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How does a woman from the Cape of Good Hope end up in Breda, The Netherlands? And more to the point, how does she end up contacting one of Europe’s most famous doctors via a Dutch sea captain in The Hague? This woman’s ailment, diagnosed by Tissot as a form of nervous illness that manifested itself as paralysis, appears to me to be only incidental. Far more intriguing is the back story; namely her journey from one of the southernmost regions of Africa to Europe’s Low Countries.

In a long history of colonization and seafaring, the Cape of Good Hope has had various names. In the fifteenth century, the Portuguese explorer, Bartolomeu Dias named it the Cape of Storms. More optimistic was his compatriot, John II, who later renamed it the Cape of Good Hope because of the promise of new trade routes. The correspondent in question, however, was likely referring to a small community settled about 100 km from the Cape itself, but bearing its name.

Now known as Cape Town, this community, too, has been profoundly shaped by centuries of colonialism, from its establishment by the Dutch East India Company in 1652 to later incursions by the British (in order to protect it from the French). Madame was likely a member of the settler community and perhaps her father worked for the Dutch East India Company. It would seem likely that her husband, too, worked for the company or perhaps in some diplomatic capacity for why else would she have made the long and likely treacherous journey to Europe after her marriage? Was she Dutch? Was she African, a member of the Khoikhoi who also lived and farmed in the area? These details I don’t yet know.

All I know is this: she wrote her letter in 1780 at the age of 51. She was born in Africa where, at the age of 16 she was married and left the country of her birth. Over the next fifteen years of her marriage she was pregnant 10 times and carried seven children to term. She had three miscarriages. She began menstruating at the age of 12 and has never experienced any problems. At the age of 28, she experienced a serious bout of smallpox, but did not suffer any ill after effects. She enjoyed perfect health until 1778, when she hit menopause. Since then, she  experienced paralysis in both her legs and her arms. She visited numerous doctors to no avail.

How might she have experienced the travails of her suffering body? By 1780, she’d lived in Europe for over thirty years; she’d had her children there; it’s likely she buried her husband there. But it’s hard for me to imagine that her European experiences weren’t somehow coloured by her childhood in what is now South Africa.

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Tissot’s most famous work, the Avis au people sur sa santé, includes a long list of questions that a patient should be able to answer about their ailment. These questions look familiar to us, for they are very similar to those that our own family doctor might ask. Given this, one might wonder why Tissot felt the need to include this information.

A closer look at a letter from Madame La Millière, written in November 1767, might give us some hints. Madame de La Millière had already been in contact with Tissot before writing this letter, but even given the fact that he was likely aware of her case, there are many gaps in her narrative. Even the word ‘narrative’ is itself problematic. Narrative, to me, implies coherence, structure and flow… a crafted piece of work that draws the reader in. This letter, however, jumps from topic to topic, seemingly without reason.

It seems, at first glance to be about arm pain. Then it’s about leg pain and fainting. And suddenly it’s about stomach problems. By the end, we’re back to arms. And in the middle of it all, she takes a moment to pass on her doctor’s regards, noting that he has performed many successful inoculations in the previous months.

The letter is both highly descriptive and frustratingly inscrutable. Thus, we learn that she has lost the use of her left arm and now fears that she’ll lose the use of her other arm. We learn about the pains in her legs and the kind of treatment she has been following. We learn the name of her doctor and hear a bit about his suggestions. We learn when pains began and ended. All of these details correspond to Tissot’s suggested guidelines.

But descriptive vocabulary is decidedly limited, and for a twenty-first century reader, the words ‘soufrante’ [sic] and ‘douleurs’ wear quickly. How many nuances might these words have contained in the mid-eighteenth century? What might Madame have meant when she chose to use them – seven times [douleurs] in the course of a 700 word letter?

Other language, too, is vague, leaving the reader many questions: when Madame states that she has ‘lost’ an arm and is almost at the point of ‘losing’ her legs, what does she mean? Why does she link her digestive problems with physical pain in her arms and legs? And how, if she is experiencing such pain in her arms, is she able to write the good doctor a three page letter?