"Tapd 66 times". What did Dame Mary Page endure?

December 22, 2018 9:26 AM

Dame Mary Page died in March 1728 at the age of 56, and is buried in In London's Bunhill Fields cemetery. "In 67 months she was tapd 66 times," her tomb's inscription tells us. "Had taken away 240 gallons of water without ever repining at her case or ever fearing the operation." What on earth was being done to this poor woman, what condition was it supposed to address, and is there even the slightest chance it wasn't doing more harm than good?
posted by Paul Slade to Science & Nature (10 answers total)

Meig's syndrome, possibly.
posted by Iris Gambol at 9:30 AM on December 22, 2018 [1 favorite]

It might be dropsy (edema).

Samuel Johnson had very similar-sounding treatments as detailed in Boswell's biography.
posted by jamjam at 10:07 AM on December 22, 2018

The 'tapd' I've been involved in involved an ultrasound to see where the inside bits are today and a spot chosen. Then they poke a big needle in and connect it up to a 1l vacuum bottle and suck the fluid out. I hit 3l once.

So basically just like 'tapping a keg'. But 18th century style. That's a guess at to what was being done.
posted by zengargoyle at 10:42 AM on December 22, 2018

Could well be ascites, and draining the fluid (still called "doing a tap" as far as I know) is still used as a way of relieving the symptoms. My spouse had ascites caused by end-stage liver disease (he had a transplant) and latterly was having 9-10 litres drained off his abdomen every day. There are risks attached, infection mainly, but it was the only way the doctors could keep him remotely comfortable at that stage.
posted by altolinguistic at 11:03 AM on December 22, 2018 [3 favorites]

Paracentesis is the technical term being danced around in the replies above. It fits logically but I don’t have any historic evidence that that’s what “tapd” meant at the time.
posted by telegraph at 12:48 PM on December 22, 2018

Best answer: Here's the description of the case by Mary Page's physician, Richard Mead. His diagnosis was ovarian dropsy, or ovarian edema as it would now be called:

A widow lady, whose opulent estate served to render her virtues more conspicuous, fell into an ascites, in the fifty-first year of her age. For this she was tapped; but as she soon filled up again, the operation was repeated once a month for the first year; and at each tapping, one with another, there were drawn off forty-four pints of water. The next year she was likewise tapped every month, and the whole quantity, being equally divided, made twelve pints for every month. And in the fourth and fifth years, and seven months of the sixth, in which time she underwent thirty tappings, each tapping amounting only to sixteen pints. After the last time, she began to grow weak and waste away; and she was seized with almost a constant difficulty of breathing, as we observe in a Dropsy of the breast, attended with frequent faintings; whereas before, through the whole course of the disease, in the intervals of tapping, she was chearful in conversation, used exercise, and even diverted herself with dancing. But, now life began to sit heavy upon her, and she died at length, a very easy death. Now, it is very surprising, that a human body, in that space of time, could furnish such a vast quantity of water, to wit, one thousand nine hundred and twenty pints; and it is my opinion, that this water was first collected in the ovaries.

(Mead, Medical Precepts and Cautions (1755), ch. 8, 'Of the Dropsy'.) The inscription on the tomb was placed there at Mary Page's own request, 'for the information of posterity'.
posted by verstegan at 1:09 PM on December 22, 2018 [26 favorites]

Response by poster: Thanks, verstegan. A better answer than I could possibly have hoped for.
posted by Paul Slade at 3:55 PM on December 22, 2018

As for your supplementary, "is there even the slightest chance it wasn't doing more harm than good?" now that's a fascinating question too. Mead's opinion of tapping was that it "sometimes preserves, but seldom kills, and always considerably eases the pain". He regarded Mary Page's case as a medical success, as she survived several years longer than she would have done without his intervention.

The case entered the medical textbooks, and Sir Thomas Watson, in his Lectures on the Principles and Practice of Physic (1844), praised Mead for having turned paracentesis (tapping) from a very risky operation into a fairly routine one:

Formerly, the rapid evacuation of a large quantity of liquid from the belly was often attended by terrifying effects: fainting, convulsions, almost instant death. [..] Dr Mead was the first to suggest that external compression should be substituted in lieu of the tension taken off by the operation. The complete success of that expedient fully justified his ingenious opinion; we now drain the cavity of its liquid contents without scruple or delay.

Watson admitted that this was not a "mode of cure, but simply of temporary relief from distress". But he still thought it was worthwhile: "when it is essential to the comfort and continued existence of the patient, it brings sensible relief to her distress, and often materially prolongs her life".

On the other hand, we can only guess at what Mary Page thought about having to undergo this painful operation so many times. Mead thought it wasn't so bad for her: "she was chearful in conversation, used exercise, and even diverted herself with dancing". Even at the end "she died a very easy death". But the preacher of her funeral sermon wrote that "her pains were almost intolerable" and any bodily movement "gave her almost exquisite Torture for a considerable Time after". So perhaps this wasn't quite the triumph of medical science that Mead would have us believe.
posted by verstegan at 5:40 PM on December 22, 2018 [7 favorites]

Man, I would love to have all my weird medical shit on my tombstone.
posted by The Underpants Monster at 8:45 PM on December 22, 2018 [7 favorites]

An ascitic tap is a frequently performed procedure in palliative care today and people get a lot of relief from not carrying around 6L of extra fluid in their abdominal cavity.

I would imagine that the way her death is described and extreme abdo pain - it probably came about from infection of the fluid from doing the procedure without modern notions of asepsis.
posted by chiquitita at 1:43 AM on December 23, 2018 [3 favorites]