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James Marion Sims (January 25, 1813November 13, 1883) was an American physician in the field of
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...
. His most famous work was the development of a
surgical technique Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
for the repair of
vesicovaginal fistula Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). Presentation Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder ('' vesica'') and the vagina that allows the continuous involu ...
, a severe complication of obstructed childbirth. He is also remembered for inventing Sims speculum, Sims sigmoid
catheter In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...
, and the
Sims position The Sims position, or left lateral Sims position, named after the gynaecologist J. Marion Sims, is usually used for rectal examination, treatments, enemas, and examining women for vaginal wall prolapse. The Sims Position is described as in t ...
. Against significant opposition, he established, in New York, the first hospital specifically for women. He was forced out of the hospital he founded because he insisted on treating cancer patients; he played a small role in the creation of the nation's first cancer hospital, which opened after his death. He was one of the most famous and venerated physicians in the country. In 1876, he was elected President of the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's sta ...
. He was one of the first American physician to become famous in Europe. He openly boasted that he was the second-wealthiest doctor in the country. However, as medical ethicist Barron H. Lerner states, "one would be hard pressed to find a more controversial figure in the history of medicine." A statue in his honor, the first statue in the United States in honor of a physician, was erected in 1894 in
Bryant Park Bryant Park is a public park located in the New York City borough of Manhattan. Privately managed, it is located between Fifth Avenue and Avenue of the Americas ( Sixth Avenue) and between 40th and 42nd Streets in Midtown Manhattan. Th ...
in New York City, but removed in 2018. There are ethical questions raised by how he developed his surgical techniques. He operated without
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
on enslaved
black women Black women are women of sub-Saharan African and Afro-diasporic descent, as well as women of Australian Aboriginal and Melanesian descent. The term 'Black' is a racial classification of people, the definition of which has shifted over time and a ...
, who, like prisoners, could not meaningfully consent because they could not refuse. In the 20th century, this was condemned as an improper use of human experimental subjects and Sims was described as "a prime example of progress in the medical profession made at the expense of a vulnerable population". He has been called a "butcher" and compared to Nazi physician
Josef Mengele , allegiance = , branch = Schutzstaffel , serviceyears = 1938–1945 , rank = '' SS''-'' Hauptsturmführer'' (Captain) , servicenumber = , battles = , unit = , awards = , commands = , ...
. Sims' practices were defended as consistent with the US in the era in which he lived by physician and anthropologist L. Lewis Wall, and other medical historians. According to Sims, the enslaved black women were "willing" and had no better option. Sims was a voluminous writer and his published reports on his medical experiments, together with his own 471-page autobiography (summarized in an address just after his death), are the main sources of knowledge about him and his career. His positive self-presentation has, in the late 20th and early 21st centuries, been subject to revision.


Childhood, education, and early career

James Marion Sims, who preferred to be called "Marion", was born in Lancaster County, South Carolina, the son of John and Mahala (Mackey) Sims. His father, Col. John Sims, "now
856 __NOTOC__ Year 856 ( DCCCLVI) was a leap year starting on Wednesday (link will display the full calendar) of the Julian calendar. Events By place Byzantine Empire * March 15 – Emperor Michael III overthrows the regency of his mot ...
of Texas," participated in the
War of 1812 The War of 1812 (18 June 1812 – 17 February 1815) was fought by the United States of America and its indigenous allies against the United Kingdom and its allies in British North America, with limited participation by Spain in Florida. It be ...
, being stationed at Charleston. His paternal grandfather was one of Marion's men; his great-grandfather was with Washington at Braddock's defeat. His maternal grandfather, Charles Mackey, was taken prisoner by
Banastre Tarleton Sir Banastre Tarleton, 1st Baronet, GCB (21 August 175415 January 1833) was a British general and politician. He is best known as the lieutenant colonel leading the British Legion at the end of the American Revolution. He later served in Portu ...
, and would have been hanged, but for the intervention of his wife. For his first 12 years, Sims' family lived in Lancaster Village, north of Hanging Rock Creek, where his father owned a store. Sims later wrote of his early school days there. "Reprinted from ''The New York Medical Journal'' for April 12 and 19, 1884." "Read before the
Medical Society of the County of New York Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
, January 28, 1884."
After his father was elected sheriff of Lancaster County, he sent Sims in 1825 to the newly established Franklin Academy, in Lancaster. In 1832, after two years of study at the predecessor of the University of South Carolina, South Carolina College, where he was a member of the Euphradian Society, Sims worked with Dr. Churchill Jones in
Lancaster, South Carolina The city of Lancaster () is the county seat of Lancaster County, South Carolina, United States, located in the Charlotte Metropolitan Area. As of the United States Census of 2010, the city population was 8,526. The city was named after the famou ...
. He took a three-month course at the Medical College of Charleston (predecessor of the Medical University of South Carolina), but found it too rigorous. He moved to
Philadelphia Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Since ...
,
Pennsylvania Pennsylvania (; ( Pennsylvania Dutch: )), officially the Commonwealth of Pennsylvania, is a state spanning the Mid-Atlantic, Northeastern, Appalachian, and Great Lakes regions of the United States. It borders Delaware to its southeast, ...
, in 1834 and enrolled at the
Jefferson Medical College Thomas Jefferson University is a private research university in Philadelphia, Pennsylvania. Established in its earliest form in 1824, the university officially combined with Philadelphia University in 2017. To signify its heritage, the un ...
, where he graduated in 1835, "a lackluster student who showed little ambition after receiving his medical degree". As he put it:
I felt no particular interest in my profession at the beginning of it apart from making a living.... I was really ready at any time and at any moment to take up anything that offered, or that held out any inducement of fortune, because I knew that I could never make a fortune out of the practice of medicine.
He returned to Lancaster to practice. As of that date "he had had no clinical experience, logged no actual hospital time, and had no experience diagnosing illnesses." After his first two patients (infants) died, Sims was despondent. He left and set up a practice in Mount Meigs, near
Montgomery, Alabama Montgomery is the capital city of the U.S. state of Alabama and the county seat of Montgomery County, Alabama, Montgomery County. Named for the Irish soldier Richard Montgomery, it stands beside the Alabama River, on the Gulf Coastal Plain, coas ...
. He described the settlement in a letter to his future wife Theresa Jones as "nothing but a pile of gin-houses, stables, blacksmith-shops,
grog Grog is a term used for a variety of alcoholic beverages. The word originally referred to rum diluted with water (and later on long sea voyages, also added the juice of limes or lemons), which British Vice-Admiral Edward Vernon introduced ...
-shops, taverns and stores, thrown together in one promiscuous huddle". He was in Mount Meigs from 1835 to 1837. Sims visited Lancaster in 1836 to marry Theresa, whom he had met many years earlier, when a student in Lancaster. She was the daughter of B.C. Jones, and the niece of Churchill Jones, and had studied at the South Carolina Female Collegiate Institute. In 1837 Sims and his wife moved to Cubahatchee, Alabama, where they remained until 1840. He was a "plantation physician", who had "a partnership in a large practice among rich plantations." "Sims became known for operations on clubfeet, cleft palates and crossed eyes." This was his first experience treating enslaved black women, whose owners summoned Sims to treat them. Being a "plantation physician" was not as lucrative as Sims hoped a life as a doctor would be.


