The Father of Modern Gynecology

The J. Marion Sims Foundation takes its name from one of Lancaster County’s most distinguished historical figures. Dr. James Marion Sims was one of the most famous physicians of his time, renowned as a surgical genius and as one of the founders of operative gynecology. He practiced briefly in Lancaster before moving his practice to Alabama, and later to New York City.

His patients included Empress Eugenie of France, wife of Napoleon III, Scotland’s Duchess of Hamilton, and the Empress of Austria. He was called on to administer surgical treatment to President James A. Garfield after he was shot in 1881. Dr. Sims served as president of the American Medical Association in 1876, as president of the International Medical Congress in 1877, and as president of the American Gynecological Society in 1880.

Born in 1813 in what is now Heath Springs, Dr. Sims has been widely honored in his native state. A monument is dedicated to him on the State House grounds in Columbia, and the Medical University of South Carolina has established the J. Marion Sims Chair in Obstetrics-Gynecology. A dormitory at the University of South Carolina is named for Dr. Sims and Lancaster County’s first countywide hospital was named the Marion Sims Memorial Hospital.

Dr. Sims died in 1883. Several oil portraits of him and his family members are displayed in the Foundation offices, as are some of his original surgical instruments.  [J. Marion Sims Foundation  (along with this portrait of the good doctor)]

However, according to Wendy Brinker, an artist and activist, honoring Sims is a “monumental mistake” for many reasons, including his medical experiments on slave women, many of whom suffered and died as the result of his work. She also claims that Sims attributed the cause of disease among the slaves to moral weakness and did nothing to improve the conditions in which the slaves lived. [James Marion Sims — Father Butcher]

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Before we jump into this debate . . . 

America is experiencing two pandemics, one caused by a strange, new, and deadly virus, and the other caused by years of systemic racism. If you are here now, it’s because racism is in the news, people are protesting, and of course, Dr Sims is back in the news.

Black Lives Matter

If you have a problem with that, and want to scream all lives matter, I can tell you from personal experience that when I had a bumper sticker that read: Save The Whales, it did not imply “fuck all the other fish in the ocean.”

In a time when there are politicians at the highest peak of our government stoking the fires and breeding divisiveness, we must make a stand. This pandemic as taught us we cannot go back to normal because normal did not work. We are currently working on articles about racism in America and will shed light on its hidden history. Some of us are just now learning about Black Wall Street, the Tulsa Massacre, Juneteenth, and the Wrightsville Murders, which up till now most people thought was just an Ellery Queen mystery novel. We will also shed light on our Native population which has been treated the harshest of our minorities, and during the current pandemic is being hit the hardest.

However, this is an historical treatise, which started years ago (we were the first to write extensively on Sims on the internet) and we concluded that Dr Sims was a monster. 

Because of even more extensive investigations, and especially reading and learning from black historians, we are taken the scholarly route and simply present the precise facts, events, and results, non-judgmentally. 

You are free to make judgements. If you want to leave comments calling us racists, bigots, idiots, etc, feel free. They will vanish into the ether. 

The context within we live presently is distinctly removed from historical context, and any judgement leveled at historical figures from our vantage point is de trop.

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There are numerous articles on the web about Dr Sims, but the most enlightening document is his own biography, which I found at the Minneapolis Public Library. It is called The Story of My Life, and was published in 1884. [It is now on the web: The Story of My Life]

In his autobiography, Dr Sims recalls his ambivalent route into medicine. He studied under a surgeon who was an alcoholic. His first solo contact with a patient resulted in his bleeding a child, but when it came time for him to prescribe a nostrum, he recalls: “I had no more ideas of what ailed the child, or what to do for it, than if I had never studied medicine.” In fact, the most telling paragraph in his biography, one that is most often quoted when referring to the good doctor is the following:

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 of the most balanced criticisms we found of Dr Sims is called “J. Marion Sims: Man or Monster – Can We Judge a 19th Century Scientist By 21st Century Standards?”  However, sadly, that paper is no longer on the web.

First, let us take a look at the featured image at the top. It comes from the University of Alabama at Birmingham:

This undated image released by the University of Alabama-Birmingham in January 2006, shows the painting entitled “Medical Giants of Alabama,” painted by Marshall Bouldin, III, in 1982. The subjects portrayed in the painting include, patient, Anarcha Wescott, and standing, from left, Tinsley Harrison, William C. Gorgas, Champ Lyons, J. Marion Sims, and Lister Hill. The painting has been removed from above the fireplace at the University of Alabama at Birmingham’s Center for Advanced Medical Studies because of questions of race, gender and medical ethics. Complaints from guests and an ongoing scholarly controversy surrounding Sims’ medical experimentation on slave women in the 1840s led a committee of doctors to recommend its removal in late 2005. (MARSHALL BOULDIN, III)

Before we go on, this . . .

