Silver Sutures in Surgery: The Anniversary Discourse, Before the New York Academy of Medicine, Delivered in the New Building of the Historical Society, on the 18th November, 1857 (Classic Reprint)
(Excerpt from Silver Sutures in Surgery: The Anniversary D...)
Excerpt from Silver Sutures in Surgery: The Anniversary Discourse, Before the New York Academy of Medicine, Delivered in the New Building of the Historical Society, on the 18th November, 1857
ON this happy return of another Anniversary, it must be a source of congratulation With every well-wisher of this Academy, to see here on the platform With our distinguished President, (dr. Mott, ) SO many of the eminent men, Who, like him, have at various times ably filled the same high position.
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Notes cliniques sur la chirurgie utérine dans ses rapports avec le traitement de la stérilité (French Edition)
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(This is a reproduction of a classic text optimised for ki...)
This is a reproduction of a classic text optimised for kindle devices. We have endeavoured to create this version as close to the original artefact as possible. Although occasionally there may be certain imperfections with these old texts, we believe they deserve to be made available for future generations to enjoy.
Clinical Notes on Uterine Surgery, With Special Reference to the Management of the Sterile Condition
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James Marion Sims was an American physician and a pioneer in the field of surgery, known as the "father of modern gynecology. " His most significant work was the development of a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstructed childbirth. He is also remembered for inventing Sims' speculum, Sims' sigmoid catheter, and the Sims' position.
Background
Sims was born on January 25, 1813, in Lancaster County, South Carolina. His father, John Sims, descended from the English colonists of Virginia, was a tiller of the soil, the village hotel keeper and sheriff, a great hunter and cock fighter; his mother was Mahala (Mackey), of Scotch-Irish origin.
Education
Marion grew up in a variety of schools and attended the South Carolina College, Columbia, during the presidency of Thomas Cooper, a man of remarkable learning, who, Sims thought, "exerted a very bad influence, " because he was a pronounced infidel and denied the Mosaic authorship of the Pentateuch. Graduating in 1832, Sims reached home two months after his mother's death. She had counted on his entering the Presbyterian ministry, while his father wanted him to study law. He therefore turned to medicine, although his father reckoned it a profession "for which I have the utmost contempt. " With the local Dr. Churchill Jones as preceptor, Sims entered the Charleston Medical School in November 1833, where John Edwards Holbrook, celebrated herpetologist, was his professor of anatomy. Here he found his billet and pitched in zealously. The following October, in true medical peripatetic fashion, he traveled by stage to Philadelphia and matriculated in the Jefferson Medical College. While he was there smallpox broke out, contracted from a dissecting room subject, and several of the students died; Sims, who nursed one of them, was protected by a vaccination he had forgotten. He graduated in May 1835, and returned home with a full set of surgical instruments.
Career
Settling in Mount Meigs, Alabama, Sims attracted attention, after eight or nine other doctors had been consulted to no avail, by urging an abdominal incision for an abscess, although a consultant had diagnosed cancer. A layman-arbiter siding with Sims, he performed the operation, and the patient recovered.
In 1840, Sims moved to Montgomery. One of his early achievements here was the complete rectification of a cleft palate with a hideous snout-like protrusion; the patient came to him wearing a double-thick blue veil to hide her face even from her own family, but the new presentable mouth effected by the operation made of her a really pretty woman. Chapin A. Harris, of the Baltimore College of Dental Surgery, visiting Montgomery, insisted on the publication of the case, and although Sims protested that he had never written anything in his life, the article appeared in the Journal of Dental Surgery for September 1845. In June of that year a call to a colored girl of seventeen, Anarcha, three days in labor, proved the turning point in Sims's life. Impaction and extensive sloughing resulted in a large bladder fistula and a wreck of a patient, unfit for all social relationships - a burden for life on her master's hands. This was his first fistula case, but two others shortly appeared, all being regarded as incurable. In spite of strenuous objections, the third patient was sent to Sims's small negro hospital. At that very juncture, an accident to a patient causing a uterine displacement revealed to him a new approach and suggested a way of treating his fistula patients, on whom, with a newly devised speculum, he now inaugurated a long-drawn-out series of operations. Anesthesia was not yet known; doctor friends, enthusiastic coadjutors in holding the patients so long as there was a bright hope of relieving the incurable malady, could no longer be commandeered when weeks and months brought only slight improvement, and Sims had to depend upon the poor sufferers themselves for any assistance.
After many failures, his brother-in-law, Dr. Rush Jones, pleading the waste of time and labor and the consequent injustice to his family, begged him to drop the whole matter. Subsequently, in a moment of inspiration, he had a local artisan make some silver wire for sutures which were passed and tightened with perforated shot. This was the crucial step; the thirtieth operation on Anarcha was crowned with success. The silver sutures and the unparalleled deftness and skill the surgeon had acquired in the long, patient years of repeated efforts had transformed the situation. This operation took place in the late spring of 1849; two weeks later, Betsey and Lucy were also cured.
