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James Marion Sims is revered by many as a great physician and a pioneer in gynecological surgical procedures. He developed the earliest surgical treatment for vesicovaginal fistulas a condition that usually includes a tear from the bladder to the vagina. Sometimes from the bladder to the rectum. Fistulas are a terrible complication of some obstructed labors. In those days women with these problems usually ended up as social outcasts with uncontrollable leaking urine and sometimes feces. Such was the stigma associated with the condition suicide was not an uncommon result. Sims eventually developed a successful surgical treatment of VVF. The final breakthrough came with his use of silver thread for sutures which greatly reduced the probability of infections. He said of himself, “I had made, perhaps, one of the most important discoveries of the age for the relief of suffering humanity.” There are several monuments to his medical breakthroughs, including one in Central Park. He became rich and respected. He also invented the vaginal speculum and the the "Sim's Position" for women undergoing gynecological exams.
In the first half of the 19th century medical training was rudimentary. The civil war demonstrated the primitive state of surgery. Wounds today that are easily repaired back then were often as not a death sentence.
James Sims graduated from the Jefferson Medical College in 1835 and returned to Lancaster, S.C. to practise, however his first two patients died and he moved to Alabama. Sims was not comfortable with his knowledge of women's medical problems, including fistulas and usually referred them to other doctors. It was one of those accidents of history that changed his mind and set him on a path to fame and wealth.. A local woman had a horseback riding accident and while treating her placed her in a position that allowed him to see into her vagina. This convinced him he had a chance to develope a surgical technique to treat vesicovaginal fistulas. He moved to Montgomery, Alabama and opened a hospital for women in his backyard. His first "patients", or "experimental subjects" were slave women from local plantations. These slave women were worthless to their owners, they couldn't work in the fields or in the house.
Sims used 14 slaves to experiment on. Most of these he bought and kept on his property. Slave women were at high risk of VVF because of poor nutrition, young age when giving birth and lack of prenatal care. He mentions the names of three slave women in his journals, Anarcha, Betsy, and Lucy. Lucy was his first subject. He was so confident of a cure that he invited local doctors to observe the operation. Although anaesthetic was in use in the 1840's and ether had been in use since the early part of the century Sims used neither. Lucy was placed naked on her hands and knees, with 12 observing males, and operated on. The operation was not a success.
Lucy endured excruciating pain during the hour long operation and nearly died from blood poisoning. Sims said, 'I thought she was going to die . . . it took Lucy two or three months to recover entirely from the effects of the operation'. Another slave, Anarcha, underwent 30 operations. After four years Sims finally perfected his technique. It is believed other slaves also were operated on up to 30 times.
So Sims became successful, rich and famous, even repairing the fistula of Empress Eugénie, empress consort in the court of Napoleon Ill. Sims used anaesthetic when operating on white women. He spent most of the latter half of his life as a "celebrity physician" travelling Europe and America demonstrating his technique.
From the NYT's Health Section;
Statues of Sims were erected in South Carolina, Alabama and New York City, where in 1855 he opened the first hospital exclusively for women. The New York statue stands in Central Park at Fifth Avenue and 103rd Street.
One of Sims's modern legacies is the almost total absence of vesico-vaginal fistulas in the developed world, because of advances in childbirth and the operation he pioneered.
From this lofty perch, Sims had a long way to fall. And fall he did, beginning in the mid-1970's, as Americans dealt with the volatile issues of racial and sexual equality. Historians, many of them sympathetic to the civil rights and women's movements, saw an urgent need to revise Sims's history.
One of the first scholars to weigh in was Dr. Graham J. Barker-Benfield, then a historian at Trinity College in England, who argued that Sims had used slave women as guinea pigs to advance his career.
The women, Dr. Barker-Benfield wrote in 1974, had ''endured years of almost unimaginable agonies'' undergoing repeated surgery. Rather than being willing participants, the women had been powerless to refuse.
Writing in 1985, Diana E. Axelsen, a philosopher at Spelman College, described Sims's patients as ''victims of medical experimentation.'' Wendy Brinker, a South Carolina filmmaker, nicknamed Sims ''Father Butcher'' and asked why the state's monument to him still stood.
Underlying these pronouncements was the belief that Sims's early biographers had been guilty of ''presentism,'' evaluating past events based on their own values at the time. Living in an era that uncritically celebrated white male doctors, the historians contended, these writers had viewed Sims far too favorably.
More recently, a few scholars have been trying to revise this revisionist history. ''To deify or vilify Sims is not the answer,'' said Dr. Deborah Kuhn McGregor, a historian at the University of Illinois at Springfield. Dr. McGregor uses Sims's story in her book ''Sexual Surgery and the Origins of Gynecology'' to discuss the complex ways that race and sex influence medical practice.
One of Sims's strongest defenders these days would have to be Dr. L. Lewis Wall, a Washington University surgeon who believes that the scholars who pilloried Sims were guilty of the same presentism they had identified in others' work.
Dr. Wall has a special reason for coming to Sims's defense. He routinely travels to Africa to repair vesico-vaginal fistulas. Contending that the rest of the world has lost interest in the victims of this disorder, who may still number in the millions, he has founded the Worldwide Fund for Mothers Injured in Childbirth (www.wfmic.org).
''These kinds of pathologies no longer exist here,'' Dr. Wall noted. But women with fistulas are ''absolutely miserable and absolutely outcasts, reeking of urine 24 hours a day,'' he said, noting that he can restore both the health and dignity of such women.
But does this justify what Sims did? Many do not think so. When Dr. Wall made a presentation on Sims at a recent meeting of the American Association for the History of Medicine, members of the audience challenged the idea that his admirable efforts as a surgeon gave him valid historical insights.
