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SECRET CURES OF SLAVES

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Londa Schiebinger

SECRET CURES of Slaves people, plants, and medicine in the eighteenth-century atlantic world

stanford university press • stanford california

Stanford University Press Stanford, California © 2017 by Londa Schiebinger. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or in any information storage or retrieval system without the prior written permission of Stanford University Press. Printed in the United States of America on acid-free, archival-quality paper Library of Congress Cataloging-in-Publication Data Names: Schiebinger, Londa L., author. Title: Secret cures of slaves : people, plants, and medicine in the eighteenth-century Atlantic world / Londa Schiebinger. Description: Stanford, California : Stanford University Press, 2017. | Includes bibliographical references and index. Identifiers: LCCN 2016049163 (print) | LCCN 2016051270 (ebook) | ISBN 9781503600171 (cloth : alk. paper) | ISBN 9781503602915 (pbk. : alk. paper) | ISBN 9781503602984 (ebook) Subjects: LCSH: Human experimentation in medicine—West Indies—History—18th century. | Slaves—Health and hygiene—West Indies—History—18th century. | Blacks—Medicine—West Indies—History—18th century. | Traditional medicine— West Indies—History—18th century. | Tropical medicine—West Indies—History— 18th century. Classification: LCC R853.H8 S347 2017 (print) | LCC R853.H8 (ebook) | DDC 610.72/408996073—dc23 LC record available at https://lccn.loc.gov/2016049163

For Robert

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CONTENTS

List of Figures

ix

Acknowledgments

xi

Introduction Medical Experimentation in the Atlantic World

1 4

Human Subjects The Taxonomy of Experiments

5 8

The Colonial Crucible The Circulation of Knowledge The Problem of Sources

12 13 14

The Rise of Scientific Medicine Experimentation in the West Indies The Science of Skin Color, or the Physiological Niceties of Race L’Homme Planté: Place Versus Race

19 21 24 35

2.

Experiments with the Negro Dr’s Materia Medica Bois Fer and the Circulation of Knowledge The African Hypothesis The European Hypothesis The American Hypothesis The Greater Atlantic Hypothesis

45 50 51 57 57 61

3.

Medical Ethics Ethics in Europe: “To Help, or at Least to Do No Harm” Ethics in the West Indies: The Question of Slaves Who Goes First? Experiments with Cold Water Slaves: A Protected Category?

65

1.

66 71 79 86

Contents

viii

4.

5.

Exploitative Experiments

91

Quier’s Smallpox Experiments Thomson’s Yaws Experiments

92 99

Soldiers and Sailors

106

Children and the Poor in Europe Are Bodies Interchangeable? The Medical Context

109 112

The Colonial Crucible: Debates over Slavery

117

Obeah and Sorcery Experiments with Placebos

118 123

Outlawing Slave Medical Practitioners The Professional Exclusion of Gens de Couleur Libres Are Bodies Interchangeable? The Colonial Context

126 130 133

Advocating Better Living Conditions Experiments with Breeding

139 142

Conclusion: The Circulation of Knowledge The European Colonial Nexus The African Slave Trade Nexus The Amerindian Conquest Nexus Agnotology and the Atlantic World Medical Complex

147 147 153 156 158

Appendix: Featured British and French Doctors in the West Indies

167

Notes

169

Bibliography

203

Image Credits

223

Index

225

FIGURES

1. 2.

Atlantic World circa 1774. The West Indies circa 1774.

3. 4.

The circulation of knowledge in the eighteenth-century Atlantic World medical complex. Cap-Français, Saint-Domingue, 1779.

14 23

5. 6. 7.

Analysis of race, Médéric-Louis-Élie Moreau de Saint-Méry. Thermometer circa 1800. The first of Colin Chisholm’s six experimental groups.

27 36 39

Colin Chisholm’s six experimental groups. An early image of yaws. Entry for bois de fer, Jean-Baptiste Pouppé-Desportes. Bois de fer, Jean-Baptiste-Christophe Fusée-Aublet. West Gondwana. Negro Dr as knowledge broker. William Wright (1735–1819). Plan of the hospital for sick slaves, Good Hope Estate, Jamaica, circa 1798. Edward Jenner’s lancet. Burning of Cap-Français. Elisha Perkins’s metallic tractors. The European colonial nexus, the flow of knowledge between Europe and the Americas. The African slave trade nexus, the flow of knowledges, diseases, people, medicines, and plants from Africa to the Americas. The conquest nexus, Amerindian knowledge in the plantation medical complex. Agnotological barriers in the Atlantic World medical complex.

40 53 58 60 61 63 73

8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.

2 3

77 93 118 124 148 154 157 159

ix

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ACKNOWLEDGMENTS

Writing history has changed. Over the years I worked on this book, vast resources became available online. My thanks to the diligent souls whose fingers are at times anonymously captured in the scans as they copy the pages of rare and valuable books, and to the Web designers who have improved the interfaces with these materials over the years. I have nearly an entire century and a half of rare books now downloaded to my own computer— and I can print out, mark up, and make notes on 250-year-old texts! Rather than traveling to Paris, Aix-en-Provence, London, Edinburgh, Jamaica, and beyond, scholars now have valuable texts at their fingertips. Texts can be consulted many times, perused without taking copious handwritten notes, searched, and generally enjoyed. Images are printable. Much can be learned by searching Eighteenth-Century Collections online—what a resource! Although one loses the tactile pleasure of eighteenth-century papers and leather bindings, one does not miss the mold, dust, jet lag, and hours waiting for things to be delivered to the reading-room table. Now one can read Jean-Barthélemy Dazille while taking breaks to do laundry (the benefits— physical and intellectual—of interspersing heavy-duty research and writing with mundane chores should not be underestimated). Nothing, of course, replaces travel to the places where the history was made to experience firsthand the people, sights, sounds, heat, and complexity of various environments. And nothing substitutes for research in the archives and talks with knowledgeable librarians and archivists. Many thanks are due for the making of this book. My imagination was jolted and my learning advanced during my sabbatical year at the Stanford Humanities Center, where new ways of visualizing historical data have sprung up in the past decade. I benefited greatly from my colleagues there—especially Caroline Winterer, Nicole Coleman, Paula Findlen, and Dan Edelstein—who have devised new ways to map the Republic of Letters. “Seeing” data is exciting, and this book represents my first attempts at mapping the circulation xi

xii

Acknowledgments

of people, plants, and medicine in the Atlantic World. None of this would have been possible without my collaboration with Erik Steiner, Codirector of the Spatial History Project at the Center for Spatial and Textual Analysis (CESTA), Stanford University. Erik took my raw concepts and rendered them with visual elegance. Across this entire process, he provided exacting technical skills, frameworks, and guidance along with much good humor. It was difficult reducing what might have been beautifully layered colored images to two dimensions in black and white for print on paper. I might have done a complete Web production (similar to genderedinnovations.stanford.edu), but since this is a history project I have chosen a traditional mode of intellectual conveyance. Books are still wonderful to hold in your hand. My thanks go, too, to the Alexander von Humboldt-Stiftung for support for the research freedom that started this project. Lorraine Daston’s gracious hospitality during my stay at the Max-Planck-Institut für Wissenschaftsgeschichte and the excellent Moral Authority of Nature group made for an auspicious beginning. I thank the National Science Foundation (grant no. 0723597) and the National Library of Medicine, National Institutes of Health (grant no. 1162326), for supporting this work. Any conclusions are mine and do not necessarily reflect the views of the NSF or NLM. A special thanks to Marcella Phillips, National Archives of Jamaica; the very helpful Biodiversity Heritage Library; the Wellcome Library; Drew Bourn, Historical Curator, Stanford Medical History Center, Lane Medical Library; and Mary Munill, Interlibrary Borrowing, Stanford University Libraries. James Delbourgo, James McClellan, and François Regourd offered excellent comments on the manuscript. Other colleagues and audiences also thought along with me throughout the process. These included Mary Pickering, my dear friend from graduate school; Hal Cook and his Early Modern Drug Trade in the Atlantic World Conference, Wellcome Trust Centre for the History of Medicine at University College London; Bernard Bailyn and the International Seminar on the History of the Atlantic World, Harvard University; Theresa Levitt and Deirdre Cooper Owens, who organized the Porter Fortune Symposium on Science, Medicine, and the Making of Race, University of Mississippi; the Historisches Seminar, Johann Wolfgang Goethe-Universität, Frankfurt; and Paula Findlen, who directed the Empires of Knowledge: Scientific Networks in the Early Modern World workshop at Stanford University. A special thanks to the many patient students who read large portions of this book in seminar and offered helpful comments; to Hannah LeBlanc, who helped with notes and bibliography; and to Halley Barnet, who did some last-minute research for me in Paris.

Acknowledgments

Earlier versions of portions of this book have been published elsewhere as “Human Experimentation in the Eighteenth Century: Natural Boundaries and Valid Testing,” in The Moral Authority of Nature, ed. Lorraine Daston and Fernando Vidal (Chicago: University of Chicago Press, 2003), 384–408; “Scientific Exchange in the Eighteenth-Century Atlantic World,” in Soundings in Atlantic History: Latent Structures and Intellectual Currents, 1500–1825, ed. Bernard Bailyn (Cambridge, MA: Harvard University Press, 2009), 294–328, reprinted in Waltraud Ernst, ed., Ethik—Geschlecht—Medizin: Körpergeschichten in politischer Reflexion (Berlin: LIT, 2010), 41–69; “Medical Experimentation and Race in the Eighteenth-Century Atlantic World,” Social History of Medicine 26, no. 3 (2013): 364–82, reprinted in The History of Science, ed. Massimo Mazzotti (London: Routledge, 2015); and “The Atlantic World Medical Complex,” in Empires of Knowledge: Scientific Networks in the Early Modern World, ed. Paula Findlen (New York: Routledge, forthcoming). I thank these journals, editors, and presses for their interest in my work. Finally, to Robert Proctor, Geoffrey Schiebinger, and Jonathan Proctor, as always, my love.

xiii

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SECRET CURES OF SLAVES

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INTRODUCTION These Observations determined me to try some Experiments. —A. J. Alexander, planter, Bacolet, Grenada, 1773

IN 1773, AN EXTRAORDINARY EXPERIMENT

pitted purported slave cures against European treatments in Grenada, a small island south of Barbados, just off the coast of South America (figure 1). The planter Alexander J. Alexander’s experiment with his “Negro Dr’s” “Materia Medica,” as he styled it, reveals how Europeans tested and evaluated what they deemed slave cures. The disease in question was yaws, a bacterial infection that produces horrid ulcers and lesions in its victims and, in advanced stages, excruciating pain, especially in the hands and feet. Yaws thrives in humid, tropical areas where overcrowding and poor sanitation prevail. Needless to say, slaves throughout the West Indies were plagued by it. Planters took note because slaves with yawey feet often could not walk and hence could not work. Jamaican physician James Thomson wrote, “Any proprietor of Negroes is well aware of the loss he sustains from the yaws. . . . The finest looking slave will . . . in a few months become a burden to himself and his master.”1 This book analyzes the eighteenth-century Atlantic World 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. Three questions motivate this work. A first investigates the circulation of knowledge in the Atlantic World. When A. J. Alexander tested his slave’s medicine, what was he actually investigating? African cures transported to the Americas? Remedies developed by Amerindians—Arawaks, Tainos, and Galibis or Kali’na—and transmitted to African slaves, who, unlike Europeans, were familiar with what we today call tropical medicine? Cures developed by plantation slaves in the Americas? Or, by some great twist of irony, cures communicated by the French to the slave via the plantation complex? A second overarching question digs into the ethics of experiments using enslaved bodies. How were human subjects chosen for experimentation? What ethical brakes kept scientific enthusiasm from overwhelming vulnerable populations? 1

2

Introduction

Figure 1. Atlantic World circa 1774. The Atlantic Ocean is not an empty space but alive with winds and currents that influenced merchant shipping lanes, patterns of the slave trade, and, ultimately, the circulation of knowledge among its littoral regions. The currents are broadly circular, allowing European ships passage to Africa, then sweeping them on to Brazil, the Caribbean, and North America before propelling them back to Europe. Plying directly from the West Indies to Africa was nearly impossible.

A third question investigates race and the interchangeability of bodies. What notions of uniformity and variability across living organisms drove the testing of new drugs and medical techniques? Were tests done on white bodies thought to hold for black bodies (and vice versa)? Were male and female bodies considered interchangeable in this regard? We must remember that these were not purely scientific queries but questions fired in the colonial crucible of conquest, slavery, violence, and secrecy. The sun-drenched sugar islands of the West Indies provide a fascinating setting for this study (figure 2). Still in the eighteenth century there was a robust mix of and competition between Amerindian, African, and European diseases, medicines, and practitioners. The West Indies—the string of islands in the Caribbean that constitute the Greater and Lesser Antilles—

Introduction

were embedded in what I call the Atlantic World medical complex. Here I borrow from Philip Curtin’s notion of the “plantation complex.” For Curtin, the plantation complex—stretching from Bahia, Brazil, to Charleston, South Carolina—was an “economic and political order centering on slave plantations in the New World tropics.”2 We add to Curtin’s analysis the medical order that melded people, plants, and their knowledges in the Atlantic World. Europe dominated the medical complex as it did the plantation complex economically, politically, and militarily, yet people, goods, labor, food, timber—and, we will add, disease, knowledge, and medical remedies—moved promiscuously between continents, masters and slaves, and imperial monopolies. Here we examine the dynamics of the Atlantic World and how that larger medical complex shaped experimental practices on the ground in the Caribbean.

Figure 2. The West Indies circa 1774. This book focuses on British territories, including Jamaica, Grenada, and Saint Christopher, and French territories, including Saint-Domingue (renamed the Republic of Haiti in 1804), Guadeloupe, Martinique, and Cayenne in French Guiana. Jamaica and Saint-Domingue were the most valuable eighteenth-century sugar islands and, consequently, hubs of plantation medicine and experimentation.

3

4

Introduction

MEDICAL EXPERIMENTATION IN THE ATLANTIC WORLD

In step with the broader culture of experimentalism that arose across Europe in the seventeenth and eighteenth centuries, physicians in both Europe and its colonies developed new standards for observation and experimentation in medicine. Since antiquity, physicians and healers of all sorts had tried new and untested cures in the regular care and management of patients, and especially in desperate situations. By the late eighteenth century, however, as the historian Andreas-Holger Maehle has shown, medical treatments were increasingly tested according to a set of procedures—what we today call protocols—agreed upon by the European medical community at large. Physicians at the time selfconsciously labeled these procedures “trials” or “experiments,” essais, épreuves, or expériences, and even “controlled experiments” (Regeln [sic] Versuche). Francis Home, royal physician and professor at the University of Edinburgh, wrote in his Clinical Experiments that “real experiments . . . tend to make medicine as certain as most other sciences.”3 While modern medical regimes have deep historical roots, eighteenthcentury experimental practices differed significantly from those of today. Early modern experimental trials were not randomized, and although the historian of medicine Ulrich Tröhler has reported some therapeutic blind trials, they were not double or triple blind. By and large, experiments did not employ placebos, even though what would eventually be called the “placebo effect” was well understood (chapter 5). Physicians sparingly employed statistical or probabilistic statistical methods.4 Historians have begun to rigorously investigate experimentation in the eighteenth century. The canonical experiments are well known: the Newgate Prison experiment in 1721 launched the testing of the smallpox inoculation in Britain; James Lind’s 1747 controlled study of twelve sailors demonstrated that oranges and lemons could prevent and cure scurvy; John Hunter’s 1767 self-inoculation with gonorrheal pus proved that the disease was transmissible; and Edward Jenner’s 1798 experiments established the value of vaccination against smallpox. Historian Rolf Winau has examined to what extent eighteenth-century experimental practices were controlled and repeatable.5 This book examines medical testing with humans in French and British West Indian colonies. Colonial drug testing and human experimentation were driven by physicians’ desire to create scientific medicine. Tropical disease—a  term that arose in this period—was something new to Europeans, and physicians struggled to find cures in the face of massive mortality.6 Thomas Dancer, longtime physician in Jamaica and island botanist, warned that whatever the merit of medical books imported from Europe, their find-

Introduction

ings “are not so well suited to . . . tropical climates, where diseases put on a different aspect and character; where they commonly run a shorter course, and have a more fatal tendency.”7 Fine educations in Europe could not guarantee success on the ground in the tropics. I have written extensively elsewhere about European bioprospecting in the West Indies for Amerindian and African cures.8 Europeans, from the sixteenth through to the end of the eighteenth century, tended to value medical knowledge of the peoples they encountered around the world, including that of Africans and Amerindians. With the decline of Amerindian populations in the Caribbean, slave medicines took on an unexpected importance, even though in the first half of the eighteenth century Africans on the big sugar islands were no more native to the area than Europeans (at least 80 percent had been born in Africa). Unlike Europeans, however, Africans knew tropical diseases, their prevention, and their cures. Here we delve into how various new remedies were tested. We must keep in mind that physicians’ desire to develop new cures in the Caribbean was largely driven by the political and economic ambitions of European states. Medicine of “warm” or “tropical” climates was necessary to keep slaves—as valuable commodities of powerful masters—alive on West Indian plantations. Tropical medicine was also required to keep large populations of soldiers and sailors healthy and ready for combat. In his Treatise on Tropical Diseases; or on Military Operations, Jamaican surgeon Benjamin Moseley highlighted how the failure of European cures led to political defeat. “It was chiefly owing to the ravages of  .  .  . [dysentery] in the French armies,” Moseley wrote, “that the English islands were not invaded earlier; and it was also owing to the same cause, that the English forces were, in many instances, unable to defeat their enemies.” Moseley developed a cure for dysentery while stationed in the West Indies—a cure that was implemented everywhere that Britain had troops. Yellow fever also wreaked havoc when the British attempted to invade and take Saint-Domingue during revolution in the 1790s. The invasion was beaten back primarily by mortality rates as high as 70 percent—not by soldiers’ guns and bayonets.9 HUMAN SUBJECTS

Finding new and effective cures requires testing new drugs in living organisms. A perennial question for doctors, patients, and ethicists is: Who will go first? On whose body will unknown and potentially dangerous drugs be tested? By whom, and for whose benefit? Today, such questions are mediated through carefully crafted codes of patients’ rights (chapter 3). Here we

5

6

Introduction

explore how drugs were tested in the eighteenth century, and specifically how human subjects were chosen for experiments. In early modern Europe many poor souls were subjected to medical testing. Drug trials tended to overselect subjects from wards of the state, such as prisoners, hospital patients, and orphans. Most experimental subjects came from the same groups used for dissection: that is, persons with no next of kin to insist on Christian burials or, in the case of medical care, to seek out and pay for expensive cures. Because it was thought that these subjects owed their well-being to the state, it was generally accepted that they should repay their debt and benefit society more generally by being used in medical testing. Nine children from the Hôpital de la Pitié, for example, were used in an experiment for a remedy for the “itch” in the 1780s. As was often the case in experiments that were recorded, all were “perfectly” cured. (Publication bias to record only positive results ran rampant.)10 In addition to charity patients, physicians used their own bodies to evince their confidence in a cure and, rarely, royal bodies to promote public health measures, such as inoculation for smallpox. Experimentalists generally assumed an interchangeability of bodies, so that testing on charity patients was thought to provide valuable data for physicians’ private practice among the wealthy. One population not available in Europe and used in colonial experiments was slaves. The question of underrepresented minorities in medical experimentation is still volatile today: minorities, especially African Americans in the United States, tend to be simultaneously underrepresented in medical research and historically exploited in experimentation.11 As the ethicist Robert Baker has written, modern bioethics arose from the need to protect vulnerable subjects, such as “racial minorities, the economically disadvantaged, the very sick, and the institutionalized,” who may be recruited as research subjects because of their “dependent status” and “their frequently compromised capacity for free consent” or “because they are easy to manipulate as a result of their illness or socioeconomic condition.” The 1979 Belmont Report was issued as a response to researchers’ exploitation of vulnerable populations, most notably the six hundred impoverished Alabaman African American sharecroppers recruited by the US Public Health Service in its Tuskegee Syphilis Study (1932–72). This study followed the natural progression of untreated syphilis in rural African American men, 399 of whom suffered from the disease and went untreated even after penicillin became widely available.12 The legacy of Tuskegee and other abuses persists today among many African Americans, who are understandably reluctant to participate in clinical trials. Some African Americans believe that researchers (the majority of

