“J. Marion Sims”的意思、由来-开放百科全书

Sims perfected his surgical techniques by operating without anesthesia on enslaved black women.^[1]^[2] In the 20th century, this was condemned as an improper use of human experimental subjects and Sims was described as "a prime example of progress in the medical profession made at the expense of a vulnerable population".^[1]

But Sims' medical ethics have also been defended by modern commentators. For instance, physician and anthropologist L. Lewis Wall, founder of the Worldwide Fistula Fund, has argued that Sims conformed to the accepted medical practices of the time. His operations on slave women provided effective relief from a previously untreatable condition that was catastrophic to their health and quality of life.^[2] It appears the subjects were willing; they had no other, better option. According to Sims, the slave women were "clamorous" for the operation.^[2]

Sims was a voluminous writer and his published reports on his medical experiments, together with his own 471-page autobiography (summarized by Wylie^[8]), have been the main sources of knowledge about him and his career. His positive self-presentation has, in the late 20th and early 21st centuries, been subject to revision. Aside from his treatment of slave women, Sims was not an appealing figure. "Many called him a braggart."^[9]

Early life, education and career

J. Marion Sims (called Marion) was born in Lancaster County, South Carolina,^[3] the son of John and Mahala (Mackey) Sims. For his first 12 years, Sims's family lived in Lancaster Village north of Hanging Rock Creek, where his father owned a store. Sims later wrote of his early school days there.^[4]{{rp|4–5}}

After his father was elected as sheriff of Lancaster County, he sent Sims in 1825 to the newly established Franklin Academy, in Lancaster (for white boys only). In 1832, after two years of study at the predecessor of the University of South Carolina, South Carolina College, where he was a member of the Euphradian Society, Sims worked with Dr. Churchill Jones in Lancaster, South Carolina. He took a three-month course at the Medical College of Charleston (predecessor of the Medical University of South Carolina).

He moved to Philadelphia, Pennsylvania, in 1834 and enrolled at the Jefferson Medical College, where he graduated in 1835, "a lackluster student who showed little ambition after receiving his medical degree".^[2] As he put it,

He returned to Lancaster to practice. After his first two patients died, Sims left and set up a practice in Mount Meigs, near Montgomery, Alabama.^[4]{{rp|7}} He described the settlement in a letter to his future wife Theresa Jones as "nothing but a pile of gin-houses, stables, blacksmith-shops, grog-shops, taverns and stores, thrown together in one promiscuous huddle".^[5]{{rp|374}} He was in Mount Meigs from 1835 to 1837.^[16]{{rp|6}} Sims visited Lancaster in 1836 to marry Theresa, whom he had met many years earlier, when a student in Lancaster. She was the niece of Churchill Jones, and had studied at the South Carolina Female Collegiate Institute.^[5]{{rp|177–178}}^[6]

In 1837 Sims and his wife moved to Macon County, Alabama, where they remained until 1840.^[16]{{rp|6}} He was a "plantation physician",^[20] who had "a partnership in a large practice among rich plantations."^[4]{{rp|7}} "Sims became known for operations on clubfeet, cleft palates and crossed eyes."^[20] This was his first experience treating slaves, who were brought to him by their owners.

In 1840 the couple moved to Montgomery, Alabama,^[4]{{rp|7–8}} where they lived until 1853.^[16]{{rp|10}} There Sims had what he described as the "most memorable time" of his career.^[7] Within a few years he "had the largest surgical practice in the State", the largest practice that any doctor in Montgomery had ever had, up to that time.^[8]{{rp|7}} "He was immensely popular, and greatly beloved."^[8]{{rp|8}}

Medical experimentation on enslaved African-American women

Repair of vesicovaginal fistula

In Montgomery he continued treating slaves (who made up two thirds of the city's population^[28]{{rp|34}}). He built a hospital for them on his property.;^[4]{{rp|9}} at the time it was the only such facility in the state. It has been called "the first woman's hospital in history".^[9] In 1845 he was brought a woman with a condition he had not seen before: vesicovaginal fistula.

In the 19th century, vesicovaginal fistulas, though not fatal, were a common, socially destructive, and "catastrophic complication of childbirth",^[2] that affected many women. There was no effective cure or treatment. Lacking adequate birth control, women generally had a high rate of childbirth, which increased their rate of complications.^[10] Vesicovaginal fistulas occur when the woman's bladder, cervix, and vagina become trapped between the fetal skull and the woman's pelvis, cutting off blood flow and leading to tissue death. The necrotic tissue later sloughs off, leaving a hole. Following this injury, as urine forms, it leaks out of the vaginal opening, leading to a form of incontinence. Because a continuous stream of urine leaks from the vagina, it is difficult to care for. The victim suffers personal hygiene issues that may lead to marginalization from society, and vaginal irritation, scarring, and loss of vaginal function. Sims also worked to repair rectovaginal fistulas, a related condition in which flatulence and feces escape through a torn vagina, leading to fecal incontinence.^[2]

