A Dr J Marion Sims Dossier Essay

, Research Paper

Among

the immortalized on the Alabama Capitol grounds is a 19th century physician known as the

father of gynecology. Represented by the second of two bronze sculptures facing Dexter

Avenue on the right of the marble steps, Dr. James Marion Sims invented procedures,

instruments, and techniques that helped the spectrum of female diseases to become

recognized as a separate field of medicine. His monument was erected in 1939 by the

Alabama Medical Association. Capitol Curator Melanie Betz notes that a concerted effort to

beautify the state house surroundings coincided with the end of the Depression.

Unfortunately, the name of the sculptor could not be found.

There is, however, much available information on this interesting doctor

of medicine. Born in Lancaster County, South Carolina, in 1813, Sims attended the

Charleston Medical College and completed his training at Jefferson Medical College in

Philadelphia. He practiced briefly in his native state before moving to Mount Meigs,

Alabama, in 1835.

His autobiography, The Story of My Life (published in 1884;

reprinted in 1968), reveals a man of paradox who was modest yet self-assured, sickly yet

energetic, seemingly without specific goals yet capable of tremendous concentration.

Before he ingeniously devised an instrument – based on a bent-handled spoon – with which a

woman’s pelvic organs could be viewed, Sims was a general practitioner and surgeon who

preferred to work on clubfeet and crossed eyes. According to a 1937 article in the

Montgomery Advertiser by then Alabama Archives Director Peter A. Brannon, Dr. Sims and his

wife Theresa built a "log house of two stories and some pretensions" east of

Line Creek on the old Federal Road. They moved to Montgomery in 1840, where the doctor’s

first patients were a family of free Negroes. He soon had clients among the carriage trade

as well.

A 1930 address by Dr. Clarence Weil, on the occasion of the unveiling of a

bronze tablet marking the Montgomery office and infirmary of Dr. Sims, tells of the

honoree’s public thank you to the city in 1877, specifically to the "Crommelins and

Pollards who gave me houses to live in until I was able to provide one for myself."

His office and small eight bed infirmary were on the East side of Perry Street between

Washington and Dexter Avenue.

Edmond Souchon, M. D., writing in 1896 in the American Surgical

Association, expresses his elation on seeing "the forever famous little hospital in

which he [Sims] experimented upon [slave women] Lucy, Betsey, Anarcha, and finally cured

them; the hardware store where he bought the legendary pewter spoon from which developed

the great and celebrated duck-bill speculum; the jeweler’s store where the first silver

wire for sutures was drawn…" Brannon’s article pinpoints the hardware store as

Hall, Moses and Roberts, located at what was later 104 Dexter Avenue; the jewelry store

was owned by a Mr. Swan at 108 Dexter.

Perhaps in response to criticism for what he himself candidly described as

experiments on slave women, Dr. Sims noted in his autobiography: "I kept these

Negroes at my own expense…I succeeded in inspiring my patients with confidence they

would be cured eventually; they would not have felt that confidence if I had not felt

confident, too…I trained my patients to assist me in the operations."

The point has been made that Lucy, Anarcha, and Betsey did indeed suffer

from a chronic, embarrassing condition. Also to his credit, Sims informed their owners

that the women could not be expected to work while they were in his care. And once he came

up with the idea of using silver wire instead of silk sutures, all three were effectively

cured in the summer of 1849.

Sims moved to New York in 1852, stating the Alabama climate didn’t agree

with him. He had caught malaria within a year of his arrival, and other illnesses plagued

him throughout his time here. He refused to submit to a country doctor’s favorite

procedure of blood-letting, insisting that "Those who were bled and purged died the

quickest." He credits a Montgomery druggist with saving his life on one occasion

simply by giving him brandy, quinine, and caring attention. Members of his family were

frequently ill. A little son Merry, who was born on Christmas Day, 1845, died in 1848 and

is buried in Oakwood Cemetery.

Others believe Sims left the South to advance his career. He would later

claim to have departed the country for an extended tour of Europe in 1861 because he

needed "a little holiday," but according to biographical material from his

Pennsylvania alma mater: "Upon the start of the Civil War, Dr. Sims fled to Europe,

leveling anti-southern sentiment against him." The travels abroad brought him acclaim

from foreign governments.

