The first detailed description of living with esophageal cancer - John Casaubon’s 1690 diary
John Casaubon was an English surgeon in the late 1600s who developed an esophageal tumor in late 1690 and wrote about it in his diary before dying in January of 1691. It's harrowing, enlightening, and strangely beautiful. This blog post is the only place in the world you can read the full transcription of the diary entry.
John Casaubon’s diary
Monday Dec 29. 90.
At dinner I was almost choaked by swallowing a bit of a roasted Sd of mutton which as I thought stuck in the passage about the mouth of the stomach. But it suffered noething to goe downe and the stomach threw all up, though never soe small in quantitie, to all our amazements the sckilfull not knowing what 2 make of my condition. It being an unusuall afflixion wch. my melancholi suggested it an extraordinarie judgment. I could swallow about 2 spoonfulls about half way (as I thought) and then it would flush up in spite of my hart. Some small humiditie or dropps of what I dranck, rather distilld, or dropt into the stomach which afforded a bare living nourishment and on a sudden I grew lean as a skeleton and at some tymes very faint and feeble, although I recouerd in some measure and had stomach 2 eate, my meate doeth noe gt. good and I am in a kind of atrophie. What warme weather may do I cant’ tell, but hope well. Alwayes after I have bine at Stoole I am for a whyle very faint or weake which I much wonder at. It is a sine of gt weakenes certainly and of insoaed decay.
Context
A couple of friends and I wrote a paper on the history of esophageal cancer, mentioned elsewhere on this blog.
One of the neat things in the paper is the first full transcription of a diary entry from John Casaubon, which is the first first-person detailing of esophageal cancer I can find. It’s the last entry in the diary, and from what I could gather he died within the next week or two. It has been transcribed in partial form in other papers, but I had to know what I was missing in the ellipses, so wrote to the archivist at the Southampton City Archives in the United Kingdom, who was great and sent me a scan of the relevant page. The copyright for the microfilm scan of the diary is owned by the British Library (oh, the complexities of copyright), but the text itself is ancient and therefore public domain, so I finished the transcription and included it in the paper. My transcription also does not attempt to modernize or “correct” any of the spelling or punctuation: this is exactly what he wrote (including using “2” instead of “to,” and the absolutely delightful 1600s British phonetic spelling of the word “inside” as “insoaed”).
However! I should say, “One of the neat things in the paper was supposed to be…”
Somehow, at some point in the revision process, a line in the transcription disappeared. None of us noticed the omission, focused as we were on other things the reviewers wanted tuned up. The transcription is also present in full in my author’s working copy, so I have no idea how a small chunk was omitted. There was no copy-pasta, I sent the working copy to the journal in full. In any case, I wrote to the journal to ask that the missing line be added, and, after a review process, was refused. It doesn’t change the scientific conclusions of the paper, and would require publishing a correction, so they said no. I pushed back, as it is the only truly unique discrete data in the whole paper (everything else is contextualization, arrangement, and interpretation of prior publications). Alas, I suppose my humanist’s heart has different priorities than the scientific journal’s editors.
So, now, this blog post is the only public place you can find the whole transcription. That’s a bummer, I wish it was immortalized in a PubMed-indexed journal article, but this is the next best thing.
If you are interested in what was omitted in the journal article’s version, I split out the missing section below.
At dinner I was almost choaked by swallowing a bit of a roasted Sd of mutton which as I thought stuck in the passage about the mouth of the stomach. But it suffered noething to goe downe and the stomach threw all up, though never soe small in quantitie, to all our amazements the sckilfull not knowing what 2 make of my condition. It being an unusuall afflixion wch. my melancholi suggested it an extraordinarie judgment. I could swallow about 2 spoonfulls about half way (as I thought) and then it would flush up in spite of my hart. Some small humiditie or dropps of what I dranck, rather distilld, or dropt into the stomach which afforded
a bare living nourishment and on a sudden I grew lean as a skeleton and at some tymes very faint and feeble, although I recouerd in some measure and had stomach 2 eate, my
meate doeth noe gt. good and I am in a kind of atrophie. What warme weather may do I cant’ tell, but hope well. Alwayes after I have bine at Stoole I am for a whyle very faint or weake which I much wonder at. It is a sine of gt weakenes certainly and of insoaed decay.