By Marvin Ross
Dr Marion J Simms (1813–1883 ) is considered to be the father of modern gynecology but he is now getting a great deal of bad press on Facebook and elsewhere for allegedly operating on slaves without anaesthesia.
Unfortunately, this is likely another example of the failure of many in their zeal to expose racism in our society to mistake what actually happened. Thanks to my medical writing colleague, Bruce Wilson, for bringing this to my attention. Simms developed surgical techniques for Vesicovaginal fistula which:
“was a common and catastrophic consequence of birth in which a hole develops between a woman’s bladder and her vagina and leads to constant, unremitting, and uncontrollable urinary incontinence. Attempts to cure this condition had eluded many previous generations of surgeons who had tried to repair these devastating injuries time and again, but without significant success.”
Simms set up a hospital behind his home in Montgomery, Alabama in order to try to develop a treatment for this condition. The reality of this condition was described by Dr P M Kollock at the annual meeting of the Georgia State Medical Society in April, 1857:
The poor woman [with a vesicovaginal fistula] is now reduced to a condition of the most piteous description, compared with which, most of the other physical evils of life sink into utter insignificance. The urine passing into the vagina as soon as it is secreted, inflames and excoriates its mucous lining, covering it with calcareous depositions, and causing great suffering. It trickles constantly down her thighs, irritates the integument with its acrid qualities, keeps her clothing constantly soaked, and exhales without cessation its peculiar odour, insupportable to herself and those all around her. In cases where the sloughing has been extensive, and the loss of substance of the tissues great, and where neither palliative nor curable means have availed for the relief of the sufferer, she has been compelled to sit constantly on a chair, or stool, with a hole in the seat, through which the urine descends into a vessel beneath.
Given this reality, it is not surprising that many women, in their desperation, were willing to try anything to get relief.
As for consent,Simms stated:
For this purpose [therapeutic surgical experimentation] I 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
It has also been said the Simms operated without anaesthesia but again it is not quite that simple. Simms first surgery was done in 1845 which predated the use of chloroform as an anaesthetic. Even after it was introduced, many doctors were cautious in its use. The view was that:
humane, conscientious, highly reputable practitioners and ordinary lay people held many misgivings about the new discovery. Neither sadists nor fools, these critics alleged a variety of rational drawbacks to the use of anaesthesia.
Sir James Young Simpson who discovered chloroform did not feel that it was necessary in this type of surgery. He stated:
“The mere amount of pain endured by the patient is perhaps less than in most surgical operations, as the walls of the vesicovaginal septum are far less sensitive than you would a priori imagine”.
What was truly an assault on African Americans was the Tuskeegee experiments performed on many with venereal disease. This video explains what happens and begins with an apology from President Clinton
Of course, today we have the very negative impact that Covid-19 is having on African Americans for many reasons and the failure of the US to have universal healthcare for its citizens. So despicable is the concept of making profits in exchange for health and that impact on the poor and marginalized, that a former health industry executive apologized for the lies he helped to spread about universal healthcare and the attacks on the Canadian system.
Those seeking justice and equity for minorities would be better off fighting for those injustices.