In the mid-19th century, gynecology was not a well-developed field: "the practice of examining the female organs was considered repugnant by doctors." In medical school, doctors were often trained on dummies to deliver babies. They did not see their first clinical cases of women until beginning their practices.^[10]{{rp|28}} Sims had had no formal background in gynecology prior to beginning his practice in Alabama.^[4] He remarked in his autobiography that "if there was anything I hated, it was investigatng the organs of the female pelvis".^[28]{{rp|34}}

When a woman came to him with an injured pelvis and retroverted uterus from a fall from a horse, he placed her in a knee-chest position and inserted his finger into the vagina; this triggered a full distention of the vagina with air, allowing Sims to see the vagina clearly. The distention inspired him to investigate fistula treatment.^[10]^[4] Soon after, he developed a precursor to the modern speculum, using a pewter spoon and strategically placed mirrors.^[11]

From 1845 to 1849, Sims started doing experiments on slave women to treat vaginal problems. He added a second story to his hospital, for a total of eight beds.^[4]{{rp|10}} He developed techniques that have been the basis of modern vaginal surgery. A key component was silver wire, which he had a jeweler prepare.^[12] The Sims' vaginal speculum aided in vaginal examination and surgery. The rectal examination position, in which the patient is on the left side with the right knee flexed against the abdomen and the left knee slightly flexed, is also named for him.

Experimental subjects

In Montgomery, between 1845 and 1849, Sims conducted experimental surgery on 12 enslaved women with fistulas in his backyard hospital.^[13] They were brought to him by their owners. Sims asked for patients with this fistula, and "succeeded in finding six or seven women".^[4]{{rp|9}} Sims took responsibility for their care on the condition that the owners provide clothing and pay any taxes; Sims provided food.^[11] One he purchased "expressly for the purpose of experimentation when her master resisted Sims' solicitations."^[28]{{rp|35}}

He named three enslaved women in his records: Anarcha, Betsy, and Lucy. Each suffered from fistula, and all were subjects of his surgical experimentation.^[14] From 1845 to 1849 he conducted experimental surgery on each of them several times, operating on Anarcha 13 times before the repair of her fistulas was declared a success.^[10] She had both vesicovaginal and rectovaginal fistulas, which he struggled to repair.^[2] Sim's ignored the AMA's Code of Ethics and Jones counsel.^[15] "Notwithstanding repeated failures during four years' time, he kept his six patients and operated until he tired out his doctor assistants, and finally had to rely upon his patients to assist him to operate."^[4]{{rp|10}} Unlike his previous essays, which included at least a brief description of his patients, the article issued in the American Journal of the Medical Sciences is devoid of any identifying characteristics of Anarcha, Betsy, and Lucy.^[15]

Although anesthesia had very recently become available, Sims did not use any anesthetic during his procedures on these three women.^[14] According to Sims, anesthesia was not yet fully accepted into surgical practice, and he was unaware of the use of diethyl ether.^[2]^[11] Ether as an anesthetic was available as early as the beginning of 1842.^[11]

A 2006 review of Sims' work in the Journal of Medical Ethics said that ether anesthesia was first publicly demonstrated in Boston in 1846, a year after Sims began his experimental surgery. The article notes that, while ether's use as an anesthetic spread rapidly, it was not universally accepted at the time of Sims' experimental surgery.^[2]

In addition, a common belief at the time was that black people did not feel as much pain as white people.^[16] One patient, named Lucy, nearly died from septicemia. He had operated on her without anesthetics in the presence of twelve doctors, following the experimental use of a sponge to wipe urine from the bladder during the procedure.^[10] She contracted septicemia because he left this sponge in her urethra and bladder.^[13] He did administer opium to the women after their surgery, which was accepted therapeutic practice of the day.^[17]

After the extensive experimental surgery, and complications, Sims finally perfected his technique. He repaired the fistulas successfully in Anarcha. The silver-wire sutures, developed in 1849,^[4]{{rp|10}} helped him make the first completely successful repair of a fistula. Sims published an account of this in his surgical reports of 1852.^[1] He proceeded to repair fistulas in several other enslaved women.^[18] According to Durrenda Ojanuga from the University of Alabama, "Many white women came to Sims for treatment of vesicovaginal fistula after the successful operation on Anarcha. However, none of them, due to the pain, were able to endure a single operation." The Journal of Medical Ethics reports a case study of one white woman, whose fistula was repaired by Sims without the use of anesthesia, in a series of three operations carried out in 1849.^[2]

