Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840

By Rana A. Hogarth

In 1748, as yellow fever raged in Charleston, South Carolina, doctor John Lining remarked, "There is something very singular in the constitution of the Negroes, which renders them not liable to this fever." Lining's comments presaged ideas about blackness that would endure in medical discourses and beyond. In this fascinating medical history, Rana A. Hogarth examines the creation and circulation of medical ideas about blackness in the Atlantic World during the late eighteenth and early nineteenth centuries. She shows how white physicians deployed blackness as a medically significant marker of difference and used medical knowledge to improve plantation labor efficiency, safeguard colonial and civic interests, and enhance control over black bodies during the era of slavery.

Hogarth refigures Atlantic slave societies as medical frontiers of knowledge production on the topic of racial difference. Rather than looking to their counterparts in Europe who collected and dissected bodies to gain knowledge about race, white physicians in Atlantic slaveholding regions created and tested ideas about race based on the contexts in which they lived and practiced. What emerges in sharp relief is the ways in which blackness was reified in medical discourses and used to perpetuate notions of white supremacy.

• Language: English
• Publisher: The University of North Carolina Press
• Release date: Sep 26, 2017
• ISBN: 9781469632889

Rana A. Hogarth

Rana A. Hogarth is assistant professor of history at the University of Illinois, Urbana-Champaign.

Book preview

Medicalizing Blackness

Medicalizing Blackness

Making Racial Difference in the Atlantic World, 1780–1840

Rana A. Hogarth

The University of North Carolina Press    CHAPEL HILL

This book was published with the assistance of the Lilian R. Furst Fund of the University of North Carolina Press.

© 2017 The University of North Carolina Press

All rights reserved

Set in Espinosa Nova by Westchester Publishing Services

Manufactured in the United States of America

The University of North Carolina Press has been a member of the Green Press Initiative since 2003.

Library of Congress Cataloging-in-Publication Data

Names: Hogarth, Rana A., author.

Title: Medicalizing blackness : making racial difference in the Atlantic world, 1780–1840 / Rana A. Hogarth.

Description: Chapel Hill : University of North Carolina Press,

[2017]

| Includes bibliographical references and index.

Identifiers: LCCN 2017011938 | ISBN 9781469632865 (cloth : alk. paper) | ISBN 9781469632872 (pbk : alk. paper) | ISBN 9781469632889 (ebook)

Subjects: LCSH: African Americans—Medical care—Southern States—History. | Blacks—Medical care—Caribbean Area—History. | Health and race—Southern States—History. | Health and race—Caribbean Area—History. | Ethnic Groups—Diseases. | Medical care—Utilization—Southern States—History. | Medical care—Utilization—Caribbean Area—History.

Classification: LCC RA448.5.N4 H64 2017 | DDC 362.108996/073—dc23

LC record available at https://lccn.loc.gov/2017011938

Cover illustration: Negro Heads, with punishments for intoxication and Dirt-eating, plate 20, Richard Bridgens, Sketches of West India Scenery (1836). Courtesy of the Beinecke Rare Book and Manuscript Library, Yale University.

Portions of chapter 5 were previously published in a different form as Charity and Terror in Eighteenth-Century Jamaica: The Kingston Hospital and Asylum for Deserted Negroes, African and Black Diaspora: An International Journal, March 2016, 1–18. Reprinted by permission of the publisher (Taylor & Francis, http://www.tandfonline.com).

For Pete

Contents

Prologue

Acknowledgments

Introduction

PART I | Making Difference: Race and Yellow Fever

1 Black Immunity and Yellow Fever in the American Atlantic

2 An African Corps in a Most Distressed and Sickly Condition

Yellow Fever in the West Indies

PART II | In Sickness and Slavery: Black Pathologies

3 Incorrigible Dirt Eaters

Contests for Medical Authority on Jamaican Plantations

4 Of Paper Trails and Dirt Eaters

West Indian Medical Knowledge in the Antebellum South

PART III | Disciplining Blackness: Hospitals

5 That the Asylum for Deserted Negroes Is Now Complete for Their Reception

Surveillance and Sickness in Jamaica

6 For the Acquisition of Practical Knowledge

Genealogies of Medical Exploitation in the South

Epilogue

Notes

Bibliography

Index

Illustrations

Portrait of Benjamin Rush (1814) 26

Bush Hill (undated) 29

Portrait of Richard Allen (1823) 33

Map of the West Indies (1783) 53

Negro Heads, with punishments for intoxication and Dirt-eating (1836) 99

Cachexia Africana; or the Habits and Effects of Dirt-eating in the Negro Race (1845) 108

