Toward an Understanding of the 'Medical Plantation' as a

Cultural Location of Disability

By Rachel Dudley - Disability Studies Quarterly Vol 32, No 4 (2012)

Abstract
This article uses Sharon Snyder and David Mitchell's concept of "cultural locations of disability" to
theorize the 19th century medical plantation as a space in which black enslaved women were used as
raw materials for medical-scientific advancement. The central argument is that the history can be
perceived in new ways by applying the dual frameworks of black feminist theory and cultural disability
theory to understand the medical plantation as a cultural location of disability. In so doing, the article
demonstrates that on the 19th century medical plantation—a locality spatially separate from the
agricultural plantation—black women's bodies were imagined as the ideal test subjects of research and
innovation within what became modern gynecology.

"Mr. Wescott, Anarcha has an affection that unfits her for the duties required of a servant"
—Dr. James Marion Sims to an Alabama slave plantation owner, 1845

Introduction
For enslaved women on southern plantations vaginal fistulas were a liability that threatened plantation
profits. Fistulas meant that women's reproductive capacity could no longer be used as a form of slave
capital and that they were no longer available for sexual exploitation from slave-holders. The condition
was most often the result of difficult and prolonged labor which compromised the lives of both mother
and child. Scholars interested in health and slavery such as Deborah McGregor have explained the
ways in which the demands put on enslaved women's productive and reproductive labor had an impact
on the frequency of fistulas on the plantation: "the origins of the disorder were entangled in the system
of slavery itself" (1998, 68). What this means is that the political economy of slavery produced distinct
experiences of lost bodily integrity for enslaved women expected to reproduce and to be sexually
available as a condition of their bondage.
This article references experimental procedures to correct vesico vaginal fistulas performed by James
Marion Sims—known widely as "the father of modern gynecology"—on black female slaves in
Alabama, between 1845 and 1849. Though various scholars with interests in the medical humanities
have explored this history from various angles, the goal within this work is to begin animating a
conversation between the fields of black feminist studies, cultural disability studies, and medical
history by revisiting the origin narrative of modern gynecology. This approach is not about reaching
back into history to claim these women as some sort of 'black crip' ancestral figures but rather to assert
that such a dual framework is particularly suited to enliven new ways of perceiving and understanding
this history.
I argue that examining the 'medical plantation' as a central feature of this history and as a cultural
location of disability allows us to bring the aforementioned bodies of knowledge together productively
with implications for continued exploration in the future. It also allows for a continuation of important
cross-disciplinary work begun by scholars, activists and artists who attempt to destabilize hegemonic
medical narratives and critique cultural artifacts which celebrate the great life of Sims and disappear
the bodies/lives/realities of the numerous pained and enslaved women on whom he experimented
(Kapsalis 1997; Kuppers 2007; McGregor; 1998 Wanzo 2009, Washington 2005). I assert that the space
of the medical plantation was an integral feature in the use of black women's bodies to transform a
condition representing an impediment on the slave plantation into a kind of medical entrepreneurship
and a discrete branch of medicine.
In making this argument, I draw from performance studies scholar Petra Kuppers' concept of the
"medical plantation" to refer to a locality spatially separate from the cotton, rice, coffee, sugar, wheat or
tobacco plantation and specifically designated for medical practice on enslaved women as well as
cultural disability studies scholars Sharon Snyder and David Mitchell's characterization of cultural
locations of disability as current and historic sites that "[h]ave been set out exclusively for disabled
citizen[s]" (2006, 3). This article also joins growing conversations in disability studies involving
research related to critical race and disability studies as well as research related to slavery, health,
illness, and disability from a humanities rather than a fully biomedical perspective. 1
The first section offers a brief background in order to orient the rest of the analysis. Next, the paper
provides a broader historical context in relation to black women's healthcare and medical/scientific
perceptions of black women's bodies in the nineteenth-century. The next section elaborates on what
cultural locations of disability are and flushes out a theorization of the medical plantation as such a
space. Here, I also highlight how the early history of gynecology has been taken up by other scholars
doing work in the medical humanities and I discuss how understanding the medical plantation as a
cultural location of disability extends their important work.

