J. Marion Sims is a controversial figure in both the history of Alabama and early modern medicine. His experiments on enslaved women in Alabama and poor women in New York occurred without their ability to consent, dispute treatment options, or seek a different doctor.
In writing about him I have also committed a deep mistake in relying too heavily on his accounting of his life without consulting additional monographs on the topic or making mention of his intense ambition and desire for fame and fortune. Below are some links for further reading on the central issues of his medical ethics.
Part 2: “…so sickly a season as that.”
Sims established himself as well as he could in Mount Meigs. As a fledgling doctor and occasional pioneer he now felt more confident in who he was and why he existed. With this new found esteem came stubbornness. He briefly returned to South Carolina to visit family. Again he proposed to Theresa Jones, this time she accepted. They married on December 21, 1836.
However, before all that happened, Sims needed to return briefly to Alabama to attend some business. He rode on a stage coach through Georgia and the vestiges of the Creek Nation. They traveled the well-worn paths of the Old Federal Road. Originally built to connect Washington D.C. to New Orleans, the road provided one of the only viable and steady links from south Alabama to the rest of American civilization. Sims scarcely arrived safely in Montgomery county before being called upon to leave it again.
The Creek Nation, threatened from all sides, rose up in late March of 1836, young bands of men raided stage coaches traveling the Old Federal Road. Their aggression effectively sealed off everything south of Huntsville and ensured a violent response from the area’s white residents.
Sims joined a group of 120 or so “unruly and impatient,” men from Mount Meigs and spent five long summer weeks scouting from a forward base in Tuskegee. Eventually the regular army, under General Gaines, arrived and sent the volunteers home. Although they did not fight, Sims claimed that this experience showed him “the honors of war.” Soon men that volunteered alongside Sims called upon him for medical help. His time in the Creek Nation solidified his position as a popular local doctor. (167-170)
By mid-June malaria rampaged across Montgomery county. The population withered before it and “There were not enough well people to wait on the sick ones.”
On September 4, 1836, Sims came to the plantation of Captain John Ashurst, his commander during the brief sojourn into Tuskegee, to treat thirty enslaved people waylaid by malaria. Sometime previous to his visit, probably 10 to 30 days, a mosquito alighted upon him and transferred the parasite into his blood. However, he did not manifest symptoms until his visit to the Ashurst’s plantation.
Indeed, his mention of this visit prior to describing his own nearly fatal bout with malaria highlighted the strange times in which he lived. Malaria literally derives from the Italian ‘mala aria’ or bad air. Humanity knew nothing of the mosquito’s role in this plague until the 1884 publication of “Treatise on Marsh Fevers,” by French military physician Alphonse Laveran.
Prior to this beautiful discovery those who could afford to avoid swamps did so. In fact the necessity of avoiding swampy lowlands drove both the British establishment of ‘hill stations’ across India and French mountain settlements in North Africa. While in the United States less swampy northern cities often received affluent white southerners wishing ‘to take the air’ during malarial outbreaks back home.
So, J. Marion Sims commenting on his visit to slave quarters immediately prior to a serious outbreak of malarial fever is meant to inform a contemporary audience, which understood the immediate link between atmospheric conditions and the onset of malaria, of the cramped and uncomfortable conditions in those quarters as much as it is to provide a narrative of his life.
He soon found himself near to death and confined to a bed. Another, more conventional, doctor from the county came to visit him and inspected his body before signalling a young slave woman named Anarcha. He said, “Bring me a string, and a little cotton, and a bowl; I am going to draw a little blood from the doctor.”
Sims refused this treatment. He lived in the declining days of Heroic medicine, a medical tradition increasingly limited to older physicians, and commented that “mortality followed the practice of the doctors.” Confronted with parasitic fevers, conventional wisdom called for blood to be drained and stomachs purged. Those treated more robustly than others “died the quickest.”
After the withdrawal of the elderly Dr. Lucas, and his Heroic traditions, Sims contented himself to waste away into “an emaciated skeleton.” Only Anarcha sat with him for much of this period. She brought water when he could drink and food when he could eat.
Fortunately a young Englishman named Thomas B. Coster came to see Sims. He arrived with a miracle derived from the ‘bark of barks’ – Coster brought quinine.
Long known of in Spain, England, and France – immediately treating malaria patients with large doses of quinine failed to catch on in much of the United States until the works of two doctors from Madison county highlighted its efficacy.*
Sims contended that prior to “Fearne and Erskine,” doctors implemented traditional Heroic methods, like bleeding and purging, followed by small doses of quinine treatment, but they “preached the doctrine of giving it without any regard to preliminary treatment… in sufficient doses to affect the system at once.” So persistent were they in their plaudits for the drug that Sims called their medical ideology “quininism.”
Thanks to his refusal of Dr. Lucas and the intervention of Coster he soon recovered.
This outbreak of malaria changed Sims. It altered his perceptions of what medicine might do, he emerged from the epidemic a man ready to cast aside traditional treatment methods and instead wholeheartedly adopt that which might seem radical or untested, but at least emerged from long observation.
Without the 1836 Malaria Outbreak, J. Marion Sims might have remained a small-time piney woods doctor. Instead he began the transformation that made him into one of the greatest, and most controversial, experimental surgeons of the modern era. (170-175)
*It is worth noting that Fearn’s early love of quinine, as a peculiarly Spanish treatment for diseases, only highlights my theory that he was a raging hispanophile. Honestly he may have just gotten lucky in this regard. The phrase, “well the Spaniards do it,” seemed to guide most of his life choices.
Sims, J. Marion. The Story of My Life. New York: D. Appleton and Company, 1884.