A view of Harbour Street and King Street, Kingston (1825) 146

Plan of the Hospital For the sick Slaves upon Good Hope Estate (1798) 154

Montpelier Estate, St. James (1825) 156

Ichnography of Charleston, South-Carolina (1790) 161

Advertisement, Dr. John Wagner (1826) 182

Advertisement for anatomical rooms, Dr. John Wagner (1826) 183

Prologue

Besides, there are many striking variations between the temperaments of the whites, and those of the Negroes, sufficient almost to induce a belief of a different organization, which the knife of the anatomist, however, has never been able to detect.

—DR. COLLINS, Practical Rules for the Management and Medical Treatment of Negro Slaves in the Sugar Colonies by a Professional Planter, 1803

In 1803, a British practitioner known only as Dr. Collins set out to offer the best advice for maintaining the health and productivity of the enslaved African laborers that toiled on plantations across the Atlantic World. Collins’s words, however, did much more than advise; they revealed the very real ways that Atlantic World slavery became essential to modern conceptions of race and racial difference.¹ With a stroke of his pen, Collins hinted at a complex and pressing question that had nagged at physicians and anatomists for years: Was there something physiological that made the black race and white race innately different? Collins, it appeared, believed that there was. Race, by the time of Collins’s writing, had already emerged as a characteristic that distinguished different kinds of humans from one another based on visually distinct physical and physiological traits. And while a number of scholars have argued that culture, language, and climate had much more to do with the idea of race than biology did, or that race did not become associated with biological essentialism until well into the nineteenth century, these arguments do not explicitly consider how race was made and remade in the context of American slave societies.² Within these spaces, Europeans increasingly grew to define African and Native American populations by their customs, religion, and bodies. Indeed, scholarship from the last twenty years reveals that race signified difference in a heritable, biological, and social sense in eighteenth-century American slaveholding societies.³

If we return to Collins’s statement, we see a relatively unsurprising approach to understanding human difference based on racial characteristics. This viewpoint ought to sound familiar to us, even if it is cringeworthy. For better or worse, Collins invoked a concept of race that is still in use today, despite its shortcomings. Though no longer acceptable to us now, this way of talking about racial difference was particularly useful to Collins. Both a planter and a physician, he sought to draw distinctions between black and white bodies through close examination of the ways each type of body adapted to its surroundings, labored, and responded to disease in the Americas. Observing, examining, and treating bodies was, after all, the bread and butter of most physicians, whether self-styled, formally trained, or otherwise. And what better place to make observations on bodily difference than in the plantation societies of the Americas, where black and white people inescapably (albeit reluctantly) mingled. Collins’s dual professions gave him the ideal vantage point to make such observations. Unlike European anatomists who made comparative pronouncements about race based on others’ travel accounts or the confines of their own dissecting rooms and theaters, Collins lived and practiced among each race. He saw firsthand differences in their habits, their responses to disease and therapy, and their regimes of health. As a plantation owner himself, Collins could translate what he observed into applied rather than theoretical knowledge. The knowledge that Collins produced and disseminated would end up in a guidebook on slave management, not a treatise on humankind—which might have been of lesser value to the planter seeking to turn a profit, though nonetheless instructive.

Written primarily for an audience of slave owners and physicians who lived and worked in the Caribbean, Collins’s guidebook covered such topics as provisioning, lodging, feeding, and healing slaves, and provided a list of diseases to which slaves frequently succumbed—diseases that would scarcely have appeared in the temperate climate of Europe or England. It was not the first or even the most comprehensive publication of its kind. It was, in fact, very ordinary in relation to other similar texts circulating within the Caribbean—and circulate they did, as slave mortality and plantation productivity were major concerns among planters. As Trevor Burnard and Vincent Brown have pointed out in their own work, black populations on islands like Jamaica faced high mortality, more often than not from mistreatment and want, though disease was also a common cause of death.⁴ Slave owners and physicians seeking to maximize profits, then, had a vested interest in identifying and understanding the ways that black people’s bodies labored, thrived, and experienced sickness.