Sims later moved to New York to found a Woman's Hospital, where he performed the operation on white women. According to Ojanuga, Sims used anesthesia when conducting fistula repair on white women. But L. L. Wall, also writing for the Journal of Medical Ethics, states that as of 1857, Sims did not use anesthesia to perform fistula surgery on white women, citing a public lecture where Sims spoke to the New York Academy of Medicine on November 18, 1857. During this lecture, Sims said that he never used anesthesia for fistula surgery "because they are not painful enough to justify the trouble and risk attending their administration". While acknowledging this as shocking to modern sensibilities, Wall noted that Sims was expressing the contemporary sensibilities of the mid-1800s, particularly among surgeons who began their practice in the pre-anesthetic era.^[10]^[16]^[2] In 1874 Sims addressed the New York State Medical Society on "The Discovery of Anaesthesia",^[19]^[20] and in 1880 read to the New York Academy of Medicine a paper, soon published, about a death from anesthesia.^[4]{{rp|22}}^[21]

Trismus nascentium

During his early medical years, Sims also became interested in "trismus nascentium", also known as neonatal tetanus. It is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from the mother having been immunised are at risk for this disease. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. In the 21st century, neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure. It is rare in developed countries.^[22]

Trismus nascentium is now recognized to be the result of unsanitary practices and nutritional deficiencies. In the 19th century its cause was unknown, and many African slave children contracted this disease. Medical historians believe that the conditions of the slave quarters were the cause. Sims alluded to the idea that sanitation and living conditions played a role in contraction.^[23]

Sims also thought trismus nascentium developed from skull bone movement during protracted births. To test this, Sims used a shoemaker's awl to pry the skull bones of enslaved women's babies into alignment. These experiments had a 100% fatality rate. Sims often performed autopsies on the corpses, which he kept for further research on the condition.^[23] He blamed these fatalities on "the sloth and ignorance of their mothers and the black midwives who attended them", as opposed to the extensive experimental surgeries that he conducted upon the babies.^[24]^[25]

Critiques of experimentation

Sims' experimental surgeries without anesthesia on enslaved African-American women, who could not consent, have been described since the late 20th century as an example of racism in the medical profession. This is seen as part of the historical oppression of blacks and vulnerable populations in the United States.^[1] Patients of Sims' fistula and trismus nascentium operations were not given available anesthetics. He caused the deaths of babies on whom he operated for the trismus nascentium condition.

Author Harriet Washington, in her 2007 book Medical Apartheid, writes of Sims' experiments: "Each naked, unanesthetized slave woman had to be forcibly restrained by other physicians through her shrieks of agony as Sims determinedly sliced, then sutured her genitalia."^[27] Facing South, a publication of The Institute for Southern Studies, wrote that enslaved women were forced to hold each other down during surgery.^[28]

Physician L.L. Wall, writing in the Journal of Medical Ethics, says fistula surgery on non-anesthetized patients would require cooperation from the patient, and would not be possible if there were any active resistance from the patient. Wall writes that surviving documentation from the time says the women were trained to assist in their own surgical procedures. Wall also argues the documentation suggests the women consented to the surgeries, as the women were motivated to have their fistulas repaired, due to the serious medical and social nature of vesicovaginal and rectovaginal fistulas.^[2]

According to gynaecologist Caroline M. de Costa, writing in The Medical Journal of Australia:

In his autobiography, J. Marion Sims said he was indebted to the enslaved women. After multiple failed operations he was discouraged, and the enslaved women encouraged him to proceed, because they were determined to have their medical afflictions cured.^[2] Shortly after Sims' successful repair of Anarcha's vesicovaginal and rectovaginal fistulas in 1849, he successfully repaired the fistulas of the other enslaved women. They returned to their plantations.^[18]

Sims has been criticized for operating on the enslaved women without their consent. Wall writes in the Journal of Medical Ethics, that legally, consent was granted by the slave's owners. He noted that enslaved persons were a "vulnerable population" with respect to medical experimentation. Wall also writes that Sims obtained consent from the enslaved women themselves.

He cites an 1855 passage from New York Medical Gazette and Journal of Health, where Sims wrote:

Deirdre Cooper Owens wrote: "Sims has been painted as either a monstrous butcher or a benign figure who, despite his slaveowning status, wanted to cure all women from their distinctly gendered suffering."^[88] She describes these opposing views as overly reductionist, saying his history is more nuanced. He lived in a slave-holding society and expressed the racism and sexism that were considered normal during his time. He contributed significantly to the field of gynecological surgery. Sims' suture technique developed in the 1840s for fistula surgery is still in use by modern-day physicians.^[30]

New York and Europe

Sims moved to New York in 1853 because of his health and was determined to focus on diseases of women. He had an office at 267 Madison Avenue.^[31]