Editor’s Note: When writing about history, one must include historical perspective, or we are left to judge that period by our own standards rather than the standards of the time. For example, today we talk about institutionalized racism in the US, but in antebellum America, in the deep south particularly, there was blatant, in-your-face racism.

Additionally, once you’ve given perspective, to make that history come alive, writers often toss in their own perspective, or opinions, as it were. To have no bias is impossible, but one can aspire to objectivity by being “fair and balanced,” to borrow a phrase, and the more information you can gather, the more fair and balanced you can be.

As one historian put it:

Historians live and operate within a certain era and cannot help but be biased.  The trick is to be aware of this bias as much as possible and try to write as fair and balanced an assessment of events and people as you can.  The amount of research material often dictates what you can do.

Chris Losson

The key to an objective understanding of a certain period in history is the amount of material you can dig up.

This article along with a piece focusing on Anarcha and her sister slaves were originally researched and written in the first half of 2004. At that time, the only materials we’d found on him were his books, and a few articles scattered about the web, many of them teaming with errors. Since then, everyone and his brother has published something about Sims and detractors are now calling for his statue in New York to be taken down because he “experimented on slaves.”

Given the wide variety of perspective in all the accounts we’ve recently uncovered, the question of whether Sims was a monster or a healer is debatable. And in a time when too many of us seem to be easily offended, judgements are tossed about like so many Frisbees at the beach.

Because we have compiled as much information as possible and read every viewpoint from PhD to blogger with an iPad, we’re are going to offer you an even more balanced (yes, and fair) presentation of history, and offer you, hopefully, a more dynamic and objective perspective of both Sims’ work and Anarcha’s participation. Note the word “participation,” because everywhere you look, authors have focused only on the fact that she was a slave and could not decline to participate, and yet many accounts show that she not only willingly participated, but stayed on after she’d been cured of this horrible, painful, and life-shortening disorder. You see, when people are written off as “just slaves,” we are ignoring the glow of human dignity inside each one of us, including slaves. 

Given the glut of information that was available to our extensive investigation, we hope we’ve presented a more thoughtful treatise to pass on to you. We hope you enjoy this trip into the past. 

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Looking back in history, it has been hard not to judge it harshly, since so many lives have been destroyed by ignorance. Ignorance and prejudice. The experiments conducted by Sims have been compared to the experiments of Dr Mengele, except that Mengele wasn’t trying to heal anyone and could not have cared less about his subjects.

We know this about Sims: He was sickly, ambitious, brilliant, thoughtful, and caring. He was also an excellent surgeon, and in medical circles, was not afraid to remind everyone of his prowess. Many called him a braggart.

He’s contracted malaria early in his career, and it nearly killed him. He was exquisitely observant, and refused the standard treatment of the time.

If I had been bled I should never have got well nor been here to tell you this story. I was very ill; the fever raged, and I didn’t know how to arrest its progress by the treatment with quinine. This was before the days of quininisni, and fevers were allowed to take their course. Patients were bled, purged, administered tartar emetic, and given fever-mixtures every two hours during the twenty-four ; the patients were salivated, and the patients died, some of them sooner than others. Those who were bled and purged the strongest died the quickest.

He credits a pharmacist for saving his life with brandy and quinine.

We also know this about Sims: He was a racist. He was no more a racist than anyone else in his time at his location, and those racist concepts colored how he viewed black people. 

Medical historian, Dr. Deirdre Cooper Owens wrote:

The controversy is twofold and tends to lack historical nuance. Sims has been painted as either a monstrous butcher or a benign figure who, despite his slaveowning status, wanted to cure all women from their distinctly gendered suffering. As a historian and researcher, I am usually frustrated by the ahistoricism and reductionism that has emerged on both sides of the Sims debate. To better understand Sims, his enslaved patients, and the state of medicine, we must contextualize the antebellum South and its racial politics.

She goes on to say that he lived in a slave-holding society, expressed the racism and sexism considered normal during his time, but, in the end,  he contributed significantly to the field of gynecological surgery.