Sims was now fully justified in declaring, "Then I realized the fact that I had made, perhaps, one of the most important discoveries of the age for the relief of suffering humanity. " Six weeks later he collapsed with an old intestinal complaint and had to quit work and spend several years moving from place to place in search of relief. His weight dropped to ninety pounds. Lying in bed at home, desperately ill, in the fall of 1850, he wrote the history of the vesicovaginal fistula operation, which appeared in the American Journal of the Medical Sciences for January 1852 and was reprinted separately in 1853.
In 1853, dismissing his negro servants and selling out all his interests in Montgomery, Sims journeyed to New York with his family and bought a house on Madison Avenue. Valentine Mott, Francis, Stevens, Delafield, and other leaders of his profession, astounded by his claims, began to seek him out. The first New York fistula cases brought no remunerative practice, since some of his colleagues even borrowed his instruments for their own use. This situation finally forced him to consider the establishment of a hospital, where poor patients could be received and visiting doctors instructed. Henri L. Stuart assisted at the beginning of the project by using the city papers to invite the physicians of New York to hear Sims speak on the need of a woman's hospital. When the day arrived in the spring of 1854, no less than 250 doctors filled the hall. From that time on, with the further effective cooperation of the leading women of the city, chief among them Mrs. William E. Dodge, the hospital plan advanced to its inauguration at 83 Madison Avenue, May 1, 1855, with about thirty beds - all charity. The state charter for the Woman's Hospital of the State of New York was obtained in 1857, the city bargaining for fifty free beds and giving in exchange the old Potter's Field with its memories of the cholera epidemic of 1832.
In June 1861, Sims, never vigorous physically, sailed for Europe for a rest. Wherever he went he was royally received. Sir James Y. Simpson of Edinburgh was especially interested in his work. In Paris, he met Jobert de Lamballe, writer of the Traité de Fistules (1852), and Velpeau and Nélaton. The elderly Civiale complimented him before a group of students; the King of the Belgians made him a Knight of the Order of Leopold I. In Paris, he cured one of Jobert's patients after sixteen futile efforts. Doctor Mungenier brought him a woman with an enormous fistula of more than twenty years' duration, whom he cured by a single operation; some seventeen or eighteen of the leaders in the profession were present at this tour de force. These, with five previous successful operations in Paris within three or four weeks, "created a furore among the profession. "
He returned to New York in January 1862, but, unhappy there because of his sympathy with the South, took his family back to Paris in July to find abundant work awaiting him. In 1863, the Empress Eugénie was under his care for several weeks, and for the next two years Paris yielded him a comfortable living. In London, in 1866, he published his Clinical Notes on Uterine Surgery (brought out in an American edition the same year). This book was a potent factor in the formation of the nascent specialty of gynecology. Hearing of the destitution in his native county following Sherman's march to the sea, he sent five thousand francs to relieve the most needy, later giving enough to buy a large house and sixty acres of land for the helpless indigent, to be known as The J. Marion Sims Asylum for the Poor.
After the Civil War he returned to New York, but upon the outbreak of the Franco-Prussian War in 1870, went again to France to organize and become surgeon-in-chief of the Anglo-American Ambulance Corps. For distinguished professional services, France bestowed on him the Order of the Commander of the Legion of Honor. In 1872, again in New York, he was made a member of the board of surgeons of the Woman's Hospital, where work had been maintained efficiently by Thomas Addis Emmet, but two years later he resigned, offended by the ruling of the managers limiting to fifteen the spectators admitted to any operation. In 1876, he was president of the American Medical Association.
His last visit to the South, in March 1877, was the occasion of a triumphal entry into Montgomery where he was met by the medical and surgical societies, his old friend W. O. Baldwin delivering a notable address. In 1880, he presided over the American Gynecological Society. Happy memories and many friendships drew him to revisit Paris in 1882. On returning, in August 1883, he bought a building lot in Washington, where he intended to settle, but pneumonia claimed him on the morning of November 13, three days after the execution of the title deed.
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Membership
Member of the board of surgeons of the Woman's Hospital (1872), President of the American Medical Association (1876)
Connections
Sims's wife was Eliza Theresa Jones of Lancaster, to whom he had been devoted since they were respectively eleven and nine years old. She took him in spite of strong parental opposition, married him while poor (December 21, 1836), lived in log cabins with him and the rapidly arriving children, guided him in all but his professional activities, and cared for and clung to him through years of harassing, exhausting illnesses, herself ill part of the time. Repeatedly she made the crucial decisions of life. With a son and four daughters, she survived him.