Slave health on plantations in the United States
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Diseases among slaves
West Indian physicians and authors, particularly the British, often shared their knowledge of black-related diseases with North American colleagues. Diseases that are thought to be "negro diseases" include, but are not limited to:
- nascentium, or "nine day fits"
- high infant mortality
- whooping cough
- "lepra psoriasis"
While working on plantations in the Southern United States, many slaves faced serious health problems. Improper nutrition, unsanitary living conditions, and excessive labor made them more susceptible to diseases than their masters; the death rates among the slaves were significantly higher due to diseases.
There are contrasting views on slave's diets and access to food. Some portray slaves as having plenty to eat, while others portray "the fare of the plantation [as] coarse and scanty". For the most part, slaves' diet consisted of a form of fatty pork and corn or rice. Historian, U.B. Phillips, found that slaves received the following standard, with little or no deviation: "a quart of cornmeal and half pound of salt pork per day for each adult and proportionally for children, commuted or supplemented with sweet potatoes, field peas, sirup, rice, fruit and 'garden sass'". Scholars came to realize that the slave's diets were quantitatively satisfactory, but not qualitatively sufficient. The poor quality of food led to slaves that were either "physically impaired or chronically ill", according to Eugene Genovese (American South historian).
Antebellum plantations had a larger population of hogs than cows, therefore producing more pork than beef. There are a few reasons behind having more pigs than cows: a stereotype that slaves preferred pork over beef, beef was harder to preserve so it was typically only served fresh (which happened more often in the winter because the cold slowed spoiling), a fear of fresh meat because it was believed that it caused disease among blacks (which it was probably not that fresh), and the planters' conviction that "hog was the only proper meat for laborers". Due to the lack of cattle consumption and use (other than for fertilizer), another problem arose among slaves' diets: absence of milk.
There was often a stereotype in the Antebellum south that slaves were lactose intolerant. However, many slaves had trouble digesting lactose (in dairy products) because it was not a common staple in their diets.Due to the scorching summer heat and the poor quality of the animals themselves, milk became a scarce product only available seasonally. When it did become available, it was first given to whites and if any remained, then to slave children. Additionally, there is some scientific hypotheses behind blacks more often being lactose intolerant than whites today. In West Africa, the presence of the tsetse fly made raising cattle practically impossible, creating a historical situation in which there was no need for humans to develop higher levels of the lactate enzyme (which allows the body to digest lactate).
Due to slaves' diets lacking quality, there were many vitamin and nutrient insufficiencies that lead to sicknesses:
- Vitamin A deficiency led to weakened eyesight
- Lack of milk contributed to diseases such as rickets and calcium deficiency
- Inadequate iron led to anemia
The masters only gave slaves pairs of "gator shoes" or "brogans" for footwear, and sometimes children and adults who were not working had to walk around barefoot. These clothes and shoes were insufficient for field work; they did not last very long for field slaves. It is judged that the health of male workers broke down rapidly after they joined the field gangs.
Medical attention given to slaves
Slave masters often tried to cure their ill slaves before they sent the slaves to a doctor. Planters wishing to save money relied on their own self-taught skills and the help of their wives to address the health care needs of slaves. Some blacks developed or retained from African heritage their own brand of care, complete with special remedies, medical practitioners and rituals. If the home treatment did not help to improve the slave’s condition, they would then send them to the physician or asked the doctor to come to the plantation. A slave who became ill meant loss of working time; death an even greater loss. Given the cost of slaves and their importance to plantation economies, planters organized slave hospitals to treat their serious health problems. There were also separate physicians for slaves and whites because it was believed that slaves' bodies were fundamentally different from whites'. Due to this thinking, many slaves became the subjects of physician's experiemtnal interests to help expand both the physician's knowledge and repuation, often resulting in slave's mutilation and death.
Slave hospitals were thought to be an essential part of plantation life by Dr. A.P. Merrill and Dr. Samuel A. Cartwright. The physicians believed that the slaves’ bodies were biologically and physiologically different than whites, therefore they should have their own resource for medical attention and treatment. In some histories of the Antebellum South, like William Scarborough’s Masters of the Big House, slave holders are depicted as going to great lengths to protect the health of their slaves. Examples of this include vaccinating slave infants against small pox, paying hundreds of thousands of dollars in medical expenses and dispensing sherry or madeira to sick slaves. Dr. Merrill provides a detailed description of what he thinks slave hospitals should be like in his 1853 article about plantation hygiene. However, in reality, the hospitals were representations of the way slaves were viewed: as chattel. They were often a slave cabin used to isolate those with a fever or illness, and to make sure that the slave was not faking an illness in an attempt to run away. Frances Kemble’s recollection of the slave infirmary at Butler Island paints a stark reality of slave women lying on the floor in “tattered and filthy blankets”. More commonly, slaves that actually made it to an infirmary off of the plantation were subjected to physician’s active experimentation and research.
Southern medical education’s predisposition for use of black bodies to teach anatomy and be subjects of clinical experiments was dangerous and invasive and led to a major distrust of white physicians among slaves. The exploitation of slave’s bodies for medical knowledge created a horrific doctor-patient relationship that involved a third party: the slave owner. This relationship often left the slave voiceless and deemed “medically incompetent”, therefore taking control of their own bodies away from them.
