The Portrayal of J. Marion Sims' Controversial Surgical Legacy

Abstract

While historians, ethicists and the popular press have debated Dr. Sims' legacy, medical sources have continued to portray him unquestionably as a great figure in medical history. This division keeps the medical profession uninformed and detached from the public debate on his legacy and, thus, the larger issues of ethical treatment of surgical patients.

Taking Down Statues

“…This began to change during the latter half of the 20th century as academic discussion began to occur regarding his legacy. 4 However, Sims' legacy remains relatively untarnished within the modern medical community. 4 Textbooks almost uniformly portray him as a skilled and revolutionary surgeon and Sims' own perception of his achievements has largely been embraced by the rest of the profession.…”

“…4 However, Sims' legacy remains relatively untarnished within the modern medical community. 4 Textbooks almost uniformly portray him as a skilled and revolutionary surgeon and Sims' own perception of his achievements has largely been embraced by the rest of the profession. 4 Southern physicians frequently publish glowing biographies and reviews of his career and push back against attempts to frame his discoveries in the context of the oppression of slave women in the American South.…”

“…1 While such debates rage in popular media and academic literature, his legacy as the "father of gynaecology" continues to sit comfortably in surgical textbooks and in the collective mind of the medical community. 4 This refusal to re-examine a difficult and contentious period in medical history has the potential to distance the profession from those it aims to serve.…”

History Is a Tangled Mess: Medical Progress, But at What Cost?

“…According to multiple accounts, these operations were done without the women's consent and without anesthesia. [7][8][9][10][11] These women were treated primarily for vesicovaginal fistulae, a physically and socially debilitating complication of childbirth, for which, at that time, there was no cure. Sims came up with innovative techniques to visualize the relevant anatomy and developed novel surgical procedures where none had been previously successful.…”

Vesicovaginal fistula: what is the preferred closure technique?

“…Unlike many gynecologic surgeries which have a shorter history, modern vaginal VVF surgery date back to surgical attempts around 1663 with the first reported successful closure by Johann Fatio in 1675. Vaginal skin flaps and tension-free closure were adopted in the 1830s predating the landmark work by J. Marion Sims in 1852 on a slave named Anarcha who after 30 attempts using silver wire achieved successful vaginal closure [3]. Although, the original Hippocratic oath relegated the (abdominal) removal of vesical calculi to trained practitioners (lithotomists), it was not until around the mid 1880s that Trendelenburg introduced the abdominal suprapubic approach for VVF.…”