A Dr J Marion Sims Dossier Essay (стр. 2 из 2)

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


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


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


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