J. Marion Sims

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.^[1]

J. Marion Sims

Early career

Sims was born in Hanging Rock, South Carolina, 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, and took a three-month course at the Medical College of Charleston. He then moved to Philadelphia, Pennsylvania 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.

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 fistulas - usually the result of traumatic labor - were, in those days, social outcasts. No cure was available. In Montgomery, Alabama, 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.^[1] 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.^[1] 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.^[2] 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.

Sims Speculum

In Central Park

These experiments set the stage for modern vaginal surgery. Sims devised instruments including the Sims' speculum 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. He insisted on cleanliness. His technique using silver-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, 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 and Paris, and from 1863 to 1866, served as surgeon to Empress Eugénie. 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.^[2]

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 (the younger), depicting Sims in surgical wear^[3] can be found on the peripheral wall of Central Park, at Fifth Avenue and 103rd Street, opposite the New York Academy of Medicine. This is the first statue in the United States depicting a physician.^[2] Other memorials can be found on the grounds of the South Carolina State Capitol in Columbia ^[4]

J Marion Sims

Contributions

• Vaginal surgery: fistula repair.
• Instrumentation: Sims' speculum; Sims' sigmoid catheter.
• Surgical positioning: Sims' position.
• Fertility treatment: Insemination and Postcoital 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 was needed to stop bleeding, repair the damage and drain the wound. Thus his opinion was sought when President James Garfield was shot and transmitted by telegram from Paris. Sims' recommendations gained acceptance after his death.^[2]
• 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.^[2]

Death

He died in New York City, New York in 1883 at the age of 70^[5].

References

1. ^ ^{a b c} Lerner, Barbara (October 28, 2003). "Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9907E3D81131F93BA15753C1A9659C8B63&sec=health&spon=&partner=permalink&exprod=permalink. 
2. ^ ^{a b c d e} H M Shingleton (March–April 2009). "The Lesser Known Dr. Sims". ACOG Clinical Review 14 (2): 13–16. 
3. ^ The bronze standing figure is signed "[F. v]on Miller fec. München 1892"; it was first erected and dedicated in Reservoir Square, now Bryant Park, in 1894 and reerected at its present site in 1934 (Text of historical sign).
4. ^ http://www.scstatehouse.gov
5. ^ "Ob/Gyn Biographies". www.obgynhistory.com. http://www.utilis.net/history/peo.html. Retrieved 31 December 2010. 

External links

• J. Marion Sims article, Encyclopedia of Alabama
•  "Sims, James Marion". Appletons' Cyclopædia of American Biography. 1900. 
• Washington, Harriet A. "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present" [1]
• 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]

Persondata
Name	Sims, J. Marion
Alternative names
Short description
Date of birth	January 25, 1813
Place of birth
Date of death	November 13, 1883
Place of death