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“…the impression that Sims was treating the empress…”

See “…the duchess now arranged the approval needed…,” above.

It is highly unlikely that both the Duchess of Hamilton and Empress Eugenie—along with a number of other royals—would have required, or might have believed they would benefit from, Sims’s attention in the form of surgical procedures. Particularly in light of the fact that some very highly placed French surgeons regarded Sims’s procedures as dangerous, it is improbable that Sims would have been permitted to perform operations, even if they had been required (and this is made further unlikely by the fact that a young royal he did operate on nearly died—see “He froze,” above).

Although an operation performed on Empress Eugenie has long been part of Sims’s narrative, I think it’s far more likely that Eugenie was used as a cover so that Louis Napoleon could communicate with the Confederate government at a particularly delicate time in the American Civil War. It’s worth noting that there is no document that proves that Sims operated on Eugenie, and he never indicated what procedure he was supposed to have performed on her, even though on other occasions he was known to have broken patients’ confidence. There is only Sims’s word that such an operation took place—and even his champions have acknowledged that he is not a particularly reliable source.