In 1855 he founded Woman's Hospital, the first hospital for women in the United States. His project met with "universal opposition" from the New York medical community;^[4]{{rp|11}} it was due to prominent women that he established it. They were visited by "prominent doctors, who endeavored to convince them that they were making a mistake, that they had been deceived, that no such hospital was needed, etc."^[4]{{rp|12–13}} "I was called a quack and a humbug, and the hospital was pronounced a fraud. Still it went on with its work."^[4]{{rp|13}} In the Woman's Hospital, he performed operations on indigent women, often in an operating theatre so that medical students and other doctors could view it, as was considered fundamental to medical education at the time.^[32] Patients remained in the hospital indefinitely and underwent repeated procedures.^[32]

Sims and the Confederacy

In 1861, during the American Civil War, Sims, a "loyal Southerner",^[32]{{rp|46}} moved to Europe, where he toured hospitals and worked on fistula patients in London, Paris, Edinburgh, Dublin, and Brussels.^[23]^[4] However, according to J.C. Hallman, he was there as one of several government agents of the Confederacy, who were seeking money (loans), diplomatic recognition of their new government (no country ever recognized it), and supplies and ships. An intercepted letter informed Lincoln's Secretary of State, William Seward, that Sims was "secessionist in sentiment", and that his "purpose in going abroad at this time is believed to be hostile to the government", as Seward reported to U.S. diplomats in Europe.^[33] According to the U.S. Minister in Brussels Henry Shelton Sanford, Sims was a "violent secessionist", and his "movements in Europe had 'given color to (the) opinion' that he was a spy".^[33]

The most celebrated episode in Sims' life was his summons, in 1863, to treat Empress Eugénie for a fistula. This widely reported episode helped Sims to solidify his worldwide reputation as a surgeon.^[23] But according to Hallman, no source confirms that Eugénie had any medical problem at all. Simms' visits to the palace were semi-diplomatic Confederate visits, and the illness an invention to escape the vigilance of the U.S. diplomats, who had their eyes on Sims. Eugénie became an "ardent disciple" of the Confederacy.^[33]

Expressing the views of many Southern whites, Sims later said that "the dreadful mistake it was to give the negro the franchise."^[33] Two years later, offering a toast on board the steamer Atlantic, returning to Europe, he claimed that in the aftermath of the war, the South had been degraded “beyond the level of the meanest slave that ever wore a shackle.”^[33]

At the same time, Sims argued that it was puerile for the South to sulk in its loss. He called for an acceptance of the issues of the war, including the 15th amendment. “It is folly to talk of the lost cause,” he said.^[33]

Later career

Having treated royalty, after his return to the United States, Sims raised his charges in his private practice. He effectively limited it to wealthy women, although "he always had a long roll of charity patients".{{clarify |date=October 2018 |reason=quote needs to be ascribed}}^[34]{{rp|25}} He became known for the Battey surgery, which contributed to his "honorable reputation"{{clarify |date=October 2018 |reason=quote needs to be ascribed}}. This involved the removal of both ovaries. It became a popular treatment to relieve insanity, epilepsy, hysteria, and other "disorders of the nerves"{{clarify |date=October 2018 |reason=quote needs to be ascribed}} of women. At the time, these were believed to be caused by disorders of the female reproductive system.^[32]

Sims received honors and medals for his successful operations in many countries. Since the 20th century, the necessity of many of these surgeries has been questioned. He performed surgery for what were considered gynecological issues: such as clitoridectomies, then believed to control hysteria or improper behavior related to sexuality. These were done at the requests of the women's husbands or fathers, who were permitted under the law to commit the women to surgery involuntarily.^[18]

Under the patronage of Napoleon III, Sims organized the American-Anglo Ambulance Corps, which treated wounded soldiers from both sides at the Battle of Sedan.^[18]

Break with the Woman's Hospital

In 1871, Sims returned to New York. He got into a conflict with the other doctors of the Woman's Hospital, with whom he carried on a dialogue by means of published pamphlets.^[35]^[36]^[37] One issue was whether the hospital would treat women with uterine cancer, because the hospital was founded to treat diseases of women, and cancer was not a disease peculiar to women. In addition, cancer was feared as contagious. The second issue was how many outsiders (doctors or medical students) could observe any given operation, as was common at the time. This meant they could observe the sexual organs of white women patients; there were no African-American patients. The Board of the hospital set a limit of 15; previously there had been as many as 60.

After quarreling with the board of the Woman's Hospital over the admission of cancer patients, Sims became instrumental in establishing America's first cancer institute, New York Cancer Hospital.^[38] Hallman says that "Sims was thrown out of his own hospital in New York in 1874, in part because his fellow doctors had determined that his work was reckless and lethal".^[33]

In reply to the treatment he received from the Woman's Hospital, Sims was unanimously elected president of the American Medical Association, an office he held from 1876 to 1877.^[8]{{rp|18}}^[23]

Death

In 1880, Sims contracted a severe case of typhoid fever. W.Gill Wylie, an early 20th-century biographer, said that although Sims suffered delirium, he was "constantly contriving instruments and conducting operations".^[4] After several months and a move to Charleston to aid his convalescence, Sims recovered in June 1881. He traveled to France. After his return to the United States in September 1881, he began to complain of an increase in heart problems. He had suffered two angina attacks in 1877.