Proving the existence of demonstrable differences between blacks and whites ended up being a process that was at best complicated and at worst elusive, as implied by Collins’s observation at the head of this prologue. But that does not mean that physicians did not try. It is tempting to assume that Collins, who ran a plantation in St. Vincent, was motivated by his direct ties to the slave system to make the supposed differences between black and white people’s bodies appear to be more than they were in his guidebook. However, Collins need not have been a planter to make the assertions that he did. In fact, there were a number of other physicians who found merit in investigating the alleged differences between the two races, regardless of whether they were pro-, anti-, or ambivalent toward slavery. In other words, physicians could have an interest in locating racial differences without having (economic) interests in slavery.

Understanding what racial differences meant medically could also benefit a physician’s professional standing in a slave society or, at the very least, be of use to slaveholders eager to master the health of their labor force to ensure productivity. Knowledge about how to manage the health of plantation slaves would almost certainly elevate a physician’s reputation in the eyes of the planter who paid him for his services. Considering how little faith planters and slave owners had in the medical profession at the time—many preferred to use in-home care either administered by a trusted slave, the overseer, or themselves—it was of paramount importance for physicians to demonstrate their competency when they were called out to a plantation.⁵ In other words, a good physician would need to win over planters and slave owners, by proving that they were capable of managing slaves’ health. Knowing this no doubt troubles us when we think about how conditioned physicians were to seek out evidence of racial difference. An equally troubling corollary to this trend is the ease with which physicians translated specific observations about how and why black people’s bodies became susceptible to some diseases and not others into physiological truths with clinical value. More than simply validating the existence of racial differences, they spoke about them with great authority, transforming the knowledge of managing black health into a medical specialty of sorts. The more they commented on illnesses to which only black people were allegedly vulnerable, compared black and white suffering from disease, and offered expert knowledge on how to care for black patients, the more they validated the belief that blackness influenced health and sickness. In the most reductive of terms, black people’s bodies came to function as unwilling repositories for physicians to generate new kinds of professional knowledge.

There were, of course, contradictions that plagued this project of making race and racial differences real—black people were supposedly suited for backbreaking plantation work in the hot sun, but some physicians and slave owners complained of the innate indolence of the race (hardly the traits of a race designed for intensive labor). No matter how obvious these contradictions and inconsistencies appear to us now, they did little to stem the degree of scrutiny and manipulation to which black people’s bodies were routinely subject. We must be cautious in relegating this practice of reifying race to the past. Partly because of the ways that race is still read as a visually distinguishable bodily feature, and partly because of the ways those with power have invested race with social and material meanings, this approach to constructing identity has not only succeeded but endured. Its success is apparent in the corollaries it spawned that held that apparent traits of each race were real—so real, in fact, that they could be discerned on a body like landmarks on a map. This approach to understanding identity continues to haunt the ways in which physicians and scientists imagine the root causes of present-day health disparities, especially those that affect the descendants of forcibly transplanted black Africans. One needs to look no further than the Food and Drug Administration’s 2005 approval of BiDil—the only FDA-approved drug for congestive heart failure for individuals who self-identify as African American.⁶ As Susan Reverby rightly points out, this problematic milestone had its roots in the way that twentieth-century physicians invested race as a real concept by employing it as a surrogate marker of difference.⁷ Some might even go so far as to conclude that the approval of this race-based therapy might induce a belief of a different organization between African Americans and other races.

