In Recognition of Breast Cancer Awareness Month this post recounts the experience of Abigail Adams Smith with breast cancer. Nabby, as she was called (featured in the last post), developed a tumor in her breast at the age of 45. She journeyed, from upstate New York where she was living, to her parents’ home in Massachusetts. She wrote a letter to the famous doctor Benjamin Rush describing her condition and requesting his advice. Her letter was enclosed with one from her father to Rush on September 12, 1811. She wrote:

… about May 1810 I first perceived a hardness in my right Breast just above the nipple which occasioned me an uneasy sensation, like a burning some times an itching & at time a deep darting pain through the Breast, but without any discolouration at all. it has continued to Contract and the Breast has become much smaller than it was. the tumor appears now about the size of a Cap, and does not appear to adhere but it be loose.… I applied to a Physician and he recommended me to apply a Plaister of the cicuta*.… I have also taken a considerable of cicuta in Pills, but I thought they produced a heaviness in my head…. I have consulted several Physicians upon the Subject they have all advised me not to make any outward application to it…. Still I am uneasy upon the Subject—for I think I observe it becoming harder and a little redness at times on the skin…. Dr Warren who has seen it told me that in its present state he would not advise me to do anything for it….

* Hemlock: a poultice prepared with the leaves of the plant was applied topically to treat tumours.

Doctor Rush chose to reply to his old friend John Adams, rather than writing to Nabby herself about such a sensitive topic. Below are excerpts from Rush’s letter to John Adams:

… After the experience of more than 50 years in cases similar to hers, I must protest against all local applications and internal medicines for her relief. They now and then cure, but in 19 cases out of 20 in tumors in the breast they do harm or suspend the disease until it passes beyond that time in which the only radical remedy is ineffectual. The remedy is the knife. From her account of the moving state of the tumor, it is now in a proper situation for the operation. Should she wait till it suppurates or even inflames much, it may be too late. The pain of the operation is much less than her fears represent it to be …. I repeat again, let there be no delay in flying to the knife. Her time of life calls for expedition in this business, for tumors such as hers tend much more rapidly to cancer after 45 than in more early life. I sincerely sympathize with her and with you and your dear Mrs. Adams in this family affliction, but it will be but for a few minutes if she submit to have it extirpated, and if not, it will probably be a source of distress and pain to you all for years to come. It shocks me to think of the consequences of procrastination in her case.

Following the reply from Rush, dated September 20, Nabby had the breast removed. Read the distressing account of the surgery performed on Nabby in James Olson’s book, Bathsheba’s Breast, (Johns Hopkins University Press, 2002) Nabby hoped she had been cured. But her mother wrote to her brother John Quincy on October 22, 1813:

we are all well, except your Sister Smith, who has had a very sick winter, she has so far recovered, as I hope, to be upon her journey here again, John has undertaken to get her here at her most earnest request. I fear it will be, to be laid by her Ancestors. Such are her complaints; that I fear I shall have one of the distressing and trying scenes of my Life to go through To heaven I submit, trusting that as my trials are, so will my strength be—

Nabby died in 1813 from a recurrence and spread of the cancer.

For Nabby’s description of her problem and her mother’s comments see a presentation made on November 4, 2013 at the South Shore Hospital on Long Island, New York, sponsored by the Abigail Adams Historical Society. For Rush’s reply see “Benjamin Rush on Cancer,” by Michael Shimkin in Cancer Research, 1976; 36:2117-2118.

Abigail Adams, called Nabby, was the eldest child of John and Abigail Adams. She had married Colonel William Stephen Smith in London in 1786 while Smith was serving on the staff of John Adams, the American minister to the Court of St. James’s at the time. The next year Nabby had her first child William Steuben. The Smiths returned to America in 1788 and settled in New York where Nabby had two more children, the younger of whom died shortly before his first birthday. Nabby’s father, John Adams, became vice president in 1789 when a new government was formed after the ratification of the Constitution. Smith’s business ventures took the family back to London between 1790 and 1793. In the following letter written to her mother upon their return to New York in 1793, Nabby describes their voyage, undertaken in the winter when the trip could be expected to be difficult, and the reason for their departure from London.