Sims makes his reputation in Montgomery

In 1840 the couple moved to
Montgomery, Alabama Montgomery is the capital city of the U.S. state of Alabama and the county seat of Montgomery County, Alabama, Montgomery County. Named for the Irish soldier Richard Montgomery, it stands beside the Alabama River, on the Gulf Coastal Plain, coas ...
, where they lived until 1853. There Sims had what he described as the "most memorable time" of his career. Within a few years he "had the largest surgical practice in the State", the largest practice that any doctor in Montgomery had ever had, up to that time. "He was immensely popular, and greatly beloved." When he returned to the city for a visit in 1877, he was treated as a hero. In Montgomery, Sims continued with what he had done as a plantation physician: treating the enslaved, who made up two thirds of the city's population. He built a hospital or "Surgical Infirmary for Negroes", for those women their owners brought him for treatment. It began with four beds, but it was so successful he added a second floor, doubling capacity to eight beds. Once source says it expanded to twelve beds. It has been called "the first woman's hospital in history". It was also the first hospital specifically for Blacks in the United States. In 1840, the field of
gynecology Gynaecology or gynecology (see American and British English spelling differences, spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with ...
did not exist; there was no training on the subject, for Sims or anyone else. The only books were on
midwifery Midwifery is the health science and health profession that deals with pregnancy, childbirth, and the postpartum period (including care of the newborn), in addition to the sexual and reproductive health of women throughout their lives. In many ...
. Medical students did not study pregnancy, childbirth, or gynecological diseases. Student doctors were often trained on dummies to deliver babies. They did not see their first clinical cases of women until beginning their practices. "The practice of examining the female organs was considered repugnant by doctors." Sims shared this view, remarking in his autobiography that "if there was anything I hated, it was investigating the organs of the female pelvis".


Attacks on and defenses of Sims

* Criticisms ** Sims' primary interest was not healing the woman he experimented on, but in building his reputation as a doctor. ** Sims conducted experiments on enslaved women, without their consent. ** He did not use anesthesia, because he did not think the enslaved women's suffering was important. ** One patient almost died from
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
caused by a sponge left at the bladder entrance. ** Sims forced black women to assist him in his experiments, as white doctors would not. ** He experimented 30 times on one woman. (A defender praised this as indicative of Sims' "perseverence".)


Medical experimentation on enslaved women


Repair of vesicovaginal fistula

In 1845 he was brought a woman with a condition he had not seen before:
vesicovaginal fistula Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF). Presentation Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder ('' vesica'') and the vagina that allows the continuous involu ...
. In the 19th century, vesicovaginal fistulas, "one of the most loathsome and disagreeable maladies to which females are subject," though not fatal, were a common, socially destructive, and "catastrophic complication of childbirth", that affected many women. There was no effective cure or treatment. Lacking adequate birth control, women generally had a high rate of childbirth, which increased their rate of complications. Vesicovaginal fistulas occur when the woman's bladder, cervix, and vagina become trapped between the fetal skull and the woman's pelvis, cutting off blood flow and leading to tissue death. The necrotic tissue later sloughs off, leaving a hole. Following this injury, as urine forms, it leaks out of the vaginal opening, leading to a form of
incontinence Incontinence or Incontinent may refer to: *Fecal incontinence, the involuntary excretion of bowel contents * Urinary incontinence, the involuntary excretion of urine * Lack of moderation or self-control, especially related to sexual desire - see ...
. Because a continuous stream of urine leaks from the vagina, it is difficult to care for. The victim suffers personal hygiene issues that may lead to marginalization from society, and vaginal irritation, scarring, and loss of vaginal function. Sims also worked to repair rectovaginal fistulas, a related condition in which
flatulence Flatulence, in humans, is the expulsion of gas from the intestines via the anus, commonly referred to as farting. "Flatus" is the medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be swallowed enviro ...
and
feces Feces ( or faeces), known colloquially and in slang as poo and poop, are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the large intestine. Feces contain a rela ...
escape through a torn vagina, leading to
fecal incontinence Fecal incontinence (FI), or in some forms encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents, both liquid stool elements and mucus, or solid feces. When this loss includes flatus (gas), it is referre ...
. When he went to see a patient with an injured pelvis from a fall from a horse, he placed her in a knee-chest position and inserted his finger into the
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
. This allowed Sims to see the vagina clearly, and inspired him to investigate fistula treatment. Soon after, he developed a precursor to the modern speculum, using a pewter spoon and strategically placed mirrors. Sims was not the first to successfully treat a vesicovaginal fistula however. He was preceded by Dr. George Hayward in 1839 and John Peter Mettauer in 1838. Henry van Roonhuyse's clinical treatise entitled ''Medico-Chirurgical Observations'' (1676) outlined essential repair steps that are recognizable today. From 1845 to 1849, Sims started doing experiments on enslaved black women to treat vaginal problems. He added a second story to his hospital, for a total of eight beds. He developed techniques that have been the basis of modern vaginal surgery. A key component was silver wire, which he had a jeweler prepare. The Sims' vaginal speculum aided in vaginal examination and surgery. The rectal examination position, in which the patient is on the left side with the right knee flexed against the abdomen and the left knee slightly flexed, is also named for him.


Experimental subjects

In Montgomery, between 1845 and 1849, Sims occasionally conducted experimental surgery on white women, but his main subjects were 12 enslaved black women with fistulas, which he treated at his own expense in his backyard hospital. They were brought to him by their owners. Sims asked for patients with this fistula, and "succeeded in finding six or seven women". Sims took responsibility for their care on the condition that the owners provide clothing and pay any taxes; Sims provided food. One he purchased "expressly for the purpose of experimentation when her master resisted Sims' solicitations." He named three enslaved black women in his autobiography: Anarcha, Betsy, and Lucy. Each suffered from fistula, and all were subjects of his surgical experimentation. From 1845 to 1849 he conducted experimental surgery on each of them several times, operating on Anarcha 30 times before the repair of her fistulas was declared a success. She had both vesicovaginal and rectovaginal fistulas, which he struggled to repair. Sims ignored the AMA's Code of Ethics and Jones counsel. "Notwithstanding repeated failures during four years' time, he kept his six patients and operated until he tired out his doctor assistants, and finally had to rely upon his patients to assist him to operate." Unlike his previous essays, which included at least a brief description of his patients, the article issued in ''
The American Journal of the Medical Sciences ''The American Journal of the Medical Sciences'' is a monthly peer-reviewed medical journal. History The journal was established in 1820 as the ''Philadelphia Journal of the Medical and Physical Sciences'' by Nathaniel Chapman. A new series was ...
'' is devoid of any identifying characteristics of Anarcha, Betsy, and Lucy. Sims' one-time collaborator,
Nathan Bozeman Nathan Bozeman (March 25, 1825 — February 16, 1905), was a physician and early gynecologist, first in Montgomery, Alabama, and then in New York City. He studied medicine at the University of Louisville, graduating in 1848. He was collaborator o ...
, supplied the names of other African-American women treated by Sims during this period: * Ann McRee, 16, treated by Sims for fistula in 1849. * Lavinia Boudurant, 13, had a bladder calculus removed by Sims in 1850. * Delia, 23, "Dr. Sims' own servant
lave ''Lave'' was an ironclad floating battery of the French Navy during the 19th century. She was part of the of floating batteries. In the 1850s, the British and French navies deployed iron-armoured floating batteries as a supplement to the wooden ...
, between 1850 and 1853 underwent ten or more operations for fistula repair. * Julia McDuffie, 20, operated on by Sims for fistula closure in March 1853, and again in June 1853, after his departure for New York, by his former colleague
Nathan Bozeman Nathan Bozeman (March 25, 1825 — February 16, 1905), was a physician and early gynecologist, first in Montgomery, Alabama, and then in New York City. He studied medicine at the University of Louisville, graduating in 1848. He was collaborator o ...
.


