Doctoring Freedom

The Politics of African American Medical Care in Slavery and Emancipation

Gretchen Long

• Publisher: The University of North Carolina Press
• Year: 2012
• Print ISBN: 9781469628332, 9780807835838
• eBook ISBN: 9780807837399
• Topic: Social Sciences
• Subtopic: North American History
• Index: Social Sciences

For enslaved and newly freed African Americans, attaining freedom and citizenship without health for themselves and their families would have been an empty victory. Even before emancipation, African Americans recognized that control of their bodies was a critical battleground in their struggle for autonomy, and they devised strategies to retain at least some of that control. In Doctoring Freedom, Gretchen Long tells the stories of African Americans who fought for access to both medical care and medical education, showing the important relationship between medical practice and political identity.
Working closely with antebellum medical journals, planters' diaries, agricultural publications, letters from wounded African American soldiers, WPA narratives, and military and Freedmen’s Bureau reports, Long traces African Americans' political acts to secure medical care: their organizing mutual-aid societies, their petitions to the federal government, and, as a last resort, their founding of their own medical schools, hospitals, and professional organizations. She also illuminates work of the earliest generation of black physicians, whose adult lives spanned both slavery and freedom. For African Americans, Long argues, claiming rights as both patients and practitioners was a political and highly charged act in both slavery and emancipation.

Chapter One
When the Slaves Got Sick

Antebellum Medical Practice

In 1856 a brief article by planter and physician W. C. Daniell titled “Health of Young Negroes” appeared in the southern agricultural journal DeBow’s Review. Daniell wrote that, from “recent conversations” with a fellow Louisiana sugar planter, he had learned that “lock jaw” had killed a large number of infants on Louisiana sugar estates. His article was an attempt to share with other planters a postpartum regime that would decrease the incidence of this disease on plantations. The lockjaw, he maintained, had its origin in the breast milk that slave infants ingested in the first ten days of life. Once he had located the source of infant death in African American women’s production of poisonous milk, he devoted the remainder of the article to explanations of his own solution—systematic deprivation of mother’s milk. He recommended feeding the newborn “on sweet oil and molasses in such proportions as to keep the bowels loose” and having “the mother’s breasts freely drawn and daily emptied of their milk . . . in any one of several ways; by the nurse, the midwife, another and older child, or by a puppy.”¹

Stories of the inhumane treatment of slaves during the antebellum period in the American South are familiar to most Americans. For our study of African Americans’ health care during the decades after the Civil War, it is important to consider the specifics of treatments endured by slaves in the name of health care just a few years earlier. Even more important for our consideration, however, are the slaves’ own medical undertakings and the ideology underlying the owners’ actions. Both the day-to-day efforts of African American slaves to resist their owners’ control over their bodies and the theories that supported harsh policies of slave management left a legacy that lasted long into freedom. Actions taken by the slaves in an effort to preserve their own health became a part of their collective memory and culture and furnished a context for African Americans’ organized efforts to obtain health care after emancipation.

While the advice given to plantation owners in agricultural journals and other writings purported to be merely practical, with articles on slave management appearing alongside advice on animal husbandry and crop cultivation, such articles necessarily had an ideological foundation. In many cases, to accept the journals’ advice about health care for slaves, the owners had to believe that the slaves on their plantations were basically different from themselves. During the antebellum period, as slave owners found themselves increasingly under attack by abolitionists, the role of ideology broadened from support of slave management to the defense of slavery as a system, and physicians, clergy, economists, and social commentators joined the debate with theories about the nature of people of African descent.

Theories and propaganda on both sides of the debate about slavery focused on the aspect of a slave that was of greatest economic value—the body. Slave owners pointed to their self-interested care for the slave’s body, which provided labor for the planter’s field, ready cash if sold, and in the case of a female slave, infants to replace laborers who died. Abolitionists used the body of the slave, often bearing scars from beatings and abuse, as a powerful emotional symbol in the campaign against slavery. This debate had importance not only before the Civil War, when the central question was whether to maintain the economic system of slavery or abolish it, but also for decades after emancipation, as ideas formed during the antebellum period continued to affect profoundly the lives of African American citizens.

Dr. W. C. Daniell’s plan for newborns, as outlined in “Health of Young Negroes,” left no room for decision-making by the slave mother or the slave community. Slaves, however, did exert some control over their health care in spite of the formidable obstacles posed by the slave system. Reluctance or outright refusal to comply with the medical demands of a master was one way in which slaves wrested some control of their bodies and lives away from owners. Another means of retaining control came from African American healers, many of whom were nurses and midwives who cared for fellow slaves. While Daniell assumed that the slave owner would control the health regimen of a newborn infant, he offered no guidance on how to manage effectively the treatment plan of separating mother and infant. Taking it for granted that slave owners would be closely involved and omnipresent in the hours directly after a birth, he assumed that the master’s authority and involvement would extend uninterrupted through the first ten days of the infant’s life. The article mentions the nurse or midwife only as one who might empty the mother’s breasts. It ignores the possibility that a slave nurse might, when ordered under Daniell’s regime to remove a hungry newborn from the mother, refuse or—more likely—merely pretend to take part in this treatment.