Introduction

whom are white) will expose them to unnecessary risk; others doubt that they, as a group, will benefit from the research. Yet US federal law requires that minority populations be included in clinical research to support their health and well-being.13 Historians of the US South have emphasized that slaves were exploited in medical experiments and dissections. Historian Todd Savitt’s excellent work has carefully documented that physicians in the American South, especially in the nineteenth century, often took advantage of African Americans by testing new techniques and remedies. In several instances, Savitt tells us, physicians purchased blacks for the “sole purpose of experimentation.” Though white subjects were included in some experiments, blacks constituted the overwhelming majority. The power of the master joined to the authority of medical men tended to render slaves vulnerable. “Blacks were considered more available and more accessible in this white-dominated society,” Savitt has concluded. “They were rendered physically visible by their skin color and were legally invisible because of their slave status.”14 Experimentation and the use of human subjects are specific to particular times and places. This book investigates medical practices in the late eighteenth-century Atlantic World. A major finding of this book is that, in many instances, European physicians in the British and French West Indies did not—as might be expected—use slaves as guinea pigs. Slaves were considered valuable property of powerful plantation owners whom doctors were employed to serve. The master’s will prevailed over a doctor’s advice, and colonial physicians did not always have a free hand in devising medical experiments to answer scientific questions. The overarching motive was economic: the profitability of the plantation complex depended on slave labor (chapter 5).15 Importantly, as we shall see, clinical wards of medical schools— epicenters of medical testing in Europe and the American South—were not established in the Caribbean in this period (chapter 1). Persons of African descent in the Caribbean may have become more vulnerable after emancipation, when doctors had no masters to answer to. Discussing the legal status of free people of color, Jamaican Robert Renny stated that they were “placed in a worse situation than slaves, who have masters interested in their protection.”16 Much of Renny’s sentiment, however, was informed by his loyalty to the British crown and the colonial enterprise. As we shall also see, some experiments with slaves in the eighteenth century were exploitative (chapter 4). But it is important to emphasize that in the eighteenth-century West Indies strong parallels emerged between slaves, soldiers, and sailors—as large populations in economies of few resources.

7

Introduction

8

Medical men might serve both populations—soldiers and sailors in time of war, and slaves in time of peace. Health was precarious: in desperate situations, physicians serving large populations often experimented with new remedies as a last resort. THE TAXONOMY OF EXPERIMENTS

To what extent were slaves exploited in eighteenth-century West Indian experiments? To answer this question I develop a taxonomy of the varieties of experiments within the context of eighteenth-century medical ethics: exploitative (taking undue risk with human life) versus nonexploitative (testing with care in the group likely to benefit from the cure); invasive versus noninvasive; therapeutic to the individual involved versus nontherapeutic. Today informed consent would also be a key consideration in judging the exploitative nature of experiments. This, however, was not the case for experimental populations—the poor, soldiers, sailors, or slaves—in the eighteenth century. It was enough that physicians judged the treatment to be in a subject’s best interest. Although patient consent was not required, physicians often complied with patients’ or parents’ wishes (chapter 3). Chapter 1 focuses on two sets of experiments and how race was investigated in each: those by the Jamaican physician James Thomson, searching specifically for anatomical and physiological differences between the races, and those by Colin Chisholm, inspector general for troops in the British West Indies, examining human constants in both blacks and whites across temperature zones. James Thomson is a complex character. The historian Richard Sheridan praised him for seeking to blend the “best elements” of African and European cultures. And, as we shall see throughout this book, Thomson was a strong advocate of Africans and their medical knowledge. Intimating his closeness to slaves, he insisted that physicians should consider “patients’ wishes, when they do not materially interfere with the actual state of disease.”17 Yet Thomson engaged in a grotesque set of experiments to understand skin color through dissection of persons of African origin. I focus on this experiment— done late in the period we investigate here—because it is what we expect to find. Motivated by debates on racial difference taking place in Europe, Thomson mounted a search to locate the ultimate physiological source of blackness in human skin. Thomson’s were among the most detailed experiments in the Caribbean at this time aimed at understanding racial differences. Colin Chisholm, naval inspector and plantation owner in Demerara (later part of British Guiana) on the coast of South America, designed experiments to

Introduction

understand basic human nature and not, like Thomson’s, to uncover racial difference. Chisholm’s study included race as a variable, but his focus was “place,” specifically the birth and immigration status of patients. Were they born in Europe or Africa, and had they subsequently immigrated to the West Indies? Were they newly arrived or residents of long standing? Were they West Indian Creoles (persons of European or African origins born in the islands)? For Chisholm, these, and not race per se, were important factors predicting health. Employing newly developed thermometers, Chisholm’s experiments were designed to answer questions crucial to the colonial enterprise. Specifically, he sought to determine whether “animal heat” changed dramatically with climate and whether a period of “habit or assimilation” was required for humans to regain their internal equilibrium. Chisholm’s experiments were not intended to be therapeutic. They were noninvasive (measuring only axillary temperature) and nonexploitative in the sense that they did not take undue risk with human life.18 Chapter 2 turns to experiments to test the enslaved African’s cure for yaws featured in A. J. Alexander’s experiment. One of my purposes in this book is to expand our knowledge of African contributions to science. Alexander considered his slave’s cure for yaws “Negro Materia Medica.”19 And indeed historians often write about “slave medicine,” tending to assume an African origin of a particular cure. One question we will explore is whether Africans brought their medicines and techniques with them from their homelands or whether they experimented with new plants and cures found in the West Indies. This raises methodological questions about how to trace the circulation of knowledge in the Atlantic World. In chapter 2, we attempt to identify the provenance of Alexander’s slave cure. When documents fail, I turn to the plants in the Negro doctor’s cure: Were they indigenous to Africa? The Americas? Or both? What can the plants tell us? Alexander’s experiment was designed to test a cure, in this case for yaws. Ethicists at the time accepted that therapeutic experiments were permissible when commonly used medicines failed, which was often in the tropics. Edinburgh physician John Gregory stated in his medical lectures that “desperate measures should be used in some cases, where every other method has been proved ineffectual. In such circumstance we should have recourse to medicine which under more favourable circumstances might be thought dangerous.”20 (Gregory’s were lectures that numerous physicians in the British Caribbean would have known about because the vast majority were educated in Edinburgh; see chapter 1.) In Alexander’s account of his experiment, slaves were not exploited. He showed restraint by trying the new cure first in only two

9

10

Introduction

subjects before expanding the test group. And his first two subjects were precisely those who stood to benefit most from the treatment. He allowed the European physician’s control group to include four slaves. The physician’s cure followed standard European practice at the time. Alexander’s yaws patients and Leonard Gillespie’s sailors (chapter 4) were tested in the context of seeking cures for large groups of like patients (slaves and sailors). These new treatments were intended to be therapeutic. Typically, subjects were observed as they proceeded through a treatment, and results were recorded, sent by letter to other physicians, and often published in efforts to increase the efficacy of practice locally and globally within the empire. Chapter 3 investigates eighteenth-century ethical brakes to medical experiments in the Atlantic World. The first section looks at ethics in Europe, the second at ethics in the Caribbean. The question is: Did experiments with slaves give birth to new debates and discussion? Did slaves become an exploited or a protected category? Although there was no fixed code of ethics in this period, physicians followed a standard format in testing (testing first in animals and then in humans, for example). They tested in specific populations (importantly, on themselves). They recognized certain limits to testing (such as patients’ requests and their own conscience).21 Self-experimentation—the notion that the physician “goes first”—was also an important part of the Atlantic World medical complex. William Wright, a learned physician and botanist in Jamaica as well as a member of the College of Physicians in Edinburgh, experimented with the therapeutic virtues of cold baths to treat fevers over the course of two decades. He fought hard to secure his “indisputable priority” in the discovery of this treatment. Part of his claim was that he had first tested this new therapy on himself.22 It was common in this period for physicians to go first. We see examples with Bertrand Bajon in Cayenne and James Thomson in Jamaica. A physician’s willingness to take a drug first served as a measure of faith in the treatment. Further, a physician considered himself a proficient subject, better able than others to provide reliable information about the effects of a cure on the body. It is not surprising, then, that Wright claimed to have tested his cold baths first in himself. We see, however, that, in fact, he first tested his technique in some five hundred subjects during the fatal smallpox epidemics of 1768—nearly a decade before trying it on himself.23 Although not explicitly stated, the large number suggests his subjects were slaves. Chapter 4 lies at the heart of this study. This chapter focuses on the exploitation of slave bodies in eighteenth-century medical experiments, primarily John

Introduction

Quier’s experiments with smallpox inoculation and James Thomson’s inoculations with yaws. These physicians took risks beyond what was reasonable to treat the individual patient; they took unusual liberties with human bodies. As we shall see, Quier was employed by plantation owners and would have inoculated for smallpox with or without his experiments. Masters had the final word in decisions concerning their slaves. There was no issue of slave consent—or, for that matter, often physician consent. Quier remarked that “in Negro practice” a physician himself was rarely able to choose his patients.24 Slaves certainly did not go first in Quier’s experiments in the 1760s. Experiments had been carried out successfully with prisoners (who gained their freedom as a reward) at London’s Newgate Prison in 1721. Two English royal princesses had been inoculated in 1722 without mishap to prove the safety of the procedure.25 In fact, when epidemics raged, not inoculating incurred considerable risk. But, as we will see, Quier took what he considered a rare opportunity to explore questions about inoculation still pressing within European medical circles. Quier used the slaves under his care to answer questions that doctors back in Europe dared not. He sought to advance science and not necessarily the best interests of the patient.26 It is interesting that Quier carried out his experiment one year after arriving in Jamaica. He reported implementing his experiments at the behest of Donald Monro, of the famed Edinburgh medical dynasty. Quier and Monro had served together in the British army stationed in Germany. Each found alternative employment after the war—Monro in London, and Quier in Jamaica.27 Quier’s results were sent to Monro in letter form. Monro read them before the College of Physicians in London and eventually published them in journal and book form. Heated controversy, however, arose between the two men about the interchangeability of bodies across race and social class. I find it significant that after this first extensive study Quier published no more—even though he practiced in Jamaica for nearly a half century until his death in 1822. Chapter 4 sets Quier’s experiments in context by analyzing James Thomson’s experimental inoculation with yaws in slave children as well as experiments with other often exploited populations, such as soldiers, sailors (who, like slaves, had negligible agency in determining their own fate), and the poor in Europe. We also investigate Jean-Barthélemy Dazille’s experiments with water that arose from his efforts to implement public health measures in Saint-Domingue. Dazille was a French colonial physician par excellence, yet he railed against anatomists concerned with the minute intricacies of skin color while physicians and surgeons arrived in the colonies

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Introduction

grossly ignorant of the causes and treatments of tropical disease. To remedy the situation he published his Observations sur les maladies des nègres (Observations on Negro diseases) in 1776 and 1792. For Dazille, the largest health problem was not bodily differences between Europeans and Africans but neglect in the care of slaves—insufficient nourishment, lack of proper clothing, and excessive labor that often exceeded their strength. He treated the ill under his care without regard for color and nearly lost his commission by insisting that slaves in royal hospitals receive the same rations of wine and blankets as soldiers.28 THE COLONIAL CRUCIBLE

Chapter 5 pulls out to a larger frame to understand the violence and fears endemic to colonial struggles. This chapter explores aspects of African medicine that were not put to test, such as Obeah or healing practices (often joining the natural and supernatural) developed by slaves in the British West Indies.29 Europeans were interested in the material aspects of African healing traditions—the specific herbs or bathing techniques used—but they shied away from Obeah’s spiritual or mystical aspects. This is surprising, since European physicians understood the potential benefits of what we today call the placebo effect. In 1799, the well-known English physician John Haygarth performed a placebo-controlled trial to understand the role imagination played in the “cause and cure of disorders of the body” and to unmask the fraud of Elisha Perkins’s tractors—metallic conductors of electricity purported to cure a variety of diseases.30 European physicians often depended on what they called “medical faith” to enhance the effects of their medicine. In the Caribbean, the British, however, did not often see (or at least did not acknowledge) the continuities between their beliefs and practices and those of Obeah doctors. What was diagnosed as “imagination” in Europeans was judged “superstition” in Africans. The fear of Obeah, revolt, and revolution was so great that experiments with electricity were conducted on Obeah men alleged to have instigated Tacky’s Rebellion in Jamaica in 1760. The condemned men were submitted to “experiments” with electricity.31 While a strong tradition of experimenting with prisoners condemned to death still prevailed, no results benefiting medicine were recorded from these so-called experiments. The Tacky Rebellion led to the outlawing of Obeah in Jamaica in 1760 (although not in other British-held islands in this period). Fears of slave practices were so great in Saint-Domingue that in 1764 all persons of African origin were banned from “exercising medicine or surgery and from treating any illnesses

Introduction

under any circumstances.”32 In practice, of course, slave practitioners remained on the front lines for slave care, especially in rural areas. European physicians’ primary job in the colonies was to keep slaves healthy—to dole out, as one physician put it, “the balm of humanity to those unfortunate beings.”33 European physicians, however, were also deeply embedded within the colonial complex, and many were slave owners themselves. The majority of physicians, as we shall see, never put pen to paper. They were working men with little time to write. Those who did write often did not comment on their views of slavery or of Africans’ physical, moral, or intellectual characters. Chapter 5 investigates the views of the four physicians called as expert witnesses to testify in the British government’s extensive hearing on the “present state of the African trade.” The 1788 Report of the Lords of the Committee of Council—a massive 890-page document—treated queries relative to the slave trade and the treatment of slaves throughout the British West Indies.34 This document provides a rare view of ordinary physicians’ practices on the ground. THE CIRCULATION OF KNOWLEDGE

The Conclusion adumbrates patterns in the circulation of knowledge in the Atlantic World medical complex (figure 3).35 I characterize three major nexuses across which people and their knowledges moved: the colonial nexus linking Europe and the Americas, the slave trade nexus joining Africa and the Americas, and the conquest nexus that brought Amerindian practices into the plantation complex. Nexus identifies a plurality of connections linking various parts of the Atlantic World. Multidirectional trade in people, disease, plants, and knowledges between Europe, Africa, and the Americas sped along these interconnected nexuses to create the Atlantic World medical complex. Within this larger context, we will explore how medical practices from these disparate Atlantic traditions mixed within the Caribbean. The West Indies served as a “center of calculation” where knowledge was created to respond directly to challenges posed by plantation complexes, namely, how to cure new and persistent disease emerging from the collision of peoples on newly established, often poorly supplied, plantations.36 Doctors and healers—of all types—in the West Indies served as “knowledge brokers” culling valuable bits and pieces from these rich traditions to create new and, occasionally, effective cures. These knowledge brokers were not mere intermediaries or “go-betweens,” but men and women situated in the push and pull of life-and-death struggles for political, economic, cultural, and personal survival. Some, such as the European doctors and surgeons, were employees

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Figure 3. The circulation of knowledge in the eighteenth-century Atlantic World medical complex. Three major nexuses characterized the dynamic multidirectional trade in people, disease, plants, and medicines between Europe, Africa, and the Americas. The European colonial nexus linked Europe and the Americas. The African slave trade nexus joined Africa and the Americas. The Amerindian conquest nexus carried Amerindian knowledge into plantation complexes. The Atlantic World medical complex arose from a fusion of African, Amerindian, and European knowledge traditions.

of empire—whether private contractors to plantation owners in the British islands or pensioners of the king in the French islands. Others, such as Alexander’s “Negro Dr,” were enslaved within various plantation complexes. Whoever they might be, these men and women took the vast empiry of empire to create knowledge responsive to local subsistence. Chapters 2 and 6, in particular, trace how knowledge of African and Amerindian origins— developed in the West Indies—shipped along with other cargoes into Europe, often transshipping out again back to the colonies and beyond. The Conclusion also investigates agnotology, or the types of cultural ignorance, that blocked specific knowledges from crossing from one nexus to the next.37 THE PROBLEM OF SOURCES

This book began with a “find.” While researching Plants and Empire, I discovered John Quier’s smallpox experiments, which served not only to improve inoculation practices in the Caribbean but also to investigate questions

Introduction

that physicians in Europe would not. Investigating Quier’s practices led to my driving question in this current book: Were the myriad vulnerable slave bodies exploited in medical experiments? As I progressed, I became intrigued with the origins of modern medical testing. I also became intrigued to discover how Amerindians and persons of African origins in the Caribbean tested the remedies widely used on plantations. I focus on two empires—the British and the French—to allow for comparison of attitudes toward non-European regimes of healing, experimental procedures (largely similar across Europe), and colonial medical infrastructure (which differed in essential aspects). Work across even greater swaths of territory, such as the Dutch, Danish, and Spanish empires, would further sharpen our understanding. Recent work on the Spanish Americas, for example, has unearthed Spanish Inquisition records that transcribed the testimony of condemned healers of African origins. Since Natalie Zemon Davis’s pathbreaking work on Martin Guerre, court records have held the promise of access to the lives of those who could neither read nor write. Although Inquisition court reporters understood themselves to be transcribing the accused’s words verbatim, testimony was filtered (consciously or unconsciously), first, through translation and, further, through Catholic cosmologies.38 Hence, our access to Amerindian and African-based medical practices—many actively collected—is filtered through European texts, whether those of the Inquisition in Spanish America or of naturalists and medical doctors across the Americas. This book consequently privileges European-style experimentation—in both the sources used and the ways “experimentation” is conceptualized. While we can glean much from European scribes, many African and Amerindian naturalists active in these areas remain faceless and nameless—often referred to as “slave doctors” or “Negro doctors.” It is possible that native Amerindians (the Caribs, Arawaks, or Galibi ) or enslaved Africans in the Caribbean—both women and men, as the French emphasized—forged methods for testing the drugs that Europeans were so eager to know about upon their arrival. Here we get only suggestions and fleeting clues. The ethnobotanist Tinde van Andel, for example, has argued that slaves tested plants by “trial and error,” as reported by Daniel Rolander in Suriname in the 1750s. According to van Andel’s account, these methods consisted mostly of testing for toxicity by tasting new plants. Historian Pablo Gómez has found instances of African-Cartagenan healers experimenting with potential cures—sometimes on themselves, sometimes on animals, and at other times using a special mat. Further, Bertrand Bajon, a royal naval surgeon

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and then private physician in Cayenne, reported that “sauvages” (by whom he meant Amerindians) knew many remedies but had not “the least idea of medicine.” He continued, however, that many of these remedies were successful. Whatever testing methods the Amerindians and slaves in Cayenne may have used, Bajon was not privy to them; he lamented that both Amerindians and enslaved Africans shrouded their cures in secrecy (see Conclusion).39 If there were independent experimental traditions in the West Indies among the indigenous or slave populations, these have yet to be discovered. Even when slaves had an effective cure, Europeans often insisted on testing it by their own methods. Thus cures, whether those of enslaved Africans or Amerindians, were tested by European medical establishments according to newly developing medical procedures throughout European holdings. Although we do not have direct accounts of African medical techniques, we can glimpse African practitioners’ expertise in tropical medicines by working in new ways with traditional sources. Chapter 2, in particular, is inspired by Judith Carney and Richard Rosomoff ’s fascinating work that offers new clues to how plants and knowledge of their uses circulated. Following their lead, I have shifted focus from the “republic of lettered men” to the “republic of plants.” What can the circulation of plants themselves tell us about the provenance of a cure? And about whose knowledge is embedded in that cure? Carney and Rosomoff have discussed in detail Africa’s botanical legacy in the Atlantic World. The African diaspora, they emphasize, is one of plants as well as people. Altogether, Carney and Rosomoff calculate, nineteen genera from fifteen botanical families moved from Africa to tropical America. These included yam, millet, banana, groundnut, tamarind, guinea squash, hibiscus, sesame, okra (used as food and also combined with Amerindian plants to produce abortifacients), lablab bean, sorghum, and a species of rice. In this way, they urge, “Slaves Africanized the food system of plantation societies of the Americas.”40 It is impossible to know with any precision how much African medical knowledge was transferred into the New World. Displaced Africans must have found familiar medicinal plants growing in the American tropics, and they must have discovered—through commerce with the Amerindians or their own trial and error—plants with virtues similar to those of plants used back home. They may also have carried seeds and African medical plants on board slave ships (chapter 2). This book stands at the confluence of many streams of literature: the history of medicine, human experimentation, slavery, race, colonialism, empire, indigenous knowledge, and the circulation of people, plants, and knowledges.