Who Was James Marion Sims? How do enslaved women figure into his medical career?
James Marion Sims had been practicing medicine for ten years before being summoned to the Wescott
plantation near Montgomery, Alabama. He was called upon by another prominent physician to attend
"To a case of labor which had lasted three days and the child not yet born" (Sims 1885, 226). It was
June of 1845 and by this time Sims claims that he had established himself as a reputable surgeon and
family physician who's first self-proclaimed "great discovery of medicine"—though slow to garner
support in the burgeoning medical literature—involved treatment of trismus nascentium, also known as
lock-jaw. His second "great discovery" would play a pivotal role in how he became a wealthy, well-
known, and internationally-celebrated lecturer, an entrepreneurial medical showman, the founder of the
Women's Hospital in New York, and one of the often acknowledged fathers of modern gynecology.
In his autobiography, The Story of My Life, Sims recalls that before leaving for the Wescott plantation
he had been told by another physician, who had built a reputation working on functional derangement
of the urinal system in women: "I am thinking that you had better take your instruments along with
you, for you may want to use them" (226-7). When they arrived at the plantation Sims came upon
Anarcha, a seventeen year-old slave who had been in labor for three days. Labor within the plantation
economy was often prolonged because of lack of access to adequate nutrition and because the workload
was not typically reduced for pregnant slaves. 2
Describing the situation Sims wrote: "[t]he child's head was so impacted in the pelvis that the labor
pains had almost entirely ceased". He consulted with Dr. Henry, the other physician present, and
concluded: "[t]he sooner she was delivered the better, and without any great effort the child was
brought away with forceps" (227). Whether or not it was the use of forceps that led to what Sims called
an extreme "sloughing of the soft parts" remains unknown.
Within five days, Anarcha became completely incontinent, both from her vagina and her rectum. Sims
recalls, "I went home and investigated the literature of the subject thoroughly and fully. Then, seeing
the master of the servant the next day, I said: 'Mr. Wescott, Anarcha has an affection that unfits her for
the duties required of a servant" (227). The affection to which Sims refers is vesico-vaginal fistula—
fissures within the vaginal walls or between the vagina and rectum—commonly resulting from
traumatic child-birth or the insertion of foreign objects into the vagina. At the time, fistulas were
considered incurable. 3
Sims' aforementioned comment to the plantation owner deserves some further scrutiny because it
underscores why Anarcha underwent a shift from a being a forced participant in a plantation economy
to an experimental subject of a medical economy. Black enslaved bodies were valued within the
political economy of the time only to the extent that they were productive or useful—in the fields, in
labor and reproduction, through sexual exploitation, in the house of the master, or as suggested here in
medicine. The fistula meant that Anarcha's reproductive capacity could no longer be used as a form of
slave capital and she was no longer available for sexual exploitation from slave-holders and perhaps
that her ability to work would have been hampered.
What is known within the primary record about Anarcha comes to us only through plantation ledgers,
medical journals and Sims' own autobiographical writing. It is known that she was not the only woman
on whom Sims would experiment. He mentions two more women by first name—Lucy and Betsey, but
he may have owned up to twelve whom were used in Sims' series of experiments over four years. Over
time, many slave-holders brought their slaves who were experiencing vaginal/reproductive conditions
to Sims and he also sought out slaves as well for his medical experiments (Sims 222-247). They were
housed in what is being called here a medical plantation.
As Sims tells it, he purchased a spoon and invited two medical students to assist as he tested his new
theory on Lucy: "Before I could get the bent spoon-handle into the vagina, the air rushed in with a
puffing noise, dilating the vagina to its fullest extent. Sims felt he was viewing something "no man had
seen before" because the act of looking into a woman's vagina represented a breach of nineteenth
century Victorian social propriety. 4 However, enslaved women were excluded from notions of genteel
femininity as expressed in representations of Sojourner Truth's "Ain't I A Woman Speech" delivered in