Fact: Sims’ suture technique developed in the 1800s for fistula surgery is still in use by modern-day physicians. [More Than a Statue: Rethinking J. Marion Sims’ Legacy]

This piece is quite interesting and handles the anesthesia debate (below) nicely: J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review.

About Anesthesia

We know that Sims knew about anesthesia, for when Dr Crawford Long came under attack for using ether during surgery, it was Dr Sims who turned out to be one of his staunchest supporters and actually wrote, in 1877, a pamphlet called The Discovery of Anaesthesia, which you can read in full here on the web, just click on the title.

If you’ll recall from our tongue-in-cheek essay “The History of Anesthesia,” our religious roots led to the belief that pain was simply a part of life and that was all there was to it. To relieve pain or avoid pain during surgery was frowned upon by many Calvinists. Add to that the nameless statue standing tall at Massachusetts General Hospital in Boston, a tribute to the (nameless) Father of Anesthesiology, and you can see why we called our paper on the “The History of Anesthesia,” an “hysterical perspective.”

Sims wrote that pamphlet in order to cement Long’s role in the history of anesthesia, as well it did.

Sims knew of anesthesia. Detractors like to point out that he didn’t use anesthesia on slave women, while he did use it on a white women for the same surgery. There are problems with this, because Sims published a paper on a white woman whose fistula he repaired without the use of anesthetic in 1849.

Sims was focused rivetingly on curing a horrible malady, and though he had heard of anesthesia being used in surgery a year after his first attempts using Anarcha and her slave sisters, he was untrained, and today being accused of “experimenting on slaves,” it’s a bit ironic that he’s also accused of not using anesthetic because had he attempted to use an anesthetic, that too would have been just another experiment. And having no formal training the use of anesthesia, experimenting is dangerous often resulting in a successful operation with the patient dying. There was no practice of fasting before surgery back then; they had no idea a patient could aspirate during anesthesia. 

People don’t realize how driven Sims was. He had friends, family, and colleagues constantly harping on him, if not about how much he overworked himself, then about his ethics, his focus; everything he did was under scrutiny.

Dr Sims was one of the first physicians to actually view the genitalia of his women patients. The morals of the time allowed a physician to palpate the area only. However, propriety went out the window when working on slave women, so he examined them while they kneeled on all fours, up on his examination table.

Introducing the bent handle of the spoon I saw everything, as no man had ever seen before. The fistula was as plain as the nose on a man’s face. The edges were clear and well-defined, and distinct, and the opening could be measured as accurately as if it had been cut out of a piece of plain paper. The walls of the vagina could be seen closing in every direction ; the neck of the uterus was distinct and well-defined, and even the secretions from the neck could be seen as a tear glistening in the eye, clear even and distinct, and as plain as could be. I said at once, “Why can not these things be cured?

Many of his patients died nameless and faceless, many of them suffering for weeks before being relieved by death. He did not use anesthesia, but he did give them opium for the pain. Critics say he purposely addicted them to opium, but physician and scholar LL Wall claims differently: Did J. Marion Sims deliberately addict his first fistula patients to opium?

One of his patients, a slave by the name of Anarcha, underwent thirty operations on Sims’s table. This is right out of his autobiography, though you’ll hear different numbers on the web.

Two other slaves mentioned in his biography were Lucy and Betsey. Though faceless, these three are not nameless. Their place in history should not be lost, and to ensure this, we’ve created a posting honoring Anarcha, Lucy, and Betsey, as the Unsung Mothers of Modern Gynecology.

After his initial success with his new tool, a speculum fashioned from a pewter spoon, he was charged with new energy to surgically cure this horrible disorder, vesico-vaginal fistula, that many young slave mothers suffered from.

This is quite a different Dr Sims than his colleagues had previously known, who would have turned away a woman with “female problems” because it was “out of his line.”

And when he started his first surgeries, “the other doctors in the city were all willing to help me, and all seemed anxious to witness the operations.” After three years of failure, nobody wanted to help him so he trained his patients, especially Anarcha to assist.

Detractors claim he used the slaves as slaves, but it is well documented that he took them on at his own expense, and informed their owners that they would not be required to work while under his care. But his enthusiasm, especially in the beginning was contagious and his patients vied for a spot on his operating table under his scalpel. Four years later, even after “the repeated failures, I had succeeded in inspiring my patients with confidence that they would be cured eventually. They would not have felt that confidence if I had not felt confident too; and at last I performed operations only with the assistance of the patients themselves.”