Introduction

It could not have been written without some of the remarkable works that dug deep into existent sources and conceptualized large swaths of historical territory. Of special note are Richard Sheridan’s work on health care in the British Caribbean, Pierre Pluchon’s and Mark Harrison’s studies of colonial and military medicine, James McClellan III and François Regourd’s monumental work on science and medicine of all sorts in the French Antilles, Philip Curtin’s foundational work on the plantation complex, Judith Carney and Richard Rosomoff ’s exquisite exploration of African ethnobotany, and Robert Baker’s synthesis of medical ethics across cultures and epochs.41 A NOTE ON TERMINOLOGY :

peoples of African origins were called Negroes (in French, Nègres) or slaves (esclaves) in the eighteenth-century plantation complex. I will refer to them in this fashion. They were occasionally called blacks (noirs), but more often Negroes. It would be improper to call the enslaved Africans if they were, in fact, African Creoles born in the islands. Many people of African origins in the Americas were, in fact, Africans—but they hailed from such diverse cultures that to call them “African” reveals little about their specific knowledge or beliefs.42 European rarely specified slaves’ specific origins or provided names of any useful sort (chapter 1).

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Chapter 1

THE R ISE 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 19

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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

The Rise of Scientific Medicine

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

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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

The Rise of Scientific Medicine

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

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

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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 naturalists Carolus Linnaeus (responsible for the first taxonomy of humans), Georges-Louis Leclerc, comte de Buffon (who devised the modern notion of species), and Johann Blumenbach (celebrated as the “father” of physical anthropology), whose five races presage our contemporary racial divides.15 Historians of the Atlantic World, however, challenge historians of science, asserting that it was not European science but colonialism—and often colonists themselves—that fashioned racism in its modern form. Joyce Chaplin, for example, has detailed how English colonists in the Americas had already developed notions of bodily fixity in the 1640s, much before European natural-

The Rise of Scientific Medicine

ists. According to Chaplin, English colonists eschewed environmentalism, the going theory of human variation that taught that exposure to sun, heat, moisture, winds, and distinctive foods accounted for racial variation. Colonists in the Americas realized that over time they did not, in fact, take on the characteristics of Amerindians. Further, colonists interpreted the Amerindians’ mass mortality in the face of European disease as revealing inherent physical weakness (and moral inferiority) and construed the durability of their own bodies as a sign of their right to subdue America and its inhabitants. Europeans’ presumed bodily superiority seemingly supported their imperial ambitions.16 Working in New Spain, Jorge Cañizares-Esguerra has developed a similar analysis of the Spanish. He too argues that Spanish colonists developed modern forms of racism that have wrongly been attributed to European naturalists. To defend themselves from negative European characterizations, Spanish Creoles (Spanish born in the Americas) insisted that their bodies differed radically from those of Indians—again because observation over time revealed that the American climate did not transform Spaniards into Aztecs, Mayans, or Incas and that the cold air of Europe did not turn black persons white. According to Cañizares, Juan de Cárdenas, an émigré Spanish physician, produced the first modern treatise on racial physiology in 1591. Although Cañizares interprets this and other Creole texts as early expressions of modern racism, he also concedes that these developments within colonial Spanish America had little impact on Europe.17 Guillaume Aubert, discussing French politics in New France, breaks with Chaplin and Cañizares by tracing the new language of race back to Europe, specifically to metropolitan class politics and not to naturalists’ cabinets. As is well known, before the late eighteenth century race in most European languages referred to family lines or pure breeds of animals. According to Aubert, elites in France strove to preserve their family line, holding that “noble blood” bred a “noble race.” He documents how French ministers initially invoked these notions of blood to build social cohesion in their newfound colonies by encouraging marriages between French men and North American native women. From these bonds, state ministers hoped to forge a métis—a blended and united—people. By the early eighteenth century, however, race in its modern sense reared its ugly head. Whiteness alone became equated with purity of blood, and métis (people of mixed blood) were pushed aside throughout the French colonial world. Whites of any social standing in Saint-Domingue, for example, took on the title of sieur, dame, or demoiselle, although in France these titles were reserved for the gentry. Aubert concludes that in relation to slavery colonial officials articulated their arguments for the inherent superiority of whites over blacks in the quasi-biological lexicon of metropolitan aristocrats.18

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It is important to understand that the types of documents historians use and the particular countries and continents they study determine, to a large extent, where they locate the origins of modern racism. Historians, relying on various types of literature, legal documents, or travelogues, find the roots of modern racism in the biblical curse of Ham (the disfavored son of Noah), medieval Muslim slave markets, Spanish notions of limpieza de sangre (purity of blood), and even African slave markets themselves. Nicolas Hudson, for example, employing linguistic tools and texts, has very importantly noted that the modern meaning of race did not enter European dictionaries until the 1830s. As he has shown, in eighteenth-century dictionaries—Samuel Johnson’s, that of the Académie française or the Encyclopédie—race retained its traditional meaning of “lineage” or “stock.” Similarly ethnographic travel literature of the seventeenth century described non-European peoples largely in terms of customs, language, religion, government, and the like, and not primarily in terms of bodily features. Hudson details how by the late eighteenth century race, in its modern sense, came to dominate ethnographic scholarship, while the term nation was reserved to describe political and social divisions within Europe, and tribe increasingly replaced nation in descriptions of peoples considered “savage” outside of Europe.19 These broad cultural and political discussions form the backdrop for specific experiments carried out by colonial physicians in the West Indies. In eighteenth-century Atlantic World slave societies, skin color—rather than a shaved head or fired branding—became an immediately readable sign of legal status and reputed moral worth. Manchester physician and obstetrician Charles White confirmed that the “great diversity of complexion” among humans— being so “obvious and striking”—has generally been considered “the principal and most characteristic distinction of the varieties, as they are called, of the human race.” The Creole lawyer Médéric-Louis-Élie Moreau de Saint-Méry, who wrote extensively on Saint-Domingue, elaborated 128 legal categories of color that included “Blanc” (white), “Nègre” (black), “Mulâtre” (mulatto, as Moreau de Saint-Méry conceived it, white plus black), “Quarteron” (quadroon, white plus mulatto), “Métis” (mestizo, white plus Amerindian), “Mamelouque” (mestizo plus white or Quarteron), “Griffe” (black plus mulatto), “Sacatra” (black plus Griffe), and any of the mixtures with Native Americans (figure 5).20 Despite these exacting distinctions, the primary color line in slave economies divided whites from blacks. The naturalist Alexander von Humboldt, who traveled extensively in the Americas at the end of the eighteenth century, wrote that “in America, the greater or lesser degree of whiteness of skin decides the rank which a man occupies in society. A white who rides barefooted on horseback thinks he belongs to the nobility of the country.”21

Figure 5. Page 1 of Médéric-Louis-Élie Moreau de Saint-Méry’s eighteen-page analysis of race in prerevolutionary SaintDomingue. Note that Moreau de Saint-Méry’s classes privilege males. Class I comprises offspring of a white male breeding with females of various racial backgrounds—a “Négresse,” “mulato,” “quadroon,” etc. Class II comprises offspring of a black male breeding with females of various origins.

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Physicians in the West Indies were interested in racial characteristics in relation to their job: that of keeping white planters and black slaves well and fit for work. Nonetheless, physicians often took positions on hotly debated topics, such as the cause of racial variations in skin color—whether induced by the heat of the sun or an innate property of the skin. The first experiments we consider here investigate skin color and were carried out by James Thomson sometime between 1814, when he arrived in Jamaica, and 1822, when he died.22 Before we turn to Thomson’s investigation of skin color, it is important to note that European physicians working in the Atlantic World tended to see black and white populations as undifferentiated wholes. Most Europeans knew little about Africa, its people and geography. To the itinerant plantation doctor, riding horseback long distances from plantation to plantation, enslaved Africans were simply “Negroes.” Thomson, who developed a great familiarity with his patients, was shocked by his countrymen’s and women’s ignorance of Africa and its people. “We hear persons,” he railed, “who have never resided among the natives of Africa, exclaim that they are astonished how one can distinguish the individuals, seeing they all have woolly hair, and are of a uniform complexion.” Africans, he instructed his readers, are brought from the most diversified regions, and present modifications in “stature, complexion, and moral qualities, that equal in every respect those acknowledged to exist amongst the inhabitants of the European continent.” Thomson inveighed against his European confrères who represented these natives of Africa as “base, treacherous, and revengeful.” “Alas!” he cried, “what confidence can we place in those who report the characters of others with so much decision, while in reality they are incapable of discriminating their own.”23 Despite Thomson’s admonition, physicians (including Thomson himself ) tended to see Europeans as one group and plantation slaves as another. When West Indian plantation owners did pay attention to Africans’ origins and cultures, it was with respect to slaves’ willingness to submit to hard work without revolt. Physician and poet James Grainger, active on the island of Saint Christopher in the 1760s, was among the few to make distinctions among Africans with respect to health. He cautioned planters to choose their slaves with care. “The different nations of Guinea,” he wrote, “are not only very different in their manners and passions, but from the constitution of their native climates, are subject to a variety of different disorders.” The Coromantees were a “brave and free people” and unlikely to submit to bondage. The “Minnahs” tended to commit suicide upon the least, and even without any, provocation. The Mandingans were plagued with worms, while the Congolese were likely to have dropsy. For these reasons, Grainger warned planters against purchasing

The Rise of Scientific Medicine

natives of those countries. If such a purchase could not be avoided, Grainger recommended buying young: boys not past the age of fifteen and girls not past twelve. The women of “Ibbo” were to be preferred to the men of that country because it was the women who were the primary laborers there. But Grainger cautioned against purchasing women because they suffered from obstruction of the menses, which led to barrenness and other disorders.24 Others, too, noted differences among African peoples. Intelligence collected by the British government in 1788 noted that “Popos” brought with them to Jamaica the “pernicious” custom of dirt eating and warned that the “abuse of earth eating adds largely to the annual death roll of Jamaica.” Physician John Williamson complained that female slaves were often sick with “chlorosis,” “mal de estomac,” and the anemia that accompanied these diseases, and that especially those from “Mungola” and Angola seldom recovered. The Angolans, he continued, did not seem to possess that “strength of mind or body” of the “Eboes” and Coromantees, yet they became good “domestics and mechanics”; the “Eboe Negroes,” when brought young, became “industrious excellent labourers,” but, when brought after age twenty or twenty-two, became “excessively sulky and untractable to the most kind indulgent treatment.”25 But such specificity was rare. In reality, Africans from divergent cultural backgrounds were mixed on West Indian plantations. Planters sought to repress revolt by purchasing Africans who spoke different languages and adhered to different customs. Planters also based purchasing decisions on physique (and the ability to labor), not provenance.26 West Indian doctors also tended to see whites, or Europeans, as undifferentiated wholes, despite the fact that these peoples hailed from different religions, cultural regions, and language groups—and were often embroiled in wars. Army apothecary William Lempriere listed the origins of Europeans admitted to the public hospital in Kingston between 1793 and 1794. The majority of his 410 patients came from England (170), Scotland (66), Ireland (84), Wales (31), and the Isle of Man (4). Others hailed from other European countries: Germany (13), Holland (6), Spain (4), France (3), Portugal (2), Denmark (1), Sweden (1), Norway (1), Italy (1), and Greece (1). The rest were from “America,” presumably the United States (12), Jamaica (2), Bermuda (1), Barbados (1), and Tortola (1). One came from the East Indies, and the origins of four others were unknown.27 Skin color—understood primarily as what made blacks black—was, then, a subject of intense legal and medical interest throughout the Atlantic World medical complex. Questions about the origin and location of color in the skin were firmly established in European research traditions from Marcello Malpighi’s investigations in the seventeenth century onward. In 1737, the great

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Dutch anatomist Bernhard Albinus, for example, published his tract on the color of “Ethiopians.” This work featured some of the earliest colored anatomical illustrations. The plates portrayed a thumbnail and dissected portions of skin (some from the breast) of an African woman. Historian Renato Mazzolini has pointed out that in the voluminous literature on skin color—its origins, causes, and location in the body—published in Europe between 1675 and 1810, not a single text had a title referring to the skin color of peoples other than Africans. European discussions of skin color peaked, according to Mazzolini, in the 1770s.28 Questions about skin color circulated in the Atlantic. In 1739, the Académie royale des sciences of Bordeaux (France’s second-largest slave port) announced a prize contest to discover the physical cause of the color of Negroes. In response, Pierre Barrère published his Dissertation sur la cause physique de la couleur des nègres, which featured findings derived from his dissection of two Negroes in Cayenne in 1741. Though too late for the contest, John Mitchell in Virginia also investigated the true nature of color in blacks, white, and “Indians” by scalding and blistering the skin—sometimes of living subjects. Several decades later, Benjamin Moseley, working in Jamaica, investigated whether all babies were born white, so that only the genitalia and fingernails betrayed a baby’s true complexion. Moseley inspected the labia, pudendum, and scrotum of newborns with care to learn their true color. He also, according to his own report, studied fetuses miscarried in late-stage pregnancies. From these he concluded that persons of “African race” or “mixed progeny” are darker than the rest of humankind, especially in those crucial areas. Their color is evident, he concluded, “even before they come into the world.” John Hunter also published a dissertation on the varieties of humankind as a student at Edinburgh in 1775 and brought his attitudes and techniques of inquiry with him to his service in Jamaica.29 James Thomson thus plunged into hotly debated questions when he took up the unsavory investigation of skin color in his Jamaican practice. If climate did not cause differences in human skin color, then what did? And, more specifically, what was it that made blacks black? White skin was taken to be the norm in this period, and it was generally assumed that all other races “degenerated” from this pristine origin. The great European authority on human varieties, Johann Blumenbach, taught that “it is very easy for white skin to degenerate into brown, but very much more difficult for a darker skin already impregnated with carbonaceous pigments to become white, when the secretion and precipitation of . . . carbonaceous pigment has once deeply struck root.” A few dissented from this opinion; Charles White and James Prichard, for example, maintained that humans were originally black, arguing that black animals bred

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white ones (albinos) accidentally but no white ones bred black ones. Concerning this point, Thomson responded that “some ingenious men have affirmed that our first parents were black, and that the European complexion is a degenerated state. I should be sorry to think this was true, if it was for no other reason than that the enthusiasm excited by Milton’s divine description of our fair mother Eve should be shaded by such a ludicrous assertion.”30 Blumenbach, who studied all aspects of human variation in depth, concluded that the “proximate cause” of blackness was an “abundance of carbon in the human body.” This became embedded in the Malpighian mucus—the anatomical location of skin color. Blumenbach, like many of his contemporaries, continued to cling to the notion that blackness and “tawny hues” were caused by the heat of the sun in the tropics—if not by direct action on the skin, then by its powerful influence on the functions of the liver. Thomson rejected environmentalism, writing that “there are facts to shew that three-hundred years have made little alteration in the complexion, where intercourse with the natives has been avoided; why intense heat should produce black has never been explained.”31 Thomson mounted a search to locate the ultimate physiological source of blackness in human skin. What is of particular interest is the detailed (one might say grotesque) nature of his inquiry. Spurred on by the questions of the day, Thomson reported that “some time ago I instituted a series of experiments regarding the differences of anatomical structure, observable in the European and Negro” through “numerous dissections of the latter.” Although Thomson had access to European bodies (people who died in his care), he did not— perhaps out of what was known at the time as “delicacy”—report opening those bodies. Thomson did not say how many African bodies he dissected for this particular study, yet we can take him at his word that his dissections related to skin color were “numerous.” Thomson commonly dissected in the course of his work. He noted with some apology that he had opened between forty and fifty of those who “fell a sacrifice” to influenza, some of them children, to better understand and treat the disease. He also dissected (specifically calling it that) infants who had died of tetanus in efforts to find the cause of the disease.32 Detailing his method for studying skin, Thomson recorded how he “blistered” the surface with boiling water. This he let putrefy until he could detach the “plexus of vessels” that he judged to contain the “colouring matter.” He was keen to point out that no “distinct membrane,” unique to Africans, existed. Rather, this plexus of vessels secreted a peculiar matter to the surface of the skin, and this was what made Africans black. As the intensity of this substance diminished, so too did the intensity of skin color until it “vanishes entirely in the quadroon.” Thomson also brought new evidence—unique to his experi-