1851 at a women's convention in Akron, Ohio—canonical reading within Women's, Gender, and
Sexuality Studies. 5 Hence, enslaved women were ideal experimental subjects for medical research
especially research involving intimate privates and reproductive conditions.
Upon gazing into Lucy's vagina Sims claims he was certainly on the brink of a great discovery and he
states, "I immediately went to work to invent instruments necessary for performing the operation on the
principles that were self-evident on the first inspection of the first case" (235). This easy slippage in
Sims' life narrative whereby he goes from directing the medical gaze into Lucy's vagina to seamlessly
applying "self-evident principles" in the invention of the duck bill speculum certainly attests to his
power in casting the narrative in a drastically heroic manner. Still, his speculum developed in 1846
would become a major technological innovation in modern gynecological practice. Ten years later, the
American Journal of Medical Sciences published his procedures to suture vesico-vaginal fistulas using
the duckbill speculum (Sims 1856).
It bears repeating that this medical innovation was founded on the bodies of black enslaved women
with vaginal fistulas, which can and should be recognized as a kind of disability woven into the
economy of slavery. It was the scientific and cultural view of the black body as being always already
pathological that created the conditions for Sims to have uninhibited access to them as experimental
subjects. Sims would alternate between the women, performing un-anesthetized surgeries on Anarcha
over thirty times until he was finally able to develop and later publish a procedure to suture fistulas.
A Brief Overview: The Bodies of Black Women in the Nineteenth Century
There is a wealth of scholarship that historicizes and contextualizes the cultural attitudes and discourses
surrounding black women's bodies within the nineteenth-century. 6 Aptly, health educator and
performance studies scholar Terry Kapsalis notes that Sims' experimental subjects were triply
pathologized and perceived as excessively symptomatic: "The first pathological symptom was their
primary racial characteristic: their skin color. In a medical world that categorized life as either normal
or pathological, people of the African diaspora were continually condemned to the category of
pathological, their "abnormal" skin color serving as a foil for 'normal' white skin" (41). In fact, displays
of "ethnic otherness" were central to the development of the modern freak show which allowed
audiences to be educated and entertained by embodied differences from shifting ideological norms
(Bogdan 1988, Garland-Thomson 1996).
These freak shows also displayed "pathological" black female sexuality; most notably Sara Baartman
was displayed for a number of years throughout Europe as the Hottentot Venus, to demarcate
differences between the "normal" European body form and the "pathological" African genitalia,
buttocks and breasts (Crais and Scully 2010 and Gilman1985). She was posthumously dissected by the
famous nineteenth-century scientist George Cuvier, her genitals and organs kept in jars for further
study. Though Baartman was not an American slave, her story is part of the larger cultural construction
of black female pathology which incorporated African American slave women. This brief overview of
how black women's bodies were treated during the period helps us to understand why they were ideal
subjects who became a part of the first act in Sims' career as a world-renowned medical showman.
Interestingly, Sims greatly admired the enormously successful entrepreneurial showman P.T. Barnum
whom he mentions in his autobiography as a "good friend". In discussing the relationship between the
two men, Terry Kapsalis asks, "[W]hat might link a surgeon-slave-master to a showman ringmaster?
Both exercise mastery over bodies, particularly grotesque bodies (in the sense of either open, oozing
bodies or freaks)" (33). The link between the two men is significant in highlighting how various
cultural enterprises and medical fields were spun from the raw material of disabled bodies. While
Barnum developed his mastery and appropriation of disabled bodies into a specialized form of
entertainment, Sims developed his mastery of the fistula into a medical plantation which helped to
create a discrete medical specialization. Though Kapsalis is not necessarily situated in disability
studies, a disability studies framework allows for an understanding of the medical plantation created by
Sims as a cultural location of disability created particularly for enslaved women.