Anesthesia

Although
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
had very recently been used experimentally, Sims did not use any anesthetic during his procedures on these three women. According to Sims, who later published a history of anesthesia, it was not generally known ("popularized") until 1846, and he was unaware of the use of
diethyl ether Diethyl ether, or simply ether, is an organic compound in the ether class with the formula , sometimes abbreviated as (see Pseudoelement symbols). It is a colourless, highly volatile, sweet-smelling ("ethereal odour"), extremely flammable li ...
. Experimental use of ether as an anesthetic was performed as early as 1842, however it was not published or demonstrated until 1846. A 2006 review of Sims' work in the ''
Journal of Medical Ethics The ''Journal of Medical Ethics'' is a monthly peer-reviewed academic journal covering the field of bioethics that was established in 1975. According to the ''Journal Citation Reports'', the journal has a 2019 impact factor of 2.021, ranking it fou ...
'' said that ether anesthesia was first publicly demonstrated in Boston in 1846, a year after Sims began his experimental surgery. The article notes that, while ether's use as an anesthetic spread rapidly, it was not universally accepted at the time of Sims' experimental surgery. In addition, a common belief at the time was that black people did not feel as much pain as white people. Given this, Sims did not anesthetize the women he operated on while developing his fistula repair technique. Anesthesia was itself still experimental; early anesthetic agents were much more dangerous than the replacements developed in the 20th century. Dosing was experimental. Underdosing did not kill the pain; overdosing could and sometimes did kill the patient. Chloroform could be obtained from a druggist, but nitrous oxide and the highly flammable ether had to be manufactured by the surgeon, on the spot. In Sims' day, surgeons were trained to operate quickly on unanesthetized patients. Anesthesia was first used in dentistry, and was just being announced as an exciting novelty in privately published pamphlets, some claiming credit for the anesthetic's first use, at the same time as Sims' fistula repair experiments. Sims was well informed and subscribed to medical journals. He must have read one of the many reports about research into anesthesia; religious objections to anesthesia were brought up. As late as 1853, when Sims's fistula experiments were concluded and reports on them were being published, many "still doubted" chloroform's safety, and "the rules of its administration are etto be formalized." Sims later became an expert on
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
, publishing on
nitrous oxide Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or nos, is a chemical compound, an oxide of nitrogen with the formula . At room temperature, it is a colourless non-flammable gas, and ha ...
in 1868, and in 1874 on
chloroform Chloroform, or trichloromethane, is an organic compound with formula C H Cl3 and a common organic solvent. It is a colorless, strong-smelling, dense liquid produced on a large scale as a precursor to PTFE. It is also a precursor to various ...
. In 1874 Sims addressed the New York State Medical Society on "The Discovery of Anaesthesia", in which he claimed American precedence over the British, and in 1880 read to the
New York Academy of Medicine The New York Academy of Medicine (the Academy) is a health policy and advocacy organization founded in 1847 by a group of leading New York metropolitan area physicians as a voice for the medical profession in medical practice and public health ...
a paper, soon published, about a death from anesthesia. One patient, named Lucy, nearly died from
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
. He had operated on her without anesthetics in the presence of twelve doctors, following the experimental use of a sponge to wipe urine from the bladder during the procedure. She contracted sepsis because he left a sponge in her urethra and bladder. He did administer
opium Opium (or poppy tears, scientific name: ''Lachryma papaveris'') is dried latex obtained from the seed capsules of the opium poppy '' Papaver somniferum''. Approximately 12 percent of opium is made up of the analgesic alkaloid morphine, which ...
to the women after their surgery, which was accepted therapeutic practice of the day. After the extensive experimental surgery, and complications, Sims finally perfected his technique. He repaired the fistulas successfully in Anarcha. He was the first to use silver as a suture, thus avoiding the infections associated with silk sutures. The silver-wire sutures, developed in 1849, were what allowed him to finally repair Anarcha's
fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...
s. Sims published an account of this in his surgical reports of 1852. He proceeded to repair fistulas in several other enslaved black women. According to Durrenda Ojanuga, "Many white women came to Sims for treatment of vesicovaginal fistula after the successful operation on Anarcha. However, none of them, due to the pain, were able to endure a single operation." The ''Journal of Medical Ethics'' reports a case study of one white woman, whose fistula was repaired by Sims without the use of anesthesia, in a series of three operations carried out in 1849. Sims later moved to New York to found a Woman's Hospital, where he performed the operation on white women. According to Ojanuga, Sims used anesthesia when conducting fistula repair on white women. But L. L. Wall, also writing for the ''Journal of Medical Ethics'', states that as of 1857, Sims did not use anesthesia to perform fistula surgery on white women, citing a public lecture where Sims spoke to the
New York Academy of Medicine The New York Academy of Medicine (the Academy) is a health policy and advocacy organization founded in 1847 by a group of leading New York metropolitan area physicians as a voice for the medical profession in medical practice and public health ...
on November 18, 1857. During this lecture, Sims said that he never used anesthesia for fistula surgery "because they are not painful enough to justify the trouble and risk attending their administration". While acknowledging this as shocking to modern sensibilities, Wall noted that Sims was expressing the contemporary sensibilities of the mid-1800s, particularly among surgeons who began their practice in the pre-anesthetic era. Anarcha, Lucy, and Betsy, three of the enslaved black women experimented upon by Sims without consent, are memorialized in a statue entitled " Mothers of Gynecology", erected in Montgomery, Alabama, on September 24, 2021.