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ence in the West Indies—to this investigation. He noted that the coloring principle in the skin was capable of regeneration. The “jet black Negroes,” he wrote, known as “Brechie Negroes” in Jamaica, who according to custom in their own country had undergone an operation of having the greater portion of the skin on the brow and forehead removed, scarred black (thus Thomson’s views differed from those of European anatomists, such as Bernhard Albinus and Petrus Camper). Thomson found this also true of slaves who had suffered yaws: as it healed, their “mamma yaw” (or central eruption) regenerated its original color.33 These investigations raise questions about where and how Thomson learned his experimental techniques—whether from his father’s partner and longtime Jamaican experimenter John Quier or in Edinburgh. Thomson informed his reader that, as a student in Edinburgh, he had been advised that “if my situation in life ever led me to the West-Indies,” to study “the disorders to which the Negroes are liable.” Thomson also recounted how he had learned experimental techniques at Edinburgh. “Some years ago, while at the University of Edinburgh,” he wrote, “a few of us associated for the purpose of making experiments on various medicines, the active properties of which we had reason to question.”34 Yet Thomson greatly admired Quier, who practiced in the neighboring parish during his lifetime, and dedicated his book to him (chapter 4). Although Thomson showed (at least to his own satisfaction) that the African hue did not derive from the sun, he was quick to point out the great utility of dark skin in hot climates. Black, from its known powers, he reasoned, not only absorbed but also radiated more heat than any other color. Africans’ pigment constantly cooled the body and prevented it from becoming overheated. This unique cooling system—along with a broadly expanded chest, brawny shoulders, and well-turned limbs—explained, at least to Thomson, why Africans could allegedly withstand the heat of the tropics that Europeans could not. For this reason, the British army recruited Africans as “black pioneers” for each regiment in Jamaica to carry out “duties of fatigue” outdoors and in the sun.35 Thomson, like many others at the time, thus provided an answer grounded in the physiological uniqueness of African bodies to a question of importance to legislatures as they considered abolishing slavery: Why were Africans able to labor in the heat of the Caribbean sun so fatal to Europeans? Many physicians were called to answer this question (chapter 5). In addition to his investigation into skin color, Thomson studied other anatomical differences between Europeans and Africans. He found Africans’ skulls thicker and heavier than Europeans’ and their feet insufficiently arched to accommodate easy walking. Breaking with European anatomists, such as Petrus

The Rise of Scientific Medicine

Camper and Samuel Thomas von Sömmerring, Thomson found no uniquely African facial angle that assimilated blacks to animals, and, significantly, Thomson found no peculiar ape-like length in Africans’ forearms. According to Thomson, the bodies he examined exhibited the “greatest variety” in these matters. Further, his repeated analysis of Africans’ blood revealed no significant variation from that of Europeans.36 Thomson derived his information from dissections of African slaves. It was fairly common for physicians to perform autopsies after patients died—in both Europe and the West Indies. Pouppé-Desportes, royal physician in SaintDomingue, opened many bodies—mostly white—to study the course of yellow fever. J. F. Lafosse, a physician also working in Saint-Domingue, lost some fifteen slave children in a short time. These he opened to find the cause of death—which he confirmed to be malnutrition. Even prominent citizens were autopsied. Unclaimed cadavers were also used by surgeons to perfect surgical speed and technique. But historians and ethicists at the time were quick to caution that dissection and autopsy should be performed with care. James Gregory, son of the great medical ethicist in Edinburgh, wrote that to open a body required a warrant for that purpose from hospital managers. Such opening also often required permission from the next of kin. In Saint-Domingue, however, we see one extraordinary example of autopsy used to police slaves. The issue was infanticide (slave mothers accused of killing their infants). In the 1780s, the royal physician Jean-Barthélemy Dazille threatened to open all dead infants on plantations to report the manner in which they died. In this way, he wrote, an “enlightened physician” can make the guilty “tremble.”37 While Thomson may have performed autopsies to determine the cause of death, he called his investigations “dissections.” And he used these bodies to answer questions about racial differences. His investigations, like John Quier’s (chapter 4), went well beyond his immediate work as a physician. They were prompted by ongoing debates in Europe about the precise anatomy of race. Although Thomson does not cite him, Sömmerring had published his Über die körperliche Verschiedenheit des Negers vom Europäer (Concerning the physical difference between Negroes and Europeans) in 1784 and again in 1785. Sömmerring procured his bodies from Africans settled as a colony by Duke Frederick II of Hessen-Kassel at Wilhelmshöhe, near Frankfurt, in Germany.38 Thomson, of course, had a ready supply of Africans: not Africans kept for display in a duke’s gardens, but working subjects who lived and died on Caribbean plantations. Despite Thomson’s interest in broader questions of race, he considered his anatomical research—especially his analyses of the origins of skin color—also diagnostic and contributing to his ability to treat patients of African origins.

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Africans’ plexus of vessels secreting matter to the skin’s surface was very active, Thomson judged, and was responsible for the “rank and unpleasant” smell of their perspiration that he found could not be lessened even with repeated bathing. This perspiration was acidy (it turned litmus paper red, he reported). But no matter how unpleasant it was, Thompson deemed perspiration the plantation physician’s greatest diagnostic tool. In his opinion, “obstructed perspiration” in blacks could lead to dysentery, for example, while a “constant flow” protected them from various types of itchy skin. Thomson considered the power of diagnosis so great in this matter that he foretold the death of a particular slave woman from the simple observation that she had ceased to perspire. The health of Africans, he continued, depended on maintaining a proper equilibrium in the action of the cutaneous system, which in turn secured the health of the internal organs—the lungs and bowels. He cautioned his fellow physicians, however, that perspiration diminished in pregnant women and ceased completely after menopause and in old age. Thomson was adamant that, in a natural state, Africans enjoyed robust health. Many African peoples, he noted, had no word in their language for “fever.” His numerous dissections revealed the perfections of their anatomy: their viscera exhibited the marks of unimpaired organization; their glandular systems were uniformly free from disease.39 Other physicians were equally impressed with the healthy effects of abundant perspiration. In his report to the British government, James Chisholme, who had practiced in Jamaica for twenty years, testified that “obstructed perspiration” might induce tetanus—the disease that killed a quarter of newborn slave infants. Williamson, also in Jamaica, wrote that “the greater number of affections to which Negroes are liable, may be considered, more or less, if not wholly, owing to obstructed perspiration.” For Lempiere, checked perspiration was not a somatic failing in slaves but was due to their coarse “frocks and trowsers,” which, in his opinion, left the body completely unprotected from “sudden transitions of calm and breeze.” The improved “mode of dressing” that whites had adopted on the advice of physicians had done much, he reported, to prevent disease.40 Perspiration was, indeed, seen as key to survival in the tropics—and in this matter Africans set the standard. James Currie, who gathered information globally for his experiments performed at the Liverpool Infirmary (chapter 4), cited at length Colin Chisholm’s study on core body temperature in humans (below). Currie observed that Europeans simply lacked the “perspirable matter” required for hot climates. Consisting nearly of pure “lymph,” their perspiration too speedily dissipated by evaporation, thus failing to keep the skin uniformly moist and cool. To simulate by artifice in Europeans the benefits from perspiration that Africans enjoyed by nature, Currie recommended that his countrymen in the West

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Indies adopt the practice of “ancient” Eastern nations and almost “all savages” of applying “unguents” to the skin. Additionally, Currie recommended that the English embrace the now widely practiced habit of the French in the West Indies of immersing oneself in a “tepid” bath after exercise under a burning sun.41 L’HOMME PLANTÉ: PLACE VERSUS RACE

Race dominated much plantation medicine. But “place,” too, was important. The historian of medicine Mark Harrison has judged that “colonial medicine was predominantly a medicine of place.” For Harrison, British colonial medicine represented an “epitome of knowledge distilled from a variety of learned traditions, folklore, and scientific investigation” created in specific cultural locations. Eighteenth-century colonial doctors, however, considered “place” paramount in a second sense—the Hippocratic sense of “airs, waters, and places.” We might consider the robust colonial literature on assimilation a literature of “place” in this latter sense, emphasizing how people, plants, and animals, set in motion by empire, could effectively be transplanted from one place or climate to another.42 Place, in this sense, denoted specific geographical locations—specific latitudes, altitudes, weather conditions, and temperatures. Eighteenth-century literature on place specified the origins of humans, plants, and animals: Where were they native to? If transplanted from afar, were they from similar or vastly different climes? Place in the Hippocratic sense was considered an important variable determining health. For health and healing, “place” emerged in the eighteenth century as a profound category of analysis alongside, and sometimes trumping, race. Colin Chisholm’s experiments are of note for analyzing “place” in this second sense. Chisholm, a surgeon in the island of Grenada, inspector general of the ordnance medical department in the West Indies, and eventually fellow of the Royal Society in London, performed extensive experiments to discover whether core human body temperature was the same in all climates or places. Chisholm’s experiments were designed to understand the basics of human nature and not, like Thomson’s, to uncover racial difference. In these experiments, Chisholm used race—boiled down, again, to the categories of black and white—as one variable among many.43 The question of “the degree of animal heat within the tropics” was of great importance to therapeutics. Understanding body temperature in healthy human subjects aided physicians in diagnosing and treating fever—one of the greatest killers of European sailors, soldiers, planters, and enslaved Africans in tropical areas. Chisholm, who wrote extensively on fevers, sought to understand how body temperature might change as people were transplanted from place to place.44

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Others before Chisholm had studied human body temperature. For example, Daniel Fahrenheit’s new, portable mercury-in-glass scaled thermometer (1714) was much employed for this purpose by Boerhaave’s students Gerard van Swieten and Anton de Haen in Vienna. Indeed, Chisholm remarked that the thermometer he used for weather readings was “graduated by Fahrenheit’s scale and made by Fraser in London” (figure 6).45 Chisholm was trained in Aberdeen and wrote enthusiastically about European scientific debates in various contexts. But he was first and foremost a colonial surgeon and plantation owner, and his questions responded to the colonial enterprise. Chisholm sought to understand whether (human) “animal heat” was as diverse as global climates. Specifically he wanted to know whether a period of lengthy assimilation was required for humans moving to the West Indies. Colonists, he wrote, believed that “animal heat is subject to a diversity nearly similar” to the diversity of climate and that, when individuals changed climates (traveling, for example, from England to the Caribbean), changes to their human body heat occurred such that human body temperature did not right

Figure 6. Thermometer circa 1800 of the sort described by James Currie (chapter 4). It is possible that this type of thermometer was used by Colin Chisholm.

The Rise of Scientific Medicine

itself again until “habit” or “assimilation” had transpired. To establish the facts of the case, Chisholm judged it “proper to lay before the reader the results of various thermometric experiments on human subjects.”46 Chisholm implemented “experiments or trials” (as he labeled them) to test these notions and to establish “principles” for acclimatizing humans to new locations.47 He deliberately composed his test population of Europeans and Africans, but race was not his concern. Of keen interest were categories of “place”: whether the “white” or “Negro” test subject was (a) newly arrived in the colonies, (b) fully assimilated, or (c) Creole (i.e., “native” to the West Indies). In addition to place or climate, Chisholm investigated the intersection of other human differentials that physicians in this period understood to be important determinants of health, namely age, sex, temperament, and occupation. To these, he added “colour” and proximity to contagion. Reporting on the West Indian fever epidemic of 1793–95, Chisholm found that neither “age” nor “sex” exempted victims from attack but that “colour” was important to determining its virulence. Considering his “classes of inhabitants,” he reported that the most likely to be infected were sailors and soldiers (categories of occupation), those newly arrived from Europe (category of place), and those “given to drink” (category of temperament). Next were white males (categories of race and sex) recently arrived from Europe (category of place), followed by lower-class white males, especially those who were intemperate (category of temperament) or weakened by previous disease (category of health status). White females came next, especially those “connected to shipping” and recently from Europe. People of color ranked sixth for possible infection, followed by “Negro-men,” especially sailors and porters. “Negro-women,” among these domestics, and finally children, particularly “those of colour,” ranked ninth.48 Within the plantation complex, place of origin was especially important for predicting the mortality and morbidity of slaves and could determine a significant portion (up to a third) of their price. Planters were warned to buy “Negroes” carefully. Those “newly transplanted” (rendered nouvellement transplantés in French territories) might suffer from a change in climate or regimen and even from sadness. The risks involved made bossales—as slaves newly transported from Africa were called in French—less expensive than “acclimatized Negroes” (those living in the West Indies for a long period of time) or “Creole Negroes” (those born in the West Indies). In the 1780s, an “imported Negro man” cost between thirtyseven and forty-five pounds sterling in the islands of Antigua, Grenada, and Saint Christopher, while a full-grown “country-born [Creole] Negro” in the same islands might fetch fifty-six to sixty pounds. In Jamaica, prices averaged seventy to one hundred pounds sterling.49

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“Place,” in the sense of place of origin, was associated with the larger colonial enterprise of transplantations worldwide. Since the sixteenth century, Europeans had gained formidable profits by transplanting nature—plants, animals, and people—from one part of the globe to another. The voyages of scientific discovery were fueled by the assumption that plants, medicines, foodstuffs, animals, and peoples could be transplanted and acclimatized. The great Carl Linnaeus, for example, hoped that he could “fool,” “tempt,” and “train” tropical plants to grow in Arctic lands and thereby create “Lapland cinnamon groves, Baltic tea plantations, and Finnish rice paddies.”50 English physician William Falconer noted that plants and animals transported quickly from one climate to another often failed to thrive but that “man,” thanks to his superior reason, could successfully manipulate every climate and situation.51 Successful acclimatization required a detailed understanding of how to move colonial peoples and goods gradually through changes of temperature, soils, and exposures to sun and rain. Referring to plants, James Lind remarked in 1768 that an “utmost care and attention are required, to keep them in health, and to inure them to their new situation.” The same was considered true for humans, and increasingly naturalists drew analogies between transplanting plants and humans. “Some climates are healthy and favorable to European constitutions,” Lind philosophized, “as some soils are favorable to the production of European plants. But most of the countries beyond the limits of Europe, which are frequented by Europeans, unfortunately prove very unhealthy to them.” More European imperial adventurers, he pointed out, died of sickness than from shipwreck or attack by savage natives.52 Chisholm’s experiment, then, contributed to the colonial project of transplanting humans successfully and efficiently (at the lowest cost possible) to the Caribbean sugar islands. His goal was both scientific (to understand animal heat) and practical (to do away with unnecessary acclimatization procedures). He also wished to understand how it was that the “Negro race,” as natives of the tropics, could successfully withstand fevers and contagions while whites could not.53 Chisholm conducted his tests in “Demerary” (Demerara, later part of British Guiana, now Guyana) on the coast of South America, where he owned a plantation. Demerara lay at the latitude of 6° 30' north of the equator—an important data point for Chisholm’s study of “place.” Chisholm experimented deliberately and chose his test subjects with care. He composed his first group of twelve “white persons” (later in the text elaborated as men), in “perfect health,” “newly arrived” from the British Isles, between the ages of sixteen and twenty-eight (figure 7). To conduct his experiments, Chisholm carefully placed a thermometer in the armpit of each subject in such a way as to ensure that

Figure 7. The first of Colin Chisholm’s six experimental groups used for his study of “animal heat”—or core body temperature—in humans in Demerara. Chisholm’s experimental variables included age, “colour,” and place—whether the subject was newly arrived in the Caribbean, fully assimilated, or Creole (i.e., “native” to the West Indies).

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40

no “currents of air” disrupted the results. The mean “heat” of the first group of subjects measured 96 degrees. Next he tested a group of twelve white persons, again in perfect health, but who were fully assimilated to the tropics—with the same result (figure 8). These groups were followed by three groups of Africans: twelve “robust Negro men, in perfect health, natives of the Gold Coast of Guinea, in Africa, lat. 5° 10' N," who were newly arrived in the colony; twelve “robust Negro men, in perfect health,” longtime residents in Demerara; and, finally, twelve “robust and healthy Negroes” born in Demerara. These groups measured 97.5, 96.5, and 98 degrees, respectively. Chisholm finished off his trial with a group of diverse ages and races. He tested white infants between the ages of six weeks and thirty months, a black child nearly four years of age, a mulatto and “mustee” of about the same age, and a “black,” aged eighty, to ensure that extreme age (being very young or very old) did not influence his results. The mean heat of these subjects was 98 degrees.54 Chisholm, as a plantation owner, had ready access to numerous slaves. We are not told how he procured his “white” subjects. As noted above, Chisholm was not testing for racial difference. His question was about place, and he carefully chose his subjects—all “in perfect health”—from both European and African populations. Although Amerindians were plentiful in Demerara, they were not colonial subjects that interested Chisholm. Degree of Animal Heat Within the Tropics Chisholm’s Experimental Categories Mean Heat

Mean Pulse

16–28 years

96°

82

Resident in tropical climate 4-20 years

None given

96°

70

12 Negro men

Native of the Gold Coast of Guinea (Africa), newly arrived

None given

97.5°

88

4

12 Negro men

Resident in Demerary 4-20 years

None given

96.5°

82

5

12 Negroes

Creoles or natives of Demarary

16–30 years

98°

85

6

3 White, 2 Black, 1 Mulatto, 1 Mustee

Unspecified

6: 6 weeks – 5 years 1: 80 years

98°

116

Race Group

Place of Origin

Age

1

12 White persons

Newly arrived from a cold climate

2

12 White persons

3

Figure 8. Chisholm’s six experimental groups.

The Rise of Scientific Medicine

The only standard human variant that did not interest Chisholm in this particular experiment (or for which he lacked subjects) was sex: of the sixtyseven subjects Chisholm examined, none were specifically denoted as women. It is impossible to say whether his second group of “white persons,” fifth group of “Negroes,” and sixth group of random subjects included females. His case histories indicate that in his regular practice he treated primarily men, but he also treated the occasional wife of a soldier, free mulatto woman, Negro woman, servant woman, and the like.55 (When discussing women’s cases, Chisholm sometimes noted their phase in the menstrual cycle.) Chisholm’s neglect of women in this experiment is surprising because physicians typically considered sex along with age and temperament in diagnosis and treatment (chapter 4). His choice of male subjects may have resulted from the rarity of women among planters and slaves in the Caribbean. He was, however, a surgeon with an active practice, and at least some women were available to him. Chisholm’s overall conclusion from his experiments was important: the degree of human animal heat was “universally the same”: that is to say, core body temperature was the same within the tropics and in northern climates. He found specifically that Europeans, whether assimilated or newly arrived to tropical climates, measured 1.5 degrees of heat less than in their native country but nearly 2 degrees less than Africans. The “unassimilated Negro of Africa and the Creole Negro of South America, born under nearly the same parallel of north latitude,” both possessed nearly the same degree of heat. He noted that the “assimilated Negro of Africa, in South America, possesses nearly the same degree of heat the assimilated European does,” but “one less than the unassimilated Negro of Africa,” and so on through his various combinations of factors. He seemed not to have taken into account that a person’s temperature might vary by time of day, by level of physical activity prior to measurement, and, for women, by time of the month. Nonetheless his final conclusion was that the mean heat of sixty-seven persons of “different countries, different climates, different temperaments, different ages, and of every shade of colour from white to black” overall was 97 degrees—precisely “the mean heat observed in the human body in health and vigor in Great Britain.”56 Others at the time were also interested in human constants. French colonial physician Dazille demonstrated that the natural temperature of the human body was between 31 and 33 degrees centigrade, using Réaumur’s thermometer. Human temperature varied (3 degrees either way), Dazille taught, by temperament, latitude, and state of health, among other factors. James Thomson was interested in the human pulse. As a baseline, he used his own pulse as determined through self-observation while he was a student at Edinburgh.

