Sex, Sickness, and Slavery

Illness in the Antebellum South

Marli F. Weiner, Mayzie Hough

• Publisher: University of Illinois Press
• Year: 2012
• ISBN:
  9780252094071
• Topic: History
• Subtopic: World History
• Index: History

Marli F. Wiener skillfully integrates the history of medicine with social and intellectual history in this study of how race and sex complicated medical treatment in the antebellum South. Sex, Sickness, and Slavery argues that Southern physicians' scientific training and practice uniquely entitled them to formulate medical justification for the imbalanced racial hierarchies of the period. Challenged with both helping to preserve the slave system (by acknowledging and preserving clear distinctions of race and sex) and enhancing their own authority (with correct medical diagnoses and effective treatment), doctors sought to understand bodies that did not necessarily fit into neat dichotomies or agree with suggested treatments.    Focusing on Southern states from Virginia to Alabama, Weiner examines medical and lay perspectives on the body through a range of sources, including medical journals, notes, diaries, daybooks, and letters. These personal and revealing sources show how physicians, medical students, and patients--both free whites and slaves--felt about vulnerability to disease and mental illnesses, how bodily differences between races and sexes were explained, and how emotions, common sense, working conditions, and climate were understood to have an effect on the body.   Physicians' authority did not go uncontested, however. Weiner also describes the ways in which laypeople, both black and white, resisted medical authority, clearly refusing to cede explanatory power to doctors without measuring medical views against their own bodily experiences or personal beliefs. Expertly drawing the dynamic tensions during this period in which Southern culture and the demands of slavery often trumped science, Weiner explores how doctors struggled with contradictions as medicine became a key arena for debate over the meanings of male and female, sick and well, black and white, North and South.

CHAPTER 1

Constructing Race

For mid-nineteenth-century white southerners, race was a biological category so deeply rooted that determining whether the group of people variously called black, African, or Negro were even of the same order of being as those who were white, European, or Caucasian was a fundamental question. Scientists, physicians, clergymen, and more ordinary observers questioned whether God had created all human beings according to one design or whether humans were of different species, the results of separate creations, a belief known as polygenesis. Making a determination between the theories supporting the unity of human beings from the time of creation and those that emphasized racial differences as a result of separate creations was no easy undertaking, in part because the consequences were profound. Those arguing for the unity of the human race from the time of creation generally founded their thinking in Christian teachings and claimed that no matter what the color of their skin or other physical characteristics, all human beings could be saved. Medical and scientific observers, by contrast, tended to argue for racial diversity. They claimed that like horses and donkeys that were distinct types of animals but yet could mate and produce offspring, albeit sterile ones, Negroes and Caucasians were distinct orders of being. They viewed Africans as closer to apes than to Europeans, justifying their position by a variety of scientific observations of skulls, genitalia, and other body parts. Adherents of both positions were convinced of the inherent inferiority of Africans and the superiority of Caucasians. Even those who believed that all peoples were created at the same time agreed that the influence of the environment on subsequent generations had resulted in profound differences.¹

The origins of race were of more than theoretical or political interest for those who were concerned with caring for the sick. If those of African descent were of a different species from Europeans or Americans,² then their bodies experienced disease differently and responded differently to treatment. Not acknowledging the implications of those differences could have serious, even fatal, consequences. As a result, white southern physicians and slaveholders believed it was important to study the disease consequences of differences and to apply that knowledge in ways that would ameliorate suffering and save lives.

Slaves had their own understandings of the origins of race and their implications for bodily suffering. Far less elaborately developed at least in surviving sources than the ideas of whites, slaves’ theories nevertheless sought to explain not just the origins of the visible differences between the races, but also the bodily consequences of those differences. Some of their explanations were built upon Christian imagery, such as those that viewed Africans as the descendants of Ham, cursed but still human. Others referred to God as a baker who burned one attempt at creating humans and undercooked another, resulting in dark and light skins; the implication was that those of mixed race were God’s ideal.³ Whatever their explanation for racial diversity, slaves could not help but be immediately aware of the consequences, legal as well as medical. Slaves recognized not only the close ties between their skin color and subordination, they also knew that their race was vulnerable to physical as well as emotional suffering as a result of that subordination.

Members of both races who sought explanations for and control over suffering and disease had to grapple with the nature of illness itself and its racial context. For whites in particular, this was a problematic undertaking, for explanations of disease causation were very much in flux in the mid-nineteenth century. Medical authorities still spoke of imbalances in the four humors familiar from ancient medical writings, but their explanatory usefulness was compromised by newer ideas that attributed disease not just to the peculiarities of the individual body but also to its race, sex, wealth, housing, diet, work, and location. Diseases did not present the same symptoms or follow the same trajectory from person to person or even in individuals of the same race, sex, or body type.⁴ The individual course of the disease in the body demanded individualized treatment; what was therapeutic for one person was not necessarily so for another. In addition, one disease could easily shade into another, making distinctions even more difficult to determine for physicians hoping to cure their patients’ ills. Physicians sometimes did not even bother to try to name a specific disease in a suffering individual, since diseases and bodies were so specific. If nothing else, allopathic physicians intent on validating their professional credentials could point to this extreme specificity as a means of justifying their own knowledge and importance. Since few generalizations were possible, only experts could determine what was best for the individually suffering body.⁵