''Trismus nascentium''

During his early medical years, Sims also became interested in ''trismus nascentium'', also known as
neonatal tetanus Neonatal tetanus (''trismus nascentium'') is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from an immunized mother are at risk. It usually occurs through infection of the unhealed umbilical ...
, that occurs in newborns. A 19th century doctor described it as "a disease that has been almost constantly fatal, commonly in the course of a few days; the women are so persuaded of its inevitable fatality that they seldom or ever call for the assistance of our art." ''Trismus nascentium'' is a form of generalised
tetanus Tetanus, also known as lockjaw, is a bacterial infection caused by ''Clostridium tetani'', and is characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually ...
. Infants who have not acquired
passive immunity Passive immunity is the transfer of active humoral immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when ...
from the mother having been immunised are at risk for this disease. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. In the 21st century, neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure. It is rare in developed countries. ''Trismus nascentium'' is now recognized to be the result of unsanitary practices and
nutritional deficiencies Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues ...
. In the 19th century its cause was unknown, and many enslaved African children contracted this disease. Medical historians believe that the conditions of the quarters of enslaved people were the cause. Sims alluded to the idea that sanitation and living conditions played a role in its contraction. He wrote:
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.
Sims also thought ''trismus nascentium'' developed from skull bone movement during protracted births. To test this, Sims used a shoemaker's awl to pry the skull bones of enslaved infants into alignment. These experiments had a 100% fatality rate. Sims often performed autopsies on the corpses, which he kept for further research on the condition. He blamed these fatalities on "the sloth and ignorance of their mothers and the black
midwives A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; c ...
who attended them", as opposed to the extensive experimental surgeries that he conducted upon the babies.


Background

The use of enslaved people for medical research was uncontroversial in the
Antebellum South In the history of the Southern United States, the Antebellum Period (from la, ante bellum, lit= before the war) spanned the end of the War of 1812 to the start of the American Civil War in 1861. The Antebellum South was characterized by ...
. A prospectus from the 1830s of the South Carolina Medical College, the leading medical school in the South, pointed out to prospective students that it had an advantage of a '' peculiar'' character: The college announced, in advertisements in the Charleston papers, that it had set up a surgery (
operating room Operation or Operations may refer to: Arts, entertainment and media * ''Operation'' (game), a battery-operated board game that challenges dexterity * Operation (music), a term used in musical set theory * ''Operations'' (magazine), Multi-Ma ...
) for negroes, and offered to treat without charge, while it was in session, any "interesting cases" sent by their owners, "for the ''benefit'' and ''instruction'' of their pupils". They extended the offer to free "persons of color". The advertisement ends by pointing out that their sole objective was "to promote the interest of Medical Education. "


Criticism of Sims

Sims' experimental surgeries without anesthesia on enslaved women, who could not consent, have been described since the late 20th century as an example of racism in the medical profession. This is seen as part of the historical oppression of black people and vulnerable populations in the United States. Patients of Sims' fistula and ''trismus nascentium'' operations were not given available anesthetics. He caused the deaths of babies on whom he operated for the trismus nascentium condition. In regards to Sims' discoveries, Durrenda Ojenunga wrote in 1993:
Terri Kapsalis Terri is an alternative spelling of Terry. It is a common feminine given name and is also a diminutive for Teresa. Notable people with the name include: *Terri Allard (born 1962), American country/folk singer/songwriter * Terri S. Armstrong, Ame ...
writes, in ''Mastering the Female Pelvis'', that "Sims' fame and wealth are as indebted to slavery and racism as they are to innovation, insight, and persistence, and he has left behind a frightening legacy of medical attitudes toward and treatments of women, particularly women of color." Drawing on Sims' published autobiography, case-histories, and correspondence, historian Stephen C. Kenny highlights how Sims' surgical treatment of enslaved infants suffering from neonatal tetanus was a typical, but tragically distinctive, feature in the career of an ambitious medical professional in the slave south. Individual doctors like Sims and the profession were incentivized in multiple ways through the system of chattel slavery, many were not only enslaver-physicians, but also traded in enslaved people, while at the same time their medical research was advanced directly and significantly through the exploitation of the enslaved population. In a related article exploring the types, frequency and functions of slave hospitals in the American South, Kenny identifies Sims' private 'negro infirmary' located behind his office on South Perry as an example of a 'hospital-for-experimentation', where Sims also undertook a series of gruelling and dangerous invasive surgeries on enslaved men. Sims used the surgical opportunities presented by long neglected chronic – and often incurable – cases of illness and injuries among the enslaved to sharpen his skills and stake a claim for professional celebrity – all in the context of the profits to be made from human trafficking one of the South's busiest slave markets. Author Harriet A. Washington, in her 2007 book ''
Medical Apartheid ''Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present'' is a 2007 book by Harriet A. Washington. It is a history of medical experimentation on African Americans. From the era of sl ...
'', writes of Sims' experiments: "Each naked, unanesthetized slave woman had to be forcibly restrained by other physicians through her shrieks of agony as Sims determinedly sliced, then sutured her genitalia." ''Facing South'', a publication of the
Institute for Southern Studies The Institute for Southern Studies is a non-profit media and research center based in Durham, North Carolina, advocating for progressive political and social causes in the Southern United States. Publishes include: ''Southern Exposure'' (1973 to ...
, wrote that slaves were forced to hold each other down during surgery.


Defense of Sims

Physician L. L. Wall, writing in the ''
Journal of Medical Ethics The ''Journal of Medical Ethics'' is a monthly peer-reviewed academic journal covering the field of bioethics that was established in 1975. According to the ''Journal Citation Reports'', the journal has a 2019 impact factor of 2.021, ranking it fou ...
'', says fistula surgery on non-anesthetized patients would require cooperation from the patient, and would not be possible if there were any active resistance from the patient. Wall writes that surviving documentation from the time says the women were trained to assist in their own surgical procedures. Wall also argues the documentation suggests the women consented to the surgeries, as the women were motivated to have their fistulas repaired, due to the serious medical and social nature of vesicovaginal and rectovaginal fistulas. According to gynaecologist Caroline M. de Costa, writing in the ''
Medical Journal of Australia The ''Medical Journal of Australia'' is a peer-reviewed medical journal published 22 times a year. It is the official journal of the Australian Medical Association, published by Wiley on behalf of the Australasian Medical Publishing Company. The ...
'': In his autobiography, J. Marion Sims said he was indebted to the enslaved black women on whom he experimented. Shortly after Sims' successful repair of Anarcha's vesicovaginal and rectovaginal fistulas in 1849, he successfully repaired the fistulas of the other enslaved women. They returned to their owners' plantations. Sims has been criticized for operating on the enslaved black women without their consent. Wall writes in the ''Journal of Medical Ethics'' that legally, consent was granted by the slaves' owners. He noted that enslaved black women were a "vulnerable population" with respect to medical experimentation. Wall also writes that Sims obtained consent from the women themselves. He cites an 1855 passage from ''New York Medical Gazette and Journal of Health'', where Sims wrote:
For this purpose herapeutic surgical experimentationI was fortunate in having three young healthy colored girls given to me by their owners in Alabama, I agreeing to perform no operation without the full consent of the patients, and never to perform any that would, in my judgment, jeopard life, or produce greater mischief on the injured organs—the owners agreeing to let me keep them (at my own expense) till I was thoroughly convinced whether the affection could be cured or not.
Deirdre Cooper Owens wrote: "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." She describes these opposing views as overly reductionist, saying his history is more nuanced. He lived in a slave-holding society and expressed the racism and sexism that were considered normal during his time.