Cultural Locations of Disability

Disability studies scholars Sharon Snyder and David Mitchell have characterized cultural locations of
disability as localities that:
[h]ave been set out exclusively for disabled citizens such as nineteenth-century charity
systems; institutions for the feebleminded during the eugenics period; the international
disability research industry, sheltered workshops for the "multiply handicapped "; medically
based and documentary film representations of disability; and current academic research
trends on disability (2006, 3).

Part of what Snyder and Mitchell reference is the development of disability identities through the
creation of various specialized institutions in the nineteenth-century and this has been of keen interest
to a number of contemporary cultural disability scholars and historians (Davis 2010; Longmore and
Umansky 2001; Reiss 2008, Stiker 2000). These isolated spaces were usually designed through
collaborations between government, medicine, and civil society to contain and manage disability. By
the early twentieth-century charity systems, asylums, alms houses, rehabilitation centers and various
other institutions had been developed to contain people considered insane, the blind, deaf, and/or
'multiply-handicapped'. These institutions were also designed to tend to people with an overall inability
to work within a modern marketplace that required specific standards of bodily control and self-
autonomy. Snyder and Mitchell demonstrate how the early locations actively disenfranchised people
often deemed pathological and isolated them.
The creation of these cultural spaces was a part of the modernist project which entailed classification
and management of various bodily variations as well as the development of statistics as a mechanism
for capturing averages and creating standards of the normal body (Davis 2006). Often these institutions
were built and maintained through seemingly benign discourses of sympathy, charity, benevolence and
normalization. Snyder's and Mitchell's work is important because it examines the social and medical
management of disability as a central aspect of the modernist project while focusing particularly on the
connection between early cultural locations of disability and eugenic impulses.
Significantly, the authors leave room for additional analyses of cultural locations of disability beyond
those explicitly theorized in their work, referring to the locations chosen for review they mention:
"[t]hey are not the only locations that we might have selected for inclusion her[e]" (22). With this in
mind, their work can be extended beyond an emphasis on institutional spaces of containment only for
"disabled citizens". Recognizing that blacks were chattel slaves not entitled to any rights of citizenship,
we can turn toward a cultural location intimately connected to enslaved black women's reproduction in
bondage.
Sims' medical plantation was a space where black female 'pathology' and disability were transformed
from abnormalities and impediments within the slave economy to economic activity and reproduction
within the medical economy. Below, three core features of the medical plantation as a cultural location
of disability are outlined so that we can continue to "theorize the space between embodiment and
ideology" (Snyder and Mitchell 8).
First, the medical plantation was isolated and private thus removing the women from any community
of other slave doctoring practices, healers, root doctors and/or midwives. Because Sims was not the
first to discover or attempt to treat fistulas, it is at least worth imagining how the black slave
community themselves might have responded to the condition. Republished in The Black Women's
Health Book is a chapter from Mules and Men by Zora Neal Hurston entitled, "Prescriptions of Root
Doctors" which lists various conditions and cures commonly used to treat them. One entry reads:
"Fistula—sweet gum and mullen cooked down with lard. Make a salve" (1994, 15). Hurston was also
an anthropologist whose writing may speak to the prevalence of vaginal fistulas on the plantation and
to slave ingenuity in attempting to treat the condition before Sims would gain credit for finding a cure.
In Working Cures, a groundbreaking study that chronicles various aspects of slave approaches to
healthcare, Sharla Fett explains: "[c]ommunities in slavery nurtured a rich health culture, a
constellation of ideas and practices related to well-being, illness, health, and death, that worked to
counter the onslaught of daily medical abuse and racist scientific theories" (2). Fett's central assertion is
that slave communities participated in a relational idea of slave health based on relationships between
individuals and broader communities that worked against notions of slave "soundness" held by
slaveholders. Thus, the medical plantation is a symbolic space that represents the shift away from
midwifery, root medicine, and folk knowledge toward a white male medical establishment as a feature
of modernity. This is significant because the medical plantation also represents the kind of spatial
distancing that always occurred for people being walled off within the early cultural locations of
disability. Nineteenth century cultural locations of disability built on ideas about rehabilitation or
restoration to 'normal' functioning involved isolation from larger communities and the application of