At the same time that physicians were bent on coming to grips with the racialized characteristics of bodies, they also needed to find generalizations so that they could build their profession upon an agreed-upon body of knowledge that could be transmitted to students in medical schools. To describe their undertaking as exclusively political or mercenary is unnecessarily harsh, although such factors certainly entered into their deliberations. Mid-nineteenth-century physicians of all sorts were engaged in a wide-ranging struggle for professional definition, and such considerations were unlikely to be excluded from their thinking. Southern physicians, however, were additionally concerned with constructing theories of the body that had explanatory power in the sickrooms of both slaves and whites. In their efforts to do so, they developed theories of race and disease that directly influenced their analysis of individual suffering bodies as well as lay understanding of the meaning of health and illness. The solutions they devised affected individuals’ experiences of illness, the treatment of the sick, and the South’s racial politics.

Physicians’ interest in exploring the differences between black and white bodies was more than simply medical. In addition, physicians sought to claim a place for themselves in the increasingly shrill national debate about slavery. By offering their expertise as impartial observers of immutable biological truths, doctors hoped to demonstrate the inevitability and benefits of slavery and, at the same time, enhance their own reputations. Some might wish to contest the implications of race and the legitimacy of slavery, but southern doctors were united in their belief that the truth could be known by studying the laws of science and nature. While thus positioning themselves above the political fray, doctors insisted on the primacy of race in defining bodies, which allowed them to speak with a new kind of authority in defense of slavery. The success of their efforts to do so, closely tied to strategies for developing their own professional status, inspired yet even more searching for scientific truth in a circular process. While some physicians were able to critique the practices of individual slaveholders and call for a more humane slavery, none was able to recognize the politics that was at the heart of science as they perceived it. Instead, those who sought national recognition for their conclusions about raced bodies and slavery ended up simultaneously defending a particular southern science of medicine, one far less objective than they were willing to admit.

Defining the Differences between Races

Physicians concerned with the bodily consequences of race differences typically grounded their thinking in observation. Empiricism was a common strategy of midcentury medical practice that effectively served the needs of those whose culture and society led them to view race as paramount in explaining human variation.⁶ Confronted with multiple challenges to and defenses of slavery, southern doctors could rarely see beyond race as a way of defining bodies. Instead, they turned their attention to studies of comparative anatomy as a means of determining for themselves the meanings and consequences of race for the body.

Midcentury southern physicians were unlikely to ask themselves whether the differences between whites and blacks were no more than skin deep. To do so would have required them to acknowledge the possibility that slavery was immoral, because the human beings inside those skins were essentially the same. As a group, physicians were quite unprepared to do this, although many called for improvements in the treatment of slaves. Instead, assumptions about race differences were so ingrained as to be beyond question; the only significant issue had to do with the meanings of those differences, not their existence. Their studies of comparative anatomy, then, were built on the presumption that there were significant race differences, differences that led them to consider the medical meanings of race.

Inspired in part by a new scientific interest in accurate measurement, physicians and natural scientists made a variety of efforts to quantify physical difference. Their interest in comparative anatomy was influenced by the work of such men as Samuel Morton and Louis Agassiz, non-southerners whose work was much admired in the South. After studying medicine in Edinburgh, Morton studied fossils and tuberculosis, practiced medicine, taught anatomy at the Pennsylvania Medical College, collected skulls, and became well known among American scientists through his position as corresponding secretary of the Academy of Natural Sciences. At his death in 1851, he had amassed over a thousand skulls. Even more prestigious was Louis Agassiz, the Swiss-born Harvard professor widely acknowledged to be America’s premier scientist. He founded and directed Harvard’s Museum of Comparative Zoology; later he would become the “only major scientific opponent of evolution.” Agassiz’ personal repugnance toward blacks influenced his belief in polygenesis and his theories of racial differences.⁷ He lectured repeatedly in Charleston between 1847 and 1853 and held a chair in comparative anatomy at the Medical College of South Carolina in 1852–53. He thus influenced many southern naturalists, scientists, and physicians to share both his scientific approach to race and his interest in comparative anatomy.⁸

Medical interest in comparative anatomy and racial difference was aided in the 1830s and 1840s by scientific and popular interest in phrenology, which sought to understand personality by reading the shape of individual skulls. While phrenology’s claims to scientific validity were diminished by its reputation as a parlor curiosity, efforts to measure the comparative size, weight, and volume of skulls retained an aura of legitimate science long after the public’s enthusiasm for phrenology had dimmed. Led by Morton, natural scientists collected as many skulls as they could from different races and sought to measure their volume by filling them with sand, millet, pepper seed, or buckshot. As expected, they found that Caucasian skulls were the largest while “Ethiopian” the smallest.⁹ They found it easy to move from measuring skulls to assertions about brain size; smaller skulls could only mean smaller brains and therefore lesser intelligence.

