Discovery of disposable vaginal speculum is between 1845 and 1849, conducted gynecological experiments on the bodies of enslaved black women. And developed new surgical techniques to repair obstetric fistulas, which occur during childbirth when the baby’s head is pressed against the vaginal walls for a long time, interrupting the blood supply and creating openings through which urine or feces can enter the vagina. Although basic anesthetics were available at the time, Sims did not use them to cut and stitch his patients.
At the time, there was a widespread myth that blacks had a higher pain threshold. It allowed those who got rich by harming black people to free themselves from the need to feel empathy or guilt. Like many other lies of convenience, it has had a life of its own and lives on in modern medicine. A 2016 study found that, against all evidence, some medical students and doctors still believe that blacks have less sensitive nerve endings and thicker skin.
Development of Vaginal Speculum
Another of Sims’ accomplishments was the development of a medical device that was the precursor to the modern disposable vaginal speculum. Their version consisted of a curved clamp used to hold the vagina open and a series of cleverly placed mirrors to view the internal structures. The modern speculum has a distinctive duke-shaped mouth. Doctors often use a clear, disposable plastic speculum to examine the vagina and facilitate the collection of cervical cells to examine for abnormalities that may lead to or suggest cervical cancer. It is estimated that the NHS cervical cancer screening program saves 4,500 lives a year, which would not have been possible without the help of the speculum.
Experiments
However, the speculum has many meanings. It is obviously associated with Sims, whose scientific reputation was based on his easy access to black women’s bodies and his ability to inflict pain on them. But the people whose intimate body parts he studied – cisgender women, transgender people, and people of the opposite sex – also often had difficult encounters in a remedy that still focuses on the needs of white, cisgender men. As mentioned earlier, the underestimation of pain among marginalized people is not a thing of the past, and studies show that women and people of color wait longer for pain medication and that their pain is often minimized. And of course using a speculum is physically uncomfortable and can be embarrassing and offensive.
Open Source Speculums
The 3D printed and open source speculum by the feminist group GynePunk is an attempt to counteract this history and these associations. The idea of a speculum that can be printed and used outside of the doctor’s office represents the liberation of marginalized bodies from the gaze and oblivion of traditional medicine. It symbolizes a rejection of the oppressive qualities of medicine and a willingness to work outside of its paradigms.
However, it raises important questions about what we do with objects that disturb us. The Sims statue was removed because such monuments honor black people by dehumanizing them. We had nothing to lose by pulling it down, but we had everything to gain by removing its powerful shadow from public space and beautifying history. But what about research? Should we abandon this tool and its usual use to protest medicine’s treatment of the marginalized and its shameful history of development?
Use of Vaginal Speculum
The speculum is not a monument. It is an instrument, an object whose use, unlike sculpture, is not primarily representational. It can sometimes be accused of representing medical patriarchy, but this should be weighed against the lives it saves. Medicine and the tools that save lives, including the endoscope, are the product of a long history, often told as the triumphant (often dubious) story of the “great white man.” But this is a distortion of the facts. Scientific discoveries and inventions have always been commonplace achievements. They were made possible by the largely invisible work of working-class women, and social inequalities left some free to think and play while others worked. And in some cases, they depended on the bodies of marginalized people who were unwilling to consent.
Conclusion
The denial of medicine has too many consequences. It may be a problematic paradigm, but it belongs to all of us and we should try to improve it, not reject it out of hand. Marginalized populations deserve health care that takes their needs into account, not just in retaliation for past and present injustices, but because marginalization itself is a determinant of poor health. We must begin to tell the brutal story of the speculum and demand health justice, but we must work from the center, not the periphery, and reclaim what is the heritage and right of us all. Sims must fall, but the speculum can be restored. For more: JimyMedical.co.uk.