White doctors often held African American nurses and their skills in disdain, dismissing their methods as a mixture of crude medical technique and superstition.² In spite of this, black women were often left to tend the seriously ill and to deliver babies. When interviewed in the 1930s about her girlhood in slavery, one woman remembered her grandmother, a midwife who “trained with Indians.” She recalled that her grandmother would deliver babies and then a white doctor would “examine de child and de mother, an ’ee alright, he hold de nurse responsible for any affection (infection) that took place.”³ This midwife, though not trained formally, was entrusted with postpartum care and blamed if anything went wrong with mother or child. The relationship between white doctors and black nurses on plantations, then, provides important context for Daniell’s advice to planters.

Daniell’s article in DeBow’s Review is one example of agricultural advice rooted in a theory that the bodies of African Americans are different from those of whites. Daniel did not propose his regimen for combating lockjaw as a solution for people in general—only for slaves on plantations. Journals like DeBow’s presented health regimens like that recommended by Daniell, who was himself both a physician and a slave owner, as based on scientific findings. On the surface, the article attempted to address a real problem. Although the overall slave population was reproducing itself by the 1850s, demographic analyses bear out the truthfulness of what Daniell heard about mortality on Louisiana sugar plantations.⁴ An established doctor, Daniell published a number of articles in standard journals of medicine and a medical monograph on fevers in Savannah.⁵ However, medical publishing in 1856 was radically different from that of our world of double-blind studies and peer-reviewed journals. Antebellum medical practitioners developed theories and cures before the advent of a scientific understanding of germs and contagion. Lacking that sort of intellectual framework, writers like Daniell claimed to rest their medical practice on sound theories that many white Americans of various political persuasions accepted. Although DeBow’s Review, an agricultural and economic periodical, did take an overtly pro-secessionist stance in the years leading up to the Civil War, its primary purpose was practical. The planters who read Daniell’s recommended regimen hoped to reduce infant mortality among their slaves; that would be their only motivation for putting his regime into place. At the same time, however, the author’s assumption that slave infant mortality was the fault of black women’s milk, and not due to the living conditions on most plantations, deftly confirmed white southern beliefs about the physical shortcomings of slaves and the innate inability of slave women to mother effectively.

The effect of Daniell’s regime—if it were carried out—on the health and morale of slaves would have been profound. The newborn infant—separated from his or her mother and prevented from suckling—would be fed a nutritionally inferior mixture of molasses and oil. The mother, deprived of her newborn baby, could be forced to nurse an older child or—even more bizarre—a puppy, an ordeal that would have physically inscribed on the slave woman’s body her parity with the owner’s livestock. In addition, Daniell’s prescription would have far-reaching effects on the whole slave community, not only shaping the illness or health of mother and child but also underscoring the degradation that a master’s medical orders could inflict on a slave community.

Faced with owners’ harsh medical practices like the one recommended by Daniell, African American slaves often turned to their own community for help with their ills—whether physical, mental, or spiritual. The care that African Americans provided for one another often rested on understandings of their bodies that were different from those of white doctors. In a sense, these different understandings helped slaves reclaim their bodies from masters’ presumed control and, by extension, from the rule of the larger system of slavery. In providing care to one another, in accepting African American healers and rejecting regimens like the one Daniell recommended, or, as happened most often, in cobbling together medical provisions that drew from a number of sources—white and black, herbal and medicinal, sacred and secular—enslaved people challenged the racial ideology that supported slavery. At the same time, they cemented bonds of community, fellowship, and trust with other slaves.

Slaves in the antebellum South lived in a complicated medical universe. Not only did medical care on plantations entwine with racial hierarchy, but American medicine itself was undergoing a crisis in confidence. In American households, including southern plantations, medical care by trained physicians competed with fads and home cures. A slave owner would decide whether the treatment he provided his slaves would be homeopathic or would be the newer allopathic or “chemical” medicine. For slaves, any decisions they could make about their health care were even more complex. A slave’s protestations of illness or pregnancy might bring a lightened expectation of labor. The illness itself, or that of a close family member, could signal a period of spiritual reflection and healing or alert the patient and family to the evil designs of an enemy. Medical treatment could mean familiar care provided by trusted fellow slaves. On the other hand, it could mean submitting oneself, when weak and vulnerable, to an overseer whose primary goal was discouraging malingerers or to a master who insisted that bleeding and enemas would cure most sickness. Even if slaves believed that the masters’ treatments were effective, they knew when they took them that they were participating in a system that understood their bodies purely in relation to agricultural production. One ex-slave, remembering the castor oil and turpentine that his master dispensed as medicine, recalled that white owners were “as pa’taculah with slave as stock—that was their money, you know.” If the oil and turpentine didn’t work, the same man remembered that “if we was real sick, they had the Doctah fo’ us.”⁶ Regardless of whether cures came from familiar plants, from a slave healer’s rituals, from the overseer’s medicine chest, or from the doctor’s black bag, illness and treatment on slave plantations demarcated lines of community, religious belief, and power.