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This he used to understand the effects of drugs, such as coffee, in the treatment of disease.57 Chisholm’s experiments contributed directly to the project of acclimatization, a matter of “humanity” and of the pocketbook, as James Grainger had put it some thirty years earlier. Medical men’s attention to seasoning slaves went beyond temperature to treat also diet and “habit,” and mode of life. Grainger, for example, recommended that, as with plants, conditions for new slaves should be as similar as possible to those of their country of origin. When brought to the plantation, Africans should be well clothed and fed food similar to what they ate at home. Grainger recommended learning the diet of specific African peoples from “their country folks.” Moreover, if the Africans had brought palm oil (which, he wrote, prevented the loss of fluids from sweating), they should be permitted to “anoint their bodies” with it after bathing. Most importantly, Grainger taught that newly arrived Africans must be introduced to plantation labor gradually. “To put a hoe in the hands of a new Negro and to oblige him to work with a seasoned gang, is to murder that Negro.”58 The French agreed. The editor of the Gazette de médecine pour les colonies published in Saint-Domingue wrote—with a typically French delicacy concerning food—that “it is necessary during the first months to place many sorts of foods before the eyes of new Negroes so that they can choose those that . . . give them the greatest pleasure.” The editor assured his audience that offering a good variety of foods was the key to successful acclimatization of newly arrived Africans. It is equally important, he continued (from a male point of view), to encourage dances and other pastimes with the “Negroes” of their own country, presenting as much as possible “the ripest Négresses” in order to inspire an “attachment,” because the stomach does not function properly unless the spirit is “content and satisfied.” The editor of the Gazette added that M. Decout, who initiated this advice, was a “very learned surgeon” and wealthy from his profession. The topic was of such importance that in 1772 a prize of 1,200 livres was promised by the Academy in Bordeaux for the best paper on “the surest means of preserving the Negroes who are transported from Africa to the colonies from frequent and often deadly illnesses.”59 Grainger, in the British islands, also advocated for learned societies in Europe to offer prizes for discoveries on the topic of materia medica. Prizes were offered “daily,” he wrote, for improvements in agriculture and other parts of economic botany, but not for means and methods of improving the health of humankind. “Yet such discoveries,” he continued, “would not, like many others, be confined in their influence to one nation only: the world would reap the advantage of them, for the world is interested in the improvement of medicine;

The Rise of Scientific Medicine

and the palms which might be gathered by Britons in such pursuits, would be more lastingly honourable than the laurels of their conquests.”60 THE WEST INDIES

established an active culture of medical experimentation.

The traditions traced here were imported from Europe. Both Thomson and Chisholm brought emerging European techniques for human testing with them to the colonies. Chisholm also brought the necessary instruments, in his case, Fahrenheit’s thermometer. Yet both Thomson’s and Chisholm’s studies were prompted by the colonial enterprise. Thomson’s study was designed to investigate racial differences, primarily as these related to health. Chisholm, by contrast, was interested in “place.” While he included race as a variable, his chief concern was bodily histories detailing a person’s colonial transport through climatic zones globally. Even once race emerged—defined in modern terms—West Indian physicians emphasized other somatic characteristics as crucial to maintaining health. This chapter has highlighted physicians’ experiments with Europeans and persons of African origin. It should be noted that experiments with Amerindians were rare: Zabdiel Boylston’s smallpox inoculations, if we consider those experimental, included Native Americans. John Mitchell wrote in passing on the cause of skin color in “Indians” and “other tawny People” in the 1740s in Virginia. Thomson’s experiments with skin color, however (as far as we can ascertain), exploited only enslaved African bodies. By the early nineteenth century when Thomson was experimenting, Amerindians had been eradicated from the Jamaican plantation complex.61 Place featured prominently in colonial medicine. A “Carib” cure for gout, communicated to a European administrator in Martinique, was reported in the 1777 Parisian Journal de médecine, chirurgie, pharmacie, etc. In response to queries, the author assured his French confrères that the remedy worked with the same success in Europe as in America. In other words, the cure was effective in both hot and cold climates. But, as was characteristic of this period, the author claimed that only expérience (meaning testing) would provide a final resolution to these questions.62 In subsequent chapters we will examine how physicians experimented with treatments in efforts to keep patients alive—and, in the case of slaves, to return them to work (and profit making for masters) as soon as possible.

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Chapter 2

EXPER IMENTS W ITH THE NEGRO D R ’S M ATER I A MEDIC A The Negroes Method is making them stand in a Cask where there is a little fire in a pot & sweating them powerfully in it twice a day giving them decoctions of 2 woods in this country called Bois Royale & Bois fer . . . —A. J. Alexander, planter, Bacolet, Grenada, 1773

ALEXANDER J. ALEXANDER’S

experiment with his “Negro D r’s” “Materia Medica” in 1773 reveals how Europeans tested and evaluated what they deemed slave cures. Much has been written on slave medicine in the plantation complex. It is important to understand, however, that no “pure” African medical regime was transplanted to Caribbean plantations. As the anthropologist Paul Brodwin has emphasized, slaves in the New World rarely shared a common language or healing practices. Africans from vastly different parts of the continent were mixed first in Africa through chaotic capture, transport, and sale and second in the Caribbean through planters’ strategies to prevent uprisings by separating kith and kin. As a result, medicine practiced by enslaved Africans on Caribbean plantations drew from a variety of medical, religious, and cultural traditions.1 Yet West Africans made vital contributions to plantation materia medica. Judith Carney and Richard Rosomoff have documented the “Africanization” of food systems on Caribbean plantations. Shifting attention from European commodity crops (sugar, coffee, cotton, and tobacco) and plantation economies of scale, Carney and Rosomoff examine African subsistence crops and the knowledge systems embedded in them. Using shipping records, pictorial evidence, and oral histories, Carney and Rosomoff describe how African slaves naturalized their food crops in the American tropics—especially the Caribbean, where 40 percent of slaves were shipped. Successful middle passages required two meals per day for several hundred slaves. Ships provisioned on the west coast of Africa were often filled with unhusked, unmilled grains to be pounded and prepared as foods along the way. Importantly, some of this unused grain arrived as plantable seed when ships docked in Caribbean ports. Plantations thus had all the ingredients needed for successful acclimatization of African crops in the Americas: seeds, people skilled in their cultivation, and people (often facing starvation) who knew and enjoyed these foods. These grains and other crops were planted in gardens or provision grounds that slaves worked in the few hours allotted to them on Sundays and holidays.2 45

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The same may be true for medicinal plants. Slaving captains may have— wittingly or unwittingly—shipped African medicinal plants to the Caribbean in their cargoes of humans, animals, and foodstuffs. Seeds could be carried in the holds of ships and also in hair, fur, or soils. Enslaved Africans may have cultivated these familiar plants in their kitchen gardens. A first source of West Indian colonial medicine, as we shall see, was African. A second source was Amerindian—Arawak, Taíno, Carib, or Galibi (Kali’na). Although by the end of the eighteenth century, in the northern Caribbean, Amerindians themselves had been decimated or exiled to specific islands, many of their plant cures lived on, often as part of the Atlantic World medical complex. French physician Pierre Barrère, in Cayenne from 1722 to 1727, learned the use of simarouba, for example, from indigenes, whom he called “Sauvages,” to cure dysentery. This he tested many times. Similarly, royal physician Jean-Baptiste-René Pouppé-Desportes, in Cap-Français from 1732 until his death in 1748, presented an “American pharmacopoeia” in the third volume of his Histoire des maladies de S. Domingue that offered an extensive list of “Caraïb” remedies (see below).3 Carney and Rosomoff have also made the important point that the West Indies saw the fusion of two tropical farming systems: African and Amerindian. Evidence for this abounds in eighteenth-century sources. James Grainger, a poet and West Indian physician, noted, for example, that masters of an estate permitted slaves to clear as much ground as needed for building their huts and “planting Indian provisions.”4 It is likely that slaves planted seeds they brought from Africa and also experimented with plants indigenous to the Americas. This fusion of African and Amerindian knowledge systems is evident in plant-based cures. Plantation hospitals devoted to the care of slaves, for example, stocked “Indian arrowroot” (Maranta arundinaceae, L.) as a staple. British physician Hans Sloane, working in Jamaica from 1687 to 1689, remarked that Colonel James Walker had carried that plant from Dominica (with its relatively robust Amerindian populations) to Barbados and planted it there. From Barbados it was sent to Jamaica, where it was cultivated in gardens and provision grounds. Sloane and others emphasized the use of arrowroot as an antidote for poison-arrow wounds, wasp stings, spider bites, and the like. John Williamson, working in Jamaica a century later, noted that the starchy flour of this root was “mixed up with the neatness peculiar to the nurses in that country” to provide a nourishing diet for convalescents. It was deemed an “excellent article for the sickroom.” Although a staple of slave hospitals, arrowroot is a plant of American origins, long cultivated by Amerindians as an easily digestible food and topical medicine.5

Experiments with the Negro D r’s Materia Medica

One could provide numerous examples of cures considered slave medicine that had American and, most likely, Amerindian origins. Richard Shannon, for instance, reported that for “obstinate head-aches” slaves applied a leaf of tobacco steeped in palm wine, lime juice, or spirits to the temples. He also noted that “wild tobacco chopped up green” applied to the soles of the feet served the same purpose. Tobacco is, of course, indigenous to the Americas. Slaves either learned its medicinal virtues from Amerindians or experimented with it on their own. This would be true of any plantation medicine that featured indigenous American plants, such as ipecacuanha, jalap, or cinchona. Sometimes Africans curated Amerindian cures; sometimes they combined Amerindian techniques with their own to create something new. At other times, Africans found indigenous American plants and devised cures necessary for their own survival. As Brodwin has emphasized, slave treatments were devised through a process of “reinvention and ad hoc improvisation” in new environments.6 The circulation of knowledge in the Atlantic World medical complex is evident in Thomas Heney’s “numberless” experiments with Zanthoxylum (prickly yellow wood), an American plant whose medicinal virtues he learned from a slave woman. Heney, working in Saint David’s parish in Jamaica, bathed the putrid ulcers that afflicted the “unhappy children of Africa,” as he called them, with an experimental decoction of zanthoxylon bark. To this external treatment he added a drink of zanthoxylon boiled with sarsaparilla (another American plant). Heney was an enthusiastic experimenter who, in his words, instituted his trials “with as unprejudiced and candid a mind as ever a son of Hippocrates did.” He confirmed his good results with nothing less than “repeated autopsia.”7 Heney soon encountered a slave who suffered from dry bellyache. Despite his efforts employing “emollient fomentations, anodyne, . . . cathartic glisters, mild and drastic purges, castor oil, and ultimately, blisters to the abdomen,” the woman began to sink; he “banished every ray of hope” for her recovery. The slave woman asked that her sister be called. Upon seeing her sibling’s deplorable condition, the woman administered a cure “communicated to her by their mother” and “employed . . . in Africa.” Here Heney portrayed African medicine as traditionally passed from mother to daughter. We do not know, however, how the mother had learned of the treatments—whether by experiment or tradition. After several spoonfuls of her sister’s nostrum and much sleep, the slave woman recovered fully.8 Heney, wishing to know the cure, asked the sister, but “no reward or menace” could persuade her to reveal her secret. At this point, Heney and his team

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“induced” (by what means we do not know) another slave to pretend to fall victim to dry bellyache. The sister was prevailed upon to prepare the same cure. When she left the plantation, Heney had her spied on (in his words, she was “narrowly watched”) and discovered that she gathered young and delicate zanthoxylon root along with the flowers of wild sage. (Subsequent testing revealed that sage contributed nothing to the cure.) A dutiful experimenter, Heney tested the expressed “juice” of the zanthoxylon root—according to protocol— first in himself. Once he was satisfied with its results, he began administering it to his patients for bowel complaints, so frequent, he wrote, “among the African race and their progeny.” Heney added that “negro information” had yielded other “vegetable” cures that he used with “much satisfaction.”9 It is important to point out, however, that zanthoxylon bark, the use of which Heney learned from the slave woman, is indigenous to the Americas. Heney baldly stated that because the slave woman had learned the cure in Africa (if, indeed, she was born there and not in the islands), the prickly yellow wood was “not . . . a native of Jamaica” (or, more broadly, the Americas).10 Zanthoxylon, however, is not native to Africa, and the cure, in this case, either passed from Amerindians to slaves or was discovered and developed independently by slaves in the Americas. It is worth noting that the knowledge of remedies often traveled via women to European male practitioners. The knowledge of a remedy for worms derived from fig trees and tested by Bertrand Bajon, former surgeon to the royal hospital in Cayenne, was provided by a “Négresse” from the coast of Africa and was transmitted to Bajon by a Madame Rousseau in Cayenne. Rousseau supplied Bajon with the materials required for his experiments (expériences); she also repeated his many experiments yet again. This “fig tree of Cayenne” Bajon described as native to the Americas.11 West Indian plantation medicine thus intermingled West African and Amerindian healing traditions. A third source of plantation medicine was European.12 West Indian plantations were regularly outfitted with medicines sent from Europe. Military and plantation medical protocols were first and foremost European. Yet numerous slaves served as assistants to European-trained doctors; Europeans learned from slaves, and vice versa. Enslaved Africans even adopted European modes of observation and experimentation. In a rare (because it was recorded) example, a slave named Capcua discovered a hot spring and experimented with its healing powers on two slaves before making his find public. According to the account, the twenty-five-year-old Capcua was corralling his master’s animals on the plains near Gros-Morne, Saint-Domingue, when suddenly his horse became mired in mud. As he pulled the animal out,

Experiments with the Negro D r’s Materia Medica

the horse’s hoofprints filled with hot water. Capcua immediately recalled his master’s stories about the healing powers of hot baths in Europe. Hoping that these waters had similar powers, the slave “secretly” (we are told) tested the effects of the water on a slave lame with rheumatism. Capcua fashioned a small tub above the spring and bathed the slave in the waters twice per day. After twelve baths the poor cripple was greatly relieved and in a month was “perfectly healed.” The success of this first trial convinced Capcua to devise a second. Capcua carried a patient, an abandoned slave who had lost the use of his arms and legs, in a hammock to the spring. After three weeks the man began to stir and in three months was “radically healed.” After these two trials, the reputation of the thermal baths at Port-à-Piment grew, and patients flocked to its healing waters.13 The Atlantic World medical complex fused Amerindian, African, and European traditions. Yet there were important asymmetries. In all instances, reports of West Indian cures—whether those developed by slaves, Amerindians, or Europeans—were authored by Europeans. As we have seen, European witnesses often reported cures as African in origin even when they had American roots. Late eighteenth-century reports of indigenous cures generally came from the Guianas (along the north coast of South America), where Amerindians still flourished. But even in the Guianas, Amerindians rarely served as physicians, nurses, or medical assistants, and by the late eighteenth century (in contrast to earlier periods) medical texts seldom mentioned them. It is possible that Africans perpetuated Amerindian plant usages even after the peoples themselves were destroyed. By contrast to Amerindians, European plantation doctors often worked closely with slave medical assistants—men and women—who served on estates or rode with them to make calls. John Quier, who practiced medicine fifty-six years in Jamaica, had several black medical assistants. He noted that his “negro nurses” were in the habit of bathing slaves’ swollen feet in urine (not a cure unique to Africans). Seeing no harm in the practice, he did not stop them. James Thomson, also in Jamaica, reported that “expert negroes” did surgery to secure the breasts of slave women stricken with yaws (because European medical men would not). John Williamson, also working in Jamaica, praised the skill with which a “negro doctor” extracted Guinea worms. These worms, sometimes many yards long, were wound around a small piece of wood until removed. Africans’ medical knowledge was considered of such value that European physicians in the West Indies often recommended that an “intelligent” slave—man or woman—be put in charge of a plantation’s hospital to dispense medicines, fix dressings, and the like.14

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Europeans readily collected and recorded West Indian cures—whatever their provenance. And, increasingly, they employed European-style trials to test their efficacy. The testing, recording, and publishing of cures were carried out in a similar fashion throughout European territories by European-trained physicians. BOIS FER AND THE CIRCULATION OF KNOWLEDGE

To further investigate the making of knowledge in the Atlantic World medical complex, we examine A. J. Alexander’s experiments with his “Negro Dr’s” cure for yaws carried out in the 1770s. We learn of these experiments from Alexander’s letters to Joseph Black, professor of medicine and chemistry at the University of Edinburgh from 1766 to 1797. These letters were subsequently published in the Medical and Philosophical Commentaries.15 Alexander, a Scottish planter, arrived in Grenada ready to experiment. As he wrote to Black, his former teacher at Edinburgh and family friend, he “drew up a sett of 400 & odd experiments” to determine the best way to manufacture sugar and rum. The son of a wealthy merchant and banking family (William, his father, re-exported tobacco from Glasgow to France), Alexander purchased estates in Grenada and Tobago in the 1760s and 1770s.16 His experiments were designed to enhance the efficiency of his plantation and his enslaved workforce. Alexander brought with him to the New World not only the physical equipment but also the protocols for effective experimentation. By the standards of the day, his trials were well conceived and well executed. The experiment we examine here had to do with yaws. Alexander detailed how, in 1773, he returned to his extensive properties, after a considerable absence, to find thirty-two slaves afflicted with yaws and confined to his plantation hospital. Some of them had been there for years. And those who had been sent away cured, he lamented, generally returned soon again with a new outbreak of the foul disorder. Because yaws was assumed to be a venereal disease, his surgeon employed standard mercurial treatment, which, when taken over several years, Alexander complained, left slaves’ health “broken.”17 Dissatisfied, Alexander resolved to take matters into his own hands and to “try some Experiments.” He sought out a “Negro who understood the Method of treatment in their [sic] own Country” and vowed to “let him have his Way.” Though Alexander never explicitly stated that the man was a slave, he wrote that the man had “lived upon the Estate many years,” and we can infer his status. Whether the unnamed “Negro’s” cure was reliable or not, Alexander felt he had nothing to lose by running his experiment. He put two yawey slaves under the care of the slave doctor and four under the care of his surgeon. As reported in Alexander’s letter, the Negro man sweated his patients “powerfully”

Experiments with the Negro D r’s Materia Medica

twice a day by standing them “in a Cask where there is a little fire in a pot.” He increased the sweat by giving them decoctions of two woods that Alexander identified as bois royale and bois fer. In addition, the unnamed man applied to their sores an ointment of iron rust and lime juice.18 The European plantation surgeon treated his four patients with drugs to induce sweats. To their sores he applied a number of noxious caustics: sacharum saturni (sugar of lead), green vitriol, antimony, and corrosive sublimate—all standard European treatments at the time. The surgeon’s treatment made Alexander “very angry” because it caused the slaves much pain.19 The outcome: the slave’s patients were cured within a fortnight; the surgeon’s patients were not. Alexander, a man of science, consequently gave the man of African origins four more patients, who were also quickly cured. Thereafter he put the slave in charge of all yaws patients in his plantation hospital, and at the end of two months all but about ten of the original thirty-two had been cured. Alexander’s confidence in the enslaved man grew. After the man’s “astonishing” success curing yaws, Alexander turned to him for the cure of ulcers more generally. Though the man’s treatment was not as effective as the yaws cure, Alexander judged it more useful than that of the European surgeon. In a second letter to Black concerning these experiments, Alexander elevated the man to the status of “Negro Dr.”20 What can Alexander’s experiment tell us about the Atlantic World medical complex? Alexander specifically called the slave’s therapies “Negro Materia Medica” and set them in stark contrast to those of the European surgeon. But the matter is not as straightforward as we might think. Was the slave’s cure for yaws African in origin, Amerindian in origin, European in origin, or something newly created in the West Indies? What actual data points do we have? How did knowledge circulate—across space, time, and cultures? Who learned from whom? Here we consider several hypotheses: that the cure was, indeed, of African origins; that the cure was of Amerindian origins and learned in some fashion by Alexander’s slave; that the cure was discovered by the slave independently bioprospecting in the Americas; or that a cure of Amerindian or African origins was curated by Europeans in the Atlantic World medical complex and ultimately passed along to the slave. THE AFRICAN HYPOTHESIS

Alexander’s experiment sought to cure yaws (Treponema pallidum pertenue), a form of the highly contagious treponemal infections that include pinta and syphilis and, like those diseases, can today be treated with penicillin. Yaws is believed to derive from the Carib yáya, meaning sore. Pian, the French term for