He wasn’t above trying miracle cures on himself, such as water from one

Cooper’s Well, even though he had to go to Clinton, Mississippi, to get it. His wife found

that her husband’s most bothersome ailment could be relieved by combining this curative

water with a dish of salted pickle pork. Although Sims arrived in New York with a supply

of both remedies, his physical struggles continued; he even "fell out with

sunstroke" on Fifth Avenue. Moreover, he had to struggle against a solid wall of

professional jealousy: "I was called a quack and a humbug, and the hospital

pronounced a fraud."

This was the famous Women’s Hospital he was instrumental in founding,

which opened in New York in 1855 and became the paradigm for others of its kind.

Eventually, Sims rose above his detractors to gain the respect of his colleagues. He

served as President of the American Medical Association in 1875-76. Three states claim

him: South Carolina where he was born, Alabama where he made his initial contributions,

and New York, where his dreams were realized and where he died in 1888.

The Sims statue in Bryant Park in New York City was the first ever to be

erected in the United States in honor of a physician.

The following, from an article by Stanley Aronson, M.D., in the August,

1994 issue of Rhode Island Medicine, is indicative of the respect this pioneer

physician still commands in the profession: "Sims was a complex man, not easily

understood; but no one appreciative of the devastating effects of incontinence could

possibly diminish his contributions to the health and dignity of women."

Judy Oliver is the author of a number of books and articles about the

South, and lives in Montgomery.

from Montgomery

Living Online Magazine. Copyright ? 1999, 2000 Magazine of Montgomery Living.

Online Source: http://www.montgomeryliving.com/alabama/statue.html

J. Marion Sims: One Among Many Monumental Mistakes

by Wendy Brinker

Copyright 2000. Wendy Brinker, Columbia, South Carolina.

The controversy over the Confederate flag has brought the scrutiny of

the world to South Carolina. It has exposed

old racist wounds in a place where blacks and whites have always lived a jagged, grossly

unbalanced coexistence.

South Carolina’s struggle to reconcile its history is far from over. There are reminders

everywhere of the harsh,

shameful reality of slavery. The stigma of that fateful era reaches to us from the depths

of centuries and is

ever-present in the undercurrent of both sides of the debate.

Pharaohs believed that as long as their likeness or name existed somewhere, they lived on.

Having one’s legacy

preserved in stone is perhaps an expression of the human desire for immortality or the

immortalization of an idea.

The statehouse grounds in Columbia, South Carolina is wrought with statues of men whose

contributions have been

deemed worthy of homage. Their tributes stand tall among the well-manicured beds for

future generations to

ponder. Nestled on the shady northwest corner at the intersection of Assembly and Gervais

Streets, stands an

impressive monument honoring J. Marion Sims, a South Carolinian from Lancaster County,

curiously dubbed "The

Father of Gynecology."

The monument itself is one of the largest on the grounds. Center stage, in front of a

large cement archway, is a

bronze bust of Sims, looking down with crooked brow and patronly grin. Directly beneath

his image is a quote from

Hippocrates, "Where the love of man is, there is also the love of art." Etched

in a panel to the left, an inscription

touts, "The first surgeon of the ages in ministry to women, treating alike empress

and slave." On the panel to the

right, the inscription continues, "He founded the science of gynecology, was honored

in all lands and died with the

benediction of mankind."

What an epitaph. What had this guy done to deserve such accolades? My efforts to acquaint

myself with Dr. Sims

began innocently enough on the Internet. After locating several articles and books

praising the good doctor, one

article seemed out of place. It was an academic paper entitled, "Human

Experimentation: Before the Nazi Era and

After." South Carolina’s opinion of Dr. James Marion Sims was being vehemently

opposed by some outside

sources. But this is no real buck in the trend for southern historians. South Carolina’s

opinion of itself is often

diametrically opposed to that of the outside world’s. This is evidenced by South

Carolina’s portrayal of the entire

Civil War, or rather, their rendition of "The War of Northern Aggression."

By South Carolina’s account, Dr. Sims innovated techniques and developed instruments that

changed the landscape

of women’s reproductive health. By another account, he had a reputation for being an

absolute monster. Without

regard for human suffering, he performed excruciating, experimental operations on captive

women, leaving a swath

of misery and death in his wake. What is not in dispute is that between 1845 and 1849, in

a makeshift hospital he

built in his backyard, Sims inaugurated a long, drawn-out series of gynecological

operations on countless enslaved

African women. He performed over 34 experimental operations on a single woman for a

prolapsed uterus. This was

all done without the benefit of anesthesia or before any type of antiseptic was used.

