African American Medicine in Washington, D.C.

Healing the Capital During the Civil War Era

Heather Butts

• Editore: The History Press
• Anno: 2014
• ISBN:
  9781625851895
• Argomento: History
• Categoria: African American History

The true story of the black doctors and nurses who tended to Civil War soldiers in the capital. Just as African Americans fought in defense of the Union during the Civil War, African American nurses, doctors, and surgeons worked to heal those soldiers. In the nation's capital, these brave healthcare workers created a medical infrastructure for African Americans, by African Americans. Preeminent surgeon Alexander T.Augusta fought discrimination, visited President Lincoln, testified before Congress, and aided the war effort. Washington's Freedmen's Hospital was formed to serve the District's growing free African American population, eventually becoming the Howard University Medical Center. These physicians would form the National Medical Association, the largest and oldest organization representing African American doctors and patients. This book recounts the heroic lives and work of Washington's African American medical community during the Civil War.

1

AFRICAN AMERICAN HEALTHCARE PROVIDERS AND PATIENTS IN D.C. PRIOR TO THE CIVIL WAR

While the majority of African American healthcare providers’ D.C. stories began during the war, some of them had contact with the city before the conflict. This chapter examines those providers as well as the overall state of African American healthcare before the war, particularly in D.C.

Washington, D.C., was an interesting town prior to the Civil War. In 1830, over half of the African Americans in Washington, D.C., were free. By 1850, free African Americans outnumbered enslaved African Americans by two to one. D.C. had “black codes” regulating the conduct and opportunities that were available to free African Americans.

The first black codes were instituted in 1808 and involved curfews that resulted in fines of five dollars. Unpaid fines resulted in individuals being whipped. Black codes increased in harshness in 1812 when fines increased to twenty dollars and unpaid fines were punished with six months’ jail time. African Americans in D.C. were subject to 10:00 p.m. curfews and morality laws, such as being unable to gamble, play cards or curse in public. African Americans in D.C. had very few political rights, could not testify against whites in court and had to carry documents confirming their status as free individuals at all times.¹ In 1821, additional codes were imposed on free African Americans. Black codes hindered but did not prevent a number of African Americans from prospering as restaurant owners and merchants. Others worked at a variety of trades and service occupations, including bricklayers, painters, shoemakers, nurses and physicians.²

The D.C. Compensation Act of April 16, 1862, ended slavery in D.C. and freed over 3,100 enslaved individuals. The act also reimbursed slave owners and offered newly freed slaves money to emigrate to other countries.³ In 1800, 25 percent of D.C.’s population was African American, and the vast majority of them were enslaved. Slaves also earned freedom in D.C. through the death of slaves’ owners who granted freedom in their wills.⁴ These numbers grew with time, and as African Americans labored on projects like building the White House and Capitol, they were able to buy their freedom and live in D.C. as free men and women. Thousands of slaves fled to D.C., and consequently, the Contraband Camp in D.C. was established. Historian Jill Newmark described the hospital:

On a parcel of swampy land in northwest Washington, D.C. bounded by 12^th, 13^th, R and S streets, NW, a tented camp and hospital once stood that served thousands of escaped slaves and black soldiers during the Civil War. Known as Contraband Camp, it contained one of the few hospitals that treated blacks in Washington, D.C. during the war and whose staff including nurses and surgeons, were largely African American.⁵

According to Elizabeth Keckley, dressmaker and confidante to first lady Mary Todd Lincoln:

They came with a great hope in their hearts, and with all their worldly goods on their backs…the north is not warm and impulsive. The bright joyous dreams of freedom to the slave—faded—were sadly altered in the presence of that stern, practical mother, reality. Poor dusky children of slavery, men and women, of my own race—the transition from slavery to freedom was too sudden for you.⁶

Among the issues faced by free African Americans were 10:00 p.m. curfews and morality laws seeking to legislate their behavior. With the influx of so many African American “contrabands” to Washington, D.C., shelters were constructed, first on Capitol Hill, then the U Street Corridor and eventually in Arlington County. Services such as education and healthcare began and recruitment of service members took place.⁷

It was in the face of this that healthcare issues, with respect to African Americans, surfaced. Many of these issues had their inception in slavery and in the transition for African Americans from a system of servitude to a status of freedom. This transition was more difficult for some than others and particularly difficult in a city such as Washington, D.C.