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the disease, is thought to be a Galibi word. In 1763, François Boissier de la Croix de Sauvages coined a Latin name for the disease in his nosology: framboesia, for its raspberry-like appearance.21 In the late nineteenth century, the London College of Physicians replaced Sauvages’s framboesia with morula (from morus or mulberry).22 Others invoked strawberries. Indeed, the desire to describe this grotesque disease through fruit names is remarkable. Physician Thomas Winterbottom, who worked in Sierra Leone in the 1790s, recorded African names for yaws, called by the Bulloms bihl, by the Timmanees tirree or catirree, by the Mandingos mansera, by the Soosoos dokkettee or kota, and by the Portuguese boba. Yaws is also a sailor’s term: a ship was said to “make yaws” when it did not steer steady in a stiff gale.23 The origin of yaws was as hotly disputed in the eighteenth century as that of its close relative, syphilis. Europeans saw it as a disease alternatively of African or of American origins—both continents host large tropical areas. Sauvages even distinguished yaws into two species—Framboesia Guineensis and Framboesia Americana. Savvy West Indian physicians complained that nosologists, such as Sauvages, had never seen the disease and that these distinctions only served to “puzzle the practitioner.” Examination of ancient remains today suggests that yaws has affected hominids for 1.5 million years and plagued both Africa and the Americas long before Columbus landed in the New World.24 Some European commentators went further to postulate bestial origins for yaws. The physician Thomas Trapham, writing in 1679, imagined that yaws originated in the “unhappy” coupling of humans with beasts. Indignantly, he denounced males—both Native American and African—who allowed their “humane seminals” to be wickedly and wantonly “suckt” into and caressed by the “vastly unsuitable matrices” of female malmasets, baboons, and drills. Such couplings—egregious sins against both God and nature—had wrought this “plague of morbid pollutions” known as yaws upon humankind. Benjamin Moseley, surgeon general in Jamaica, agreed that yaws was of a “bestial origin” and an African disease.25 Although by the 1790s most physicians took issue with such notions, Alexander Anderson, botanist and chief gardener in Saint Vincent, persisted in the belief that yaws arose from the carnal “connections” of “Indians and Negroes” with “some species of monkeys.”26 Europeans commonly confused yaws with venereal disease until John Hume’s lengthy 1747 article in the Edinburgh Medical Essays and Observations.27 A nonvenereal disease, yaws produces disfiguring ulcers and lesions and, in advanced stages, agonizing pain, especially in the joints, bones, the palms of the hands, and soles of the feet (figure 9). Europeans feared yaws and remained uncertain about whether the disease was transmitted via “miasmata floating in the air,” touch,

Experiments with the Negro D r’s Materia Medica

venereal contact, or “salty sea vapors.” The young physician Edward Bancroft in Dutch Guiana from 1763 to 1766 emphasized the susceptibility of slaves to infection, noting that “none ever receive this disorder, whose skins are whole” and that for this reason whites rarely were infected. But the backs of “negroes,” being often “raw by whipping,” scarcely ever escaped it.28 Malnourishment, poor housing, and fatiguing labor all contributed to slave disease (chapter 4). Europeans considered yaws an African disease.29 The prejudice against the malady was so strong that it was seen as carried by “dirtily disposed good-fornothing Negroes.”30 Europeans were concerned to distance themselves from the scourge; even a man as learned as William Wright taught that yaws was unknown to Europeans before commerce with natives of Guinea. He added

Figure 9. An early image of yaws—perhaps the first—published in a European journal. James Thomson (whose experiments we analyze in Chapter 4) apologized for the poor quality of his drawing. He promised six new excellent drawing by an “ingenious artist” in his projected second volume of Essays and Letters by West Indian Practitioners, which never appeared due to his death in 1822.

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that no traces of the disease were to be found in the writings of the ancients, “sacred or profane,” unless it were the affliction of Job (thought to be leprosy).31 Given the view that yaws was a slave malady, great shame attached to whites who contracted the disease. Succumbing to the yaws infection might reveal European men’s otherwise surreptitious affairs with slave women. Yawey whites were banned from elite society until completely cured, but even after all traces of the disease had disappeared, the lingering stigma “blasted away” any prospects for social advancement.32 Marriage to respectable women was out of the question. James Thomson noted that genteel young men accidentally infected were known to commit suicide.33 One of physicians’ first concerns was to teach planters how to detect the disease and to stop its spread. Jamaican physician Thomas Dancer taught whites how to recognize the first signs of yaws among their domestic Negroes so that the infected persons could be banished—in the same way that “Jewish law” banished lepers. He warned that slave wet nurses often tried to hide their disease to avoid being discharged. Though physicians often treated infants at the breast for various disorders by treating their mothers, in this instance Dancer assured distraught parents that a child could not be infected through a nurse’s milk and that the child was safe until the nurse broke out with pustules. The French were less sanguine about the safety of yawey nurses suckling white children. They printed and reprinted the case reported by the physician Helyes in Martinique of the “négresse” who had communicated the disease to the white infant under her care. The child’s mother caught it and the disease spread to the entire family.34 The standard treatment for slaves suffering from yaws was banishment to a yaws hut built in some remote corner of the estate. Here the patient might be cared for by an old slave woman, too infirm to work in the fields, who was employed to keep the sores clean. Or, more likely, the patient was sent away to the seaside, a plantain walk, or a provision ground in the mountains to act as a guard while fending for him- or herself. The whole operation was calculated to transpire “without any expence to the estate.” Moseley painted a bleak picture of a slave’s prospects for recovery: “A cold, damp, smoky hut for his habitation; snakes and lizards his companions; crude, viscid food, and bad water, his only support; and shunned as a leper;—he usually sunk from the land of the living.” Bertrand Bajon, surgeon at Cayenne, noted that such abandonment did not serve planters’ interests: such slaves were often rendered incapable of any service for at least two years.35 European practitioners were horrified when called to attend a yaws patient. Fearful of catching the disease, they viewed patients from afar and offered

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their opinions in a hurried and perfunctory manner. Those who dared visit the yaws house were advised to cover their faces and hands as protection against infection. Physician and plantation owner William Wright emphasized that, “should a medical man contract this filthy disease, his fortune and future prospects are ruined.” European doctors’ fear of yaws was reflected in their fees. In Saint-Domingue, physicians charged 10 livres per year per slave; they charged 150 livres for each yaws treatment.36 Despite the dangers, practitioners gradually became interested in yaws and its cure. Because yaws was seen as an African disease, experiments were done primarily on slaves. One of the most interesting trials was Alexander’s experiment to test the relative efficacy of African and European treatments for yaws, as described above. Alexander acted upon a reasonable hypothesis of where to find a cure when he turned to a man of African origins. Yet if the slave’s cure was of African origins, from what part of Africa? Who used the cure? Who developed it? We know the slave was a man; Alexander refers to him as “he.” We know that Alexander purchased the Grand Bacolet Estate in Grenada for £43,750 in 1771 and that this purchase price included 140 slaves. Alexander’s Negro doctor may have been part of that purchase.37 But here is where documents fail. Because the man is unnamed in Alexander’s report, it is difficult to conjecture about his origins. Further, although we know the man was of African origins, we do not know if he was born in Africa or in the islands—he is identified merely as a “Negro.” Although Europeans recognized that slaves born in the West Indies had a higher likelihood of survival, they most often simply considered them “Negro” or “black” without attention to finer detail (chapter 1). As a second strategy, we can look at shipping records to determine from what part of Africa the majority of the slaves transplanted to the east coast of Grenada came. Both French and British records must be searched, given that the man had lived on the estate for “many years.” The British took Grenada from the French in 1763, just a decade before Alexander’s experiment (Alexander was to lose his estate to the French again in 1779).38 Because Alexander reported the two woods using French names, bois royale and bois fer, we infer that the enslaved man was held first by the French. From the Trans-Atlantic Slave Trade Database we learn that of the 42,257 slaves transported to Grenada between 1750 and 1773 (there are few records for Grenada before 1750), 14,257 came from the Bight of Biafra and Gulf of Guinea Islands, 9,224 from the Gold Coast, and 6,931 from the Windward Coast.39 The rest came from various other West African ports. Together this information suggests a general point of origin for the cure.

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But there are complications. First, we do not know what part of the treatment the slave might have adopted from Africa—the sweating technique or the use of the two woods involved. “Sweating” in the eighteenth century was a common cure (based in Galenic medicine) and well known to Europeans. Already in 1747, John Hume, surgeon to the Naval Hospital in Jamaica, included as part of his cure for yaws sweating “in a Frame or Chair” with a “spirit of wine.” Hume followed this with an “electuary,” or sweetened medical concoction, that included Aethiops mineral (a black mercury sulfide), guaiacum, and sassafras. The infamous overseer Thomas Thistlewood in western Jamaica also included sweating as part of a treatment for yaws reported in his ten-thousandplus-page diary. Thistlewood, who doctored the slaves under his watch, learned from a nearby plantation owner, a Colonel Barclay, that he cured “crab-yaws” by boiling “hog-plum tree bark in a pot” and soaking slaves’ feet in it “as hot as can be bore” for nine days and nights. William Wright identified the hog-plum as Spondias myrobalanus, L. He noted that the bark was astringent and that the tree was so named because wild hogs fed on the ripe fruit.40 If we leave aside the enslaved African man’s sweating technique (which was fairly common) and bois royale (a name so vague it could be anything), what can we learn about the origins of his cure by tracing bois fer, one of the woods employed in his cure? It is interesting that Alexander, a Scot, conveyed a French term for this medicine. As noted above, this slave may previously have served French masters and certainly still identified his medicines in the French way (a French patois continues to be spoken in the island today). Despite the French names, Alexander considered the woods distinctive to the Negro man (whether African or Creole), identifying them as part of the “Negro Materia Medica.” Alexander promised to send Joseph Black samples of the two “medicines used by a Negro here in curing yaws.” Specimens were often lost at sea; there is no evidence that the woods reached Black.41 Alexander’s slave doctor may well have learned his cure in Africa, as Alexander suggested. Thomas Winterbottom, working in Sierra Leone from 1792 to 1796, described in detail how West Africans destroyed the “mother yaw” by heating an iron bar red hot and rubbing it with lime juice, which, when boiling, was dropped onto the open sore. Sometimes rust of iron along with black ants or Malagueta pepper was added to the juice and applied hot to the sore.42 In the absence of good documents, historians need to seek other ways of going at a problem. The question becomes: Is bois fer an African or an American cure? Is this tree indigenous to Africa, America, or both? Did the slave find African flora he was familiar with again in America? Did he, through trial and error, devise a new cure using an American tree, or did he

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learn the medicinal uses of bois fer from the Amerindians or, perhaps, even from the French? THE EUROPEAN HYPOTHESIS

Our data points for the bois fer are persistently French. In Saint-Domingue, bois de fer was already well known to “very experienced” French surgeons in the 1730s and 1740s as part of a treatment for gonorrhea. Bois de fer was also an ingredient in what Pouppé-Desportes pronounced “the best treatment” for yaws. In a practice surprisingly similar to the slave’s cure, a patient was enclosed in a well-heated chamber, bathed as his or her temperament demanded, and administered a “tisane sudorifique,” a tea that consisted of guaiacum, sarsaparilla, and bois de fer. This was followed by a “flower of sulfur,” also taken internally. Leaving no stone unturned, Pouppé-Desportes combined this treatment with bleeding and purging, which slaves objected to, and mercury, which by Alexander’s time was considered extremely harmful.43 Bois fer, then, was an established part of the French medical complex. Linguistic evidence suggests that the slave may have learned medicinal uses of bois fer from his French masters. But knowledge of the use of the plant may have come originally from Amerindians. Knowledge exchange in this period was promiscuous and multidirectional, and the French may have served merely as a conduit for that knowledge into the Atlantic World medical complex. THE AMERICAN HYPOTHESIS

The unnamed slave may well have learned about this wood from the French; we cannot rule out the European hypothesis. It is possible, however, that he learned of bois fer directly from Amerindian peoples. Pouppé-Desportes published, posthumously in 1770, an American pharmacopoeia of Caraïb materia medica. Here he provided an indigenous name for bois de fer: iberaputerana (figure 10). Bois fer translates literally to “ironwood”—a name derived from the tree’s hard, incorruptible wood. There is, however, no evidence that bois fer is what we English speakers call ironwood; William Wright identified ironwood as Erythroxylon areolatum, L., a different plant from bois fer. Nor is this plant guaiacum (a popular treatment for syphilis); Pouppé-Desportes provided a separate entry for guaiac in his pharmacopoeia.44 Pouppé-Desportes’s Carib name for bois fer does not appear in Father Raymond Breton’s 1665 Dictionnaire caraïbe-français, although Breton noted that the Caribs cured yaws easily by virtue of the favorable climate and also with powerful local remedies. These cures were complex and included the sap of a bitter, Chipíou, which was blackened with the sap of Génipa and mibi (a liana),

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Figure 10. Jean-Baptiste-René Pouppé-Desportes’s entry for bois de fer in his American pharmacopoeia. Note the Latin description (left); the French name, Bois de fer (middle); and the Carib name, Iberaputerana (right).

along with burnt reed leaves and other substances, and applied externally to yaws ulcers. When the yaws pustules burst, filaments of cotton were applied to diminish scarring. Other writers, such as Jean Nicolson, a Dominican priest, recorded Pouppé-Desportes’s Carib name for bois fer but rendered it Ibera puterana, thus assimilating it to Latin.45 Although Pouppé-Desportes purports to have recorded an Amerindian name for bois de fer, it was most likely not a Carib name. The people we identify today as “Caribs,” the warlike indigenous peoples who long resisted European occupation, inhabited the Lesser Antilles and were not typically present in

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Saint-Domingue, where Pouppé-Desportes lived and worked. While Europeans tended to call all natives of the West Indies “Caribs,” the peoples of this area were culturally and linguistically diverse. In 1775, Jean-Baptiste-Christophe Fusée-Aublet, the learned naturalist, published his magnificent Histoire des plantes de la Guiane françoise, where he provided a Galibi name for the tree in question: anacoco (figure 11). Significantly, Fusée-Aublet employed Galibi guides and assistants when herborizing in French Guiana at about the same time that Alexander was doing his experiments in Grenada.46 Proximity and porous borders made commerce—in people, plants, and knowledge—between Grenada, Trinidad, and the Guianas fluid in this period. Fusée-Aublet identified the plant scientifically as panococo, thus incorporating the Galibi into the specific name. The French naturalist Michel-Étienne Descourtilz confirmed some years later that bois de fer grew in Saint-Domingue, in two varieties—white and red—and produced a magnificent color image, featured on the cover for this book.47 Importantly, Pouppé-Desportes, Fusée-Aublet, and Descourtilz all noted that the grated bark of this tree was used in drinks to promote sweating. Further, all three suggested that bois fer was native to the West Indies. Given this history, it is likely that Alexander’s enslaved African doctor adopted an Amerindian cure—directly from Amerindians themselves or indirectly via the French medical complex. Modern-day Caribbean ethnobotanists identify a number of plants as bois fer, but in the late eighteenth century it was consistently related as the Robinia panacoco. We can say with a high degree of probability that this was the plant used by Alexander’s slave. As was common, bois fer or bois de fer had many uses in this period, and in addition to its medical virtues it was prized for its hardness. Used in commerce for building, it was “exported from America to France in large pieces.” It “took a fine polish,” we are told. Descourtilz added that the “English negroes” made dangerous clubs from it, which in their hands became “terrible weapons.”48 While Amerindians had disappeared for the most part in Jamaica and Saint-Domingue, many continued to populate the southern Caribbean (Grenada’s neighborhood) in the 1760s and 1770s. Carib knowledge was considered of such importance that in Guadeloupe a 1767 government ordinance warned against Caribs (Caraïbes) providing slaves with knowledge of plants and roots. Bertrand Bajon testified that an “Indian named Raimond” who had served for a long time as Bajon’s personal hunter had many antidotes for snakebite. These cures, Bajon claimed, were “discovered” and “named” by the Indians, or Sauvages, whom he praised as an industrious people. Raimond was so sure of his cures, Bajon remarked, that he never went hunting without them.49

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Figure 11. Robinia panacoco, known in the vernacular as bois de fer. The name Robinia celebrated the royal French gardener Jean Robin. Panacoco incorporated the Amerindian anacoco.

Experiments with the Negro D r’s Materia Medica

THE GREATER ATLANTIC HYPOTHESIS

It is, of course, possible that the enslaved African found a local wood in the West Indies that substituted for woods he employed on the west coast of Africa. Both West Africa and the greater Caribbean are tropical, and some eighty-five floral families are common to both. These plants shared a common origin in West Gondwana (a southern supercontinent of Pangaea) prior to the separation of the land masses that subsequently formed Africa and South America (figure 12). Winterbottom in Sierra Leone reported that to cure yaws the Bullom people used the bark of the yuffo, boiled in water, and taken with rice in the morning as a purgative. Further, they used a decoction of the bark as well as an infusion of bullanta to wash the ulcers. The juice from the nintee was also administered internally and externally.50 Of course, Winterbottom, writing in 1803, may have been recording cures of former African Americans now living in Sierra Leone (displaced blacks from London and the Americas settled in Sierra Leone in the 1780s and 1790s). While these plants were used in similar ways to bois fer, there is no evidence that any of them are what Alexander referred to as bois fer. A final possibility is that seeds of this tree came directly from Africa. Nicolas-Louis Bourgeois in Saint-Domingue noted that there were many “doctors” among the Africans, who “brought their treatments from their own

Figure 12. West Gondwana, a southern supercontinent of the Pangaea.

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countries,” but he did not discuss this in detail. As noted above, Carney and Rosomoff have examined shipping records and pictorial evidence to reveal how African slaves naturalized their food staples in the American tropics— especially in the Caribbean.51 The same may be true for medicines. Slave ships, provisioned with foodstuffs and medicines, potentially carried seeds or shoots that could be planted in the Americas. I think, however, that if the African man had used a wood brought directly from Africa, or if he had recognized a local wood in the West Indies that substituted for woods he employed on the west coast of Africa, he likely would have called it by an African name. European documents suggest that both Africans and Amerindians had cures for yaws. In 1794 Richard Shannon recorded that “African negroes” in the West Indies cured both yaws and venereal disease with a treatment that included sea bathing (salt would be salubrious in this instance) and drinking a decoction of camwood sharpened with sour palm wine or citrus juice to promote perspiration. Camwood is interesting here because it is a shrubby, hardwooded tree that grows in West Africa and may represent a good example of an African cure transferred to the New World. Although Shannon recorded African nomenclatures for specific diseases and cures, he noted that he had learned of these particular treatments for yaws from French authors Jean Barbot and Jean-Baptiste Labat.52 By the 1780s, cures for yaws circulated within the Atlantic World. They were compiled with frantic urgency and piled one on top of the other—without concern for provenance. The Negro doctor’s cure spread to other parts of the Caribbean. Plantation physicians Thomas Dancer and James Thomson, both in Jamaica, adopted it. Dancer pointed directly to Alexander’s slave’s sweating techniques (but ignored his use of woods), writing that “a negro at Grenada is said to have been very successful in curing the yaws, by placing the patient in a cask, with a pan of burning coals; and thus sweating him, twice in the day.” Thomson found that the “use of woods employed by the natives” (by which he meant persons of African origin), coupled with good nutrition from a “generous diet,” alleviated the symptoms of yaws more effectively than the standard European mercurial treatments. And, Thomson noted, slaves felt strongly about the use of their traditional medicines. “To refuse the gratification of their inclinations,” Thomson wrote, “would only produce discontent without advantage.”53 Dancer and Thomson may have learned of the cure from slaves they treated; from reading its account in the Medical and Philosophical Commentaries; or, in the case of Thomson, from Joseph Black in Edinburgh, where he studied. Apart from sweating, bathing, or decoctions used to cure yaws, physicians in both the British and French West Indies recommended plentiful food and

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warm clothing as the best cure. Dancer recommended “supporting the powers of the constitution” by allowing a “nourishing” diet with plenty of vegetables and “good soups of fresh meat.”54 NOTHING ABOU T THE CASE

of the bois ferr is easy. The Robinia panacocoo is indigenous to the Americas, and the French data suggest both that Pouppé-Desportes collected knowledge of the plant’s use from the “Caribs” in Saint-Domingue and that Fusée-Aublet and Descourtilz collected similar information directly from the Galibiss in French Guiana. If the cure, indeed, is Amerindian in origin, how did this knowledge circulate to Alexander’s enslaved doctor? The slave may have learned the cure directly from the indigenous peoples of the Americas. Given, however, that the man used a French (and not an Arawak, Galibi, Carib, or African) name, we might presume that both the Amerindian and the slave spoke some French—the language of the masters. More likely, knowledge of the Amerindian cure transferred to the slave via the French medical complex. Although Pouppé-Desportes’s great work was not published until 1770, the cure was already an established part of French colonial medicine in the 1730s.