My patients are all perfectly satisfied with what I am doing for them. I can not depend on the doctors, and so I have trained them to assist me in the operations.

Just as he had read about and had known about anesthesia, years later Sims would also read knew of Joseph Lister’s work with carbolic acid in attempting to keep the surgical area and surgical tools free of this new organism called a “germ.” But in 1849 Sims knew nothing about germs.

And yet it was an antibiotic substance that brought about his first and latter successes.

Failure after failure with silk sutures led him to question the silk. He’d tried lead before that that (thank God) didn’t work. He was walking to his house from his hospital when he picked up a bit of brass wire in his yard. Brass tarnishes. He went to a Mr Swan, his jeweler, and asked him if he could make a fine silver wire about the same size as the brass he’d found.

Silver has antibiotic properties. He closed up his next operation on Anarcha, her thirtieth, using silver sutures. He inserted a catheter to drain urine, and was surprised the next morning to find that “the urine came from the bladder as clear and as limpid as spring water . . . .”

He was excited, but he had to wait at least a week. The clarity of the urine did not change. Obviously this time, unlike all the rest, there was no cystitis. Day after day passed and no signs of infection. He reported that he was truly anxious to see the results and could hardly wait for the necessary week to pass so he could make his first post-surgical inspection.

When the day finally came, Anarcha was carried gently to his operation table.

I shall let the good doctor finish this story:

With a palpitating heart and an anxious mind I turned her on her side, introduced the speculum, and there lay the suture apparatus just exactly as I had placed it. There was no inflammation, there was no tumefaction, nothing unnatural, and a very perfect union of the little fistula. This was in the month of May, I think, though possibly it was June (1849). In the course of two weeks more, Lucy and Betsey were both cured by the same means, without any sort of disturbance or discomfort. Then I realized the fact that, at last, my efforts had been blessed with success, and that I had made, perhaps, one of the most important discoveries of the age for the relief of suffering humanity.

His detractors will quote him from his book, his unfinished book, from his lectures, but it seems that the moment he says he cured someone, they refuse to believe him.

Wendy Brinker says this:

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.

I’m not very sure if believing everything the doctor wrote except those things contrary to your stance on the subject is very objective, nor is it fair. There is no corroborating evidence that he did not cure these three, or even relieve more suffering from this condition. We do know that exhausted, he left his life there for New York, where he arrived just a shell of his former self, weighing less than 100 pounds.

We also know that he traveled the world over lecturing on what he’d learned and received the highest accolades for his accomplishments and that physicians everywhere praised his skill and perseverance. 

A PhD candidate by the name of Urmi Engineer (link will download his piece) wrote the following about him:

Eventually, his racial ideology, Southern background, and Confederate allegiance did not inhibit his success in the postwar years, especially among the European colonial elite. He was given several awards and honors from European state elites, including the iron cross from Germany, the order of the knights of the legion of honor from France, and he was also honored by the governments of Italy, Spain, and Portugal. He was an honorary member of medical societies in Edinburgh, Brussels, Berlin, Paris, Dublin, and Belgium.

He is memorialized in several monuments in the U.S., including a statue in Central Park. The inscription on this plaque on the statehouse grounds in Columbia, South Carolina reads:

Where the love of man is, there is also the love of art
He founded the science of gynecology
was honored in all lands and died with the benediction of mankind
The first surgeon of the ages in ministry to women, treating alike empress and slave.

That statue has been removed, because he experimented on slaves and that has riled up many “sensitive” individuals, who we will not judge either. We live in troubled times. But the fact remains that Dr J Marion Sims relieved them of a horrible, life-shortening condition that was previously incurable.

Our thanks to the J Marion Sims Foundation for the use of their image.

Caution

If you feel it is necessary to post a comment calling us racists or point to various articles on the web that disagree with ours, you should know that we’ll just delete that shit and for a number of reasons.

• You have completely ignored the main points of this article.
• You have ignored the historical contexts the article wants you to not ignore.
• You’ve got some egoistic need to strike out.

Good luck with all that. It will be ignored.

Once again we will point out that we too originally wrote that Dr Sims was a monster, but then we took it upon ourselves to investigate more thoroughly, because scholarship and knowledge are thought to eliminate prejudice.

We were the first website to honor Anarcha and her sisters by giving Anarcha credit for being the Mother of Gynecology, though with further research the article has grown into what it is today.

Further Reading

 J. Marion Sims, MD: Why He and His Accomplishments Need to Continue to be Recognized a Commentary and Historical Review