New York: the first woman's hospital

Sims moved to New York in 1853, reluctantly, because of his health. He decided to focus on diseases of women. He had an office at 267
Madison Avenue Madison Avenue is a north-south avenue in the borough of Manhattan in New York City, United States, that carries northbound one-way traffic. It runs from Madison Square (at 23rd Street) to meet the southbound Harlem River Drive at 142nd Str ...
. In 1860 a newspaper described his success as "splendid," and called him "the happiest man in New York." In 1855 he founded the Woman's Hospital, which, not counting his backyard infirmary, was the first hospital for women in the United States. At its inception, Woman's Hospital's purpose was to repair vesico-vaginal fistulas using Sims' technique, in service to the poor. There were no "pay patients" admitted. Located on Madison Avenue and 29th Street in a rented, four-story house, location deliberately chosen to be near Sims' home, the hospital's 30 beds were quickly filled. In those early days, Sims operated without assistance from other doctors, performing one fistula repair each day. His project met with "universal opposition" from the New York medical community; it was due to prominent women that he established it. They were visited by "prominent doctors, who endeavored to convince them that they were making a mistake, that they had been deceived, that no such hospital was needed, etc." "I was called a
quack Quack, The Quack or Quacks may refer to: People * Quack Davis, American baseball player * Hendrick Peter Godfried Quack (1834–1917), Dutch economist and historian * Joachim Friedrich Quack (born 1966), German Egyptologist * Johannes Quack ...
and a
humbug A humbug is a person or object that behaves in a deceptive or dishonest way, often as a hoax or in jest. The term was first described in 1751 as student slang, and recorded in 1840 as a "nautical phrase". It is now also often used as an exclama ...
, and the hospital was pronounced a fraud. Still it went on with its work." In the Woman's Hospital, he performed operations on indigent women, often in an operating theatre so that medical students and other doctors could view it, as was considered fundamental to medical education at the time. Some patients remained in the hospital indefinitely and underwent repeated procedures. When Sims addressed the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's sta ...
in 1858 on the topic "Treatment of the results of obstructed labor", the "charts" which illustrated it "caused the lady auditors to vacate the gallery."


Sims and the Confederacy

Sims' Southern sympathies were no secret—he was no
abolitionist Abolitionism, or the abolitionist movement, is the movement to end slavery. In Western Europe and the Americas, abolitionism was a historic movement that sought to end the Atlantic slave trade and liberate the enslaved people. The British ...
—and even in New York, many of his patients were Southern ladies. As the
American Civil War The American Civil War (April 12, 1861 – May 26, 1865; also known by Names of the American Civil War, other names) was a civil war in the United States. It was fought between the Union (American Civil War), Union ("the North") and t ...
drew near, this practice fell away, and he did not feel comfortable remaining in New York. In 1861 Sims, who considered himself "a loyal Southerner", moved to Europe, where he toured hospitals and worked on fistula patients in London, Paris, Edinburgh, Dublin, and Brussels. He simultaneously ran consulting rooms in Paris, Berlin, and London. However, according to J.C. Hallman, he was there as one of several government agents of the Confederacy, who were seeking money (loans), diplomatic recognition of their new government (no country ever recognized it), and supplies and ships. An intercepted letter informed Lincoln's Secretary of State, William H. Seward, that Sims was "secessionist in sentiment", and that his "purpose in going abroad at this time is believed to be hostile to the government", as Seward reported to U.S. diplomats in Europe. According to the U.S. Minister in Brussels
Henry Shelton Sanford Henry Shelton Sanford (June 15, 1823 – May 21, 1891) was a wealthy American diplomat and businessman from Connecticut who served as United States Minister to Belgium from 1861 to 1869. He is also known for founding the city of Sanford, Flori ...
, Sims was a "violent secessionist", and his "movements in Europe had 'given color to (the) opinion' that he was a spy". The most celebrated episode in Sims' life was his summons, in 1863, to treat
Empress Eugénie An emperor (from la, imperator, via fro, empereor) is a monarch, and usually the sovereign ruler of an empire or another type of imperial realm. Empress, the female equivalent, may indicate an emperor's wife ( empress consort), mother (empr ...
for a fistula. This widely reported episode helped Sims to solidify his worldwide reputation as a surgeon. But according to Hallman, no source confirms that Eugénie had any medical problem at all. Sims' visits to the palace were semi-diplomatic Confederate visits, and the illness an invention to escape the vigilance of the U.S. diplomats, who had their eyes on Sims. Eugénie became an "ardent disciple" of the Confederacy. Sims remained in Europe until almost the end of Civil War, in 1865. Sims later said that it was a "dreadful mistake ... to give the negro the franchise." Two years later, offering a toast on board the steamer ''Atlantic'', returning to Europe, he claimed that in the aftermath of the war, the South had been degraded "beyond the level of the meanest slave that ever wore a shackle." At the same time, Sims argued that it was puerile for the South to sulk in its loss. He called for an acceptance of the issues of the war, including the Fifteenth Amendment. "It is folly to talk of the
lost cause The Lost Cause of the Confederacy (or simply Lost Cause) is an American pseudohistorical negationist mythology that claims the cause of the Confederate States during the American Civil War was just, heroic, and not centered on slavery. Firs ...
," he said.


Later career

Having treated royalty, after his return to the United States, Sims raised his charges in his private practice. He effectively limited it to wealthy women, although "he always had a long roll of charity patients". He became known for the Battey surgery, which contributed to his "honorable reputation". This involved the removal of both ovaries. It became a popular treatment to relieve
insanity Insanity, madness, lunacy, and craziness are behaviors performed by certain abnormal mental or behavioral patterns. Insanity can be manifest as violations of societal norms, including a person or persons becoming a danger to themselves or t ...
,
epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrica ...
,
hysteria Hysteria is a term used colloquially to mean ungovernable emotional excess and can refer to a temporary state of mind or emotion. In the nineteenth century, hysteria was considered a diagnosable physical illness in women. It is assumed that ...
(diseased uterus), and other "disorders of the nerves" (as mental illness was called at the time). At the time, these were believed to be caused by disorders of the female reproductive system. Sims received honors and medals for his successful operations in many countries. Since the 20th century, the necessity of many of these surgeries has been questioned. He performed surgery for what were considered gynecological issues: such as clitoridectomies, then believed to control hysteria or improper behavior related to sexuality. These were done at the requests of the women's husbands or fathers, who were permitted under the law to commit the women to surgery involuntarily. Under the patronage of
Napoleon III Napoleon III (Charles Louis Napoléon Bonaparte; 20 April 18089 January 1873) was the first President of France (as Louis-Napoléon Bonaparte) from 1848 to 1852 and the last monarch of France as Emperor of the French from 1852 to 1870. A neph ...
, Sims organized the American-Anglo Ambulance Corps, which treated wounded soldiers from both sides at the
Battle of Sedan The Battle of Sedan was fought during the Franco-Prussian War from 1 to 2 September 1870. Resulting in the capture of Emperor Napoleon III and over a hundred thousand troops, it effectively decided the war in favour of Prussia and its allies, ...
.