Figure 13. The “Negro D r” as knowledge broker. A. J. Alexander’s enslaved African seemingly brokered knowledge between the French and British empires. Evidence suggests that knowledge of bois ferr passed from Amerindians to French physicians to slave doctors and, subsequently, to British plantation owners and physicians. Knowledge may also have passed directly from Amerindians to enslaved Africans.

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What is interesting is that the knowledge passed from the French to the British via a “Negro doctor.” In other words, a slave, serving successive European regimes, fashioned himself a knowledge broker between European empires (figure 13). Enslaved healers, especially those recognized for their skill, were essential to the Atlantic World medical complex. Alexander no doubt purchased this slave along with his estate, and the man continued to serve his fellow slaves no matter who was the master. This proposed pathway—from Amerindians to French physicians and naturalists to slave doctors and, subsequently, to British plantation owners and physicians—suggests that the French served as a conduit for Amerindian knowledge into the Atlantic World medical complex. Curiously, within the British world, the cure remained a “folk” art—in this case, part of slave doctors’ materia medica. Even in the early nineteenth century, British plantation physicians cited the slave as the source of this knowledge, and not learned French treatises. It is important to analyze the circulation of knowledge not only across time, space, peoples, and continents but across (or, in this case, not across) certain belief and educational domains. Ultimately, plants, like people, were constantly in motion as the politically superheated and volatile mantle shifted culturally complex lithospheres to fashion intersecting and overlapping Atlantic Worlds. We must also keep in mind that the history of human experimentation is not a happy one. In Alexander’s account of his experiment, slaves were not mistreated. Alexander showed restraint by trying the new cure first in only two subjects, and his first two subjects were precisely those who had the most to benefit from the treatment. But this was not always the case. Plantation physicians such as John Quier and James Thomson exploited slaves in their experiments. These physicians took risks beyond what was reasonable to cure the individual patient; they took unusual liberties with human bodies (chapter 4). Alexander and the Negro doctor’s brave experiment, then, is intriguing, as it opens new windows into the Atlantic World medical complex. We must keep in mind, however, that knowledge circulated within a plantation complex characterized by war, slavery, and violence (chapters 5 and 6). Alexander had charge of this slave through conquest.

Chapter 3

MEDICAL ETHICS Truth and honour, in practitioners, only can give lustre and excellence to the science of physic. —William Wright, Jamaican plantation physician, 1779

EUROPEANS IN THE EIGHTEENTH CENTURY

inherited many notions from the past, such as the Hippocratic precept that physicians are “to help, or at least do no harm.” Whether Hippocrates’s actual words or not, this motto long served as a touchstone for medical ethics. Before the late eighteenth century, few philosophers commented on the use of human subjects in experiments. Ethics consisted largely of decorum (a physician’s behavior as regulated by good taste and propriety), deontology (a physician’s duties and obligations vis-à-vis professional colleagues and patients), and political ethics (a physician’s duties to the city or state and public welfare in general). Undergirding the whole stood Christian and Jewish moral imperatives concerning a physician’s duty to comfort the sick and dying. Physicians also inherited notions concerning the sanctity of life. The great British smallpox inoculator Baron Thomas Dimsdale, for one, reminded his colleagues that those acquainted with the first aphorism of Hippocrates should be cautious where the object was no less than a human life.1 Yet before the late eighteenth century few commented on issues arising from the experimental use of patients in medical testing—questions, for example, such as: Who will go first? On whom will unknown and potentially dangerous drugs be tested? By what standards of the good, the just, and the valuable are these decisions to be made? Today such questions are mediated through carefully crafted codes of patients’ rights, tightly enforced procedures for informed consent, and legally approved medical protocols.2 The Nuremberg Code, established in 1947 to avoid the atrocities perpetrated by the Nazi regime, codified important protections for patients. The first of these was the voluntary consent of the human subject. The 1979 US Belmont Report renewed basic ethical principles for research involving human subjects largely in response to the horrors of the Tuskegee Syphilis Study. Ethical principles in the Belmont Report emphasized “respect for persons” in the sense that subjects were to be fully informed volunteers who had freely given written consent without being offered excessive reward for participation. 65

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A second principle, “beneficence,” maximized possible benefits and minimized possible harms to individual subjects. Finally, the Belmont principle of “justice” stated that research should not unduly involve persons—the poor, prisoners, or underprivileged—unlikely to directly benefit from the research. Further restrictions applied to children under the age of fourteen and the mentally ill.3 This chapter investigates eighteenth-century ethical brakes on medical experiments in the Atlantic World. European physicians and surgeons working in this period did not conduct clinical trials according to modern procedures and mores. Yet even in the absence of written protocols testing followed a set of procedures that physicians understood to constitute standard practice. Experiments were governed by agreed-upon methods and ethical standards. Although experimentation was not regulated by governments or professional societies, physicians worked with care. Jamaican experimenter James Thomson remarked, “I have seen excellent opportunities pass by me without being able, from want of proper subjects, to derive the necessary advantage from them, a thing of all others most galling to an anxious mind.”4 ETHICS IN EUROPE: “TO HELP, OR AT LEAST TO DO NO HARM”

In the early modern period, as today, experimental subjects were rare and much sought after. Physicians in this period were desperate to get bodies, preferably compliant bodies. The new university teaching hospitals springing up across Europe came to supply such bodies. Hospitals had long served as charitable organizations for the care of the poor. In the eighteenth century, institutions, such as the Allgemeines Krankenhaus in Vienna and the Royal Infirmary in Edinburgh, were established across Europe with the dual purpose of decreasing welfare costs and returning wards of the state to gainful employment. Lying-in hospitals, also created in this period, were to serve the “Wives of poor industrious Tradesmen,” of “indigent Soldiers and Sailors,” as well as unmarried women in order to secure a growing and healthy population for the benefit of the state.5 These new urban hospitals—in London, Edinburgh, and Vienna— were associated with universities in such a way that they could be used to train new doctors and to develop new therapies. European clinical wards in this period served as laboratories for medical techniques of all sorts. Large hospitalized populations—both civilian and military—allowed for rationalized teaching, controlled bedside trials, and the development of medical statistics. The class distinctions between the sick poor and the educated doctors lent medical men an authority over hospital patients that they did not enjoy with their paying patients, many of whom were wellborn.

Medical Ethics

Moreover, patients in hospitals became accustomed to strict diets and regimens that allowed for more controlled testing than doctors could secure from trials with private patients. Military hospitals, in particular, provided large numbers of patients for treatment and, eventually, corpses for dissection and autopsy.6 It was in this context that new statements of ethics developed—and primarily in Edinburgh. Francis Home, professor of materia medica at the University of Edinburgh, a center of the new experimental medicine, eulogized the new teaching hospitals, which, in his words, “amply repa[id]” the costs the public paid “by promoting the study and practice of medicine.” Under one roof, Home continued, were collected a great variety of “morbid cases” to which students had easy access and where physicians could improve their science. Home sang the praises of the Royal Infirmary of Edinburgh’s clinical ward. On this ward physicians regularly reported symptoms belonging to each disease and every effect produced by the remedies employed. These reports then became the subject of professors’ clinical lectures. “There cannot be,” Home judged, “a more useful addition to a medical college, nor a more favourable institution for the improvement of the student, of the physician, or of medicine itself.”7 For Home, writing in 1782, there were no ethical safety brakes other than personal conscience. “Nothing hinders the physician from following his own reason and experience in the cure,” Home declared. “He is responsible to his own conscience alone.” Thomas Gisborne, an Anglican minister who also championed the abolition of the slave trade (but not the emancipation of women), was not so sanguine. He wrote against “unprincipled” practitioners performing reckless experiments on hospital patients, on the reasoning that “in the populous wards of an infirmary the ill success of an adventurous trial is lost in the crowd of unfortunate and fortunate events.” Gisborne feared that the death of an “obscure, indigent, and quickly forgotten individual” had few consequences. He considered experimenters too often “rash, ignorant, careless, and obstinate.”8 Home and Gisborne relied on individual conscience to regulate experimentation. By contrast, James Gregory, son of the ethicist John Gregory, and Thomas Percival, who first coined the phrase medical ethics in 1803, took the more radical step of augmenting personal honor with institutional accountability, thus fusing eighteenth-century moral theory to the practices of newly emerging medical institutions. Speaking directly to the issue of what we might call clinical trials, Percival stipulated that “no such trials shall be instituted, without a previous consultation of physicians or surgeons” relevant to the case. The “gentlemen of the faculty,” he continued, should examine “scrupulously and conscientiously” the merits of each trial and base their judgment on “sound reasons and just analogy, or well authenticated facts.” Percival reiterated Home’s notion that

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an account of every “rare, curious, or instructive” case should be drawn up by the physician or surgeon involved and used to better medical practice.9 Although ethicists at the time professed that the “moral rules of conduct” should be the same for all patients, they were not. Ethics in relation to medical testing in humans differed by a patient’s prospects in life. Testing, by and large, was rarely carried out on upper-class patients. It is significant that Percival did not treat the issue of experimentation in his sections on the proper conduct for physicians in relation to private patients. Concerning the study of “important cases” among the well-to-do and particularly those that ended in death, Percival admonished his colleagues to record the “whole curative plan” and especially the “operation of the several remedies employed, as well as of the doses and periods of time in which they were administered,” with the “most scrupulous impartiality.” For Percival, this would serve as a vital legal document should an inquiry be made. As a by-product, it would also serve to further “wisdom and rectitude in professional conduct.”10 Few complained, however, when things went wrong in treating the poor. In Europe, testing was typically carried out on the poor: hospital patients, soldiers and sailors, orphans, and, perhaps most dramatically, condemned criminals. Most subjects came from the same groups used for dissection—persons who had no relatives to seek out and pay for expensive medical treatment or, if worst came to worst, for Christian burial. William Withering, best known for his use of foxglove (digitalis) to treat dropsy, discussed openly the practice of using the poor to test dosages of his new cure before prescribing it for his paying patients. Practicing in Birmingham in the 1770s and 1780s, Withering provided free advice to the poor one hour per day, as was customary. This practice, he remarked, “gave me an opportunity of putting my ideas into execution in a variety of cases; for the number of poor who thus applied for advice was between two and three thousand annually.” Overwhelmed by so many patients, he confessed in despair that “in this mode of prescribing . . . it will be expected that I could not be very particular, much less could I take notes of all the cases which occurred.” Concerning these patients, he continued, “I soon found the Foxglove to be a very powerful diuretic; but then, and for a considerable time afterward, I gave it in doses very much too large, and urged its continuance too long.”11 Withering copiously recorded his paying patients’ cases, and one could argue that these patients, too, were subjects of his experiments with foxglove. He, however, did not prescribe it for his paying patients until he had refined his dosages using charity patients. Although historians have made much of Percival’s ethics emerging from teaching hospitals, regulation of experimentation by consensus among resident

Medical Ethics

physicians and surgeons was also practiced in the military. In 1785, a Dr. Coste related the results of tests with an opium cure for venereal disease done in a British military hospital in Flanders. Before the trials began, the design was approved by a committee “appointed for this purpose” that consisted of a “Messieur Desmilleville, first physician of the hospital; Messieurs Boucher and Salmon, physicians at Lisle; Messieurs Chastanet, father and son, surgeons of the hospital; and Messieurs Guerin and Gigot, surgeons of two regiments in garrison at Lisle.” The trials were conducted by Messieur Merlin, one of the physicians of the hospital, under the immediate inspection of the committee. Members of the committee “set apart for these experiments” thirty patients, kept an accurate register of each case, and visited the patients daily during the whole of the treatment.12 Interestingly, the effectiveness of the cure was also judged by committee—a feature that seems not to have become standard practice in civilian teaching hospitals. After about four months, seven of the original thirty patients were declared cured by unanimous agreement of the committee. Three months later, another seven were unanimously declared cured, another four were declared cured by a majority of the committee, while seven of the original thirty were judged as doubtfully cured. Four of the patients were considered “not cured,” three by a majority and one unanimously. A month later the committee examined twentyfour of the patients a second time. This time the committee could pronounce only eight cured. Although Dr. Coste, who wrote up the experiment, deemed the committee too severe in its judgments, he “candidly” acknowledged that these experiments did little to prove opium a specific for lues venerea.13 While other physicians, surgeons, and apothecaries might “witness” the good results of an experiment in this period, all too often physicians worked on their own and judged patients “completely cured” without verification from others (this was certainly the case in the West Indies). Where did eighteenth-century European practitioners stand on the principle of justice—that is, on the principle that experiments should directly benefit the individuals upon whom they were conducted and should not unduly involve persons (the poor, prisoners, or underprivileged) unlikely to benefit from subsequent applications? By the nineteenth century, physicians had accepted the notion that experiments should do no harm to individuals regardless of the potential benefit to society at large. The great nineteenth-century experimentalist Claude Bernard wrote, “It is our duty and right to perform an experiment on man whenever it can save his life, cure him or gain him some personal benefit. The principle of medical and surgical morality, therefore, consists in never performing on man an experiment which might be harmful to him to any

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extent, even though the result might be highly advantageous to science, that is, to the health of others.” Bernard added (and this is, of course, the motivation for medical testing with humans), “But performing experiments and operations exclusively from the point of view of the patient’s own advantage does not prevent their turning out profitably to science.”14 In the eighteenth century, however, a principle of “public utility” reigned. It was generally accepted that wards of the state, such as condemned criminals and orphans, and some employees of the state, including soldiers and sailors, could “benefit society” more generally by being used in medical testing. In this way, devalued members of society were revalued by lending their bodies to medicine. Importantly, Percival, in his ethics, advocated a principle of justice for hospital patients as a class, not as individuals. His wording is interesting: testing “new remedies” and “new methods of chirurgical treatment” in hospital patients augments the “public good.” Percival emphasized that testing new remedies in this manner was especially “advantageous to the poor” in that they were the “most numerous class of society” and hence the “greatest beneficiaries of the healing arts.”15 Despite Percival’s views, a number of checks and balances were built into the system in Edinburgh, as outlined by James Gregory, who drew upon twenty-six years’ experience as a professor of clinical medicine at the Royal Infirmary. Gregory emphasized that it was a physician’s duty to experiment, even with potentially dangerous drugs, when the situation was hopeless, despite risk to a physician’s “fame and fortune.” Yet these and all other measures were checked, first, by hospital managers, who had oversight of physicians’ behavior, and second, by apothecaries. Doctors had the power to prescribe, but apothecaries filled the order. An apothecary who received what he considered a dangerous prescription could apply to the physician or even to the patient to have the prescription explained or rectified. Third, and most importantly, every treatment prescribed by a clinical professor was public, in the sense that it stood “on record in the clinical books kept by the clerks.” Medical students had access to these records and to patients’ case histories to copy verbatim. “Dangerous experiments,” made “without regard to any other consideration but the general interests of science,” would soon be known to hundreds, even thousands of “men of sense.” In later years, Gregory strengthened this latter claim: if a patient died as the result of an experiment, he judged, a physician might be culpable of “willful murder” or “at least what is called manslaughter in England, and culpable homicide in Scotland.”16 Gregory reminded his readers that clinical did not mean “empirical” or “experimental” but referred instead to the kind of medical practice and instruction that related to seriously ill patients confined to bed. Nonetheless, it is impor-

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tant to point out that it was assumed throughout these ethical debates that hospital patients might be used for experimentation without their knowledge or consent. Stating common practice, Gregory remarked, “I do not mean that experiments, of the proper kind, are not to be tried in clinical wards, or clinical hospitals.” But, he continued, patients were not to be subjected to experiments that would not be permitted in other wards or hospitals or in private practice. This last, “private practice,” did, in fact, apply safety brakes.17 In Europe, then, charity patients, soldiers, sailors, prisoners, and orphans were used (with circumspection) to test all manner of cures: from intravenous injection of laxatives for cure of venereal disease (in men) and epileptic fits (in women) to new styptics for amputation and mastectomy. From a medical point of view, there was nothing special about these patients, except their availability. Did these nascent ethics travel across the Atlantic? What ethics guided physicians when caring for slaves on New World plantations? ETHICS IN THE WEST INDIES: THE QUESTION OF SLAVES

Populations of slaves, concentrated on New World plantations, might seem a boon to European physicians. Here was a captive and controllable group available for experimentation—an ample supply of bodies. What legal or moral precepts governed New World physicians’ medical experiments with slave bodies? The ancients said little about the medical care of slaves or about medical access to their bodies. The Hippocratic Oath, for example, required the physician to “benefit the sick” and refrain from “all intentional injustice” or “mischief ” in relation to “both female and male persons, be they free or slave.” Plato is said to have suggested that doctors should treat citizens, while their assistants should care for slaves, but he developed no deeper distinctions. It should be pointed out that the tradition inherited from the ancient world was experimentation with condemned criminals, not slaves.18 Eighteenth-century ethicists may have assumed that slaves were to be treated medically on a par with free persons of similar economic status—that is to say, the poor and disadvantaged. As we saw above, the poor in Europe were thought to have a duty to be of service to medical science in return for care. Unlike Europe’s poor, however, slaves were valuable property of powerful masters, and masters were key players in the plantation complex at the heart of New World colonialism. In many instances European physicians in the colonies did not—as might be expected—use slaves wantonly to test new remedies. Documents prepared for the British government in 1788 revealed the assumption that the welfare of slaves could be left to the “discretion of the owners,