After suffering unimaginable

pain, many lost their lives to infection. It is their story that history has failed to

tell and their legacy that should be

honored, not their captor’s.

By his own account, in an autobiography entitled, "The Story of My Life," Sims

felt himself quite unexceptional.

He was born in 1813 and received his higher education at Columbia College, predecessor of

University of South

Carolina, and received a BA in 1832. His father, John Sims, was a dominant figure in Sims’

early life. To his son’s

announcement of medicine as his profession, he replied, "To think that my son should

be going around from house

to house through this country, with a box of pills in one hand and a squirt in the other,

to ameliorate human

suffering, is a thought I never supposed I should have to contemplate." Mr. Sims

reluctantly sent his son to

apprentice under the tutelage of Dr. Churchill Jones. Once respected in the community, Dr.

Jones suffered from

chronic alcoholism. Although James Marion recalled him unfit to perform his duties, he

observed the failing doctor

perform many surgeries and deliver many lectures. Inspired to become a surgeon, an

insecure Sims left for

Charleston Medical College in November of 1833. He admits, "I was afraid to be a man;

I was afraid to assume its

responsibilities and thought that I did not have sense enough to go out into the rough

world, making a living as

other men had to do."

He was unprepared for the rigors of Charleston Medical College. While there, he forged, by

his own description, an

intimate friendship with a fellow classmate and they agreed to attend Jefferson Medical

College in Philadelphia for

their next term. It was there that Sims met another great influence in his life, Professor

George McClellan. He

describes him as, "very eccentric and erratic as a teacher… Not that he had much

system, but whatever he said

was to the point." In May of 1835, equipped with some surgical instruments and an

eight-volume medical text, Sims

returned to Lancaster ready to practice medicine. He had had no clinical experience,

logged no actual hospital time

and had no experience diagnosing illnesses.

Dr. Jones had since left the area. After weeks of sitting alone in a Main Street office

his father had rented, Dr. J.

Marion Sims got his first patient. It was the young son of a prominent citizen of

Lancaster. Sims documented,

"When I arrived I found a child about eighteen months old, very much emaciated, who

had what we would call the

summer complaint, or chronic diarrhea. I examined the child minutely from head to foot. I

looked at its gums, and

as I always carried a lancet with me and had surgical propensities, as soon as I saw some

swelling of the gums I at

once took out my lancet and cut the gums down to the teeth. This was good so far as it

went. But, when it came time

to making up a prescription, I had no more ideas of what ailed the child, or what to do

for it, than if I had never

studied medicine."

Sims returned to his office and studied his medical text for any clue as to how to

proceed. The reference books

Sims relied on were by a professor at Jefferson, John Eberle, who was known for his

unorthodox approach to

medicine. He drew from various schools of thought, including the use of leeches. Sims

administered a haphazard

regimen of prescriptions to the child, going from chapter to chapter in Eberle’s books,

but to no avail. After only a

few days, the infant died. Sims’ second case came only two weeks after the first. It was

another infant with the

same symptoms. Sims retracted the gums and administered another series of treatments, this

time starting at the

last chapter and working backwards in the book. He accomplished the same result. Sims

lamented, " I had the

misfortune to lose my first two patients, and the thought of it was too terrible to be

borne. I had never heard of such

terrible luck, and never thought that such misfortune could ever happen to any young man

in the world."

In October of 1835, immediately after the death of the two infants, the elder Sims took

his son to Alabama. It is

unclear why the young doctor left Lancaster, but his reputation could not have been

favorable. After three weeks

by wagon, they made it as far as Mt. Meigs, Alabama. There were two doctors in Mt. Meigs

he apprenticed under.

One, a Dr. Charles Lucas, was a politician and had made his fortune from cotton. Sims was

impressed by the fact

that Lucas owned two to three hundred slaves and could exert his influence over the

community. The other was Dr.