Within the past few decades, a number of scholarly works have begun to reexamine how medical discourse about difference gave birth to diagnostic tools that have continued to validate the belief that innate differences between black and white bodies exist and are a function of race. Lundy Braun’s work on the spirometer is a case in point. Still used to measure lung capacity, the spirometer was championed by outspoken Louisiana physician Samuel Cartwright to prove that black people had inferior lung capacity in comparison to white people (yet black people were still touted as ideal laborers despite their collectively inferior respiratory tracts). Cartwright, a highly respected physician in the antebellum South, was a product of political wrangling over slavery and argued most stridently that black people’s bodies were not only distinct from whites’ but also designed for enslavement. As Braun argues, the spirometer continued its strange career of proving that black bodies had inherently lower lung capacities than whites throughout the twentieth century.⁸ This is not to say that Cartwright was typical of all physicians of this era, or that other bodies (differently raced, gendered, abled, and acculturated) were not subject to their share of undue scrutiny, objectification, ridicule, and exploitation at the hands of the medical profession. Rather, the point here is to illuminate how the practice of investing racial difference with practical medical use is a long and storied one, with roots in both slavery and the development of the medical profession. Drs. Collins and Cartwright, though separated by many decades and geography, shared a faith that understanding blackness within the field of medicine would yield generous benefits to both those who subjugated and profited off of black people’s bodies and those who treated them.

Acknowledgments

The craft of writing history is a collective enterprise. Even when lost in the archives, the library, or the quiet of my office, I was never truly alone when writing this book. My thoughts often drifted to the wonderful advice given to me by mentors, peers, friends, and advisers when I was in graduate school, when I was a postdoctoral fellow, and when I became a newly minted assistant professor. The comments on chapter drafts; casual conference banter; workshop critiques; and suggestions from writing partners, colleagues, friends, and family all resonated with me at some point or another as I wrote. I owe a great deal of thanks to those who have assisted me on this project.

Beyond relying on the kindness of scholars, strangers, archivists, research assistants, friends, and family, I received much-needed material and practical support from the various institutions that I attended and worked at throughout this process. I consider myself very fortunate to have completed my graduate studies at Yale University, with the Sterling Memorial Library, Medical Historical Library at the Cushing/Whitney Medical Library, and the Beinecke Rare Book and Manuscript Library at my fingertips. It also did not hurt that when I moved to east-central Illinois to start my position at the University of Illinois at Urbana-Champaign—first as a postdoc in the Department of African American Studies and then as an assistant professor of history—I was greeted with a vast and highly accessible research library as well as supportive faculty in the Department of History.

The labor of completing this book involved a number of research trips to the United Kingdom, Jamaica, South Carolina, and Philadelphia. Early in this process, I obtained a Summer Graduate Research Fellowship through the Gilder Lehrman Center for the Study of Slavery, Resistance, and Abolition, and a summer research grant through the MacMillan Center at Yale University. I passed the summer of 2009 between archives in England and Jamaica. In England, I darted between the Wellcome Library for the History and Understanding of Medicine, the British Library, the National Army Museum, the National Archives at Kew, and the Cambridgeshire Archives, all of which were staffed by knowledgeable and approachable personnel. When in Jamaica, I lingered at the Jamaica Archives and Records Department in Spanish Town, wandered around by the old naval hospital in Port Royal, and listened intently to local lore from cousins and other relatives. Subsequent return trips across the Atlantic had me returning to some of those old haunts as well as discovering new and equally wonderful repositories, like the National Records of Scotland, the National Library of Scotland, and the University of Liverpool.

Research was not always an international endeavor; I learned to appreciate much of what the southern Lowcountry had to offer while spending time at the Waring Historical Library at the Medical University of South Carolina, the South Carolina Historical Society Archives in the Addlestone Library at the College of Charleston, and the Charleston County Public Library. At the Waring Historical Library, Susan Hoffius more than ably assisted me as I pored over numerous nineteenth-century medical theses, while at the Charleston County Public Library, Nic Butler supplied me with an abundance of useful reference materials and helped me reconstruct life in colonial Charleston. Upon heading north to Philadelphia, I was welcomed by knowledgeable archivists and personnel at the Library Company of Philadelphia, the Historical Society of Pennsylvania, and the College of Physicians. Such crucial research trips would not have been possible without generous support from the Department of History at the University of Illinois, the Illinois Program for Research in the Humanities (IPRH), and the Office of the Vice Chancellor for Research at the University of Illinois. Finally, I was lucky enough to secure an excellent undergraduate summer research assistant, Mackenzee Kienitz, who helped me locate and organize some of my sources.