specialized medical authority.
The medical plantation was a private space where ideas of the Cult of True Womanhood/ Victorian
propriety—which never applied to black women—could be cast aside completely and modern medicine
could literally gaze into black women's interiors to ascertain new medical knowledge from a newly
invented medical position. Yet there has been a tendency to gloss over the particular bodies which
became the pathways leading to new ways of knowing and "looking" at women's bodies in general in
this medical history. In this sense the black female body though considered pathological, is also
indispensible to medical knowledge production. Enslaved black women were, in terms of their bodily
materiality, as much a part of the innovation of duckbill speculum as Sims—yet the bodies on which
new knowledge was extracted and capitalized upon have few traces in the archives and in broader
cultural memory.
The private space of the medical plantation that housed numerous enslaved women with fistulas for
four years also represents a space of extreme cultural forgetting and extreme archival absences. This
becomes yet another historical instance of black women being both centrally important to the
advancement of medical science while at the same time remaining profoundly marginalized. The
medical plantation is a cultural space where black women's nude bodies were literally hyper-exposed
for medical advancement even while their lives and broader stories bear few traces at all; in effect they
are both hyper-exposed in medicine and hyper-diminished in culture.
We can understand the medical plantation as a cultural location of disability that allowed for
unmediated exposure to the bodies of black women with disabilities. As many other black feminist
scholars have noted, black women's bodies have too often been simultaneously exposed and erased.
Referencing black women's sexuality in particular, black feminist scholar Evelyn Hammonds suggests:
"Black women's sexuality is often described in metaphors of speechlessness, space, or vision; as a void
or empty space that is simultaneously ever visible (exposed) and invisible, where black women's bodies
are always already colonized" (2004, 94). A later analysis at another time might interrogate the
centrality of metaphors of ability in understanding cultural representations of black women's bodies.
However, the point here is to draw a connection between black women's bodies as always already
colonized and the kind of medical exploitation that echoes colonial narratives whereby the enslaved
women's bodies and disabilities are unmapped geographies that Sims discovers and explores.
Sims' legacy and the ways in which he has been so widely remembered as an important world-
renowned medical icon and highly public figure exists is in stark contrast to the diminishment and
marginalization of the women whose bodies catapulted him into fame and fortune. So here we have the
difference between two extremes, or put another way, the difference between the public and the private
whereby the medical plantation is a private space representing extreme cultural amnesia while Sims is
widely remembered and publicly celebrated through tropes of the great American man; his presence in
public culture attests to him being someone important who lived a model life and is not to be forgotten.
Various cultural artifacts including an oil painting, statues in different states, a medical instrument, a
medical position and a hospital he co-founded all attest to the capaciousness of his legacy and the
cultural urge to remember him. The medical plantation was an isolated and private space of
containment that afforded Sims carte blanche to perform medical experimentation on medically and
socially vulnerable enslaved black women with disabilities.
So now we come to the second feature of the medical plantation as a space that both symbolically and
literally solidified a connection between medical/social vulnerability and medical exploitation. The
medical plantation is a reminder, albeit one of the most extreme kind in history, of how social
vulnerability and medical exploitation have often coalesced at the bodies of people of color and/or
people with disabilities and severe illnesses. In fact the space of the medical plantation is a literal
reminder of the ways in which gender, race and (dis)ability not only have historically co-constructed
one another, but also have been placed at the center of the development of modern science and
medicine (Baynton 2003; Kudlick 2003).
Two examples that should come immediately to mind in reference to the medical-scientific uses of
black women and notions of pathological embodiment are the aforementioned story of Sara Baartman
who was believed to represent the excesses of sexuality and also proof justifying taxonomies of racial
difference; or the contemporary story of Henrietta Lacks whose cells were extracted unbeknownst to
she and her family and later reproduced for the first time in history through cell cultures, then termed
HeLa cells which are still used within multi-billion dollar medical-scientific industries for various
kinds of research. 7
With Medical Apartheid, medical ethicist and journalist Harriet Washington provides a touchstone in
the field of medical ethics; she offers a book length review of the exploitation of black bodies within