New-York, Feb. 9th, 1792. [1793]It is with very great pleasure that I address you, my dear mamma, from this place again. You will be as agreeably surprised as our friends here were, the evening before the last, to see us, and find us safe at New-York; for our arrival was wholly unexpected to them. We avoided informing our friends of our intentions, knowing that their anxious solicitude for our safety would render them unhappy. We left England the 23d of December, in the Portland packet, at a season when our friends there thought we were almost out of our senses. But we have been highly favoured, having had a very pleasant passage—not knowing what cold weather was until a day or two before we landed; we neither saw nor experienced the want of a fire during our passage; and for three weeks had such warm weather that we were obliged to sleep with our windows open in the cabin. Our course was to the southward as far as the latitude of 30 degrees, and we were greatly favoured in coming upon our own coast. I can scarcely realize that it was mid-winter. We have all been very well upon our passage; the children look finely, and Col. Smith is very well; for myself, I was never so well at sea before. We had an excellent ship and a good captain; our accommodations were convenient; we had four poor expatriated French priests, on their route to Canada, as fellow-passengers, but they did not incommode us, we having two cabins. We had a passage of 45 days, and feel ourselves quite at home again. . . . But it is time to tell you the cause of our leaving England, which was the prospect of a war on the ocean in the spring, and we did not like the idea of crossing it with bullets whizzing round our heads. Some business, also was an inducement.

England informs France that if they attempt to open the navigation of the Scheldt, that they shall join the Dutch; this is the ostensible cause for arming, which they are doing with great vigour. But they dread internal commotions, and are fortifying the Tower, directing the guns upon the city, preparing to build barracks in the Royal Exchange—placed a double guard at the Bank; breaking up all societies for reforms of Parliament, and forbidding, by proclamations, the meeting of all societies who call themselves republicans; burning Tom Paine in almost every capital town in England in effigy, with the rights of man in one hand, and a pair of old stays in the other. In short, doing just what he wishes, I presume, making him of more consequence than his own writings could possibly effect. He is falling off pretty much in France.

Col. Smith sets off on Tuesday for Philadelphia. I shall remain here. I shall have a strong inclination to make you a visit, for I must be a visiter until May, as we have no house. We think to take one in the country for the summer. If you were in Philadelphia, I should soon be with you. I hear my father has quite renewed his youth, and that he is growing very popular; that the abuse is directed to another quarter.
Remember me to my brother, and all other friends, and believe me, / Your affectionate daughter,
A. Smith.

The letter can be found in the Adams Papers Digital Edition online HERE.

George Washington died at Mount Vernon on December 14, 1799. John Adams was president and Abigail was first lady. Philadelphia was still the capital of the United States, with the city of Washington to have that honor in 1800. Abigail Adams wrote to her sister Mary Cranch on December 30 describing a gathering she had hosted the previous week.

Last frydays drawing Room was the most crowded of any I ever had. Upwards of a hundred Ladies, and near as many Gentlemen attended, all in mourning. The Ladies Grief did not deprive them of taste in
ornamenting their white dresses: 2 yds of Black mode in length, of the narrow kind pleated upon one shoulder, crossd the Back in the form of a Military sash tyed at the side, crosd the peticoat & hung to the bottom of it, were worn by many. Others wore black Epulets of Black silk trimd with fring[e] upon each shoulder, black Ribbon in points upon the Gown & coat some plain Ribbon, some black Snail*. Their caps were crape with black plumes or black flowers. Black Gloves & fans. The Gentlemen all in Black. The Ladies many of them wanted me to fix the time for wearing mourning, but I declined, and left them to Govern themselves by the periods prescribed by the Gentlemen. The assembly Room is burnt down, and they have not any place to display their gay attire but the drawing Room and private parties, and as they expect it will be the last winter they will have the opportunity, they intended shining.

* obsolete for chenille

Women in mourning at this time typically wore white.

The letter can be found in the New Letters of Abigail Adams 1788-1801, edited with an Introduction by Stewart Mitchell (Boston: Houghton Mifflin Company, 1947) on page 244. The online version is courtesy of the American Antiquarian Society, copyright 1947. The illustration can be seen here.

Breaking my own guidelines for this blog, which usually consists of the writings of women from the years 1765 to 1799, today’s post includes some lines written by John Quincy Adams after reading some of his sister Nabby’s correspondence in 1841. (She died in of breast cancer in 1813.) I do think he expresses well how family correspondence conveys the spirit of the writers and the times in which they lived.