The first cancer hospital

In 1871, Sims returned to New York and resumed working at the Woman's Hospital, during which he provided surgical treatment for women with cancer. At the time, cancer was a disreputable disease, feared by some to be contagious or even
sexually transmitted Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral ...
. In response to Sims' efforts, the highly influential Ladies' Board of the Woman's Hospital strongly argued against the treatment of cancer patients, which resulted in the hospital prohibiting the admission of cancer patients. At a meeting of the hospital's Board of Governors in 1874, Sims gave a speech rebuking the Board for denying the treatment of cancer even in its earliest stages. In addition, he criticized the restriction imposed by the Ladies' Board limiting the number of spectators to fifteen on operating days. Previously, as many as sixty could observe any given operation, but this had been changed because the Ladies' Board considered it an affront to a woman's modesty to have more than fifteen male surgeons observe a woman's sexual organs under treatment. Sims argued that this restriction impaired the distribution of knowledge to the many surgeons who came to New York to study gynecological diseases. The controversial nature of Sims' speech within the Woman's Hospital resulted in the acceptance of his resignation by the Board of Governors a month later, as well as accusations of being "reckless" and "lethal" by a member of the Board of Governors, who argued Sims should be fired for his insubordination, and a conflict with some other doctors of the Woman's Hospital, with whom Sims carried on a dialogue by means of published pamphlets. After quarreling with the board of the Woman's Hospital over the admission of cancer patients, Sims became instrumental in establishing America's first cancer institute,
New York Cancer Hospital The New York Cancer Hospital (NYCH) on the Upper West Side of Manhattan, New York City was a cancer treatment and research institution founded in 1884. The building was located at 455 Central Park West between West 105th and 106th Streets, and ...
. In reply to the treatment he received from the Woman's Hospital, Sims was unanimously elected president of the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's sta ...
, an office he held from 1876 to 1877.


Death

Sims suffered two angina attacks in 1877, and in 1880, contracted a severe case of
typhoid fever Typhoid fever, also known as typhoid, is a disease caused by '' Salmonella'' serotype Typhi bacteria. Symptoms vary from mild to severe, and usually begin six to 30 days after exposure. Often there is a gradual onset of a high fever over severa ...
. W. Gill Wylie, an early 20th-century biographer, said that although Sims suffered delirium, he was "constantly contriving instruments and conducting operations". After several months and a move to Charleston to aid his convalescence, Sims recovered in June 1881. He traveled to France. After his return to the United States in September 1881, he began to complain of an increase in heart problems. In 1881, Sims was one of four physicians asked for an opinion about whether medical errors had contributed to the recent death of President Garfield. According to Wylie, Sims consulted with doctors for his unknown cardiac condition both in the United States and in Europe. He was "positive that he had a serious disease of the heart and it caused deep mental depression". He was halfway through writing his autobiography and planning a return visit to Europe when he died of a
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ma ...
on November 13, 1883, in
New York City New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the L ...
(
Manhattan Manhattan (), known regionally as the City, is the most densely populated and geographically smallest of the five boroughs of New York City. The borough is also coextensive with New York County, one of the original counties of the U.S. state ...
). He had just visited a patient with his son, H. Marion Sims. He is buried at
Green-Wood Cemetery Green-Wood Cemetery is a cemetery in the western portion of Brooklyn, New York City. The cemetery is located between South Slope/ Greenwood Heights, Park Slope, Windsor Terrace, Borough Park, Kensington, and Sunset Park, and lies several blo ...
in Brooklyn, New York.


