In this article, Brianna Cheng examines the use of ideas of venereal disease in anti-immigration discourse, in particular the role of J Marion Sims in furthering ideas that Chinese women were carriers of disease.

PRESCRIBING DIFFERENCE: J MARION SIMS' 1876 PRESIDENTIAL ADDRESS AT THE AMERICAN MEDICAL ASSOCIATION

In 1876, J. Marion Sims took the stage to deliver the Presidential Address at the annual meeting of the American Medical Association (AMA), the country’s foremost medical organisation, in Philadelphia. He began by congratulating the crowd for assembling during the centennial of the Declaration of Independence in the city in which it was signed: “with these surroundings, we feel that we here stand on hallowed ground; hallowed!” Sims’ nationalist spirit carried him into the thrust of his speech, a call to action against what he termed “the great question of the day”: syphilis. Unlike other conditions, syphilis’ absolute association with sexuality made it both a medical and moral threat. The source of infection in the American West, Sims declared, was Chinese women, practically all of whom were prostitutes. To contain syphilis was to control Chinese women, who “necessarily [breed] moral and physical pestilence.” 

While upholding Black women’s supposed biological difference, ironically, Sims and other doctors applied the knowledge gained from the experiments to treat both Black and white patients; however, the gynaecological treatment of enslaved women served a particular purpose in the antebellum era. Following the abolition of slave importation in 1808, slave owners exacerbated their investment in the reproductive capacity of enslaved women. Partus sequitur ventrem, which had been enshrined in law since 1662, ensured that the children of enslaved women would retain the legal status of their mothers. Thus, after, 1808, the continuation of American slavery depended on enslaved women having children, many of whom, it must be acknowledged, were the result of exploitation and rape. Slave owners found allies in gynaecologists, whose work ultimately helped enslaved women bear more children. If slave hospitals were sites where physicians helped slave owners maintain the gendered violence inherent to American chattel slavery, the sphere of public health was where doctors and the state played symbiotic roles in barring Chinese women from entering the United States.

For centuries, Western medical literature had gendered venereal disease (now commonly referred to as sexually transmitted infections) as a phenomenon carried and spread primarily by women. In the early nineteenth century, the responsibility of spreading venereal disease became pinned specifically onto prostitutes and their sexual excess. During the Civil War, understandings of the dangers of venereal disease led to experiments in the limited licensing of sex workers - informed by an understanding that disease was caused by women, not their male clientele.  In European colonies, colonial officials further differentiated white prostitutes at home from racialized prostitutes. For instance, the 1867 Commission in Hong Kong stated that Chinese prostitutes were “not ‘abandoned women’ as the prostitutes of Europe only too frequently are.” Cultural difference, rather than economic misfortune, predisposed Chinese women to sexual immorality. White Americans, especially Chinese exclusionists, applied an even more extreme version of this logic to Chinese migrant women in the American West. Newspapers often referred to all Chinese women simply as “lewd women,” “heathen harlots,” or “wretched creatures.” In his address to the AMA, Sims declared: 

“Syphilis, unlike cholera, originating when and where it may, always fixes itself in great populous centres, taking up its abode in the haunts of ignorance, poverty, squalor, filth and vice… degraded women may transmit the disease not only to scores of men, but hundreds and thousands.” 

In this formulation, Chinese migrants’ unhygienic and debauched lifestyles fostered syphilis which Chinese women then spread en masse.

The spread of syphilis, Sims announced, had to be eliminated through the “new science” of public health, wherein medical authorities were responsible not only for the health of individuals, but entire communities and the nation itself. During his speech, Sims cited the like-minded physician Dr. Hugh H. Toland, who was perhaps the most prominent medical practitioner in the American West at the time. As an expert physician, Toland had given almost identical testimonies in both Congress and the California State Senate’s investigations into Chinese immigration. In particular, he aroused anxieties about the young white boys of California contracting syphilis. At the State Senate, Toland speculated that “nine-tenths” of such infections derived from “Chinawomen,” and his prescription was to “get rid of them.” In a similar vein, Sims critiqued the 1868 Burlingame Treaty, which protected the right of Chinese migrants to enter the United States, and demanded that syphilis be “stamped out” in part through immigration legislation. Sims’ speech and Toland’s testimony illustrated that there were limits to the “public” to be protected by public health, and such limits excluded Chinese women. 

The discursive confluence of race, gender, and disease that physicians elucidated was formalized in the United States’ first iterations of restrictive immigration policies. In 1875, President Ulysses S. Grant signed the Page Act into law, which technically banned the importation of women from “Oriental” countries for “lewd and immoral purposes,” but effectively prohibited the entry of all Chinese women. Six years after Sims’ speech at the AMA, the Chinese exclusion act passed. At this point, officials had detained, interrogated, and deported scores of Chinese women. The racist logics that undergirded this legislation lives on: recent years have seen a spike in anti-Asian violence, much of which was directed towards women, undergirded by the association of Chinese bodies with disease. While J. Marion Sims’ experimentation on Black women has generated recent outrage, his career is reflective of a less acknowledged temporal and geographic through-line of medical authorities providing scientific rationale for the racial inferiority designated to Black and Chinese women in the nineteenth century. As well as the direct harm done to real patients through experimentation, Sims sponsored and legitimised a sexist and racist logic that policymakers amplified. In turn, these authorities contributed to the confluence of forces which inflicted and justified the violence inherent to both chattel slavery and the defining of immigration policies, and therefore citizenship, via racial and gendered mechanisms.

Brianna Cheng completed her BA in History and Political Science at McGill University in 2021 and her MSt in History at the University of Oxford in 2022. This article is adapted from her master’s thesis, which is forthcoming in American Nineteenth Century History.