A Dr. J. Marion Sims Dossier

1835, Dr. James Marion Sims, "the founder of modern gynecology."
Photo Source: Alabama Dept. of Archives and History.
Online Source: http://www.archives.state.al.us/timeline/1800/sims.html

http://www.sims.ie/about.html

"The Second Statue on the Right"
by Judy Oliver

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

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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

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