Vaginismus: a Franco-American story.

In November 1861, Dr. J. Marion Sims, an American gynecologist, named and described the syndrome of vaginismus, which linked symptoms of vaginal hypersensitivity to muscular spasm. The only rational treatment for this disorder, said Sims, was surgery. His work was taken up immediately in France, but the story of its interpretation and application is a rather complicated one. Félix Roubaud, a leading specialist on matters of impotence and sterility, revised earlier writings in order to make a clear place for Sims's theories. But in the succeeding decades, Sims was subject to more and more criticism in French medical circles. Some argued that French specialists had already identified all the key elements of vaginismus, and that Sims was no more than a successful publicist. Others-and these were finally the most influential-argued against surgical treatment. More and more French writers on sexual medicine argued that vaginismus was a "moral" disorder that could not properly be treated by physical methods. And within French medical circles the Sims operation for vaginismus came to represent an "American" approach that was too rational, and too straightforwardly physical.