While most masters considered provision of medical care as falling within their own realm of duty and labor, their slaves often took measures to avoid masters’ treatment. They attempted, within the confines of a largely agricultural and illiterate community, to create a set of medical practices that conceived of African American bodies apart from the dollars-and-cents calculations that informed masters’ understanding and practice. Like most people throughout history, slaves turned first to their own community for cures and treatment. Often community values nurtured by family, religion, and labor practices informed slaves’ understandings of illness, treatment, and death. Far from being ideologically neutral, the slaves’ medical culture, treatment, and recovery from illness reflected and strengthened their values and beliefs about society, the slave system, and cosmology.⁷ Sharla Fett, in her analysis of medical practice in slave communities, terms their medical care “relational”—that is, implicitly linked to connections between the individual and his or her community and physical environment. She contrasts this rubric to the masters’ model based on a notion of “soundness,” which views a slave’s physical health solely in relation to the labor the slave performs and his or her worth in the marketplace. Fett’s useful conception helps to bring medicine into the large constellation of slave practices. The worldview of the enslaved aided them in distinguishing their own medical customs from the treatments that their owners advocated. Given their different perceptions of the body and its relationship to community, to nature, and to the dead, slaves were able to transform their medical care into a meaningful and affirming social practice even when, on the surface, their treatments did not vary significantly from those of overseers and masters.

Just as planters assigned to slaves’ physical illness meanings that were intertwined with economic calculation, with notions of racialist biology, and with the political consequences of that biology, slaves often assigned illness their own meanings that encompassed forces of nature or social bonds and tensions within a social network.⁸ Spiritual wholeness was fundamental to physical health for many slaves, at least in their memories of medical culture on plantations. Many slave narratives written after freedom described the health of the body under slavery as inseparable from the psychological wellness of the wider community, which was influenced by forces of luck, magic, and morality.⁹ Slave healers, familiar with their patients’ natural and social environment, could intervene in the tension between these forces and a person’s own body. Slaves sought root doctors or conjurers not only to heal corporeal ailments but also to deflect and defeat curses and to organize fraught emotional relationships through their treatments. An individual’s healing, then, involved the acquisition of power, not only in breaking down an infection or fever, but also in solidifying and asserting one’s proper place in social relations with both blacks and whites.¹⁰

In many slaves’ belief systems, power—whether it rested with the slave, the slaveholder, or God himself—was a meaningful factor in the social equation of illness. Many slaves melded their beliefs about power and illness into Christian moral cosmology. For example, one former slave described in an interview an illness she contracted after dancing with her husband at a party. She had promised her father on his deathbed that she would never dance so that they could be “candidates together in Heaven.” The sin of disregarding her promise, which she defined in distinctly Christian terms, caused a severe illness. She recalled, “Some time later I got heavy one day and began to die. For days I couldn’t eat, couldn’t sleep, even the water I drank seemed to swell in my mouth. . . . A sight seemed to come down from heaven and it looked like it just split me open from head to my feet.”¹¹ Only a renewal of her covenant with God and Christ saved her from the illness. Often when ex-slaves recalled sickness under slavery, they contrasted different systems of healing and the power inherent in each. One woman remembered how “Doctor Jesus” healed her when white doctors had given up hope. During “a hard spell of sickness,” she wrote, “the doctors said I should not live beyond a certain time, but every time they said so Doctor Jesus said she shall live.”¹²

Many African Americans did recount connections between magic, spirituality, and health, describing in detail the spells they had seen laid on and lifted off family members and neighbors. However, many other African Americans interviewed about their lives in slavery were careful to highlight their disdain for any “magic,” conjuring, or even religious connections to their understandings of health and illness. Reading through the narratives reveals that many were loath to associate themselves with a system that affirmed stereotypical views of African Americans as backward, superstitious, and inherently impervious to the advances of modern science. Washington Dozier, interviewed in 1937 at age ninety, claimed that he “ne’er paid no ’ttention to no black cat en ting like dat. Ain bother with none uv dem charm neither. The peoples use er hab dey own doc’er book and dy search dat en use what it say do.”¹³ Dozier’s memory insists that the listener acknowledge that some slaves were literate enough to read a home remedy guide and deploy the recommended treatment. He summarily dismisses the notion that physical objects like cats, charms, and “ting like dat” could be powerful in diagnosing, causing, or curing illness. Another man reported, “We didn’t believe in hants and laughed at others who were superstitious. The Miller negroes were real smart. . . . Some superstitious negroes wore charms, but we didn’t countenance anyting like that.” This informant, demarcating three systems of healing in the slave world, disassociated himself and the other slaves on his plantation from the healing system of the African American culture—including the reliance on charms ...

Table of contents

• Cover Page
• DOCTORING FREEDOM
• Copyright Page
• Dedication
• Contents
• Acknowledgments
• Introduction
• Chapter One When the Slaves Got Sick
• Chapter Two Sickness Rages Fearfully among Them
• Chapter Three We Have Come Out Like Men
• Chapter Four We Have Come to a Conclusion to Bind Ourselves Together
• Chapter Five No License; Nor No Deplomer
• Chapter Six By Nature Specially Fitted for the Care of the Sufferer
• Conclusion
• Notes
• Bibliography
• Index