Ms. Brinker is not even sure that Sims's procedure worked, pointing out that his logs do not have follow-up data of his ''cured'' patients. ''It was all about his glory,'' she argues.
So there's the story. Now the inevitable question, " How should Dr. James Sims be judged, as a heroic medical innovator whose breakthroughs saved or improved the lives of perhaps millions, or as an evil exploiter of powerless black women in his pursuit of wealth and glory?"
In the first half of the 19th century medical training was rudimentary. The civil war demonstrated the primitive state of surgery. Wounds today that are easily repaired back then were often as not a death sentence.
James Sims graduated from the Jefferson Medical College in 1835 and returned to Lancaster, S.C. to practise, however his first two patients died and he moved to Alabama. Sims was not comfortable with his knowledge of women's medical problems, including fistulas and usually referred them to other doctors. It was one of those accidents of history that changed his mind and set him on a path to fame and wealth.. A local woman had a horseback riding accident and while treating her placed her in a position that allowed him to see into her vagina. This convinced him he had a chance to develope a surgical technique to treat vesicovaginal fistulas. He moved to Montgomery, Alabama and opened a hospital for women in his backyard. His first "patients", or "experimental subjects" were slave women from local plantations. These slave women were worthless to their owners, they couldn't work in the fields or in the house.
Sims used 14 slaves to experiment on. Most of these he bought and kept on his property. Slave women were at high risk of VVF because of poor nutrition, young age when giving birth and lack of prenatal care. He mentions the names of three slave women in his journals, Anarcha, Betsy, and Lucy. Lucy was his first subject. He was so confident of a cure that he invited local doctors to observe the operation. Although anaesthetic was in use in the 1840's and ether had been in use since the early part of the century Sims used neither. Lucy was placed naked on her hands and knees, with 12 observing males, and operated on. The operation was not a success.
Lucy endured excruciating pain during the hour long operation and nearly died from blood poisoning. Sims said, 'I thought she was going to die . . . it took Lucy two or three months to recover entirely from the effects of the operation'. Another slave, Anarcha, underwent 30 operations. After four years Sims finally perfected his technique. It is believed other slaves also were operated on up to 30 times.
So Sims became successful, rich and famous, even repairing the fistula of Empress Eugénie, empress consort in the court of Napoleon Ill. Sims used anaesthetic when operating on white women. He spent most of the latter half of his life as a "celebrity physician" travelling Europe and America demonstrating his technique.
From the NYT's Health Section;
Statues of Sims were erected in South Carolina, Alabama and New York City, where in 1855 he opened the first hospital exclusively for women. The New York statue stands in Central Park at Fifth Avenue and 103rd Street.
One of Sims's modern legacies is the almost total absence of vesico-vaginal fistulas in the developed world, because of advances in childbirth and the operation he pioneered.
From this lofty perch, Sims had a long way to fall. And fall he did, beginning in the mid-1970's, as Americans dealt with the volatile issues of racial and sexual equality. Historians, many of them sympathetic to the civil rights and women's movements, saw an urgent need to revise Sims's history.
One of the first scholars to weigh in was Dr. Graham J. Barker-Benfield, then a historian at Trinity College in England, who argued that Sims had used slave women as guinea pigs to advance his career.
The women, Dr. Barker-Benfield wrote in 1974, had ''endured years of almost unimaginable agonies'' undergoing repeated surgery. Rather than being willing participants, the women had been powerless to refuse.
Writing in 1985, Diana E. Axelsen, a philosopher at Spelman College, described Sims's patients as ''victims of medical experimentation.'' Wendy Brinker, a South Carolina filmmaker, nicknamed Sims ''Father Butcher'' and asked why the state's monument to him still stood.
Underlying these pronouncements was the belief that Sims's early biographers had been guilty of ''presentism,'' evaluating past events based on their own values at the time. Living in an era that uncritically celebrated white male doctors, the historians contended, these writers had viewed Sims far too favorably.
More recently, a few scholars have been trying to revise this revisionist history. ''To deify or vilify Sims is not the answer,'' said Dr. Deborah Kuhn McGregor, a historian at the University of Illinois at Springfield. Dr. McGregor uses Sims's story in her book ''Sexual Surgery and the Origins of Gynecology'' to discuss the complex ways that race and sex influence medical practice.
One of Sims's strongest defenders these days would have to be Dr. L. Lewis Wall, a Washington University surgeon who believes that the scholars who pilloried Sims were guilty of the same presentism they had identified in others' work.
Dr. Wall has a special reason for coming to Sims's defense. He routinely travels to Africa to repair vesico-vaginal fistulas. Contending that the rest of the world has lost interest in the victims of this disorder, who may still number in the millions, he has founded the Worldwide Fund for Mothers Injured in Childbirth (www.wfmic.org).
''These kinds of pathologies no longer exist here,'' Dr. Wall noted. But women with fistulas are ''absolutely miserable and absolutely outcasts, reeking of urine 24 hours a day,'' he said, noting that he can restore both the health and dignity of such women.
But does this justify what Sims did? Many do not think so. When Dr. Wall made a presentation on Sims at a recent meeting of the American Association for the History of Medicine, members of the audience challenged the idea that his admirable efforts as a surgeon gave him valid historical insights.
Ms. Brinker is not even sure that Sims's procedure worked, pointing out that his logs do not have follow-up data of his ''cured'' patients. ''It was all about his glory,'' she argues.
So there's the story. Now the inevitable question, " How should Dr. James Sims be judged, as a heroic medical innovator whose breakthroughs saved or improved the lives of perhaps millions, or as an evil exploiter of powerless black women in his pursuit of wealth and glory?"