According to Wylie, Sims consulted with doctors for his unknown cardiac condition both in the United States and in Europe. He was "positive that he had a serious disease of the heart and it caused deep mental depression".^[4] He was halfway through writing his autobiography and planning a return visit to Europe when he died of a heart attack on November 13, 1883 in Manhattan, New York City. He had just visited a patient with his son, H. Marion Sims. He is buried at Green-Wood Cemetery in Brooklyn, New York.

Legacy and honors

Contributions

See also

References

1. ^¹²³⁴⁵⁶Sarah Spettel and Mark Donald White, "The Portrayal of J. Marion Sims' Controversial Surgical Legacy", The Journal of Urology, Vol. 185, 2424–2427, June 2011, accessed November 4, 2013
2. ^¹²³⁴⁵⁶⁷⁸⁹¹⁰{{Cite journal|last=Wall|first=L. L.|date=June 2006|title=The medical ethics of Dr J Marion Sims: a fresh look at the historical record|journal=Journal of Medical Ethics|volume=32|issue=6|pages=346–350|doi=10.1136/jme.2005.012559|issn=0306-6800|pmc=2563360|pmid=16731734}}
3. ^{{Citation |title=Marion Sims and the Origin of Modern Gynecology |first= George Gray |last=Ward |journal= Bulletin of the New York Academy of Medicine |volume=12 |number=3 |pages=93–104 |date=March 1936 |pmc=1965916 |pmid=19311983}}
4. ^¹²³⁴⁵⁶⁷⁸⁹¹⁰¹¹¹²¹³¹⁴¹⁵¹⁶¹⁷¹⁸¹⁹{{cite book|last1=Wylie|first1=W. Gill|title=Memorial Sketch of the Life of J. Marion Sims|date=1884|url=https://archive.org/details/101310238.nlm.nih.gov/page/n1|publisher=D. Appleton and Company|location=New York}}
5. ^¹{{citation|first=J. Marion|last=Sims|title=The Story of My Life|year=1885|publisher=D. Appleton & Company|url=https://play.google.com/books/reader?id=kaYNAAAAYAAJ&pg=GBS.PP7|accessdate=October 20, 2018}}
6. ^{{cite web|url=https://www.knowitall.org/photo/south-carolina-female-collegiate-institute-barhamville-history-south-carolina-slide-collection|title=South Carolina Female Collegiate Institute, Barhamville — History Of South Carolina Slide Collection|date=2018|accessdate=October 25, 2018|publisher=South Carolina ETV Commission}}
7. ^{{cite article|title=J. Marion Sims, the controversial 'father of modern gynecology,' conducted experiments on slaves and did not use anesthesia|date=May 9, 2018|first=Martin|last=Chalakoski|newspaper=Vintage News|url=https://www.thevintagenews.com/2018/05/09/j-marion-sims/}}
8. ^¹²³⁴⁵{{cite book|title=Tribute to the late James Marion Sims|first=W. O.|last=Baldwin|location=Montgomery, Alabama|year=1884|url=https://babel.hathitrust.org/cgi/pt?id=ien.35558005350695;view=2up;seq=4|publisher=Montgomery, Ala.}}
9. ^¹{{cite web|title=James Marion Sims|publisher=Alabama Department of Archives and History|year=1995|url=https://web.archive.org/web/19990128114211/http://www.asc.edu:80/archives/famous/j_sims.html}}
10. ^¹²³⁴⁵⁶{{cite journal|last1=Ojunga|first1=Durrenda|title=The medical ethics of the 'Father of Gynaecology', Dr J Marion Sims|journal=Journal of Medical Ethics|date=March 1993|volume=19|issue=1|pages=28–31|doi=10.1136/jme.19.1.28|pmid=8459435|pmc=1376165}}
11. ^¹²³{{cite journal|last1=Axelson|first1=Diana E.|title=Women as Victims of Medical Experimentation: J. Marion Sims' Surgery on Slave Women, 1845–1850|journal=Sage |date=1985|volume=2|issue=2|pages=10–13|pmid=11645827}}
12. ^{{cite article|title=J. Marion Sims: Paving the way|first=Lamar S.|last=McGinnis, Jr.|date=January 1, 2017|journal=Bulletin of the American College of Surgeons|url=http://bulletin.facs.org/2017/01/j-marion-sims-paving-the-way/}}
13. ^¹{{cite book|url=https://as.vanderbilt.edu/archived/gfc/sitemason.vanderbilt.edu/files/dG8FJS/Kapsalis%202002.pdf|title=Skin Deep, Spirit Strong: The Black Female Body in American Culture|last1=Kapsalis|first1=Terri|publisher=University of Michigan Press|others=|year=2002|isbn=978-0472067077|editor1-last=Wallace-Sanders|editor1-first=Kimberly|edition=|series=|volume=|location=Ann Arbor, MI|pages=263–300|language=|script-title=|trans-title=|contribution=Mastering the Female Pelvis: Race and the Tools of Reproduction|type=|format=|dead-url=|issue=}}