HEALTHCARE OF AFRICAN AMERICANS IN D.C.

The toll that slavery took on both the slaves that endured the system and those who propagated it is incalculable. Information on the health of African Americans before the war is available by looking at the health of African Americans who enlisted in the war. It is critical to understand the health status of African Americans prior to the war in order to understand their health outcomes during the war.

According to English legal academic and author Edward Strutt Abdy, who visted Washington in the 1830s:

One day I went to see the slave pen—a wretched hovel “right again” the Capitol, from which it is distant about half a mile, with no house intervening…At a small window above, which was unglazed and exposed alike to heat of summer and the cold of winter, so trying to the constitution, two or three sable faces appeared, looking out wistfully to while away the time and catch a refreshing breeze; the weather being extremely hot.⁸

The hardships that African Americans had to endure while living in slavery through the 1850s took a physical and psychological toll on their health. Additionally, as African American slaves in Washington, D.C., became older and sicker, their utility lessened, and they were often reduced to begging for money to earn their keep. The usefulness of a slave was in his or her ability to be productive, and that meant being as healthy as possible, under the circumstances.

Factors such as a poor living standard, the amount and level of work and the lack of access to healthcare led to high mortality rates for slaves.⁹ According to the 1850 census, the average age of death for African Americans was 21.4 years as opposed to 25.5 years for whites. In 1860, 3.5 percent of slaves and 4.4 percent of whites were over the age of sixty.¹⁰

All experiences slaves had with a doctor or nurse were under the control of their owner. Physicians often had a contract with the slave owner to care for all the slaves on a plantation. The most obvious difference between healthcare for whites and slaves was that slaves did not have control over their own bodies. Moreover, the slave “body” was the economic engine that kept the southern economy in place. It was up to the slave owner to decide, in conjunction with the doctor, the medical course of treatment for that slave. Slaves had to report all illnesses to their owners. This, in turn, created an interesting paradox where slaves who became ill would often try to self-medicate with herbs or roots. If the illness persisted, they were forced to tell their owner of the sickness and that they had self-medicated. This would often be an indication to the owner that the slave had little interest in his or her own health or the health of his or her children. Exacerbating the healthcare problems for many slaves was that they lived in close quarters and were exposed to parasites, bacteria, human waste and garbage.

It is important to chronicle the healthcare of slaves during slavery because it is within this context that many intergenerational disease processes were inherited from African Americans in the 1800s, both for free African Americans and slaves. Under this umbrella of healthcare of slaves, we can transition to examine healthcare for African Americans during the Civil War.

It does appear that there was a cohort of African Americans, namely older slaves, that had, if not better, at least comparable health outcomes to their white counterparts. There are several reasons for this.¹¹ First, older slaves were those who had been able to avoid deadly childhood and midlife illnesses and life-threatening accidents. They might have developed a healthcare-coping mechanism that allowed them to successfully reach old age. If a slave reached a mature age, it was financially wise to keep the slave healthy and alive, either for work or sale.¹² Slaves also developed mechanisms of keeping older slaves healthy.

The psychological impact of slavery cannot be denied. The lack of mental health services for African Americans in the 1800s has led to a “legacy of neglect” for African Americans’ mental health issues today.¹³ This, coupled with the psychological trauma that African Americans went through during slavery, led to generational tension with mental health and treatment. During the 1800s, the main mental health diagnoses for all individuals were melancholy, mania, dementia and idiocy. For slaves however, drapetomania and dysaethesia aethiopicia were the diagnoses of choice.

Drapetomia, characterized by being sulky and dissatisfied, often “resulted” in slave escape and runaway situations. Many of these diagnoses were premised on the notion that slaves were unjustifiably dissatisfied with their place in life and irrationally decided to run away from a perfectly good slave master and home where they were taken care of.¹⁴

Dysaethesia aethiopicia was defined as mischief, poor work habits or destruction of property. According to Tony Lowe, while environmental factors were attributed to mental health issues of whites in the 1800s, social inferiority and biological defects were the etiology many attributed to African Americans’ mental health issues. Some doctors even suggested that slavery helped to ameliorate such inherent mental health issues.¹⁵ The stigma attached to slaves, coupled with a need to justify the institution, led to such notions.