Getting to the archives can be a tricky part of the process of writing history, but knowing what questions to ask of your sources and what to look for while endeavoring to write a history of medical attitudes about black health and bodies spanning the eighteenth and nineteenth centuries is not without challenges. Thankfully, I had the opportunity to workshop various portions of this manuscript and collect valuable comments and suggestions from a wide array of scholars. As one of the members of the inaugural scholars’ workshop offered at the Omohundro Institute of Early American History and Culture (OIEAHC)—generously funded and supported by the Lapidus Initiative—I benefited from intensive, careful, and constructive feedback from peers and senior scholars. I am grateful for having spent portions of the summer of 2015, expertly organized by Martha Howard in Williamsburg, Virginia, soaking up comments from my fellow workshop participants. I also wish to thank Karin Wulf, Brett Rushforth, Joshua Piker, Nadine Zimmerli, and Fredrika J. Teute for their time and their wisdom and for challenging me to make the most of my sources. The time I spent at the OIEAHC profoundly improved my approach to interrogating racial erasures and the silences of marginalized voices in the archive.

During the revision process, I also sought counsel from my colleagues at Illinois and was richly rewarded for doing so. They went out of their way to read drafts of the manuscript, proposals, and funding applications, and provided detailed line-item comments and editorial suggestions to boot. I am incredibly grateful to Antoinette Burton, Leslie J. Reagan, Erik McDuffie, Craig Koslofsky, Maria T. Gillombardo, and the late Nancy Ablemann for their critiques of my work and for their intellectual and practical support. I also benefited from workshopping chapters at the University of Illinois’s History Department Workshop, the history department’s Premodern World Reading Group, and the IPRH Fellows seminars. When not engaged in formalized workshops, I turned to my peers and friends, and remain deeply grateful to my writing partners, Sandra Ruiz and Samir Meghelli; we pushed one another to write, to stay on track, and we were able to laugh along the way. Finally, my dear friend, Mindy Schwartz, was generous with her time and her words of encouragement helped to sustain me throughout this process.

Over the years, I have had the opportunity to both present my work in a number of academic forums and forge lasting connections and friendships with great scholars. The annual conferences of the American Association for the History of Medicine (AAHM) were valuable spaces where I fine-tuned and tested out many of my preliminary ideas found in the pages that follow. The Porter Fortune Symposium on Science, Medicine, and the Making of Race at the University of Mississippi in 2012 introduced me to a world of remarkable scholars who have greatly influenced my work: Londa Schiebinger, Suman Seth, Nancy Bercaw, Stephen C. Kenny, Deirdre Cooper Owens, and Martin Summers, to name just a few of the participants. I also benefited from working with and getting to know Jim Downs and Catherine Clinton at a number of conferences. Both have inspired me to find my voice through the process of revising, and their friendship truly sustained me throughout the journey. Additionally, I am grateful to Alex Borucki for organizing the Slavery at the Crossroads of Medical Knowledge and Science conference, sponsored by the Department of History and the Medical Humanities Initiative at UC Irvine, and inviting me to share my work there. The constructive feedback that I have received at conferences and symposia from such scholars as Sharla Fett, Stephen C. Kenny, Mariola Espinosa, Ian Read, Gretchen Long, Jim Downs, and Pablo Gomez has been extraordinarily helpful and intellectually sustaining throughout this process.

To John Harley Warner and Susan E. Lederer I owe a great deal of gratitude, for both of these historians awakened my passion for studying the history of medicine. Taking undergraduate- and graduate-level seminars from Professors Warner and Lederer left a lasting impression on who I am as a historian. Their faith in my ideas and abilities encouraged me during graduate school and continues to shape my scholarly endeavors. Susan Lederer has served as a mentor, adviser, and friend, and she has watched this project germinate and come to fruition. Throughout it all, she has been there to offer her support, her guidance, her well wishes, and her time. I could not have asked for a better adviser!