A major field of experimentation that involved slaves was gynecology under Dr. J. Marion Sims in Montgomery, Alabama between 1845 and 1849. Dr. Sims is known for being a pioneer in the treatment of clubfoot, advances in “women’s medicine”, his role in the founding of the Women’s Hospital in New York, and as the “father of American gynecology”. Sims routinely operated on nine slave women, of which only three are known: Anarcha, Betsy and Lucy. The purpose of the operations was to try and fix conditions called vesico-vaginal fistula and recto-vaginal fistula, i.e. a tear in the vaginal wall resulting in chronic leakage from the bladder. These conditions were common results of childbirth during Sims’ time. However, these conditions do not include symptoms of chronic pain, just discomfort and most likely embarrassment, suggesting that Sims was over exaggerating their conditions to gain a competitive edge over his colleagues.
Betsy, Anarcha and Lucy survived multiple attempts to fix their condition, and although Sims was able to close the fistula, small perforations remained after healing, leakage continued, and often the sutures became infected. It was not until after the thirtieth surgery that Sims was successful on Anarcha. During these surgeries, the women were not under anesthesia, only an ineffective opium that resulted in constipation and nausea instead of anesthetic. After the success of Anarcha, many white women came to Sims to have the procedure, yet none of them endured a single operation, noting the intense pain associated with the surgery.
Dr. Sims also performed other surgical experimentations on slaves, including facial operations. Slave owners came to Sims in last attempt efforts to save their investments. One particular case that was published in the American Journal of Medical Sciences involved a slave named Sam whose owner thought he had a gumboil on his face that was a result of syphilis medication. Surgery was attempted on Sam before by another physician, but was unsuccessful because “at the first incision…Sam had leaped from is chair and absolutely refused to submit to further cutting”. Sims knew of the attempted surgery and was “determined not to be foiled in the attempt” of his own. Sims attempted to dissect the patient’s jaw-bone over the course of a forty minute operation. In this time, Sims removed a tooth to make room and after unsuccessful attempts with a “small, long, narrow saw” and “Liston’s bone forceps”, Sims resorted to the chain-saw to remove the diseased bone. Infirmaries, like Sims’, allowed physicians to be successful businessmen in the slavery based southern economy, but also to create professional reputations as clinical medical researchers.
- Kiple, Kenneth F.; Himmelsteib King, Virginia. Another Dimension to the Black Diaspora: Diet, Disease and Racism. Cambridge University Press. pp. 80–100.
- Smith, Simon; Martin Foster (December 2011). "The Hazards of Slavery". Significance. 4. 8: 180. doi:10.1111/j.1740-9713.2011.00526.x.
- McBride, David (September 2005). "Slavery As It Is: Medicine and Slaves of the Plantation South". OAH Magazine of History. no. 5. 19: 37. doi:10.1093/maghis/19.5.36.
- Savitt, Todd L. (September 2005). "Black Health on the Plantation: Owners, the Enslaved, and Physicians". OAH Magazine of History. 19 (5): 16. doi:10.1093/maghis/19.5.14.
- McBride, David (September 2005). "Slavery As It Is: Medicine and Slaves of the Plantation South". OAH Magazine of History. 19 (5): 37. doi:10.1093/maghis/19.5.36.
- Stephen C. Kenny; “A Dictate of Both Interest and Mercy”? Slave Hospitals in the Antebellum South. J Hist Med Allied Sci 2010; 65 (1): 1-47. doi: 10.1093/jhmas/jrp019
- Kenny, S. C. (2010-01-01). ""A Dictate of Both Interest and Mercy"? Slave Hospitals in the Antebellum South". Journal of the History of Medicine and Allied Sciences. 65 (1): 1–47. doi:10.1093/jhmas/jrp019. ISSN 0022-5045.
- Kauffman Scarborough, William (April 2006). Masters of the Big House. ISBN 9780807131558.
- Frances Anne Kemble, Journal of a Residence on a Georgian Plantation in 1838–1839 (1863; New York: Meridian, 1975), 69–70. For similar observations, see testimony of the Reverend Dr. Channing of Boston recalling his residence in Virginia and a visit to a very rudimentary plantation hospital, in Timothy Dwight Weld, American Slavery as It Is: Testimony of a Thousand Witnesses (1839; New York: Arno Press reprint, 1969), 44.
- Fett, Sharla M. Working Cures. pp. 142–168. ISBN 978-0807853788.
- Axelesen, Diana E. (1985). "Women as Victims of Medical Experimentation: J. Marion Sims' Surgery on Slave Women, 1845-1850". Sage: A Scholarly Journal on Black Women: 10–13.
- James Marion Sims, “Osteo-Sarcoma of the Lower Jaw—Resection of the Body of the Bone. Cure,” Am. J. Med. Sci., 1846, 7:21, 128–32; “Removal of the Superior Maxilla for a Tumour of the Antrum; Apparent Cure. Return of the Disease. Second Operation. Sequel,” Am. J. Med. Sci., 1847, 13:26, 310–15. The term “heroic” generally refers to major operations undertaken in the era before anaesthesia or antisepsis.
- Postell, William D (1970). The Health of Slaves on Southern Plantations. Gloucester: Louisiana State University Press.
- Dunaway, Wilma A (2003). The African-American Family in Slavery and Emancipation. Cambridge: Cambridge University Press.
- "The Carmichaels and the Health Care of Slaves". Claude Moore Health Sciences Library. University of Virginia. 2005.