Childers, an old-fashioned country doctor that allowed Sims to accompany him on his house

calls. After witnessing

Childers "bleed" a patient to death, one of his favorite cure-alls, Sims

admitted, "I knew nothing about medicine,

but I had sense enough to see that doctors were killing their patients; that medicine was

not an exact science; that

it was wholly empirical, and that it would be better to trust entirely to Nature than to

the hazardous skills of the

doctors."

One month after his arrival, Sims bought out Dr. Childers’ practice for a two

hundred-dollar promissory note. His

first patient came to him when Dr. Lucas was away in Tuscaloosa on legislative business.

Sims was summoned 40

miles away to the home of another cotton farmer, whose sister had taken ill with fever

after delivering a child. The

attending doctor was present, but obviously drunk. Sims refused to take over the care of

the woman because once

again, he had no idea what treatment to administer. He returned to Mt. Meigs and the woman

died the day after he

departed. A month later, with Dr. Lucas still away, another request for a doctor came.

This time, on behalf of an

ailing slave overseer. Sims reluctantly mounted up and rode off to examine the man. He

found a lump inside his

abdomen and explained, "This is matter here and it must come out or this man will

die." He was granted

permission to operate and described the procedure as such, "We went in to the room -

it was before the days of

anesthetics – and, pulling out a bistoury (scalpel), I plunged it into his belly. I think

it was one of the most happiest

moments of my life when I saw the matter flow and come welling up opposite the

bistoury." After days of continued

discharging, the man eventually made a full recovery. Such was the nature of Sims’ first

surgical experience as he

began to "practice" medicine.

Acting primarily as a plantation physician, Sims became known for operations on club feet,

cleft palates and

crossed eyes. He began to treat enslaved babies suffering from what he called

"trismus nascentium." Today, we

know this condition as neonatal tetanus. Tetanus originates in horse manure, and it is

probable that the proximity of

horse stables to slave quarters was the direct cause of the high rate of tetanus in

enslaved babies. In an article

published by Sims on the subject, he comes to quite another conclusion that offers us a

glimpse into his personal

bias. "Whenever there are poverty, and filth, and laziness, or where the intellectual

capacity is cramped, the moral

and social feelings blunted, there it will be oftener found. Wealth, a cultivated

intellect, a refined mind, an

affectionate heart, are comparatively exempt from the ravages of this unmercifully fatal

malady. But expose this

class to the same physical causes, and they become equal sufferers with the first."

Because he attributed the cause

of the disease to the moral weakness of the enslaved Africans, he never suggested the need

to improve their living

conditions.

Sims also attributed the condition in part to an accident at childbirth. He argued that

the movement of the skull

bones during a protracted birth lended to trismus. Clearly designating patients by class

and race, Sims began to

exercise his freedom to experiment on his captives. He took custody of suffering, enslaved

infants and with a

shoemaker’s awl, a pointed tool used for making holes in leather, tried to pry the bones

of their skulls into proper

alignment. According to his published articles, this procedure was only practiced on

enslaved African babies.

Because he "owned" these poor, innocent children, he had free access to the

bodies of the ones that died to use for

autopsies, which he usually performed immediately after death. Sims routinely blamed

"slave mothers and nurses

for infant suffering, especially through their ignorance."

Enslaved African midwives were undoubtedly numerous throughout the South. For hundreds of

years, childbirth

was not considered a "sickness" and for the most part, physicians did not attend

births. But in the mid-nineteenth

century, the attitude of the medical practitioners towards midwifery was changing.

Medicine was now challenging

female-governed childbirth. The early obstetricians excluded midwives from their research

and dismissed their

collective knowledge. The African midwive’s distinct tradition of spiritual rituals, usage

of herbs and knowledge

handed down orally across generations earned them an honored place within the enslaved

communities. Just as the

Southern physician was at the core of his social web, the midwife enjoyed the same social

status. This could have

fueled the white master’s need to remove them from positions of prominence. The old

persecution of midwives by

white males, reminiscent of witch hunts, was beginning to play out again on southern

plantations.

One spring afternoon in 1845, Sims was summoned to the Westcott plantation about a mile

out of Montgomery. A

young, enslaved woman named Anarcha, one of seventy-five enslaved Africans who lived

there, had been in labor

for three days without delivering. Sims tried to aid the birth by applying forceps to the

impacted head of the fetus.

