J. Marion Sims
Encyclopedia
J. Marion Sims, born James Marion Sims (January 25, 1813 – November 13, 1883) was a surgical pioneer, considered the father of American gynecology. Modern historians argue about his legacy as Sims used slaves as experimental subjects
Human experimentation in the United States
There have been numerous experiments performed on human test subjects in the United States that have been considered unethical, and were often performed illegally, without the knowledge, consent, or informed consent of the test subjects....

.

Early career

Sims was born in Hanging Rock, South Carolina
South Carolina
South Carolina is a state in the Deep South of the United States that borders Georgia to the south, North Carolina to the north, and the Atlantic Ocean to the east. Originally part of the Province of Carolina, the Province of South Carolina was one of the 13 colonies that declared independence...

, son of John and Mahala Mackey Sims. Sims's family spent the first twelve years of his life in the Heath Springs area of Lancaster county. He would later write entertainingly of his early school days, but recalled one occasion when he had to be saved from drowning by fourteen-year-old Arthur Ingram, who lived south of Hanging Rock Creek.

His father, John Sims, was elected sheriff of Lancaster County in 1825 and thereafter took up residence in Lancaster, where the boy, Marion, entered Franklin Academy.

After two years of study at the South Carolina College in Columbia, Sims worked with Dr. Churchill Jones in Lancaster, South Carolina
Lancaster, South Carolina
Lancaster is a city in Lancaster County, South Carolina which is in the United States and is located 35 miles south of Charlotte, North Carolina and 20 miles east of Rock Hill, South Carolina. As of the United States Census of 2010, the city population was 10,160. It is the county seat of...

, and took a three-month course at the Medical College of Charleston
Charleston, South Carolina
Charleston is the second largest city in the U.S. state of South Carolina. It was made the county seat of Charleston County in 1901 when Charleston County was founded. The city's original name was Charles Towne in 1670, and it moved to its present location from a location on the west bank of the...

. He then moved to Philadelphia, Pennsylvania
Philadelphia, Pennsylvania
Philadelphia is the largest city in the Commonwealth of Pennsylvania and the county seat of Philadelphia County, with which it is coterminous. The city is located in the Northeastern United States along the Delaware and Schuylkill rivers. It is the fifth-most-populous city in the United States,...

 and enrolled at the Jefferson Medical College where he graduated in 1835. He returned to Lancaster to practice, but after the deaths of his first two patients moved to Alabama
Alabama
Alabama is a state located in the southeastern region of the United States. It is bordered by Tennessee to the north, Georgia to the east, Florida and the Gulf of Mexico to the south, and Mississippi to the west. Alabama ranks 30th in total land area and ranks second in the size of its inland...

.

He returned to Lancaster in 1836 to marry the daughter of Dr. Barlett Jones, Theresa, with whom he had fallen in love while studying at South Carolina College in Columbia. They would return to Alabama together, where in 1845, Marion Sims established a private hospital for women.

Repair of vesicovaginal fistula

Women with vesicovaginal fistula
Vesicovaginal fistula
Vesicovaginal fistula is a subtype of female urogenital fistula .-Presentation:VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault....

s - usually the result of traumatic labor - were, in those days, social outcasts. No cure was available. In Montgomery, Alabama
Montgomery, Alabama
Montgomery is the capital of the U.S. state of Alabama, and is the county seat of Montgomery County. It is located on the Alabama River southeast of the center of the state, in the Gulf Coastal Plain. As of the 2010 census, Montgomery had a population of 205,764 making it the second-largest city...

, Sims experimented on three Alabamian slave women - Anarcha, Betsy, and Lucy - who were suffering from fistula problems, to develop new techniques to repair this condition or be used as experiments for medical research. From 1845 to 1849 he experimented on them, operating on Anarcha 30 times (it remains unclear if this was necessary due to stitching failure, or if Sims did it deliberately). Although anesthesia had recently become available, Sims did not use any anesthetic during his procedures on Anarcha, Betsy, and Lucy. After the extensive experiments and difficulties, Sims finally perfected his technique and repaired the fistulas successfully in Anarcha. He then "repaired" several other slave women. It was only after the success of the early experiments on the slaves that Sims attempted the procedure on Caucasian women with fistulas, this time with anesthesia.

These experiments set the stage for modern vaginal surgery. Sims devised instruments including the Sims' speculum
Speculum (medical)
A speculum is a medical tool for investigating body cavities, with a form dependent on the body cavity for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra...

to gain proper exposure.
A rectal examination position where a patient is on the left side with the right knee flexed against the abdomen and the left knee slightly flexed is also named after him as Sim's position
Sim's position
The Sims' position, named after James Marion Sims is usually used for rectal examination, treatments and enemas. It is performed by having a patient lie on their left side, left hip and lower extremity straight, and right hip and knee bent....

. He insisted on cleanliness. His technique using silver
Silver
Silver is a metallic chemical element with the chemical symbol Ag and atomic number 47. A soft, white, lustrous transition metal, it has the highest electrical conductivity of any element and the highest thermal conductivity of any metal...

-wire sutures led to successful repair of a fistula, and this was reported in 1852.

New York and Europe

Sims moved to New York in 1853 because of his health and determined to focus on diseases of women. In 1855 he founded the Woman's Hospital
St. Luke's-Roosevelt Hospital Center
St. Luke's-Roosevelt Hospital Center, an academic affiliate of Columbia University College of Physicians and Surgeons, is a 1,076-bed, full-service community and tertiary care hospital serving New York City’s Midtown West, Upper West Side and parts of Harlem....

