Secret Cures of Slaves

People, Plants, and Medicine in the Eighteenth-Century Atlantic World

Londa Schiebinger

• Publisher: Stanford University Press
• Year: 2017
• ISBN:
  9781503602984
• Edition: 1
• Topic: Storia
• Subtopic: Primordi della storia moderna

In the natural course of events, humans fall sick and die. The history of medicine bristles with attempts to find new and miraculous remedies, to work with and against nature to restore humans to health and well-being. In this book, Londa Schiebinger examines medicine and human experimentation in the Atlantic World, exploring the circulation of people, disease, plants, and knowledge between Europe, Africa, and the Americas. She traces the development of a colonial medical complex from the 1760s, when a robust experimental culture emerged in the British and French West Indies, to the early 1800s, when debates raged about banning the slave trade and, eventually, slavery itself.

Massive mortality among enslaved Africans and European planters, soldiers, and sailors fueled the search for new healing techniques. Amerindian, African, and European knowledges competed to cure diseases emerging from the collision of peoples on newly established, often poorly supplied, plantations. But not all knowledge was equal. Highlighting the violence and fear endemic to colonial struggles, Schiebinger explores aspects of African medicine that were not put to the test, such as Obeah and vodou. This book analyzes how and why specific knowledges were blocked, discredited, or held secret.

Chapter 1

THE RISE OF SCIENTIFIC MEDICINE

Real experiments . . . tend to make medicine as certain as most other sciences.

—Francis Home, royal physician and professor at the University of Edinburgh, 1782

IN THE NATURAL COURSE OF EVENTS, humans fall sick and die. The history of medicine bristles with attempts to find new and miraculous remedies, to work with and against nature to restore humans to health and well-being.

Modern medicine has fixed its own birth at the end of the eighteenth century. This period saw the rise of clinical medicine that overthrew theoretical systems in favor of practical empiricism. New teaching hospitals provided students with systematic bedside observation coupled with hands-on training. Clinical medicine, including testing on humans, began to emerge in Europe in the 1750s. Modeled on Hermann Boerhaave’s twelve-bed (six men and six women) teaching ward at Leiden’s St. Caecilia Gasthuis, clinical training was implemented in Edinburgh (1741), Vienna (1753), and Pavia (1771). Edinburgh professor James Gregory, writing of these developments in 1803, noted that the word clinical derived from the Greek word cline, which signifies a “bed,” and related properly to bedside medical lectures. “By a natural and almost inevitable latitude of speech,” he continued, this word was “extended to the patients whose cases are the subjects of those lectures, to those wards of the Hospital in which these patients are entertained, and even to the Professors who read those lectures.”¹

These hospitals, attending the “deserving poor,” offered clinicians large numbers of patients suffering from a broad cross section of diseases along with ready possibilities for autopsy. French anatomist Félix Vicq d’Azyr, in his 1790 Nouveau plan de constitution pour la médecine en France, set aside a division for the treatment of patients with rare diseases on whom physicians could “do research.” As historians Laurence Brockliss and Colin Jones have emphasized, hospitals—institutional spaces equivalent to astronomers’ observatories or physicists’ laboratories—provided potentially closed, controlled spaces where physicians could “scrutinize, investigate, and experiment upon the bodies of the sick poor, untrammeled by any outside interference, natural or human.”²

Francis Home, clinical professor in Edinburgh, judged that “nothing, at present, more distinguishes civilized from barbarous nations than the institution of hospitals for the relief of the sick.” Home labeled his treatment of these patients “experiments.” In clinical wards in particular, Home explained, a physician can “try different and new methods of cure.” Remedies, he continued, “exhibited in such diseased states of the body, and the effects resulting from their operation, when accurately and faithfully described,” are “real experiments.” Home documented his use of different drugs in particular illnesses, the specific dosages used, modes of treatment, and results. His purpose, like that of his colleagues, was to “ascertain the effects and value of several remedies in general use, and to discover new relations in others.”³

When we look at medicine in this period, however, it is important not to fetishize “human experimentation.” In the eighteenth century, as today, even the simplest medical act could theoretically and practically entail some exploration and testing of remedies. Medical testing was not (is not) always something set apart from everyday medical practices. As the great nineteenth-century experimentalist Claude Bernard wrote, “Physicians make therapeutic experiments daily on their patients, and surgeons perform vivisections routinely on their subjects.”⁴ Therapeutic experiments are often attempted when commonly used medicines fail and in desperate situations.