He recalled having little experience using the instrument. The baby was born – no record

if it lived or died – and the

mother had sustained several vesico-vaginal fistulas, or vaginal tears, resulting in

incontinence. It is unclear as to

whether Sims inflicted the damage himself while using the unfamiliar forceps or whether it

occurred as a result of

the prolonged birth. Several days after Anarcha delivered, her master sent her to Sims in

hopes he could repair the

damage. He found her condition repugnant. Obliged to her master as her value as property

was diminished

considerably, he reluctantly began to attempt to repair Anarcha’s badly damaged body.

Under slavery, women were pivotal in its very definition. Slavery was perpetuated through

the status of the mother.

If she was a slave, not only was she enslaved for life, but so were her children. They

were frequently the objects of

aggressive sexual rapes from those who held power over them. The culture and economy of

slavery imposed the

role of "breeder" on these women and their ability to reproduce was equated with

their worth as property to the

masters. They never received enhanced diets or lower work loads for pregnancy and often

endured great hardships

during childbirth. Reasons for prolonged labor among African women were probably closely

related with their diet.

In a relatively high percentage of African Americans, dairy products not only fail to

yield calcium in digestion, but

also can cause sickness. Calcium deficiencies during childhood often resulted in rickets.

This condition wasn’t fatal,

however, it caused skeletal deformities, among them a contracted pelvis that would have

resulted in a prolonged

delivery. Not surprisingly, vesico-vaginal fistulas were prevalent among enslaved women.

Sims showed an uncommon willingness to break cultural barriers in his treatment of female

disorders. Most

physicians in the Victorian period shunned the impropriety of visually examining a woman

internally. They

generally relied on the use of touch as a more genteel method. Earlier in his career, Sims

treated a female patient

who had been thrown off a pony. He placed her on her hands and knees and fashioned a crude

tool from a pewter

spoon to expand the walls of the vagina. This spoon was the first prototype for the

speculum, called the Sims

speculum. The patient’s relief was immediate, since the change in air pressure

successfully relocated her uterus to

its proper position. Sims described the moment as if he had a spiritual epiphany. "I

cannot, nor is it needful for me

to describe, my emotions when the air rushed in and dilated the vagina to its greatest

capacity whereby its whole

surface was seen at one view, for the first time by any mortal man." His success with

this single procedure

convinced Sims he could find a surgical remedy for vesico-vaginal fistulas. Finally, he

could make a name for

himself.

Eager to devote the rest of his life to this condition, he built a crude hospital in his

backyard that had a capacity of

sixteen beds and fashioned over 71 surgical instruments. Sims sent for as many cases as he

could find. Plantation

owners were happy to turn over their slaves to Sims for experimentation. They were of

little use to their masters in

their present condition. Over the next three and a half years, between January 1846 and

June 1849, he

experimented surgically on as many as eleven patients at one time. Two enslaved women in

addition to Anarcha -

Betsy and Lucy – were also young women who contracted fistulas giving birth for the first

time. Together, these

three women endured repeated operations and were patients of Sims for the duration of the

hospital’s existence.

Anarcha is believed to have undergone over thirty operations.

Sims subscribed to a commonly held belief that Africans had a specific physiological

tolerance for pain, unknown by

whites. He never felt the need to anesthetize his black patients in Montgomery. The white

women who came to him

later, after the surgery was an accepted form of treatment, were unable to withstand the

same operation without

anesthesia according to Sims. While he never administered anesthesia during the

experiments, he did include

opium in his postoperative treatment. Opium kept the patients still, which aided the

healing process, and Sims

found the accompanying constipation a necessity in the aftermath of surgery. He also

emphasized giving the patient

minimal food and water for a two-week period.

In the first months of the original surgeries, Sims would invite his colleagues to witness

the operations. As the

number of operations grew and the failures mounted, Sims soon found himself operating

alone, relying on the

assistance of the hospitalized victims themselves. After a couple of years of repeated

surgeries and failures, his

wife’s brother, Dr. Rush Jones from the neighboring county of Lowndes, implored him to

stop his experiments.

"We have watched you, and sympathized with you; but your friends here have seen that

of late you are doing too

much work, and that you are breaking down. And, besides, I must tell you frankly that with

your young and growing

family, it is unjust to them to continue in this way, and carry on this series of

experiments." Sims replied, "I am

going on.. to the end. It matters not what it costs, if it costs me my life." To

those close to Sims, it appeared his

preoccupation was becoming an obsession.

