Medicalizing Blackness This page intentionally left blank 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 This page intentionally left blank Prologue xi Acknowledgments xvii Introduction 1 paRt i | Making Difference: Race and Yellow Fever 1 Black Immunity and Yellow Fever in the American Atlantic 17 2 An African Corps in a Most Distressed and Sickly Condition 48 Yellow Fever in the West Indies paRt ii | In Sickness and Slavery: Black Pathologies 3 Incorrigible Dirt Eaters 81 Contests for Medical Authority on Jamaican Plantations 4 Of Paper Trails and Dirt Eaters 104 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 133 Surveillance and Sickness in Jamaica 6 For the Acquisition of Practical Knowledge 159 Genealogies of Medical Exploitation in the South Contents Epilogue 187 Notes 195 Bibliography 233 Index 253 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 Illustrations This page intentionally left blank xi 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. Col- lins’s words, however, did much more than advise; they revealed the very real ways that Atlantic World slavery became essential to modern concep- tions 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 anat- omists 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 char- acteristic that distinguished different kinds of humans from one another based on visually distinct physical and physiological traits. And while a num- ber 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 be- come 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 ap- proach to understanding human difference based on racial characteristics. Prologue xii Prologue 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 Amer- icas. Observing, examining, and treating bodies was, after all, the bread and butter of most physicians, whether self-styled, formally trained, or other- wise. 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 anato- mists 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 ob- served 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 top- ics 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 mis- treatment 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 Prologue xiii 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 ben- efit 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 plan- tation 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 planta- tion. 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 sus- ceptible to some diseases and not others into physiological truths with clini- cal 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 vulner- able, 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 mak- ing race and racial differences real—black people were supposedly suited xiv Prologue 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 reify- ing 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 ap- proach to constructing identity has not only succeeded but endured. Its suc- cess 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 dif- ferent 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 diag- nostic 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 Prologue xv 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 prac- tice 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. This page intentionally left blank xvii 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 as- sistant professor. The comments on chapter drafts; casual conference ban- ter; 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 prac- tical 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 profes- sor 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, Resis tance, and Abo- lition, 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 His- tory and Understanding of Medicine, the British Library, the National Army Museum, the National Archives at Kew, and the Cambridgeshire Ar- chives, all of which were staffed by knowledgeable and approachable per- sonnel. When in Jamaica, I lingered at the Jamaica Archives and Records Department in Spanish Town, wandered around by the old naval hospital Acknowl edgments xviii Acknowl edgments 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 appre- ciate 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 Li- brary. At the Waring Historical Library, Susan Hoffius more than ably as- sisted 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 Phil- adelphia, the Historical Society of Pennsylvania, and the College of Physi- cians. Such crucial research trips would not have been possible without generous support from the Department of History at the University of Il- linois, the Illinois Program for Research in the Humanities (IPRH), and the Office of the Vice Chancellor for Research at the University of Illinois. Fi- nally, 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 his- tory, 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 vari- ous portions of this manuscript and collect valuable comments and sugges- tions 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 por- tions 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 Acknowl edgments xix 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 pro- vided 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 for- malized 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 Coo- per 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 Knowl- edge 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 confer- ences and symposia from such scholars as Sharla Fett, Stephen C. Kenny, Mariola Espinosa, Ian Read, Gretchen Long, Jim Downs, and Pablo Gomez