Southern physicians shared this interest in brain size. In 1838, the Southern Botanic Journal, one of the most successful of the Thomsonian¹⁰ journals, reprinted an article by Andrew Combe, a leading theorist of phrenology, in which he argued “that de facto the negro brain is inferior in intellectual power to that of the European.” While Combe grudgingly conceded in response to critics that in some measures the two categories of skulls might appear to be equal, still he concluded that when the parts of the brain that mattered most for intelligence were measured, Europeans enjoyed “a decided superiority … over the negro.”¹¹

In addition to measuring skulls, those determined to prove white superiority paid close attention to the angle of the face. They argued that the more nearly vertical the plane of the face (orthognathic) from forehead to jaw, the greater the intellect and the more highly developed the category of people. Those whose jaws jutted out and foreheads receded had a more horizontal (prognathic) facial angle and were considered less attractive, less intelligent, and less developed. Proponents of this theory relied on both observations of individual subjects and images of characteristic types, including Greek statuary. Not surprisingly, they found what they expected, although they were never successful in offering a coherent explanation. At best, they argued from history: Because the Greeks were highly developed and had vertical faces while Africans were primitive and had jutting jaws, they assumed a correlation. They appeared not to notice the tautology in their thinking. The most extreme proponents of this view extended the analogy even to animals, sometimes including drawings of chimpanzees, apes, or baboons to demonstrate the similarity between their faces and those of Africans.

As subjects of study, physiognomy, comparative anatomy, and ethnology all sought to explain race differences. As a result, they drew the attention of clergymen and physicians as well as those who would today be considered anthropologists, natural scientists, and sociologists.¹² One of the key voices in the debate belonged to Josiah Nott, who was particularly well known throughout the nation and abroad for his writings on race theory. Nott, a physician, was educated at South Carolina College, the University of Pennsylvania, and in Europe. He practiced first in Columbia, South Carolina, and then in Mobile, Alabama. Deeply interested in science and natural history, Nott argued in a series of articles and books published from the mid-1840s to the late 1850s and beyond that blacks and whites were the result of separate creations. His racial theories were influenced by his medical training, but Nott was not primarily concerned with the medical consequences of racial differences. His concerns were more related to classifying humanity and refuting the clerical position regarding the unity of human creation than about the specifics of medical care. Nott argued that blacks and whites were created separately and amounted to separate species; mulattos¹³ were, in his view, a hybrid species sharing characteristics of both parent races.¹⁴ His writing, and those of others who shared his concerns, would set the stage for an extensive debate regarding comparative anatomy and race differences. While Nott sometimes appeared to present his views in the most obstreperous manner possible in order to goad his clerical opponents, his views were taken seriously by many physicians and laypeople who saw in them convincing explanations for race differences.

Nott published widely in the medical journals of the day while sustaining a busy and lucrative medical practice. His chief work, published jointly with the peripatetic lecturer George Gliddon, was Types of Mankind; or, Ethnological Researches, published in 1854. An immediate sensation, the book secured Nott’s reputation as a racial theorist. Here and elsewhere, Nott argued that the Bible’s account of the creation of Adam and Eve applied only to Caucasians. Humanity was divided into many different types or races, each biologically distinct and each best suited to the specific geographic area in which it had first existed.¹⁵ Further, Nott argued, the races of the world were ordered hierarchically, progressing roughly from the darkest-skinned and most geographically southern races to the lightest and most northerly ones. He also considered the implications of orthognathic and prognathic facial angles to be telling evidence of African inferiority to other races. Types of Mankind contains dramatic images of these differences and features a foldout engraving that places African skulls on a continuum alongside those of animals. Perhaps most important, Nott claimed to base his conclusions on the inescapable foundation of scientific fact, independent of theology or the chronology of human history offered in the Bible.¹⁶

For Nott, the key questions for scientific inquiry concerned the “primitive organic structure of each race,” its “moral and psychical character,” how it was “modified by the combined action of time and moral and physical causes,” and its “position in the social scale” as assigned by Providence. He argued that race differences were both original, dating from the Creation, and permanent. The history of the world showed “that human progress has arisen mainly from the war of races.” He had no doubt that some races were superior, others far inferior.¹⁷

In his effort to be precise and scientific, Nott refused to posit a direct relationship between climate and the world’s diversity of races, but he did argue that “a black skin would seem to be the best suited to hot climates” while “the strictly white races lie mostly in the Temperate Zone, where they flourish best.” According to Nott, the Caucasian races have “the largest brains and the most powerful intellect … [and] are by nature ambitious, daring, domineering, and reckless of danger”; only they “have extended over and colonized all parts of the globe” in order to “carry out their great mission of civilizing the earth.” Nott described the many varieties of Caucasians to be found in Europe, the eastern Mediterranean, and Egypt, tracing their histories as far back in time as he could.¹⁸

Nott similarly described the “African types,” which were “as varied as those of Europe or ...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Contents
• Acknowledgments
• Introduction: The Political Body
• 1. Constructing Race
• 2. Constructing Sex
• 3. Placed Bodies
• 4. Ambiguous Bodies
• 5. The Examined Body
• 6. The Unexamined Body
• 7. The Diseased Body
• Conclusion: The Body Politic
• Notes
• Index