Sims had been suturing the vaginal tears with materials common to that era, mostly silk

and catgut, which absorbed

bodily fluid. This caused inflammation around the wounds, promoting horrible infections

that would never heal. Sims

had his jeweler fashion some fine silver wire for suturing wounds. He used it on one of

Anarcha’s fistulas at the

base of her bladder. Days later, when Sims found no infection, he declared that silver

sutures were the key to

mending vesico-vaginal fistulas. He quickly utilized the sutures on all of his captives

and claimed to have cured

them all, but there is no outside evidence to support his claim. He declared, "I had

made, perhaps, one of the most

important discoveries of the age for the relief of suffering humanity." Sims never

recorded if he was able to heal

Anarcha of her other fistulas and to this day, physicians debate the type of suture to use

in the operation, although

the condition is rarely seen anymore. Sims’ level of "success" remains ambiguous

by all medical accounts.

In the fall of 1849, Sims was stricken with an intestinal illness and spent several years

moving from place to place

in search of relief. In 1853, he moved to the cooler climate of New York. While Sims

maintained a strong

commitment to the morality of owning slaves and held a strong allegiance to the South, he

began to revise and

moderate his tone for the different political climate he found on Madison Avenue. Sims

evaded the issue of slavery

and race and never admitted publicly that he experimented on patients who did not own

their own bodies. In his use

of woodcuts that accompanied his lectures, he portrayed his earlier patients as white

women. Now that he chose to

practice among white women of the upper and middle classes, he stated of his surgeries,

"I though only of relieving

the loveliest of all God’s creation." It seems he’d forgotten his distaste for

Anarcha, Betsy and Lucy and all of the

other enslaved women he had mutilated and/or killed.

J. Marion Sims went on to convince a group of philanthropic women of the old New York’s

elite class that his

motives were sincere and his methods proven. He garnered enough enthusiasm and financial

support to set up a

woman’s charity hospital in May of 1855. Sims was once again in business to perform his

operations, this time, on

poor Irish immigrant women. He traveled extensively to Europe and enjoyed the reputation

of being a famous

American doctor. While abroad in 1863, he was asked to examine Empress Eugenie of France.

This is how the

inscription came to read, "treating alike empress and slave," although he

employed very different methods of

treatment depending on the patient’s social status. He faithfully sent money to support

the confederacy, but never

returned to the south. He died in New York in 1883.

The success of J. Marion Sims as "the father of gynecology" in the United States

rested solely on the personal

sacrifices of the enslaved African women he experimented on from 1845 to 1849. Had they

not been his property,

giving him carte blanche to cut them open and sew them back up as he saw fit, he could

have never devised the

surgical technique that brought him international recognition. He never expressed any

interest in the cause of

vesico-vaginal fistulas or in the health of the women themselves. Nor did he concern

himself with the extent of

recovery made by the patients. And never did he express moral uncertainty because he had

kept several women

captive for the expressed purpose of painful surgical experimentation. Undeniably,

nineteenth century medical

practices were crude and painful, but Sims’ contemporaries felt he was unnecessarily

cruel. Other physicians of that

unfortunate era experimented on the enslaved, but among them, James Marion Sims was one of

the worst.

Since it was illegal for enslaved Africans to read or write, an offense punishable by

death, Anarcha, Betsy and Lucy

left no account of their ordeal. We can only imagine what they endured at the hands of

Sims and what horror an

enslaved woman must have felt at the news that she was being sent to him for treatment.

Surely rumors must have

run rampant among enslaved communities about what he did to women there. All over South

Carolina, Sims has

been honored and memorialized with statues and plaques. Buildings, hospitals, schools and

streets bare his name.

While it is impossible to negate the historical context of his racial, class and gender

biases, shouldn’t we agree to

apply some standard of humanity to those we choose to honor?

Wendy Brinker is an activist and artist in Columbia, South Carolina. She

co-hosts talk radio’s The Seed Show,

www.seedshow.com, with attorney Tom

Turnipseed. She wishes to thank Tom Pickett for his research assistance.

Online Source: http://www.coax.net/people/lwf/jm_sims.htm