For all its beneficial uses, the speculum has a sordid past, one connected to patriarchal authority and institutionalized racism. In , James Marion Sims, a year-old surgeon in Montgomery, Alabama, was asked by a local slave owner to treat a young woman suffering from vesicovaginal fistula.
This debilitating condition, a source of pain and incontinence, is usually caused by an obstructed labor: when the baby, stuck in the birth canal, crushes the soft tissues between the vagina and bladder.
In the antebellum South, where black women had little health care or control over their bodies, rape and chronic infections were also often to blame. Sims, a plantation doctor, lacked relevant experience, but took an interest in finding a cure. Between and , he performed dozens of surgeries, without anesthesia, on at least 12 enslaved women.
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In these experiments on human chattel, Sims developed a technique to repair fistula, the first of its kind. In the process, he invented the duckbill speculum so that he could better visualize the cervix. Sims moved to New York, where he founded the first hospital for gynecological surgery in the country. He moved to Europe in the s, where his female patients included royalty; later, he served as president of the American Medical Association. Its inscription makes no mention of the enslaved women—Lucy, Anarcha, and Betsey were the only names Sims recorded—on whose bodies he practiced his surgery.
These are the chilling origins of gynecology in America, but the shift had begun in Europe even earlier.
The speculum allowed the male doctor to access the cervix while abiding by the strictly separate gender spheres of the day. Despite its utility, the device was immediately caught up in intrigue. They worried that it could even lead patients into illicit relationships with their doctors.
Soon, hysteria, the upper-class affliction said to originate in the womb, entered these debates.
Public privates performing gynecology from both ends of the speculum …
Cartwright , Anita Hardon. Embodied knowledge: Midwives and the medicalization of childbirth in early modern Italy Jennifer F.
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