Letters written in the domestic intercourse of families are necessarily much diversified as to the subjects upon which they are written, as to the circumstances to which they relate, to the incidents which they record, and to the state of mind, of health, and of temper with which they are composed. Strangers or even members of the family of the writer, who after a lapse of years, read several of them in immediate succession, can scarcely enter into the spirit with which they are animated, but by reading a few of them at once and by alternately laying by and taking [them] up again.

Paul C. Nagel The Adams Women: Abigail and Louisa Adams, Their Sisters and Daughters (Oxford University Press: New York, 1987), p 300. The engraving of John Quincy Adams is from the 1869 $500 series of U.S. currency.

In October of 1795 John Quincy Adams was called to London from the Hague, where he was the United States minister, to exchange ratifications of the Jay Treaty. Unbeknownst to him this had already been done before he arrived. In London, however, he met Louisa Catherine Johnson and became a frequent guest at the family home. In Record of a Life Louisa described their meeting and courtship. “Time flew on its lightest pinions and I looked not beyond the hour.—I rattled and laugh’d then heedless of harm and never dreamt of change—Matters went on thus for two or three months. . . . ” Finally, persuaded that he was wooing her, Louisa agreed to an engagement which was announced on February 12, 1796. Louisa goes on to describe an incident that revealed what an odd and difficult man John Quincy was and, indeed, remained throughout their marriage.

In the Spring we made a party to go to Ranelagh [a pleasure garden] and Mr. Adams was to accompany us.— I had jokingly told him that if he went with us he must dress himself handsomely and look as dashy as possible—not aware that on this subject he was very sore. . . . The night previous to the party he took leave very coldly and desired if we went we should call for him at the Adelphi [Hotel] on our way. . . . Accordingly we took him up . . . and I obser’d immediately that he was very handsomely dressed. . . . As I had dressed myself very becomingly . . . we drove off in high spirits. . . . On entering the Rotunda our party naturally separated and Mr A offered me his arm and while we were strolling round the room I complimented him upon his appearance at which he immediately took fire, and assured me that his wife must never take the liberty of interfering in those particulars, and assumed a tone so high and lofty and made so serious a grievance of the affair, that I felt offended and told him I resign’d all pretensions to his hand, and left him as free as air to choose a Lady who would be more discreet. I then drop’d his arm and join’d my mother with whom I staid the remainder of the evening—

On our way home apologies were made and accepted but if lovers quarrels are a renewal of love they also leave a sting behind which however apparently healed reopens on every trivial occasion; and the smart frequently felt inspires the mind with a secret and unknown dread of something hidden beneath the rosy wreath of love from which we would in vain turn our thoughts; but which like the faint sunbeams through a dense fog only produce a momentary gleam of light to make the darkness which surrounds us still more impenetrable.

For several months John Quincy refused to set a wedding date, claiming insufficient funds. He returned to Holland and recommended that during his absence Louisa should “attend to the improvement of my mind and laid down a course of study for me until we met, which might be in one year or in seven.” Eventually the two married in 1797 although John Quincy’s mother Abigail did not approve.

Upon finally meeting her husband’s family in 1801 in Quincy, Louisa described her reaction. “Had I step[p]ed into Noah’s Ark, I do not think I would have been more utterly astonished. . . . Do what I would there was a conviction on the part of the others that I could not suit.” She was made to feel “a maudlin, hysterical fine lady not fit to be John Quincy Adams’ wife.” Her mother-in-law, she felt, “was in every point of view a superior Woman . . . the equal of every occasion in life.” She “forms a most striking contrast to poor me.” This “forlorn stranger,” as Louisa described herself, eventually managed to earn the affection of her father-in-law John Adams and was a great comfort to him in his old age.

This source was consulted for biographical details and events in Louisa’s later life. Her own impressions are from A Traveled First Lady: Writings of Louisa Catherine Adams edited by Margaret A. Hogan and C. James Taylor (Cambridge: The Belknap Press of Harvard University Press, 2014), pages 23-28. Her portrait as First Lady is by Charles Bird King (between 1821 and 1825) and is in The Granger Collection.