medical research from colonial times to the present. Importantly, her work goes beyond the oft cited
Tuskegee Syphilis study which was designed by U.S. Public Health Services to observe the effects of
untreated syphilis in black men in Alabama from 1932-1972. Within her book, she demonstrates that
while the black body has been used over and over again throughout history to further medical
knowledge, black people have reaped few of the benefits of medical advancement due to vast medical
disparities—or to use her stronger language—a deep seated medical apartheid.
Washington begins her review by explicitly mentioning Sims' experimentation on enslaved women in
his early career to orient the rest of her book on medical exploitation. Yet her work is not necessarily
situated in black feminist studies or cultural disability studies and as a result does not explicitly concern
itself with the interaction between gender, race and ability within spaces of medical containment such
as the medical plantation. The argument here is that the medical plantation can be considered a
precursor to the later more systematic treatment of disability coinciding with eugenic impulses referred
to by Snyder and Mitchell. Various cultural locations of disability such as mental asylums and
institutions set aside for the so called feebleminded can be understood as spaces of medical
containment where a cordoning off of the socially vulnerable from the rest of the body politic is a
defining feature.
These spaces of containment are defined by removal of individuals from family and community where
medical professionals were permitted unmediated access to treat and/or attempt to rehabilitate various
disabilities. They are cultural sites where isolation, vulnerability, and medical exploitation intersect
under the rubric of social welfare and benevolence. In fact it may very well be the case that Sims
believed he was offering benevolent medical care, yet the underlying assumption involved in the
creation of a medical space explicitly designed for vaginal surgery was a belief in a supernatural ability
of blacks to bear pain.
The third feature of the medical plantation as a cultural location of disability is that it represented a
physical space where theories of blacks having higher pain tolerance could be worked out and put to
test. As women's studies and cultural studies scholar Rebecca Wanzo explains "[f]or Sims, blackness
defined what pain meant for these women, just as white womanhood defined his understanding of
white women's pain experience" (2009, 159). In a chapter entitled, "In the Shadows of Anarcha" which
appears in her larger book project on sentimental political storytelling practices, Wanzo is interested in
the ways in which official medical narratives, past and present, obscure the pain experiences of black
women; this occurs in part because of broader cultural narratives regarding the "strong black woman"
believed to possess an extraordinary ability to bear pain.
Wanzo helps us to understand the unspoken assumptions operating within the history of modern
gynecology. She highlights for us "the ways in which the pain experience is not only physical and
psychological but also political" (158). The reason enslaved black women were the ideal test subjects
for four years of un-anesthetized vaginal surgery is directly connected to nineteenth century racial
taxonomies and widely-published medical beliefs in racial differences. These differences were assumed
to occur along the lines of ageing, intelligence, body type, sexuality, mental illness, and thresholds for
pain tolerance.
Further, Wanzo gives attention to how sentimental political storytelling practices can create counter
narratives to the stories that appear in the official archives regarding the pained black body. One such
example referenced directly by Wanzo is the Anarcha Project, a staged performance that utilizes
interpretive dance, personal stories and historical accounts to challenge hegemonic medical narratives.
The Anarcha Project employs artistic strategies of resistance in order to reconsider the repetitive
narrative of modern gynecology's origin story, to continue interrogating the relationships between race,
gender, ability and bio-medical innovation; in short it helps us begin to imagine what alternative
memorializing practices can be.
While Wanzo's work interrogates the tacit assumptions operating within the medical plantation, she
does not theorize the medical plantation itself as a feature of the history of modern gynecology because
she approaches this history from a different angle. What is being suggested here is that to understand
the medical plantation as a cultural location of disability is to understand a space where ideology made
contact with the human body. In this sense, the medical plantation was not only an experimental facility
where Sims attempted to correct fistulas but it was also a walled off testing center used to employ
theories of the 'super-ability' of black women to withstand repeated and deliberate bodily trauma. It is
one thing to hold the belief in such a hyper-ability, it is another thing to put this belief into practice
repeatedly for years on end while being faced with the corporeal reality of excruciating pain. It
becomes necessary, then, to place these experiments within a wider context of slave health care and the
relationship between pain and medical professionalism in the nineteenth century.