The slave narrative entitled The Life of Gustavus Vassa tells the story of how slave masters neglected and cruelly treated slaves.

One Mr. D—— told me he had sold 41,000 negroes and he once cut off a negro-man’s leg for running away. I asked him if the man had died in the operation, how he, as a Christian, could answer, for the horrid act before God…He…said that his scheme had the desired effect—it cured that man and some others of running away.¹⁶

The narrative goes on to describe the health of slaves, stating:

Another negro-man was half hanged, and then burnt, for attempting to poison a cruel overseer. Thus by repeated cruelties, are the wretched first urged to despair, and then murdered, because they still retain so much of human nature about them as to wish to put an end to their misery, and to retaliate on their tyrants! Their overseers are, indeed, for the most part, persons of the worst character of any denomination of men in the West Indies. Unfortunately, many humane gentlemen, but not residing on their estates, are obliged to leave the management of them in the hands of these human butchers, who cut and mangle the slaves in a shocking manner, on the most trivial occasions, and altogether treat them, in every respect, like brutes. They pay no regard to the situation of pregnant women, nor the least attention to the lodging of the field negroes. Their huts, which ought to be well covered, and the place dry where they take their short repose, are often open sheds, guilt in damp places; so that, when the poor creatures return tired from the toils of the field, they contract many disorders, from being exposed to the damp air in this uncomfortable state, while they are heated, and their pores are open. The neglect certainly conspires with many others to cause a decrease in the births as well as in the lives of the grown negroes.¹⁷

From a public health perspective, there is a question about the health of African Americans as they entered the war. How does one quantify the level of health for this population? One way to do this would be childhood health. Another way would be by using height indicators. In A Peculiar Population: The Nutrition, Health, and Mortality of American Slaves from Childhood to Maturity, Richard H. Steckel does an exhaustive review of the height and mortality data of slaves.¹⁸

In 1807, Congress passed legislation requiring ship captains to describe each slave based on name, age, sex, color and height.¹⁹ Because the need for good nutrition increases dramatically during adolescence, it is instructive to identify the average age of growth spurt in the slave population. It appears that the peak of the adolescent growth spurt for female slaves was 13.27 years and for male slaves 14.75 years, approximately 1–1.15 years behind that of averages for individuals, regardless of race, during that time period.²⁰ It is clear that young slave children were well below the expected height levels. But there is an interesting phenomenon with slaves as they matured—they essentially made up for their height disparities in their teenage years and into adulthood.²¹

Slaves caught up with respect to growth. By age sixteen and a half, for example, American male slaves were taller than factory workers and laboring classes in England, factory workers in Russia and German peasants.²²

It is provoking to think about the seeming incongruity between childhood height rates and adolescent growth spurts among slaves. Why were slave children so small? Much of this can be traced to birth rates and birth weights. Slave newborns, on average, weighed five and one-half pounds. Once born, these infants had a poor diet after breast-feeding, which led to high infant mortality and sickness rates. If a baby made it through infancy, then he or she had to deal with a poor diet as a child. Slave masters focused on working slaves and their diets, not the children’s. Slave owners did a cost-benefit analysis: If slave children made it into late childhood and early adolescence, the return on investment at that point was worth the money to the slave masters.²³

Th...

Indice dei contenuti

• Front Cover
• Half Title
• Title Page
• Copyright
• Dedication
• Contents
• Foreword
• Preface
• Acknowledgements
• 1. African American Healthcare Providers and Patients in D.C. Prior to the Civil War
• 2. Unique Healthcare Issues of African American Soldiers and Prisoners of War
• 3. African American Healthcare Providers in D.C. During the Civil War
• 4. African American Healthcare in D.C. after the Civil War
• 5. African American Healthcare Providers in D.C. after the Civil War
• Epilogue
• Notes
• Bibliography
• About the Author