Legacy and honors

* On the title page of the reprint of an article, "History of the Discovery of Anesthesia", first published in the May 1877 number of the ''Virginia Medical Monthly'', Sims listed his honors as:
Author of "Silver Sutures in Surgery," "The Sims Operation for Vesico-Vaginal Fistula," "Uterine Diseases," "History of the Discovery of Anaesthesia", Etc., Etc.; Member of the Historical Society of New York; Surgeon to the
Empress Eugenie An emperor (from la, imperator, via fro, empereor) is a monarch, and usually the sovereign ruler of an empire or another type of imperial realm. Empress, the female equivalent, may indicate an emperor's wife ( empress consort), mother (empr ...
; Delegate to Annual Conference of the Association for the Reform and Codification of the Law of Nations, 1879; Founder of the Woman's Hospital of the State of New York, and formerly Surgeon to the Same; Centennial President of the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's sta ...
, Philadelphia, 1876; President of the International Medical Congress at Berne, 1877;
Fellow A fellow is a concept whose exact meaning depends on context. In learned or professional societies, it refers to a privileged member who is specially elected in recognition of their work and achievements. Within the context of higher education ...
of the American Medical Association; Permanent Member of the New York State Medical Society; Fellow of the Academy of Sciences, of the Academy of Medicine, of the Pathological Society, of the Neurological Society, of the County Medical Society, and of the Obstetrical Society of New York; Fellow of the American Gynaecological Association; Honorary Fellow of the State Medical Societies of Connecticut, Virginia, South Carolina, Alabama and Texas; Honorary Fellow of the Royal Academy of Medicine of Brussels; Honorary Fellow of the Obstetrical Societies of London, Dublin and Berlin, and of the Medical Society of Christiana slo Knight of the
Legion of Honor The National Order of the Legion of Honour (french: Ordre national de la Légion d'honneur), formerly the Royal Order of the Legion of Honour ('), is the highest French order of merit, both military and civil. Established in 1802 by Napoleon ...
(France); Commander of Orders of Belgium, Germany, Austria, Russia, Spain, Portugal and Italy, Etc., Etc., Etc.
* A
bronze statue Bronze is the most popular metal for cast metal sculptures; a cast bronze sculpture is often called simply "a bronze". It can be used for statues, singly or in groups, reliefs, and small statuettes and figurines, as well as bronze elements t ...
by Ferdinand Freiherr von Miller (the younger), depicting Sims in surgical wear, was erected in
Bryant Park Bryant Park is a public park located in the New York City borough of Manhattan. Privately managed, it is located between Fifth Avenue and Avenue of the Americas ( Sixth Avenue) and between 40th and 42nd Streets in Midtown Manhattan. Th ...
, New York, in 1894, taken down in the 1920s amid subway construction, and moved to the northeastern corner of
Central Park Central Park is an urban park in New York City located between the Upper West and Upper East Sides of Manhattan. It is the fifth-largest park in the city, covering . It is the most visited urban park in the United States, with an estimated ...
, at 103rd Street, in 1934, opposite the
New York Academy of Medicine The New York Academy of Medicine (the Academy) is a health policy and advocacy organization founded in 1847 by a group of leading New York metropolitan area physicians as a voice for the medical profession in medical practice and public health ...
. The address delivered at its rededication was published in the ''
Bulletin of the New York Academy of Medicine The ''Journal of Urban Health'' is a bimonthly peer-reviewed public health journal covering epidemiology and public health in urban areas. It was established in 1851 as the ''Transactions of the New York Academy of Medicine'', and was renamed the ...
''. This is the first statue erected in the United States in honor of any physician. The statue became the center of protests in 2017 due to Sims' operations on enslaved black women. The statue was defaced with the word RACIST and had the eyes painted red. In April 2018, the
New York City Public Design Commission The New York City Public Design Commission, known legally as the Art Commission, is the agency of the New York City government that reviews permanent works of architecture, landscape architecture, and art proposed on or over city-owned property. ...
voted unanimously to have the statue removed from Central Park and installed in
Green-Wood Cemetery Green-Wood Cemetery is a cemetery in the western portion of Brooklyn, New York City. The cemetery is located between South Slope/ Greenwood Heights, Park Slope, Windsor Terrace, Borough Park, Kensington, and Sunset Park, and lies several blo ...
, near where Sims is buried. (As of 2022, it has not yet been installed there.) ''
Nature Nature, in the broadest sense, is the physical world or universe. "Nature" can refer to the phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. Although humans are ...
'' magazine published an editorial criticizing the removal, then retracted it after reader protests. ::In November 2017, author J.C. Hallman's article about Sims' Central Park statue, "Monumental Error" appeared on the cover of ''
Harper's Magazine ''Harper's Magazine'' is a monthly magazine of literature, politics, culture, finance, and the arts. Launched in New York City in June 1850, it is the oldest continuously published monthly magazine in the U.S. (''Scientific American'' is older, b ...
''. The article played a role in the broader discussion about Confederate monuments, and in a later op-ed for the
Montgomery Advertiser The ''Montgomery Advertiser'' is a daily newspaper and news website located in Montgomery, Alabama. It was founded in 1829. History The newspaper began publication in 1829 as ''The Planter's Gazette.'' Its first editor was Moseley Baker. I ...
, Hallman revealed Sims' career as a spy during the Civil War and the fraudulent history of another Sims monument in Montgomery, Alabama. * Another memorial was installed on the grounds of his alma mater,
Jefferson Medical College Thomas Jefferson University is a private research university in Philadelphia, Pennsylvania. Established in its earliest form in 1824, the university officially combined with Philadelphia University in 2017. To signify its heritage, the un ...
. * There is a statue on the grounds of the
Alabama State Capitol The Alabama State Capitol, listed on the National Register of Historic Places as the First Confederate Capitol, is the state capitol building for Alabama. Located on Capitol Hill, originally Goat Hill, in Montgomery, it was declared a National H ...
in Montgomery (dedicated in 1939). In April 2018, when
Silent Sam The Confederate Monument, University of North Carolina, commonly known as ''Silent Sam'', is a bronze statue of a Confederate soldier by Canadian sculptor John A. Wilson, which once stood on McCorkle Place of the University of North Carolin ...
was doused with red ink and blood, the statue had ketchup thrown on it while a skit about Sims was performed. "An alternative statue of Sims's 'first cure', the young woman known as Anarcha, was erected in protest only to be stolen in the night." This statue of Sims was originally intended to be one of Alabama's two statues in the
National Statuary Hall Collection The National Statuary Hall Collection in the United States Capitol is composed of statues donated by individual states to honor persons notable in their history. Limited to two statues per state, the collection was originally set up in the old ...
at the U.S. capitol. * Another statue of Sims, installed in 1929, is at the
South Carolina State House The South Carolina State House is the building housing the government of the U.S. state of South Carolina, which includes the South Carolina General Assembly and the offices of the Governor and Lieutenant Governor of South Carolina. Located in th ...
in
Columbia Columbia may refer to: * Columbia (personification), the historical female national personification of the United States, and a poetic name for America Places North America Natural features * Columbia Plateau, a geologic and geographic region i ...
; the mayor of Columbia, Stephen K. Benjamin, in 2017 called for its removal, as have other protestors. * A painting by
Marshall Bouldin III Marshall Bouldin III (September 6, 1923 – November 12, 2012) was an American portrait artist from the U.S. state of Mississippi. Examples of his Oil paintings are currently held in more than 400 private and public art collections througho ...
entitled ''Medical Giants of Alabama'', that depicted Sims and other white men standing over a partially clothed black patient, was commissioned for $20,000 in 1982 (paid for by donors). It was on display at the
University of Alabama at Birmingham The University of Alabama at Birmingham (UAB) is a public research university in Birmingham, Alabama. Developed from an academic extension center established in 1936, the institution became a four-year campus in 1966 and a fully autonomous univ ...
's Center for Advanced Medical Studies, but was removed in late 2005 or early 2006 because of complaints from people offended by it, and the ethical questions associated with Sims. * The Medical University of South Carolina, whose predecessor Sims attended, set up around 1980 an
endowed chair A financial endowment is a legal structure for managing, and in many cases indefinitely perpetuating, a pool of financial, real estate, or other investments for a specific purpose according to the will of its founders and donors. Endowments are of ...
in his honor. In February, 2018, the chair was renamed. However, a "J. Marion Sims Chair" in obstetrics and gynecology still appears in a March 2018 program. A J. Marion Sims Society, a student organization, existed there from 1923 to 1945. * A Sims Memorial Address on Gynecology, delivered before the South Carolina Medical Society at Charleston, is documented from 1927. * In 1950, a historical marker was erected near the site of his parents' farmhouse, where he was born. Present at the dedication ceremony were Congressman
James P. Richards James Prioleau "Dick" Richards (August 31, 1894 – February 21, 1979) was a lawyer, judge, and Democrat U.S. Representative from South Carolina between 1933 and 1957. He later served as a special ambassador under Republican President Dwigh ...
and representatives of the American Medical Association, the Medical College of South Carolina, the University of South Carolina, the chairman of Lancaster's Marion Sims Memorial Hospital board, the state archivist of South Carolina, and four of Sims' children. Dr. Roderick McDonald, president of the South Carolina Medical Association, introduced the speaker, Dr.
Seale Harris Seale Harris (March 13, 1870 – March 17, 1957) was an American physician and researcher born in Cedartown, Georgia. He was nicknamed "the Benjamin Franklin of Medicine" by contemporaries for his leadership and writing on a wide range of medical a ...
, past president of the Southern Medical Association and former editor of the ''
Southern Medical Journal The ''Southern Medical Journal'' (SMJ) is a peer-reviewed medical journal, established by Milton Antony. It is the official publication of the Southern Medical Association. The journal is indexed and abstracted in Index Medicus, Current Content ...
'', whose biography of Sims, ''Woman's Surgeon: the Life Story of J. Marion Sims'', had just been published. * The medical college at the University of South Carolina is named Sims College in his honor; in June 2020, the university passed a resolution asking for the state to rename the college pursuant to the
South Carolina Heritage Act The South Carolina Heritage Act is a South Carolina statute that forbids the removal or alteration of historic monuments located on public property in South Carolina as well as the rededication of any public areas or structures named after a hist ...
. * A cartoon of Sims appeared on the cover of the November 2017 issue of ''
The Nation ''The Nation'' is an American liberal biweekly magazine that covers political and cultural news, opinion, and analysis. It was founded on July 6, 1865, as a successor to William Lloyd Garrison's '' The Liberator'', an abolitionist newspaper t ...
''. * A J. Marion Sims Foundation was founded in 1995 in his home town of
Lancaster, South Carolina The city of Lancaster () is the county seat of Lancaster County, South Carolina, United States, located in the Charlotte Metropolitan Area. As of the United States Census of 2010, the city population was 8,526. The city was named after the famou ...
. It has dispensed almost $50,000,000 in grants. * The Marion Sims Memorial Hospital is located in Lancaster. * In
Montgomery, Alabama Montgomery is the capital city of the U.S. state of Alabama and the county seat of Montgomery County, Alabama, Montgomery County. Named for the Irish soldier Richard Montgomery, it stands beside the Alabama River, on the Gulf Coastal Plain, coas ...
, a historical marker at 37 South Perry St. marks the location of Sims' house and backyard hospital or infirmary. The building on the site is from the early 20th century. * In 1953, Sims was elected to the
Alabama Hall of Fame The Alabama Hall of Fame was established by Act of Alabama No. 646 (1951) to recognize "worthy citizens of the state who rendered outstanding service or who won fame on account of their achievements as to make them exceptional in the history of Alab ...
. * On April 3, 2018, ''Behind the Sheet'', written by Charly Evon Simpson, was presented in New York at the
Ensemble Studio Theatre The Ensemble Studio Theatre (EST) is a non-profit membership-based developmental theatre located in Hell's Kitchen, New York City. It has a dual mission of nurturing individual theatre artists and developing new American plays. Overview The E ...
: "Philomena is a slave woman forced to assist her owner as he searches for a cure for fistulas. Everything changes when she becomes his patient."