14. ^¹²³⁴⁵{{cite web|url= https://www.nytimes.com/2003/10/28/health/scholars-argue-over-legacy-of-surgeon-who-was-lionized-then-vilified.html| title=Scholars Argue Over Legacy of Surgeon Who Was Lionized, Then Vilified|author=Lerner, Barron| work=The New York Times|date= October 28, 2003}}
15. ^¹{{Cite book|title=Black on Both Sides|last=Snorton|first=C. Riley|date=2017-10-25|publisher=University of Minnesota Press|isbn=9781517901721|doi = 10.5749/minnesota/9781517901721.001.0001}}
16. ^¹{{cite news|last1=Vedantam|first1=Shankar|last2=Gamble|first2=Vanessa Northington|title=Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology |publisher=NPR |date=February 16, 2016 |url=https://www.npr.org/2017/02/07/513764158/remembering-anarcha-lucy-and-betsey-the-mothers-of-modern-gynecology |accessdate=March 7, 2017}}
17. ^{{cite journal | pmid = 17082217 | doi=10.1093/jhmas/jrl045 | volume=62 | issue=3 | title=Did J. Marion Sims deliberately addict his first fistula patients to opium? | author=Wall LL | journal=J Hist Med Allied Sci | pages=336–56 | year=2007}}
18. ^¹²³⁴⁵⁶{{cite journal | author=H M Shingleton | title=The Lesser Known Dr. Sims | journal=ACOG Clinical Review |volume=14 |issue=2 |pages=13–16 | date=March–April 2009}}
19. ^{{cite article|last=Sims|first=J. Marion|title=The Discovery of Anaesthesia|journal=Virginia Medical Monthly|date=May 1877|url=https://archive.org/details/39002011123222.med.yale.edu}}
20. ^{{cite article|first1=Julia M.|last1=Rosenbloom|first2=Robert B.|last2=Schonberger|title=The outlook of physician histories: J. Marion Sims and 'The Discovery of Anaesthesia'|journal=Medical Humanities|year=2015|volume=41|pages=102–106}}
21. ^{{cite book|first=J. Marion|last=Sims|title=The bromide of ethyl as an anaesthetic|publisher=New York Academy of Medicine|year=1880|url=https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-101215794-bk}}
22. ^{{Cite web|url=http://www.who.int/immunization/diseases/Maternal_and_neonatal_tetanus_Seminar.pdf|title=Maternal and Neonatal Tetanus|last=Roper|first=Martha|date=September 12, 2007|publisher=World Health Organization}}
23. ^¹²³⁴⁵⁶⁷{{cite web|url=http://www.english.illinois.edu/maps/poets/m_r/moss/sims.htm|title=J. Marion Sims: One Among Many Monumental Mistakes|year=2000|website=A Dr. J. Marion Sims Dossier|publisher=University of Illinois|last1=Brinker|first1=Wendy|accessdate=March 14, 2017}}
24. ^Harriet A. Washington (2008). [https://books.google.com/?id=apGhwRt6A7QC&pg=PA63 Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present], Knopf Doubleday, pp. 62–63 (via Google Books)
25. ^Joshua A. Perper and Stephen J. Cina (2010). [https://books.google.com/books?id=eHhtsODHWf0C&pg=PA88 When Doctors Kill: Who, Why, and How]. Springer Science & Business Media, p. 88
26. ^{{cite journal|last1=Kapsalis|first1=Terri|title=Mastering the Female Pelvis|page=263|url=https://babel.hathitrust.org/cgi/pt?id=mdp.39015056676086;view=1up;seq=277|publisher=Ann Arbor |date=2019-03-24}}
27. ^{{cite news|last1=Trouillot|first1=Terence|title=Pressure Builds to Take Down a Particularly Gruesome NYC Monument to Doctor Who Experimented on Female Slaves|url=https://news.artnet.com/opinion/j-marion-sims-statue-museum-of-the-city-of-new-york-1059308 |publisher=ArtNet |date=August 23, 2017 |accessdate=August 28, 2017}}
28. ^{{cite news|last1=Barber|first1=Rebekah|title=Monuments to the father of gynecology honor brutality against Black women|url=https://www.facingsouth.org/2017/08/monuments-father-gynecology-honor-brutality-against-black-women |publisher=Facing South |date=August 25, 2017 |accessdate=August 28, 2017}}
29. ^{{cite journal |last= de Costa |first= Caroline M. |title= James Marion Sims: some speculations and a new position |journal=The Medical Journal of Australia |url=https://www.mja.com.au/system/files/issues/178_12_160603/dec10116_fm.pdf |volume=178 |issue= |pages=660–663 |doi= |date=16 Jun 2003| access-date=29 Oct 2018}}
