James Marion Sims: The Father of Modern Gynecology

by Jack R. Johnson

You’ve probably heard of Dr. Joseph Mengle, the Nazi doctor whose fascination with genetics led him to work with Jewish twins in Nazi concentration camps without anesthetics or consideration of their suffering. But have you heard of James Marion Sims, the American doctor who practiced his surgical techniques on un-anesthetized American slaves?

 

On the shady northwest corner of the statehouse grounds in Columbia, South Carolina, sits a monument dedicated to James Marion Sims. Like other statues from that era, it is made of bronze, shows a single man standing erect and looking relatively benign, a faint smile for those below.  According to South Carolina activist,Wendy Brinker, it  is one of the largest statues on the site. A panel for the statue reads, “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.”

 

Indeed, J. Marion Sims is sometimes heralded in current medical text books as the father of modern gynecology, but Sims’ use of 14 enslaved African-American women as experimental subjects without anesthesia over the course of four years, has been regarded by many modern historians as highly unethical. According to Diana E. Axelson, writing in “Women as Victims of Medical Experimentation: J. Marion Sims’ Surgery on Slave Women, 1845-1850”, between 1845 and 1849, Sims experimented by surgery on 14 enslaved women with fistulas, brought to him by their masters in Montgomery, Alabama. Sims took responsibility for their care on the condition that the masters provide clothing and pay taxes. He named three enslaved women in his records: Anarcha, Betsy, and Lucy. Each suffered from fistula, and all were subjected to his surgical experimentation. From 1845 to 1849 he experimented on each them several times, operating on Anarcha 13 times before her fistula repair was declared a success.

 

Although anesthesia had recently become available (as of 1846), Sims did not use any anesthetic during his procedures on the slaves. According to Sims, black people did not feel as much pain as white people, and thus did not require anesthesia when undergoing surgery. Other evidence points to a general disregard for the safety, much less the humanity, of the slaves he was treating.

In an article published by Sims on the subject of tetanus, he makes clear his personal views of blacks: “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. ” Since 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.

 

Yet, it’s apparent from his writing that he understood the pain the women suffered. In a memoir he stated that “Lucy’s agony was extreme…she was much prostrated and I thought she was going to die”. It should be noted that he did administer opium to the women after their surgery, which was accepted therapeutic practice of the day—this had the benefit of easing their pain and probably was conducive to their healing as well.

 

  1. Lewis Wall, a doctor and professor at Washington University School of Medicine in St. Louis, defends Sims saying, “Sims’s modern critics have discounted the enormous suffering experienced by fistula victims.” He argues that based on this, slaves would have gladly undergone surgery for relief. “The evidence suggests that Sims’s original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time.” He also noted that Sims’s failure to use anesthesia on his black patients in the 1840s was not necessarily racist: “Acceptance [of anesthesia among doctors at the time] was not universal, and there was considerable opposition to its introduction from many different quarters, for many different reasons.”

    But according to the NPR report, “Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology,”it was only after his success in early experiments on the enslaved women that Sims attempted the procedure on white women with fistulas. For the surgery on white women, records show, he received the permission of his patients, and he used anesthesia.

 

http://www.npr.org/2016/02/16/466942135/remembering-anarcha-lucy-and-betsey-the-mothers-of-modern-gynecology

 

 

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