A Broader History of Slavery and Healthcare

A general understanding of the intersections of slavery and medical practice is necessary in order to
situate Sims within a broader medical profession and to understand the context in which his medical
plantation was created. In part we can turn toward nineteenth-century medical historian Todd Savitt in
order to contextualize the stories of Anarcha, Lucy, and Betsey within the broader history of slavery
and medicine. Through a bio-medical analysis, Savitt explains that plantation working conditions often
led to the ill health of slaves. In turn, the poor health of slaves: "led to medical intervention that often
became a contest between white medicine and the medical beliefs and practices of the slave
community" (Savitt 2005, 14). There exists an interesting conflict between the acquisition of
information about enslaved bodies to justify inferiority and the acquisition of enslaved bodies for
experimentation to improve white masculanized medical knowledge. The power differentials and the
vast differences in epistemological reference systems between black root doctors and medical
physicians prevented any the sharing of knowledge that may have allowed for an enhanced and blended
modern medical practice. 8
Slave ingenuity in medicine was important because slavery was an institution that required a kind of
hyper-ablebodiedness even while the working conditions, lack of adequate nutrition, corporeal
punishment, cramped slave quarters, extreme heat exposure, and forced breeding undermined such a
requirement at every turn. Though slave masters often believed that slaves were feigning illness in
order to escape the demands of slavery, it was obvious that sometimes medical intervention was
necessary—Savitt explains:
Physicians who treated the enslaved had both pecuniary and professional concerns in black
health. A physician's practice sometimes depended on a contract made with a slaveholder to
provide medical services for his "family" (including his slaves), although most doctors
 charged by the visit. Moreover, the physical differences between whites and blacks that
physicians observed and commented on became an important part of the rationale for
slavery (14).

The above quote points out that the medical plantation was integral to the development of narratives of
black difference and pathology particularly along the lines of the bodily experience of pain. Due to
extreme distrust of white slave owners' intentions and white medical practice, slaves often received
care through self-treatment, fellow herb doctors, and family remedies.
In this way, black healthcare can be framed as a form of resistance to growing white medical practice:
"The dilemma was whether to treat illness at home, risking white reprisal, or submit to white medical
practice and thus surrender their bodies to their owners. The result was a dual system in which some
slaves received treatment from both whites and blacks. To complicate matters further, physicians
answered to the slave owner so the enslaved patient might have no voice in his or her own treatment"
(Savitt16). Honing in on Savitt's remarks here raises questions about the treatment from other African-
Americans that may have been received by Anarcha, Lucy, Betsey and other slaves involved with Sims.
Did they ever receive such treatment? Might it have been sweet gum and mullen cooked down with
lard as suggested by Zora Neal Hurston? Were midwives treating these women before they were hailed
into the position of medical plantation subjects? Did the women seek alternative forms of medicine
from within their enslaved communities who had established networks of care to tend to illness and
disability?
Savitt's work and the previously mentioned work by Deborah McGregor seem to suggest that they may
have done so, yet these facts remain unknown with certainty. What is known with certainty is that the
political economy of slavery offered Sims the ideal subjects on which to experiment and to weave a
medical specialization from the raw materials of disability. Again, this was particularly so because
black susceptibility to pain was often considered different than that of whites and this was used as a
kind of justification for slavery. 9
Sims' autobiography includes comments about his subject's extraordinary tolerance for pain. For
example, in discussing his first surgeries on Lucy he says: "that was before the days of anesthetics, and
the poor girl, on her knees, bore the operation with great heroism and bravery" (236). Though Sims did
not use anesthesia in his experimentation with the women, he did use morphine over a four year period
and thus future research will need to probe deeper into the role of addiction within this history. Below, I
situate Sims' experimentation within the context of pain and medical professionalism in the nineteenth
century.