30. ^¹{{cite news|last1=Owens|first1=Deidre|title=More Than a Statue: Rethinking J. Marion Sims' Legacy|url=https://rewire.news/article/2017/08/24/statue-rethinking-j-marion-sims-legacy/|publisher=Rewire |date=August 2, 2017 |accessdate=August 28, 2017}}
31. ^¹{{cite article|title=History of the discovery of anaesthesia|last=Sims|first=J. Marion|url=https://archive.org/details/39002011123248.med.yale.edu/page/n3|page=1|journal=Virginia Medical Monthly|date=May 1877}}
32. ^¹²³⁴⁵⁶{{cite book|url=https://books.google.com/books?id=CzFvGY0lRYoC&pg=PA46|title=Public Privates: Performing Gynecology from Both Ends of the Speculum|first=Terri|last=Kapsalis|date=25 January 1997|publisher=Duke University Press|via=Google Books|isbn=978-0822319214}}
33. ^¹²³⁴⁵⁶{{cite news |title=J. Marion Sims and the Civil War — a rollicking tale of deceit and spycraft|first=J.C.|last=Hallman|newspaper=Montgomery Advertiser|date=September 28, 2018|url=https://www.montgomeryadvertiser.com/story/opinion/2018/09/28/dr-j-marion-sims-and-civil-war-rollicking-tale-deceit-and-spycraft-slaves-experiments/1443452002/}}
34. ^{{cite book|title=The Story of My Life|first=J. Marion|last=Sims|contribution=Introduction|year=1877|editor-first=H.|editor-last=Marion-Sims|publisher=D. Appleton & Company|url=https://play.google.com/books/reader?id=kaYNAAAAYAAJ&pg=GBS.PA1}}
35. ^{{cite book|title=To the medical profession: statements respecting the separation of Dr. J. Marion Sims from the Woman's Hospital, New York.|first1=E R|last1=Peaslee|first2=Thomas Addis|last2=Emmet|first3=T Gaillard|last3=Thomas|year=1877|location=New York|url=https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101205770-bk}}
36. ^{{cite book|title=The Woman's Hospital in 1874. A Reply to the Printed Circular of Drs. E. R. Peaslee, T. A. Emmet, and T. Gailliard Thomas|year=1877|location=New York|first=J. Marion|last=Sims|url=https://archive.org/details/b22440434|publisher=New York : Kent, printers}}
37. ^{{cite book|first1=E. R.|last1=Peaslee|first2=T. A.|last2=Emmet|first3=T. G.|last3=Thomas|title=Reply to Dr. J. Marion Sims' Pamphlet, entitled 'The Woman's Hospital in 1874'|place=New York|year=1877|url=https://books.google.com/books?id=0ZROVJ1iTBMC&printsec=frontcover#v=onepage&q&f=false}}
38. ^{{cite web|title=J. Marion Sims|url=http://waring.library.musc.edu/exhibits/Innovation/sims.php|website=Innovative Healthcare: MUSC's Legacy of Progress|publisher=Waring Historical Library|accessdate=March 15, 2017}}
39. ^The bronze standing figure is signed "[F. v]on Miller fec. München 1892" (Text of historical sign).
40. ^¹William Neuman, [https://www.nytimes.com/2018/04/16/nyregion/nyc-sims-statue-central-park-monument.html City Orders Sims Statue Removed from Central Park], New York Times (April 16, 2018).
41. ^{{cite article|series=Second|volume=10|number=12|first=George Gray|last=Ward|url=|title=Marion Sims and the origin of modern gynecology|journal=Bulletin of the New York Academy of Medicine|date=December 1934|pages=721–724}}
42. ^{{cite news|last1=Pérez|first1=Miriam Zoila|title=New Target for Statue Removal: 'Father of Gynecology' Who Operated on Enslaved Black Women|url=https://www.colorlines.com/articles/new-target-statue-removal-father-gynecology-who-operated-enslaved-black-women |publisher=Race Forward |accessdate=August 31, 2017}}
43. ^{{cite journal |last1=Krause |first1=Kenneth |title=Science (Indeed, the World?) Needs Fewer, Not More, Icons |journal=Skeptical Inquirer |date=2018 |volume=42 |issue=1 |pages=23–25 |publisher=Committee for Skeptical Inquiry}}
44. ^{{cite news|title=Charges dropped against man accused of throwing ketchup on Confederate statue at Capitol|author=Associated Press|date=October 9, 2018|newspaper=Montgomery Advertiser|url=https://www.montgomeryadvertiser.com/story/news/local/alabama/2018/10/09/charges-dropped-against-man-accused-throwing-ketchup-confederate-statue-capitol/1575899002/}}