, first hospital for women in America. It was here that he performed operations on indigent women, often in a theatre so that other men could view it. Mary Smith suffered 30 such operations between 1856 and 1859 at this hospital as opposed to his slave, Anarcha, who endured them in Sims' backyard stable. In 1862, during the American Civil War, he moved to Europe, and worked primarily in London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 and Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...

, and from 1863 to 1866, served as surgeon to Empress Eugénie
Eugénie de Montijo
Doña María Eugenia Ignacia Augustina de Palafox-Portocarrero de Guzmán y Kirkpatrick, 16th Countess of Teba and 15th Marquise of Ardales; 5 May 1826 – 11 July 1920), known as Eugénie de Montijo , was the last Empress consort of the French from 1853 to 1871 as the wife of Napoleon III, Emperor of...

. Honors and medals were heaped upon him for his 'successful' operations in many countries. It is dubious to label the operations as successful, because women were undergoing gynecological surgeries such as clitorectomies to control hysteria or 'improper' behavior, at the requests of their husbands/fathers who could commit them involuntarily. Under the patronage of Napoleon III, he organized the American-Anglo Ambulance Corps that treated wounded soldiers from both sides at the battle of Sedan
Battle of Sedan
The Battle of Sedan was fought during the Franco-Prussian War on 1 September 1870. It resulted in the capture of Emperor Napoleon III and large numbers of his troops and for all intents and purposes decided the war in favour of Prussia and its allies, though fighting continued under a new French...

.

In 1871 Sims returned to New York, and after quarreling with the board of the Woman's Hospital over the admission of cancer patients (which he favored), went on to found a new hospital, later to evolve into the Memorial Center for Cancer and Allied Diseases.

He was planning a return visit to Europe when he died of a heart attack on November 13, 1883 in New York. His bronze statue by Ferdinand Freiherr von Miller
Ferdinand Freiherr von Miller
Ferdinand Miller, from 1875 von Miller and from 1912 Freiherr von Miller was a ore caster, sculptor and direktor of the Academy of Fine Arts, Munich...

 (the younger), depicting Sims in surgical wear can be found on the peripheral wall of Central Park
Central Park
Central Park is a public park in the center of Manhattan in New York City, United States. The park initially opened in 1857, on of city-owned land. In 1858, Frederick Law Olmsted and Calvert Vaux won a design competition to improve and expand the park with a plan they entitled the Greensward Plan...

, at Fifth Avenue and 103rd Street, opposite the New York Academy of Medicine
New York Academy of Medicine
The New York Academy of Medicine was founded in 1847 by a group of leading New York City metropolitan area physicians as a voice for the medical profession in medical practice and public health reform...

. This is the first statue in the United States depicting a physician. Other memorials can be found on the grounds of both the South Carolina State Capitol in Columbia, SC and in front of Alabama's capital in Montgomery, AL.

Contributions

  • Vaginal surgery: fistula
    Fistula
    In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...

     repair.
  • Instrumentation: Sims' speculum
    Speculum (medical)
    A speculum is a medical tool for investigating body cavities, with a form dependent on the body cavity for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra...

    ; Sims' sigmoid catheter
    Catheter
    In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...

    .
  • Surgical positioning: Sims' position.
  • Fertility treatment: Insemination
    Insemination
    Insemination is the deliberate introduction of sperm into the uterus of a mammal or the oviduct of an oviparous animal for the objective of impregnating a female for reproduction...

     and Postcoital test
    Postcoital test
    The postcoital test is a test in the evaluation of infertility. It was apparently first performed by J. Marion Sims and later described by Max Huhner, thus it has also been called Sims-Huhner Test....

    .
  • Cancer care: Sims argued for the admission of cancer patients to the Woman's Hospital, a position that was fought as many believed the condition to be contagious.
  • Abdominal surgery: Sims advocated that in the case of an abdominal bullet wound a laparotomy
    Laparotomy
    A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.- Terminology :...

     was needed to stop bleeding, repair the damage and drain the wound. Thus his opinion was sought when President James Garfield
    James Garfield
    James Abram Garfield served as the 20th President of the United States, after completing nine consecutive terms in the U.S. House of Representatives. Garfield's accomplishments as President included a controversial resurgence of Presidential authority above Senatorial courtesy in executive...

     was shot and transmitted by telegram from Paris. Sims' recommendations gained acceptance after his death.
  • 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 was reported in Indianapolis in 1867.

External links

  • J. Marion Sims article, Encyclopedia of Alabama
  • Washington, Harriet A. "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present" http://www.medicalapartheid.com/
  • Speert H. Obstetrics and Gynecologic Milestones. The MacMillan Co., New York, 1958, pages 442-54.
  • Spencer, Thomas. "UAB shelves divisive portrait of medical titans: Gynecologist's practices at heart of debate." Birmingham News, January 21, 2006.
  • Gamble, Vanessa. "Under the Shadow of Tuskegee: African Americans and Health Care". American Journal of Public Health, November 1997, page 1773.
  • Sims, J. Marion. The Story of My Life. Appleton, New York, 1889, pages 236-237.
  • Wall LL, "Did J. Marion Sims Deliberately Addict His First Fistula Patients to Opium?." Journal of the History of Medicine and Allied Sciences, Vol 62:3, 336-356, Oxford University Press. [Effectively disputes contentions in text above that Dr. Sims exploited initial research subjects]
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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