Like many before him, Home’s colleague, James Gregory, distinguished between simple “observation” and “experiment” in medicine. Observation is the “remarking of any event or change which occurred from natural causes, and without any human contrivance.” Experiment, by contrast, is “every change produced by human contrivance.” Medical practice necessarily, he noted, includes treatment—or a contrivance. Medical practice is therefore “not only a system of experiments, but a constant series of precarious experiments; some of which approach near to certainty, but others are far removed from it.” Today we might distinguish between case reports, observational studies, and controlled, triple-blind clinical trials.⁵

The value of civilian hospitals for “promoting the practice of medicine” was great; the value of military and naval hospitals—whether in Europe, on board ships, or scattered across Europe’s far-flung colonies—was even greater. Military hospitals were sites of experimentation par excellence. Brockliss and Jones have argued that “sick soldiers within military hospitals were the first group of hospital inmates to be utilized systematically as medical guinea-pigs: for scientific motives, but also for profit.” In the face of sick and dying soldiers and sailors—especially in the new disease environments of the East and West Indies—physicians were pressed to develop a small number of effective drugs that they could employ in the field without observing the niceties of lengthy preparations and individual constitutions. This involved bedside observation and active testing of economical mass remedies in ways that normal conventions of private practice inveighed against. Historian Mark Harrison has noted that British military and naval surgeons found it “far easier” to obtain corpses for dissection and autopsy than their civilian counterparts, and this was especially true in tropical colonies, such as India or the West Indies, where death rates were many times higher than in Europe.⁶

If European urban and military hospitals were sites of experimentation, what about plantation hospitals in the West Indies? Were enslaved Africans, concentrated on New World plantations, guinea pigs for eighteenth-century medicine? One might imagine that this captive population supplied ample bodies for testing new therapies.

EXPERIMENTATION IN THE WEST INDIES

For European physicians working in the colonies, experimental empiricism was the method of the day. John Hunter, superintendent of the military hospitals in Jamaica from 1781 to 1783, famously supported the experimental method. Hunter rejected all accounts of cures except those that “fell under [his] own observation.” He was convinced that physicians who contented themselves only with those things they saw with their own eyes “will perform a work more likely to be useful towards the improvement of knowledge.”⁷

French colonial practitioners shared this view. Jean-Barthélemy Dazille, royal physician and inspector of hospitals in Saint-Domingue from 1777 to 1783, condemned those who wrote treatises based on “hypotheses” and “dreams.” Dazille’s own work, drawn from twenty-five years of labor throughout the French empire, employed “daily experience” and close observation. Dazille considered medicine a “science of facts and experience.” Dazille’s countryman working in Cayenne, Bertrand Bajon, too, based his work on “experience” and “observation,” although he bemoaned the fact that, in the colonies, he did not always have the facilities necessary for proper research.⁸

In Europe, medical experimentalists were primarily university professors who recorded and published their findings for learned colleagues at home or abroad. Francis Home in Edinburgh, for example, synthesized and reported key findings based on six years of clinical observations and experiments. To give the experiments the “utmost degree of certainty,” he wrote, “the day of the month, and the year in which the patients were received into the clinical ward, are constantly marked; so that any person may consult the cases in the clinical report-books, kept in the Infirmary, where he will find them at full length, as they have here been much shortened.”⁹

In the colonies, British experimentalists were by and large plantation physicians and surgeons in the pay of estate owners. These young men arrived in the islands with introductions to men of good standing in hopes of establishing a private practice. The more entrepreneurial of them developed partnerships and eventually became wealthy enough to purchase plantations of their own or to retire to Britain. Relatively few published anything. These doctors worked long hours riding horseback great distances from plantation to plantation. To secure a living they might be on call for the care of five thousand souls. A plantation practice, Jamaican physician John Williamson wrote, took great “bodily health, vigour, and spirit” and left little time for writing. Thomas Fraser, working in Antigua, similarly noted that “we of the profession are on these occasions [of epidemic] so much on horseback, that for my own part, while at home, I could hardly muster up spirits to put pen to paper.” Despite these hindrances, medical men were keen to publish their results, and many did so later in life. Williamson, for example, penned a hefty two-volume treatise on his experience in the West Indies after returning to Britain in 1812. And Fraser, who reported having no time for reflection, recorded his observations with such enthusiasm that he produced “a dissertation where a letter was only intended,” and that, he noted, “on a pretty abstruse subject.”¹⁰