Contributions

* Vaginal surgery: fistula repair. Invented silver wire as a
suture Suture, literally meaning "seam", may refer to: Arts, entertainment, and media * ''Suture'' (album), a 2000 album by American Industrial rock band Chemlab * ''Suture'' (film), a 1993 film directed by Scott McGehee and David Siegel * Suture (ban ...
. * Instrumentation: Sims' speculum; Sims' sigmoid
catheter In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...
. There is a petition campaign to have Sims' name removed from the devices he invented: "Sims uterine curette, uterine sound, vaginal retractor, uterine scissors, and rectal speculum." New names would be chosen by "a committee of POC (People of Color)." * Exam and surgical positioning:
Sims' position The Sims position, or left lateral Sims position, named after the gynaecologist J. Marion Sims, is usually used for rectal examination, treatments, enemas, and examining women for vaginal wall prolapse. The Sims Position is described as in t ...
. * Fertility treatment:
Insemination Insemination is the introduction of sperm into a female’s reproductive system for the purpose of impregnating, also called fertilizing, the female for sexual reproduction. The sperm is introduced into the uterus of a mammal or the oviduct of a ...
and
postcoital test The postcoital test (PCT), also known as the Sims test, Huhner test or Sims–Huhner test, is a test in the evaluation of infertility. The test examines interaction between sperm and mucus of the cervix. The PCT examines sperm survival in cervic ...
. * Cancer care: Sims argued for the admission of cancer patients to the Woman's Hospital, despite contemporary beliefs that the disease was contagious. * Abdominal surgery: Sims advocated a
laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ane ...
to stop bleeding from bullet wounds to this area, repair the damage and drain the wound. His opinion was sought when President
James Garfield James Abram Garfield (November 19, 1831 – September 19, 1881) was the 20th president of the United States, serving from March 4, 1881 until his death six months latertwo months after he was shot by an assassin. A lawyer and Civil War gene ...
was shot in an assassination attempt; Sims responded from Paris by telegram. Sims' recommendations later gained acceptance. * Gallbladder surgery: In 1878, Sims drained a distended gallbladder and removed its stones. He published the case believing it was the first of its kind; however, a similar case had already been reported in Indianapolis in 1867.


See also

*
Unethical human experimentation in the United States Numerous experiments which are performed on human test subjects in the United States are considered unethical, because they are performed without the knowledge or informed consent of the test subjects. Such tests have been performed throughout ...
* List of monument and memorial controversies in the United States#J. Marion Sims (2017) *
Anarcha Westcott Anarcha Westcott (c. 1828 – unknown) was an enslaved woman who underwent a series of painful experimental surgical procedures conducted by physician J. Marion Sims, without the use of anesthesia, to treat a combination of vesicovaginal fistu ...
* Mothers of Gynecology Movement


Archival material

Papers of Dr. Sims—about 150 items— are held by the Wilson Library,
University of North Carolina at Chapel Hill A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United State ...
. The collection has been microfilmed and some is available online. A small number of letters are in the libraries of the Medical University of South Carolinaf and
Duke University Duke University is a private research university in Durham, North Carolina. Founded by Methodists and Quakers in the present-day city of Trinity in 1838, the school moved to Durham in 1892. In 1924, tobacco and electric power industrialist Jam ...
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References


Examinations of the ethical questions regarding Sims

* Critical of Sims ** *** ** ** ** Comments on the article of O'Leary just cited. ** ** ** ** ** ** L. L. Wall responded in the same journal in 2021; cited below. ** * Defenses of Sims ** ** ** ** ** ** ** ** ** ** ** ** ** ** * Unclassified ** ** ** ** **


Further reading (arranged by date)

* * [The link is to a reprint. The title at the beginning of the text is "The clamp suture and the range of its applicability, considered in relation to the cure of the injuries incident to parturition, with statistics."] * * * * * * * * * * * * * * * * *


Video

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External links


"J. Marion Sims"
''Encyclopedia of Alabama'' * {{DEFAULTSORT:Sims, J. Marion 1813 births 1883 deaths 19th-century American physicians Activists from Montgomery, Alabama American gynecologists American medical researchers American proslavery activists American slave owners American surgeons Burials at Green-Wood Cemetery Clinical research ethics History of medicine in the United States History of Montgomery, Alabama Human subject research in the United States Infanticide Medical scandals in the United States People from Lancaster County, South Carolina People of Alabama in the American Civil War Physicians from Alabama Physicians from New York (state) Physicians from South Carolina Presidents of the American Medical Association Thomas Jefferson University alumni University of South Carolina alumni