As this project moved from chapters to a full manuscript, I found myself revisiting the writings of other scholars who have inspired this project. One such scholar, Sharla Fett, was gracious enough to provide helpful comments on the full manuscript, and for that I am truly grateful. I also wish to thank the anonymous readers at the University of North Carolina Press for their clear and instructive criticisms. In addition, I would like to thank UNC’s excellent editorial staff, Joe Parsons, Lucas Church, and Becki Reibman; their support for my project, professionalism, and proactive approach to the editorial process has made all the difference.

Finally, I would like to thank my dear friends and family; your support has been invaluable, and I cherish the laughter and joy you have shared with me over the years. To my parents, John and Charmaine Hogarth, thank you for remaining steadfast champions of everything I do. You have pushed me to accomplish my goals no matter what obstacles might be in my way. And to my dear Pete, I thank you for being such a great partner, friend, confidant, editor (albeit a reluctant one), and companion. You have been, and always will be, my light at the end of the tunnel.

Medicalizing Blackness

Introduction

By the late eighteenth century, the Atlantic slave trade had reached its zenith, and slavery in the Greater Caribbean had become a deeply entrenched, albeit contested, labor system based on race. The advent of the slave system had, by this time, transformed the distinct geographies and disease environments of this region, which stretched as far north as the Carolinas, extended as far south as the northern coast of South America, and encompassed the Greater and Lesser Antilles. At the same time, slavery also nurtured cultural syncretism in this region, formed through resistance, accommodation, and reluctant collaboration at the hands of indigenous, African, and European peoples. For the purposes of this study, I discuss the Greater Caribbean as it existed within the Atlantic World, set off by its long reliance on slavery and the cultures that developed there because of that system of labor. The term Greater Caribbean, then, represents more than just a geographical or cartographic distinction of place. It is a term that signals the various ways that the plantation economies, demographics, climate, and diseases that appeared in this region helped shape the life experiences of the different races of people that inhabited it.¹

The different types of people that came together in this region did much more than create the institutions, communities, laws, and cultures on which nations were built; they catalyzed the creation of identities that used race to forecast and distinguish perceived corporeal and intellectual ability, strength, weakness, and, in some cases, individual and generational achievements. These racialized identities owed much of their existence to the efforts of white physicians, who shepherded their creation through the conclusions they drew about human bodies and their relationship to their environs. With the increased reliance on enslaved African labor, many physicians who worked and settled in the Greater Caribbean took to trying to make sense of the apparent differences they observed between black and white people’s bodies during times of sickness. Their efforts helped to sanction the objectification, exclusion, and subjugation of black people for generations to come, and it is their efforts that form the basis of this study.

Whether by design or by chance, physicians’ objectification of black people’s bodies in slave societies became an essential component to the development of the medical profession in the Americas. As Sharla Fett notes, The history of slavery and the making of race strongly influenced the dynamics of southern plantation medicine.² Fett’s words need not be limited to medicine in the South, the plantation, or the United States. In Europe, for example, physicians took great interest in locating differences between black and white bodies and used comparative anatomy to create physiological and physical expectations for each type of body. This task was more easily completed due to the greater availability of black people being sent to Europe as either servants or specimens, courtesy of the slave trade. Black skin, for example, remained the most studied organ on the sub-Saharan African body. Londa Schiebinger’s research on race bears out this fascination with blackness. Of studies on human skin that appeared between the late seventeenth and early nineteenth centuries, not a single text had a title referring to the skin colour of peoples other than Africans.… While these works reported the dissection of thirty-eight Africans for the purpose of understanding the anatomical location of pigment in a particular layer of skin, not a single Amerindian or Asian was opened for this purpose.³

The preoccupation with blackness that emerged out of this process of constructing race became one of the hallmarks of medicine in the American Atlantic World. My aim in this book, then, is to examine how that process unfolded. A central part of this process is what I call the medicalization of blackness. Medicalization has become an umbrella term, with a range of definitions. Most recently, it has come to encapsulate how acute and chronic human conditions, traits, or problems have become transformed into medical conditions, the idea being that these conditions can be defined and managed through the language and practice of medicine.⁴ For the purposes of this study, I use the term to describe how physicians in slaveholding societies of the Greater Caribbean defined blackness as a surrogate marker of difference to stabilize and reify racial differences. Only by identifying the so-called tangible traits unique to black people’s bodies could these physicians legitimize their discussions of racial differences with physiological proof. And only by proclaiming the existence of physiological differences between black and white people could they justify the time and attention they invested into understanding the so-called peculiarities of black people’s bodies. Put plainly, the construction of racial differences and the medicalization of blackness were mutually dependent forces, essential to the development of medical knowledge production in the Atlantic World.

