1856 Physician’s Manuscript Case Study Report on the Clinical Details of a Suspected Extrauterine Conception

On offer is a weird and wonderful manuscript contribution to 19th century obstetrical medical knowledge written by a practicing Rhode Island physician. 

The document is a case study report that appears to have been written for intended publication in a medical journal (no records of its publication have been found). The report’s author is Dr. Absaolm Pride (A.P.) King (1820-1868). Dr. King was a Rhode Island-based medical doctor. (see BIO NOTES at the end of the listing for more information). Dr. King practiced both traditional medicine and homeopathy. In this case, he was acting as a community physician making home visits for patients in need. 

The report is titled “Extrauterine Conception” and, over eight pages, Dr. King describes the case of a mother of three teenagers, aged 53, who had been suffering with abdominal and pelvic concerns for years. Dr. King acknowledges the rarity of extrauterine pregnancy and its minimal mention in the medical literature. He aims to contribute this case to the literature, stating: 

“...The following case which I have the liberty to report is more interesting perhaps than instructive and will add one more to the number of (probably) abdominal conceptions…”

He discusses the poor treatment provided by another physician prior to his involvement in the case. Dr. King believes that this extrauterine pregnancy occurred 18 years prior, and that the patient and her doctor at the time believed it ended with a spontaneous abortion that never produced products of conception vaginally. The woman had been treated for severe constipation and piles (Haemorrhoids), which Dr. King believed were caused by the abdominal pregnancy. He then goes on to describe how the woman passes the conception rectally, and gives fairly graphic detail of his findings. 

Some excerpts of the report follow (graphic content has omitted from the excerpts):

“Mrs. — called me to attend her some ten months since; I found her extremely prostrated having been confined to her bed for the last two or three weeks and medicated by her family Physician for what he called “Stoppage”. The treatment had been a cathartic in the evening followed by an opiate at night until the stomach would no longer submit to much barbarisms…”

“…exertions for relief proved successful and saved her the mortification and me the unpleasant duty of making an exploration [of] her annus. The obstruction provided to be no less than parts of a faetal skeleton, perhaps five months advanced…”

“…It is now several months since Mrs. – has had any unnatural body pass per rectum. The “piles” tenderness in the pelvis - constipation and many other contributions to her ill health have passed away and she enjoys better health now than for eighteen years previous to thee last ten months…”

While this medical report is unarguably odd, the physician’s assessment, diagnosis, plan and evaluation give great insight into the clinical decision making of a physician managing medical and obstetrical concerns in the 19th century. Knowing that Dr. King also practiced homeopathy and believed in alternative medicine provides another angle for the reader to consider when analyzing this case. This report would make a fascinating piece of study for student doctors, nurses or any engaged health care practitioner.

The eight pages are handwritten in black ink. All pages are in good condition with no rips or tears. Some fold lines are present as is some normal age toning. The writing is legible. The report is signed by Dr. A.P. King and the report is accompanied by an envelope with the title of the report written in King’s hand. 

BIO NOTES: Dr. A.P. King was born in Preston, Connecticut to parents Daniel King and Cynthia Pride. In 1845, he graduated from a mainstream medical school, the Berkshire Medical Institute, in Pittsfield, Massachusetts (some sources say he graduated from Harvard Medical School - this is unconfirmed). After graduation, he worked as a physician in Apponaug and Providence, Rhode Island. On Christmas Day, 1845, he married Celia Hendricks in Woonsocket, Rhode Island. The couple remained in Rhode Island. They had four children, though, tragically, only one survived early childhood. Their third child, Eugene Pride King (1854-1921), would grow up to attend Brown University and have a successful medical career. Dr. A.P. King served the United States in the Civil War as Acting Assistant Surgeon, four years before his early death in Rhode Island.