgery were at this period.

Fanny Burney's horrific account of undergoing surgery to have a breast removed.