Anesthetics are essential for certain medical procedures. It helps prevent patients from feeling pain during surgery, screening, or diagnostic tests. But did you know before discovering anesthesia, people would just need to manage their pain on their own? 

Abigail Adams Smith, daughter of second president John Adams, had cancer in the breast. She had to go through mastectomy without the use of anesthesia, which was not discovered during the time.

Who was Abigail Adams Smith?

Abigail Adams Smith was born on July 14, 1765, in Braintree, Massachusetts. She was the eldest daughter of founding father and second president of the United States of America, John Adams. Her parents began calling her Nabby when she was little since this was how she would pronounce her name. The nickname stuck until her adulthood.

Smith was a shy and withdrawn woman but was reported to have striking characteristics such as long red hair, deep blue eyes, and porcelain complexion. It was also known that she was a brilliant woman though she did not match her parents’.

Smith met her future husband, Wiliam Stephens Smith, her father’s secretary, in 1785. At the time, Adams brought Smith and her mother, Abigail Adams, to join him in London as he took on the US minister to Great Britain.

A year later, the couple got married with Adam’s blessing. They soon had children in the following years. The Smiths settled in Jamaica, Long Island, upon their return to the country in 1788. And the following year, Smith found herself more involved in the formal interactions and social events of New York despite her dislike of it.

Smith was forced to join social events since her father became the vice president of George Washington in 1789, and her husband was appointed as the first United States Marshall for the District of New York.

As years passed, William Smith became more involved in ventures that caused the family constant financial difficulties. Despite the fact, Smith remained loyal to her husband, which also made her parents proud of her.

When Smith’s father became president, he appointed William Smith as the surveyor of the Port of New York. In 1806, William Smith was put on trial for violating the Neutrality Act of 1794. He was found not guilty but was removed from his post and stripped from any means of steady income.

Their family continued to have financial difficulties due to William’s poor investments and business ventures. Still, after a year, the family was able to recover socially and politically as they moved to a small farm in Central New York. Smith soon got sick but remained faithful and devoted to her husband until she died in 1813. (Source: Women History)

Abigail Adams Smith’s Mastectomy

In 1810, Smith felt a lump on her left breast. Upon examination, her physician diagnosed her with breast cancer. She was only 45 at the time. The lump grew to the point visible to the naked eye despite Smith’s attempts to seek out local healers and their potions.

The following year, Smith wrote to her parents of her condition, to which Adams requested her to come home to Boston and seek medical advice. Adams brought Smith to different doctors who prescribed hemlock pills to her. The pills didn’t work, thus triggering Smith to write to Dr. Benjamin Rush, another founding father, seeking advice.

Though addressed to Smith’s parents, Rush responded that his recommendation was to have Smith undergo surgery to remove the lump. On October 8, 1811, Smith underwent mastectomy performed by Boston’s best surgeon, Dr. John Warren.

The operation was done in the Adams household. The painful procedure had to be accomplished without anesthesia and with very crude instruments available at the time, such as a large fork with two razor-sharp six-inch prongs, a wooden-handled razor, and a thick, flat iron spatula constantly heated in a small oven.

Warren successfully removed the large lump, along with the left breast, but wasn’t aware that there were tumors in the lymph nodes under her arm. He took out the tumors as well. Smith made a full recovery seven months after the painful surgery, but by the spring of 1813, she fell ill again.

Tiny malignant tumors developed, spreading throughout her body. Smith’s health declined steadily until finally passing on August 9, 1813. (Source: Women History)