J. Marion Sims (1813-1883) was a surgical pioneer, considered the father of American gynecology. Modern historians argue about his legacy as Sims used slaves as experimental subjects. No cure was available for women with vesicovaginal fistulas, usually the result of traumatic labor. Sims experimented on three Alabamian slave women (Anarcha, Betsy, and Lucy) who were suffering from fistula problems, to develop new techniques to repair this condition or be used as experiments for medical research. Sims did not use any anesthetic during his procedures, although anesthesia was available. These experiments set the stage for modern vaginal surgery. Sims devised instruments including the Sims' speculum to gain proper exposure. A rectal examination position where a patient is on the left side with the right knee flexed against the abdomen and the left knee slightly flexed is also named after him as Sim's position. He insisted on cleanliness. He died of a heart attack in 1883 at the age of 70.