Nineteenth-century Pain and Medical Professionalism

Medical historian Martin Pernick has discussed the professional calculus involved in mid nineteenth-
century surgical decision-making (1985). Just a half-century before this period, physicians followed a
professional value of prolonging life over treating pain: "It is hard for us today to recreate the surgeon's
feelings before anesthesia became available. The emotional ability to inflict vast suffering was perhaps
the most basic of all professional prerequisites" (Pernick 27). It can be argued, as I argue here, that the
ability to inflict suffering for physicians working with slaves was amplified by discourses surrounding
black bodies as having a special capacity for bearing pain. Further, we cannot know, relying only on
Pernick what the ethics of medical professionalism involved when patients were also slaves housed
within a facility for their usage in surgical practice.
Significant cultural factors contributed to a new sensitivity to pain in the nineteenth century, including
sentimental literature and humanitarian reform movements. 10 According to Pernick, a shift in cultural
sensitivity to suffering and the development of new interventions in pain treatments: "Combined to
alter profoundly the professional values of nineteenth-century doctors" (26). One of these new
interventions was anesthesia, which began to be used medically in 1846. The development of
anesthesia for use in medical practice corresponds roughly to the timing of Sims' experiments from
1845-1849.
In Pernick's language, new mathematical models for evaluating the costs and benefits of such medical
drugs can be thought of as a "calculus of suffering". In the nineteenth century, physicians began to
weigh the pros and cons of pain relief during surgery. This professional shift did not happen seamlessly.
In fact, the medical field was extremely fractured around the safety of anesthesia as an intervention in
pain (30). Medical practitioners who followed the new approach to pain were influenced by, "[a]
utilitarian philosophy, a social moderation, and a numerical frame of mind, none of which were
prominent in American medicine prior to 1830" (33). By the time Sims opened the Women's Hospital
in New York, anesthesia was more widely and commonly used during surgery. Yet in Sims' early career,
beliefs in the exceptional ability of blacks to bear pain were naturalized and contributed to the use of
slave women for isolated research performed over four years on his medical plantation.
It is necessary to note that slavery scholar Saidiya Hartman cautions against the often casual discussion
of terror, pain and scenes of black suffering (1997). Within Hartman's analysis, the discussion begins
with the passage in Frederick Douglass's slave narrative where he describes the brutality of watching
his aunt being lashed. Speaking of such oft-repeated scenes of subjection in slavery:
What interests me are the ways we are the ways we are called upon to participate in such
scenes. Are we witnesses who confirm the truth of what happened in the face of the world-
destroying capacities of pain, the distortions of torture, the sheer unrepresentability of
terror, and the repression of the dominant accounts? Or are we voyeurs fascinated with and
repelled by exhibitions of terror and sufferance? What does the exposure of the violated
body yield? (3)

Of course, caution is necessary to avoid a slippage between re-remembering a painful history and
promoting the pornography and fetishism of pain. Yet actively remembering the violated bodies of
black enslaved women in this medical context can lead to a more nuanced and necessary understanding
of the medical plantation as a cultural location of disability as a space where ideology and medical
practice converge.
Given that pain—due to illness, disability, psychic trauma, addiction to morphine, or repeated vaginal
surgery—played no small role within Sims' medical plantation, we should spend more time grappling
with the important questions of pain and bodily integrity the case presents particularly in the field of
disability studies. The questions raised by the case, as has been suggested throughout this paper, are
varied and multiple but revolve broadly around issues of race, gender, space, medical vulnerability and
ethics. Black women's particular pathologized bodies were used as the generalized and generative
bodies of western gynecological knowledge. The site in which the new knowledge was extracted was a
cultural location of disability referred to here as the medical plantation. What is remembered about this
location and what is forgotten has everything to do with which epistemological frameworks we use to
interrogate it.

Conclusion
This paper has demonstrated that black women's bodies were imagined as the ideal test subjects of
research and innovation within what became modern gynecology. The paper has also provided relevant
historical contextualization of cultural and medical discourses regarding the black body and black
women's bodies in particular. Scholars who have examined the role of enslaved women within Sims'
medical career have helped to bring the stories involving Anarcha, Lucy, and Betsey into the forefront
of the larger history of gynecology's development as a discrete medical specialization. Yet a scholarly
analysis, based within the humanities, that specifically uses black feminist theory and feminist
disability theory to animate alternative understandings of Sims' medical plantation has yet to be written.
This paper has been written as a part of a larger dissertation proposal to move toward such a black
feminist/feminist disability studies mode of medical history analysis.

Endnotes
1. For example see Chris Bell's article "Is Disability Studies Really White Disability Studies"
(2010) or the recently completed dissertation entitled, "Unfit for Bondage: Disability and
African American Slavery in the United States" by Dea Boster (2003)
2. See Savitt (2002), Fogel and Engerman (1989)
3. See Ricci (1943)
4. See Barker-Benfield (2000) and Kapsalis (1997)
5. See Painter's biography of Sojourner Truth (1997)
6. For historical writings on black women and representation see Crais and Scully (2009); Gilman
(1985); Guy-Sheftall (1995); Hunter (1997); Wallace-Sanders (2002 and 2008)
7. See Landecker (2007)
8. Also see Fett (2002) and McGregor (1998) for more about contestations between slave
medicine and the medical practices of physicians.
9. For an analysis of the ways in which black pain was evoked in moral debates in the 18th and
19th century see Abruzzo (2011)
10.See for example Halttunen (1995)

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