The story that I tell in Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780–1840 reveals how physicians in the English-speaking Greater Caribbean engaged in this process not for the sake of justifying slavery but for their own intellectual, professional, and pecuniary gains. That is, while the claims these physicians made about black people’s bodies certainly served slavery apologists, these claims were not created for the sole purpose of defending slavery. The construction of blackness in the white mind served multiple purposes.⁵ Medical constructions of blackness in particular emerged to advance the standing of medical polities in the Atlantic World and expand white prerogatives. That the claims physicians made about black people’s bodies were embraced by slavery’s defenders and detractors should not obscure the rationale behind their creation. As Medicalizing Blackness demonstrates, the embrace of these claims underscores just how powerful the constellation of medical ideas about blackness was in convincing whites that race was a normative physiological trait with social as well as clinical value. At the same time, the types of labels and logic physicians used when identifying bodies as black, recording their expectations of these bodies, and describing the experiences of black patients under their care, were deeply contingent on a number of factors.⁶ The sex of the body, its degree of mixture with white or indigenous ancestry, its adaptability to the environment and perceived strength and ability to labor, and even the context in which it labored all helped to determine the degree to which blackness was perceived to influence health.

The process of defining blackness as a physiological and at times pathological trait went hand in hand with the logic physicians used to diagnose and make prognostications about illnesses and the body’s responses to them. At the same time, pathologizing blackness also served the purpose of expanding existing social divisions. The pathological and even normative traits that physicians attributed to black bodies became tools of oppression and power, for even as white physicians constructed images of healthy and robust black bodies capable of enduring brutal labor regimes, they also identified deficiencies within these bodies that disqualified them for self-government.

For too long, the myths, axioms, and lore about black people’s bodies propagated by these physicians have been referenced as marginalia or chalked up to characteristic white chauvinism of the era. Some scholars have suggested that planters, overseers, and slave owners likely did not pay any mind to the claims physicians made or the hypotheses they advanced about the physiological differences between black and white people. Historian Todd Savitt best sums this sentiment up, asserting, What each planter noticed was the incidence of disease on his and his neighbors’ plantations and the treatment which effected the quickest cures. A physician’s statement that ‘the African is less susceptible to malarious influences than the white’ had little meaning to the planter whose three or four best black workers had just been laid up with cases of malaria.⁷ Whether or not individual planters took physicians’ assertions about racial disease susceptibility as the gospel is moot. It is possible that planters fell into the trap of cognitive dissonance, believing black people to be susceptible to similar diseases as white people while maintaining that each race was physiologically distinct. Faced with a crisis of slaves sickened with malaria, Savitt’s hypothetical planter would find a physician’s statement about racial susceptibility too academic, yet that would not mean that the statement lacked merit or was untrue. In reality, these statements made up a corpus of medical ideas that profoundly affected the expectations of black and white people’s bodies living under the slave system. As Medicalizing Blackness demonstrates, this corpus of knowledge nurtured the development of medical authority in slave societies. In other words, it was precisely the propagation of these ideas that led to the universal acceptance among those with and without a vested interest in the slave system that the bodies of diasporic Africans were unquestionably different from whites, both inside and out.

MEDICALIZING BLACKNESS OWES a great debt to a number of seminal scholarly works on the relationship between race, medicine, and slavery. Todd Savitt’s Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia, for example, remains one of the most foundational texts on the nexus of health care and slavery in the American South on the eve of the Civil War. Savitt’s thoroughly researched study is a scholarly blueprint for understanding the reality of black experiences with white physicians in the antebellum South. Its impact is no doubt present in other seminal works on slavery and medicine, such as Sharla Fett’s masterful work Working Cures: Healing, Health, and Power on Southern Slave Plantations. Working Cures offers a thoughtful representation of black people’s agency over their own health and healing practices in the American South. Fett’s book demonstrates how slaves used their own