title: Did J. Marion Sims deliberately addict his first fistula patients to opium?
abstract: American surgeon J. Marion Sims (1813-83) is regarded by many modern authors as a controversial figure because he carried out a series of experimental surgeries on enslaved African American women between 1846 and 1849 in an attempt to cure them of vesicovaginal fistulas, which they had all developed as a result of prolonged obstructed labor. He operated on one woman, Anarcha Westcott, thirty times before he successfully closed her fistula. Sims performed these fistula repair operations without benefit of anesthesia but gave these women substantial doses of opium afterwards. Several modern writers have alleged that Sims did this in order to addict them to the drug and thereby to enhance his control over them. This article examines the controversy surrounding Sims' use of postoperative opium in these enslaved surgical patients. The evidence suggests that although these women were probably tolerant to the doses of opium that he used, there is no evidence that he deliberately tried to addict them to this drug. Sims' use of postoperative opium appears to have been well supported by the therapeutic practices of his day, and the regimen that he used was enthusiastically supported by many contemporary surgeons.
authors.affiliation: Department of Obstetrics and Gynecology, Campus Box 8064, Washington University School of Medicine, 660 South Euclid Avenue, Saint Louis, Missouri 63110, USA. walll@wustl.edu
authors.forename: L Lewis
authors.initials: LL
authors.lastname: Wall
mesh_terms: D001741:Black or African American; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004992:Ethics, Medical / Q000266:history; D005260:Female; D006176:Gynecology / Q000941:ethics / Q000266:history*; D049672:History, 19th Century; D006801:Humans; D009892:Opium / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D012940:Social Problems; D019966:Substance-Related Disorders; D036302:Therapeutic Human Experimentation / Q000941:ethics / Q000266:history*; D014719:Vesicovaginal Fistula / Q000208:ethnology / Q000266:history / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D009892:Opium