“The Poorer Sick”: American Gynecology and its Irish Subjects in Mid-Nineteenth Century New York City

By Charlotte Rich

In April 2018, crowds gathered on Manhattan’s Fifth Avenue to watch the dismantling of the statue of J. Marion Sims (1813-1883), the so-called “Father of Gynecology.” [1] The monument was constructed in 1892 to celebrate Sims’ contributions to gynecological research, including developing groundbreaking surgeries to treat women from Alabama to New York City to Europe. [2] For over one hundred years, the statue stood across from Mt. Sinai Hospital and the Medical Heritage Library as an uncritical monument to Sims. It honored his tireless research as the foundation of modern gynecology, alleviating the suffering of millions of women, in his lifetime and ours.

The monument, however, made no mention of the countless women whose bodies and labor enabled his research, by serving as both experimental subjects and unpaid, uncredited nurses. In 2006, historian Harriet Washington’s groundbreaking research drew activists’ attention to the untold reality of Sims’ experimentation, in which he used enslaved black women as his experimental subjects. [3] In protests, op-eds, and posts on social media, activists called for broader recognition of the brutality of his experimentation on enslaved black women, who were not credited in the monument. The dismantling of Sims’ statue represented a public reckoning with the largely forgotten contributions of enslaved black women to American medical history.

While the removal of Sims’ monument was certainly a victory for historical representation, it also constituted the erasure of the majority of Sims’ experimental subjects. In addition to his enslaved black subjects, Sims treated and experimented on hundreds of Irish immigrant women in New York City. In 1853, following his work in Alabama, Sims moved to New York City where he founded the Woman’s Hospital, a charitable research institution for the treatment of women’s reproductive disorders. [4] When founding the Woman’s Hospital, J. Marion Sims saw it as a platform through which he could fine-tune his own surgical techniques that he developed through experimentation on enslaved black women. [5]

The development of medicine during this period has often been framed as the triumphal advancement of surgical techniques, the expansion and reformation of the hospital system, and the creation of life-saving techniques for women’s diseases and the dangers of childbirth. However, prioritizing patients’ experiences as part of this history complicates these pure narratives of progress. The historical coincidence of Famine-era Irish immigration and major medical reforms, including the founding of new disciplines like gynecology, facilitated experimentation on countless Irish patients, which enabled the success of research institutions like the Woman’s Hospital.

With even a cursory glance at the Woman’s Hospital’s patient casebooks, which provide demographic information for patients, one notices a significant trend: the largest nationality represented in the hospital’s patients were Irish immigrants. The founding of the Woman’s Hospital’s in 1855 coincided with a wave of Irish immigration following the Great Famine. Hunger, destitution, and lack of economic opportunity that characterized Ireland after the Famine prompted many, especially young women, to emigrate to the United States. Because of insufficient access to health care, their physically demanding jobs, and unhealthy living conditions, Irish women frequently required reproductive health care upon arriving in cities like New York and could not afford the private physicians of the middle and upper classes. To put it simply, many Irish women in New York needed treatments for reproductive disorders, exactly when the Woman’s Hospital and gynecologists throughout the Northeast needed patients.

This historical coincidence created a relationship that was, in some ways, mutually beneficial. Poor Irish immigrants received low-cost or free treatments for debilitating conditions like fistulae, which allowed doctors to develop standardized surgical techniques to treat other women. [6] However, physicians often prioritized the professional advancement that developing a successful new surgery would accomplish over the wellbeing of patients whose bodies made that surgery possible. Even when a surgery successfully treated a patient, doctors’ own notes and published papers recount stories of abuse towards their immigrant patients. [7] Furthermore, many physicians drew from and reproduced nativist discourse in their published case studies of Irish patients, endowing these theories with medical authority. 

In spite of the prominent role that Irish women played in the history of gynecology, they have received scant attention in recent scholarship, and no mention in calls for the removal of Sims’ monument. The absence of Irish women from this contemporary debate was especially notable, given the statue’s location only about four miles from the first location of the Woman’s Hospital, the site of Sims’ Irish experiments. Furthermore, by focusing entirely on Sims’ statue, activists obscured the fact that Sims was only one of many gynecologists experimenting on vulnerable women. Irish women’s absence from this historical narrative and contemporary conversations about Sims’ legacy demonstrate how their sacrifices and contributions to the advancement of gynecologic and obstetric surgery continue to be taken for granted, and they remain voiceless.

My current research explores the role of Irish immigrant women as experimental subjects for American gynecological research in the 1850s-1870s. Despite the central role Irish women played in the development of this medical discipline as subjects, scholarship has largely ignored their contributions. Drawing from the Woman’s Hospital’s patient case books and annual reports; medical journals and physicians’ published works; and texts written by and about Irish immigrant women in New York, this thesis attempts to understand how Irish women influenced the development of gynecology. Why did Irish immigrant women constitute such a significant portion of gynecological patients in mid-nineteenth century New York City? How did medicine draw from and contribute to common conceptions about class, race, and gender as they related to Irish immigrant women? Building on the historical scholarship about enslaved black women as subjects of gynecological research in the American South, this will be one of the first in-depth studies to include Irish women in the narrative. Expanding this history will alter the understanding of American gynecology by demonstrating how dependent this period of medical specialization and advancement was on the bodies and health of Irish immigrant women. Furthermore, it will highlight how historians can use institutional medical records to uncover the experiences of Irish women, who were otherwise excluded from the historical record. 

Endnotes:

[1] P.R. Lockhart, “New York just removed a status of a surgeon who experimented on enslaved women,” Vox, April 18, 2018, https://www.vox.com/identities/2018/4/18/17254234/j-marion-sims-experiments-slaves-women- gynecology-statue-removal.

[2] “Dr. James Marion Sims Sculpture,” NYC Parks, April 16, 2018, https://www.nycgovparks.org/about/history/ historical-signs/listings?id=13315.

[3] Nadja Sayej, “J Marion Sims: controversial statue taken down but debate still rages,” The Guardian, April 21, 2018, https://www.theguardian.com/artanddesign/2018/apr/21/j-marion-sims-statue-removed-new-york-city-black- women.

Harriet A. Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York: Anchor Books, 2006).

[4] Deborah Kuhn McGregor, From Midwives to Medicine: the Birth of American Gynecology (New Brunswick: Rutgers University Press, 1998).

[5] J. Marion Sims, The Story of My Life (New York: D. Appleton and Company, 1884).

[6] A fistula is a tear in the vagina or anus resulting from a prolonged or difficult birth. Women who suffered from rickets — a condition caused by the absence of Vitamin D in one’s diet — typically developed narrow pelvises and were therefore more likely to experience fistulae. While women of all classes, races, and ethnicities were afflicted with fistulae, this condition was more common among women who lacked access to nutritious diets, including enslaved black women and survivors of the Great Irish Famine.

[7] For examples, see: George T. Dexter, “Singular Case of Hiccough Caused by Masturbation,” Boston Medical and Surgical Journal (1845): 195-197; George T. Elliot, “Induction of Premature Labor with the Douche,” New York Journal of Medicine 2, no. 3 (May 1856): 331; and Thomas Addis Emmet, Reminiscences of the Founders of the Woman’s Hospital (New York: Stuyvesant Press, 1893).

Charlotte Rich is a senior at Wesleyan University. She is interested in studying the hidden social histories of medicine to explore the roots of race and gender inequities in contemporary American medicine.

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