French colonial experimentalists who set pen to paper were, by contrast to their English counterparts, royal physicians commissioned and pensioned by the government. In Saint-Domingue, Jean-Baptiste-René Pouppé-Desportes, for example, noted that he had made little progress in therapeutics until he was appointed to the Hôpital de la Marine in Cap-Français, the capital city (figure 4). He wrote that the hospital was filled with people from such diverse backgrounds that he could follow the consequences of “general and particular” treatment in “each national type.” Bertrand Bajon, working several decades later in Cayenne, wrote with the finesse of an anthropologist about his medical encounters with persons of European, African, and Amerindian origins.¹¹

Importantly, the West Indies had little experimental infrastructure—no teaching hospitals, no medical journals, and few learned societies. The American Philosophical Society was founded in 1743 in Philadelphia, and, although after 1765 a few students from the British West Indies studied at the Medical School of the College of Philadelphia, few Caribbean physicians became members. Learned societies and local journals came late to the West Indies. In Saint-Domingue, the Gazette de médecine pour les colonies began publication in 1778 (subscriptions cost sixty-six colonial livres per annum). The journal ran only eight issues (a total of fifty published pages) and was forced to shut down in 1779 when the price of paper in the colonies skyrocketed. The Cercle des Philadelphes was famously founded in Saint-Domingue in 1784 but was forced to close its doors in 1792 amid the chaos of revolution. The Kingston Medical Society, formed in 1794 to combat a malignant fever that “baffled the power of Medicine for many months,” was defunct by 1832. No scientific journals were established in Jamaica until the 1830s. The editor of the first issue of the Jamaica Physical Journal remarked that “it is somewhat strange, if not a reproach, that, amongst the various publications which have, from time to time, issued from the Jamaica Press, no periodical has ever emanated from the Medical Community.” The Jamaican College of Physicians and Surgeons was founded only in 1833, which meant that throughout the eighteenth century the focal point for organized medical research remained in Europe. As a result, West Indian experimentalists were tightly tied into the trans-European community of drug testing. As we shall see, colonial physicians trained in Europe; they answered queries from European colleagues, corresponded with members of European learned societies, and for the most part published their results in established European journals. After 1770, some colonial physicians in both Jamaica and Saint-Domingue published books with local printers.¹²

Figure 4. Cap-Français, Saint-Domingue, 1779. Cap-Français was a hub of the French medical complex.

It is impossible to know how many doctors in the Caribbean islands experimented with new remedies or techniques without recording their results. Jamaican surgeon Benjamin Moseley noted that resident practitioners in the West Indies possessed the best treatments for that island. He regretted that “much knowledge of medical art” died with them because hot climates so enervated the mind and body to inaction.¹³

As noted in the Introduction, it is tempting to see experimentalists as European-trained physicians—those working in either Europe or its colonies. This, however, is only part of the story. Amerindian and African cures were much sought after, throughout the eighteenth century, precisely because of their effectiveness. It should be kept in mind that many of the new cures tested according to European protocols had Amerindian or African origins. Colonial missionaries, planters, merchants, and soldiers in the West Indies were often afflicted by illnesses completely unknown to Europeans. In these desperate situations, physicians discarded the costly and often ineffective drugs shipped from Europe and employed instead tropical remedies offered by “the naturals of the country whom one calls savages” (the Caribs).¹⁴

THE SCIENCE OF SKIN COLOR, OR THE PHYSIOLOGICAL NICETIES OF RACE

Slavery in the Americas was race based, and it is important to analyze how race was conceptualized and deployed in Atlantic World medical testing. In the twentieth and twentieth-first centuries, race has referred strongly to physical differences—differences in hair type and skin color, nose and lip shape, and genetic codes. The intense modern focus on the physical aspects of race has privileged the history of physical anthropology, or, as it was called in the eighteenth century, the “natural history of man,” as encompassing the history of race. Historians of science have traced the origins of modern concepts of race (and scientific racism) to the French physician and traveler François Bernier (1684) and the great eighteenth-century naturalist...