45. ^¹{{cite news|title=J. Marion Sims and the Civil War — a rollicking tale of deceit and spycraft|first=J.C.|last=Hallman|newspaper=Montgomery Advertiser|date=September 28, 2018|url=https://www.montgomeryadvertiser.com/story/opinion/2018/09/28/dr-j-marion-sims-and-civil-war-rollicking-tale-deceit-and-spycraft-slaves-experiments/1443452002/}}
46. ^{{citation|title=James Marion Sims memorial : unveiled May 10, 1929, Columbia, South Carolina|year=1929|url=https://catalog.hathitrust.org/Record/010600196|accessdate=October 27, 2018}}
47. ^{{cite news|title=Steve Benjamin says monument at SC State House 'should come down at some point'|first=Cynthia|last=Roldán|date=August 16, 2017|newspaper=The State|access-date=February 12, 2018|url=http://www.thestate.com/news/local/article167458697.html}}
48. ^{{cite news|title=Protesters want Confederate monuments removed from SC State House|first=Bristow|last=Marchant|date=August 25, 2017|access-date=April 15, 2018|newspaper=The State|url=http://www.thestate.com/news/politics-government/article169295587.html}}
49. ^¹{{cite web|title=The Father of Modern Gynecology|date=December 5, 2017|url=https://wellnessjourneys.org/2017/12/05/dr-j-marion-sims/|accessdate=October 23, 2018|publisher=Wellness Journeys}}
50. ^{{cite news|url=http://www.thestate.com/news/nation-world/article170155337.html|newspaper=The State|title=A surgeon from SC experimented on slave women without anesthesia. Now his statues are under attack|first=Deneen L.|last=Brown|date=August 30, 2017|access-date=April 17, 2018}}
51. ^{{cite news|title=A 19th-Century Doctor & [sic]|date=January 29, 2006|newspaper=Washington Post|url=https://www.washingtonpost.com/archive/lifestyle/2006/01/29/a-19th-century-doctor-38/b7534292-bdce-45f0-b5e0-c01ec647bcc9/|access-date=April 17, 2018}}
52. ^{{cite news|title=The Surgeon Who Experimented on Slaves|first=Sarah|last=Zhang|newspaper=The Atlantic|date=April 18, 2018|url=https://www.theatlantic.com/health/archive/2018/04/j-marion-sims/558248/}}
53. ^{{cite web|title=49th Annual Updates and Challenges in Obstetrics & Gynecology Spring Symposium|date=March 24–26, 2018|author=Medical University of South Carolina|url=http://academicdepartments.musc.edu/cme/Current_CME_Activities/Conference%20Master%20Folder/Managed%20Conferences/2018%20Conferences/OBGYN/Master_Faculty|accessdate=October 15, 2018}}
54. ^{{citation|title=J. Marion Sims Medical Society Records|author=Medical University of South Carolina|url=http://waring.library.musc.edu/finding-aids/pdf/mss-0756.pdf|year=2007|quote=Finding aid.|accessdate=October 25, 2018}}
55. ^{{citation|title=The Sims memorial address on gynecology, delivered before the South Carolina Medical Society at Charleston|date=November 22, 1927|oclc=18214591}}
56. ^{{cite web|title=Dr. J. Marion Sims|first=Louise|last=Pettus|publisher=South Carolina GenWeb project|year=2000|accessdate=October 25, 2018|url=https://web.archive.org/web/20010708154011/http://www.rootsweb.com:80/~sclancas/drsims.htm}}
57. ^{{cite web|title=History|url=https://www.jmsims.org/history|author=J. Marion Sims Foundation|accessdate=October 17, 2018}}
58. ^{{cite web|title=The Sims Fertility Clinic. Dedicated to the memory of J. Marion Sims|first=Gerry|publisher=J. Marion Sims Clinic|last=Murphy|year=2000|url=https://web.archive.org/web/20020802152037/http://www.sims.ie:80/clinic.html}}
59. ^{{cite web|url=http://www.sims.ie/about-us/the-clinic.483.html|title=Here I am again in my beloved Dublin|publisher=J. Marion Sims Clinic|year=2000|accessdate=October 25, 2018}}
60. ^{{cite web|title=The Clinic|url=http://www.sims.ie/about-us/the-clinic.483.html|author=Sims IVF|year=2018|accessdate=October 15, 2018}}
61. ^{{cite web|title=Oﬃce of Dr. Luther Leonidas Hill Oﬃce Site of Dr. J. Marion Sims|last=Hattabaugh|first=Lee|date=2010|publisher=Historical Markers Database|url=https://www.hmdb.org/marker.asp?marker=86413}}