The Portrayal of J. Marion Sims' Controversial Surgical Legacy (2022)


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The Journal of Urology

Volume 185, Issue 6,

June 2011

, Pages 2424-2427 rights and content

(Video) The US medical system is still haunted by slavery


In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on female slaves. A venerated physician in his time, the legacy of Dr. Sims is controversial and represents a significant chapter in the mistreatment of African-Americans by the medical establishment. This review compares the modern debate surrounding his legacy with the presentation of his operation in widely consulted urological texts and journals.

Materials and Methods

A literature review was performed of medical, sociological and periodical sources (1851 to the present) regarding J. Marion Sims and vesicovaginal fistula repair.


During the last several decades, while the controversy around Dr. Sims' surgical development has produced a steady stream of articles in the historical and popular literature, relatively little mention is found in standard urology textbooks or journals. With increased public attention, some have debated the removal or modification of public tributes to Dr. Sims. This move has been countered by arguments against the validity of judging a 19th century physician by modern standards.


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.

Section snippets

Source Material

The current and all prior editions of Campbell-Walsh Urology (previously Campbell's Urology and Urology) were reviewed for mention of Dr. Sims, his original paper and description of vesicovaginal fistula repair. The gynecological textbook Te Linde's was similarly referenced. The databases PubMed®, Ovid®, Google Scholar and Cross Reference were searched for Dr. Sims' original publication, “On the Treatment of Vesico-Vaginal Fistula,” the 1998 reprinted article and keyword Sims. The New York Times

Sims as Champion of Women'S Health

Dr. Sims' obituary in the New York Times in 1883 described “his invaluable services to the science of medicine,” and his numerous honors, including past president of the American Medical Association and decorations by several European nations.1 He was the first medical professional to have a statue in his honor in New York City, a statue which was moved from Bryant Park to Central Park and now stands across from the New York Academy of Medicine on Fifth Avenue. Throughout the early part of the

“It Was Chattel Slavery and Morphine, Not Courage, That Had Bound the Women to His Surgical Table”2

It was not until the 1960s and 70s that the representation of Sims as a respected physician and champion of women's health began to change. Authors questioned his benevolence, the ethics of experimental operations on slaves and how to portray his legacy. As one author concluded, Sims' experiments were “a classic example of the evils of slavery and the misuse of human subjects for medical research.”10

One of the first reexaminations of Sims' legacy was a 1963 doctoral thesis which was expanded

“One of the Great Figures in the History of Operative Gynecology”

In contrast to the changes in popular and historical sources, medical texts and journals are relatively static in the portrayal of Dr. Sims as a surgical innovator. Current and previous editions of Campbell-Walsh Urology, from the first edition Urology by Dr. Campbell in 1954 to the online version of the 9th edition, contain several references to Dr. Sims' contribution to fistula repair but no mention of who his subjects were or of his controversial legacy (see Appendix).

A resident today would


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 threatens to keep the medical profession uninformed and detached from the public debate on his legacy. Sims made many contributions to the field. However, as opposed to championing women's health, Sims' legacy should be associated with surgical experimentation on vulnerable populations. This question is

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There are more references available in the full text version of this article.

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Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.


What did James Marion Sims do to slaves? ›

In the 1840s, the Alabama physician James Marion Sims conducted infamous experimental gynaecological surgery exclusively on black women, bound to the surgical table by chattel slavery, physical force and opium. The drug did not allay their pain, and some historians think that they became addicted to it.

What was James Marion Sims known for? ›

Few medical doctors have been as lauded—and loathed—as James Marion Sims. Credited as the “father of modern gynecology,” Sims developed pioneering tools and surgical techniques related to women's reproductive health.

Who is considered the father of gynecology? ›

Abstract. J. Marion Sims (1813-1884) has been called the "Father of Gynecology" for his revolutionary approach to treating the diseases of women. He rose from humble origins to become a successful surgeon, teacher, and writer.

Why are gynecological procedures done without anesthesia? ›

Farid said that providing anesthesia often requires one or more painful injections and because procedures such as endometrial biopsies and IUD insertions are relatively quick, receiving multiple injections may actually be more painful than the procedure itself.

Who is the most famous gynecologist? ›

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