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whose interest in their [slaves’] preservation” secured their “good treatment.” Physicians and island agents reported that “no laws or other regulations” governed the “care to be taken of Negroes” other than those arising from “Custom or Usage” or “humanity.” The governing council on Saint Christopher island clearly understood good health care for slaves to be in the “interest of the proprietor.” Similarly, Jamaican physician John Williamson spoke of the “lives and health of Negroes” as “valuable” to proprietors.19 While I would not want to push the argument too far, it seems that in the eighteenth century slaves were protected from excessive medical exploitation by slavery. West Indian doctors and surgeons were, to be sure, complicit in a plantation complex characterized by neglect, suffering, violence, and torture.20 And we find exploitative experiments with slaves (chapter 4). Yet eighteenthcentury experiments with slaves were not comparable to those in the US South associated with nineteenth-century hospitals (see below) or the twentiethcentury Tuskegee experiments with free African Americans, where a known cure was withheld from patients while physicians studied the course of a debilitating and deadly disease in their bodies. To the extent that masters were wealthy clients, university-educated physicians in the British West Indies espoused a gentlemanly ethic. John Williamson wrote that plantation owners and their physicians should be on “intimate habits,” engaged in relationships of mutual respect that inspire “humane feelings.” According to Williamson, “character and a sense of duty” ideally regulated practice in Jamaica. The learned plantation physician William Wright agreed. His experiments with cold bathing (see below), for example, were tempered by concerns for his reputation. Should an experimental treatment lead to death, Wright cautioned, the physician would “justly lose his character.” For Wright, “truth and honour” lent “lustre and excellence to the science of physic” (figure 14).21 The care of slaves in the West Indies, like the care of the poor in Europe, was governed by physicians’ sense of humanity. A physician, for example, was not to abandon hopeless cases in order to improve his record of success. Thomas Fraser, working in Antigua, bemoaned the “scanty allowance” physicians were given for the considerable “fatigue” they endured in plantation service. “Reputation” and “conscience,” however, were “not a little concerned in the recovery of these patients, and this was always with me a motive to avail myself of every artifice that might secure a happy event.” Williamson also noted that even in hopeless cases of inveterate venereal disease (plentiful among slaves), a physician should try everything that “could be done” and never dismiss an “unfortunate human being.” This charitable ethic applied,

Medical Ethics

Figure 14. William Wright (1735–1819), Scottish naval surgeon, later plantation physician and owner in Jamaica. Wright is typical of Jamaican plantation physicians. He was educated at Edinburgh, served as a naval surgeon until the end of the Seven Years’ War in 1763, and then sought a position as a plantation physician (and, later, owner) in Jamaica. He became a learned naturalist and fellow of the British Royal Medical Society, the Royal Society of London, and the Royal Society of Edinburgh. Physicians of lesser standing, such as John Quier and James Thomson, were not rendered in portraits.

too, in the military. Leonard Gillespie, surgeon to His Majesty’s Naval Hospital at Saint Lucia, was prompted by “the duty I owe to humanity in general, and the naval service of my country in particular” to preserve life. Like his colleagues in Europe, Gillespie encouraged learning by publishing the results of his experiments and observations.22

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Yet plantation physicians, whether gentlemen or not, were employees of plantation owners and as such were subject to their will. A physician known only as Macgrudan in Jamaica reported that he wished to try what he thought a “perfect cure” for yaws (the Aethiops mineral)—a treatment that he estimated would take three or four months. He noted, however, that “planters neither care to lose their [slaves’] labour, nor to take the trouble of attending them so long.” Macgrudan remarked that he was forced by the plantation owner to administer a mercury sublimate to six of the slaves under his care despite his “protests and repugnance.”23 In practice, physicians’ ethics in the British Caribbean were regulated predominantly by contract. In answer to the British governmental inquest concerning laws or regulations for the care of sick slaves, island agents and physicians detailed the financial agreements governing care. Doctors worked on a per-call basis for which they were paid five shillings per head per year in Jamaica (fees were similar throughout the islands). For this they visited plantation hospitals at regular intervals and were “on call” for cases of acute illness or accident. Doctors were typically paid extra for surgeries, inoculations, and delivering babies (although this latter work was often the domain of women).24 While we might argue that a genteel ethic of charity prevailed among university-educated physicians, the majority of European practitioners in the West Indies were not gentlemen. Colonial physicians were by and large young men with few prospects in life. Most were poorly trained. The work was dirty and exhausting. It attracted men who scraped together a meager living as naval surgeons during wartime and as colonial doctors during peacetime. Practitioners all too often united the functions of physician, surgeon, and apothecary, prescribing remedies, performing operations, and compounding their own medicines. John Williamson remarked that practitioners in Jamaica were of “various grades”—from the apothecary’s boy to men of the greatest eminence and worth. Much “mischief,” he continued, “has been done by rash and ignorant men,” many of whom practiced without even a surgeon’s certificate—and, we might add, without training in the fine points of gentlemanly conduct.25 Plantation masters, while interested in securing their investment in human chattel, often did little to protect the health and well-being of their slaves. Medical men complained that their accounts for attendance on white persons were “badly paid” and that what masters allowed for the medical care of slaves did not at all “compensate for the trouble they generally have.” Practitioners complained further that on some plantations there was a “total inattention to prescription and diet,” and doctors’ orders were not carried out. Further, wine

Medical Ethics

was often withheld, “though it [was] customary with proprietors to send a liberal supply for the sick.”26 As in Europe, physicians in the West Indies took it as their duty to object if, for reasons of economy, their patients were given insufficient medications, food, or clothing, or poor housing. Williamson in Jamaica and Jean-Barthélemy Dazille in Saint-Domingue were strong advocates for bettering the material condition of slaves (chapter 5). In Europe, hospitals—charitable and, later, teaching—were the centers of medical experimentation. By the 1780s, both the British and French were installing hospitals on plantations. As early as 1764, James Grainger in Saint Christopher had advocated that every plantation establish a “sick house,” consisting of four detached rooms—the first upwind for fevers, smallpox, and other highly contagious diseases, a second room for surgery, a third for venereal diseases, and a fourth to house the nurses. A supplemental yaws hut was to be set well apart from other buildings. Grainger painted a rosy picture of a sick house bordered by a “strong lemon and lime hedge” (lemons and limes were used as antiseptics and antiscorbutic), herbs for medicines, and a walkway for the convalescents. The French added that the hospital must be raised a little above the ground for the sake of “cleanliness” and good air. Hospitals might also include a separate room for women “lying in.” James Thomson noted the need for a good midwife, though, he admonished, “she should not be too confident in her own opinions” and should call a physician when necessary. The Good Hope hospital built in Jamaica in 1798 was the most palatial of these setups, serving nine estates and consisting of matching three-room wings for women and for men (figure 15).27 In reality, however, plantation hospitals were mostly two-room affairs referred to, in Jamaica, as “hot-houses.” They were profoundly not teaching hospitals; they were not governed by boards or protocols. Physicians rarely attended; no students were trained. Jean-Barthélemy Dazille, inspector of hospitals in Saint-Domingue, aspired to remake the 750-bed military hospital in Cap-Français into a teaching hospital, but he had no such hopes for the ten- to sixteen-bed plantation hospitals. These hospitals, in both the British and French Caribbean, tended to be constructed in haste, “filthy in the extreme,” poorly provisioned, and attended by superannuated slaves unfit for other employment. Dazille reported that colonial hospitals were destroyed by the “insatiable cupidity” of the entrepreneurs (contractors), who diverted monies for food, medicine, and wine for the sick to personal profit. The disorder of the royal hospitals, Dazille wrote, was ruinous to the king’s finances.28 Slave hospitals were also, importantly, places of confinement, fitted with iron bars and padlocks. James Adair, plantation owner and physician in Antigua,

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Figure 15. Plan of the hospital for sick slaves built at the Good Hope Estate, Jamaica, circa 1798. This plantation hospital was elaborate, by the standards of the day, with matching wings for men and for women. It served nine estates. Ruins of this “hothouse” can still be seen today.

Medical Ethics

counseled that slave nurses should be punished severely if they neglected to administer medicines or food regularly. Having a low opinion of these women, he warned that they were “apt to waste the former, and embezzle the latter.” To ensure that a nurse carried out her duties, Adair admonished plantation managers to lock up the nurse every night with the sick and punish her if she escaped by any window.29 It is important to point out that, in contradistinction to Europe, plantation hospitals were not the locus of medical experimentation in the West Indies. As we shall see, experiments were done using general plantation slave populations, not primarily hospital inmates. It is interesting that two of the most active experimenters in Jamaica, John Quier and James Thomson, whose experiments we analyze in chapter 4, said nothing about ethics. Quier understood himself to be relating “practical observations” and “matters of fact.” His technical reports were to be “useful.” Both Quier and Thomson, however, were also plantation doctors who were close to the people. Thomson evinced a care for the people he treated. In reference to combatting the power Obeah held over slaves (chapter 5), Thomson recommended that the plantation doctor should “endeavor in his own capacity to gain the confidence of those entrusted to his care. He should never,” Thomson continued, “refuse the gratification of their wishes, when they do not materially interfere with the actual state of the disease.” Thomson represented the relationship between doctor and slave as a two-way street, where he derived useful information from the “more intelligent among them,” which he, then, used in his practice.30 Physicians’ conduct could, in rare instances, also be governed by their patients—even slave patients. John Williamson, practicing in Jamaica, noted that slaves were averse to surgical operations. One slave, James, had suffered a fracture of his big toe, after which the bone had decayed, and Williamson deemed amputation the only remedy. But the man objected. Williamson tried all remedies available to him, then informed James that no alternative but removal remained. James, however, persevered and asked to visit an “old woman” of “transcendent ability” in the vicinity. Poor James, however, returned a few weeks later, no better, and submitted to the operation. He was (as so often was reported) “perfectly” cured.31 Unlike medicine in the British Caribbean, where the majority of physicians were independent contractors, the French medical complex was a highly organized colonial machine, as James McClellan and François Regourd have beautifully detailed in their Colonial Machine. French colonial physicians by and large were pensioned by the king and served in a finely nuanced hierarchy orchestrated from Paris. The day-to-day workings of colonial medicine were overseen on the ground in French territories by the médecins du roi, or chief

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royal medical officers, followed by the royal surgeons. It was these men who penned medical treatises in the French Caribbean in this period. These medical officers, in turn, licensed military and urban physicians, surgeons, apothecaries, and midwives in the islands. Plantation surgeons were, however, generally unlicensed. The historian Pierre Pluchon has estimated that six hundred to eight hundred of them operated in Saint-Domingue in 1791.32 Given this hierarchy, experimental practices in the French Caribbean were often regulated from Paris in ways that allowed colonial physicians to ignore justificatory frameworks. For example, the lengthy Dissertation et observations sur le tétanos, published in 1786 by Saint-Domingue’s learned society, the Cercle des Philadelphes, answered, without elaboration, the Société royale de médecine’s call for information from the colonies on tetanus, the destructive disease carrying off numerous slave infants.33 Numerous plantation doctors’ observations were collected and published by the Cercle. In the French as in the British Caribbean, university-trained physicians understood themselves to be working for the good of humanity. Jean-Barthélemy Dazille, the great colonial physician in Saint-Domingue, emphasized that a good physician worked tirelessly to present useful observations that would benefit “humanity.” But, he added in contradistinction to his British counterparts, a good physician also served “his fellow citizens and the government.” French colonial physicians, rhetorically at least, promoted a mercantilist, statist agenda. For mercantilists, wealth consisted of three essential components: population, manufactures, and foreign trade. French physicians understood it as their job to keep the workforce—of sailors, soldiers, and slaves—healthy and productive. Royal surgeon Bertrand Bajon in Cayenne reminded his readers that Negroes merited a physician’s attention and sensibility. Yet he continued, without missing a beat, that the prime motive for developing new cures was that Negroes created wealth in the Americas. “It is their arms,” he extolled, “that cultivate the earth and produce the riches that fuel Europe.” The Malthusian antipopulationism that took root in England in the 1790s had no place in slave economies, where all hands were needed to fuel wealth.34 Dazille presented these economic arguments powerfully in the opening pages of his 1776 edition of Observations sur les maladies des nègres (Observations on the diseases of Negroes). In his dedication letter to AntoineRaymond-Jean-Gualbert-Gabriel de Sartine, comte d’Alby, secretary of state for the navy, Dazille declared, “The cupidity of Europe enslaved the Africans, who, despite their great utility, are the most unhappy and neglected part of the human species.” Humanity, personal interest, and politics, he continued—all demanded their rescue: “It is the population in the colonies that determines

Medical Ethics

prosperity.” If the population was strong, a colony was wealthy; if the population was weak, a colony languished. “It is specifically the abundant population of Negroes,” Dazille proclaimed, “that provides to the colonies the primitive source of their opulence.”35 Comparing French colonial holdings in the New World, Dazille calculated that territories settled with enslaved Africans, such as Saint-Domingue, created dazzling wealth, whereas those settled only by Europeans, such as Canada, soon collapsed into poverty. Dazille considered it his job as a physician to cure especially the diseases of Negroes, soldiers, and sailors. This work, he concluded, was essential “to the wealth of the colonies in particular, to the commerce of the nation in general, and to the prosperity of the state.” Robust slaves were of such value in this period that they were known as “un nègre pièce d’Inde ”—an accounting unit referring to a perfect male specimen between the ages of fifteen and thirty, robust, without physical defects, and with a full set of teeth.36 WHO GOES FIRST? EXPERIMENTS WITH COLD WATER

Self-experimentation—the notion that the physician “goes first”—was also part of Atlantic World experimental culture. The willingness to experiment on oneself was a measure of a physician’s “faith” in a particular treatment.37 Throughout this period, we have seen, doctors bioprospected for new cures and valuable plants. After identifying a potentially useful substance, an experimenter examined its color, smell, and taste in efforts to understand its relation to known drugs. In Europe, substances might then be tested for chemical properties in a laboratory. In the Caribbean, substances were prodded, tasted, scrutinized, and, at times, sent to Europe for such analysis. Testing, especially for toxicity, came next and was done through the experimental use of animals. In Vienna, Anton von Störck, pioneer of experimental pharmacology, famously tested his wonder cure for breast cancer (a hemlock extract) on a little dog in the 1760s. It would be “criminal,” he remarked, to make the first trial of this substance on a human. In Europe, the dog became the experimental animal of choice. In the West Indies, it was the chicken. Bajon in Cayenne did numerous trials with manioc or cassava root on an “infinite” number of animals, mostly chickens, to study the relation of dosage to death in 1771. Raw manioc is a deadly poison (the root contains cyanide among other toxins); cooked it is a nourishing dish.38 The next step was self-testing. Potential drugs were smelled, then touched to the skin, and finally tasted—first only with the tip of the tongue, and then, if appropriate, taken internally.

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Historian Stuart Strickland has described how natural philosophers, such as Johann Ritter, used their own bodies as “calibrated instruments” epistemologically equivalent to the voltaic columns, Leyden jars, thermometers, and other devices littering their laboratories. The body of the experimenter provided unique information not available through the use of other instruments, yet ideally it also became an instrument, simulating as nearly as possible inanimate objects’ indifference to the “prepossessions” of errant humans. Physicians, unlike the physicists, rarely used their bodies as unique instruments, as when Albrecht von Haller, in the course of dying, recorded the effects of opium in his body taken daily over the course of two and one-half years.39 More commonly, the physician was simply the first human to try a cure. Information gathered by the medical auto-experimenter was deemed credible: a medical expert could presumably distinguish effects relevant to the experiment from other “subjective” states of his own body. This information was also considered “pure,” gathered as it was from a healthy body (which, it was assumed, could handle a dangerous drug better than a body already weakened by illness). Self-experimentation—the willingness of an experimenter to “go first”—also exonerated physicians when they used the medication, perhaps with fatal results, in others.40 Auto-experimentation was, at times, taken to extremes. In the 1790s, two young gentlemen, no doubt medical students in Edinburgh, inoculated themselves with gonorrheal pus to see if they could induce disease. Their experiment began by introducing infected pus into the urethra, then “fretting the skin of the prepuce and glans with a lancet” and rubbing these with infected matter. While in both instances some irritation resulted, no gonorrhea ensued. The surgeon Benjamin Bell, reporting the trial, remarked that “experiments of this kind are productive of such anxiety and distress, that they never have been, nor probably will be, repeated so frequently as the nature of the subject would require.” Bell judged, however, that experiments with gonorrhea or venereal disease more generally were done with “great bias” for the outcome and “therefore are not trustworthy.”41 Toward the end of the eighteenth century, self-experimentation became more systematic and organized. In efforts to overcome the idiosyncrasies of an individual experimenter’s body (to calibrate his body against others), physicians and medical students tested potential drugs in groups. James Thomson in Jamaica recounted how he learned the techniques of auto-experimentation at Edinburgh, where students associated in groups for “the purpose of making experiments on various medicines.” According to his report, each man was assigned specific drugs to test in his own healthy body. Each recorded

Medical Ethics

in minute detail “the state of the pulse, vomiting, dizziness, and every other circumstance.” Drugs were taken by different individuals at the same time, and the results were compared. Thomson continued, “We then inferred that, generally speaking, the same results will follow in a morbid state, and combat successfully certain symptoms which we wish[ed] to obviate.”42 Thomson implemented this style of self-testing in Jamaica as he studied the many remedies that grew abundantly on the island. He experimented, for example, with unroasted coffee, first in himself, then in patients under his care. These traditions also animated the French Caribbean. Bertrand Bajon in Cayenne realized through several accidental slave poisonings that humans who ate the meat of animals that had died from manioc poisoning became severely ill. To confirm these observations, Bajon did tests on himself and a friend, M. de la Lustiere, with whom he lodged. They each knowingly ate poisoned chickens and became violently ill. To establish precisely the cause, they repeated the experiment. From these self-experiments, the men concluded that public sale of poisoned animals should be regulated.43 It is not surprising, then, that William Wright claimed to have first tested his new therapeutic cold bathing on himself. Wright experimented with cold baths to treat fevers, lockjaw (tetanus), and smallpox over the course of two decades. His treatment consisted of dousing a person in the “paroxysms” of fever with several pails of cold water. He preferred sea water to fresh. Although such a treatment seems not terribly invasive to our eyes, many eighteenth-century medical men taught that the shock of sudden cold was highly dangerous, especially in bodies weakened by disease.44 According to his own account, Wright was led to consider cold bathing after observing how greatly people laboring under “malignant fevers” were refreshed by washing their hands and face in cold water. He continued, however, that a practice so “new in Jamaica, and so different from the common methods,” could hardly be proposed, and he kept his opinion to himself until a “favourable opportunity” presented itself.45 In his article published in London in 1786, Wright stated that such an opportunity arose on his voyage to England in August 1777 and that the test subject was himself. As he recounted, Wright caught fever upon his return voyage from Jamaica while attending a sick sailor. This man refused to be moved into cool air. As his condition worsened, he refused medicine and food; he died on the eighth day of his illness. When Wright became ill, presumably with the same disease, he administered himself a “gentle vomit,” and the next morning a “decoction of tamarinds”; at bedtime he took an opiate but found no rest. He continued with standard medicines, such as the Peruvian bark taken every six hours along with

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some port wine—but with no success. He asked to be moved on deck, where the colder air made him feel better. “This circumstance,” he reported, “and the failure of every means I had tried, encouraged me to put in practice on myself, what I had often wished to try on others, in fevers similar to my own.” And so his experiment was on.46 At about three o’clock in the afternoon Wright stripped off his clothing and had three buckets of cold salt water thrown on him. “The shock was great,” he noted, “but I felt immediate relief.” He continued his “cold bath” twice daily for three days and gradually improved. A fellow passenger, a young gentleman, also caught fever and, having witnessed Wright’s recovery, requested the cold bath. Wright agreed and combined the man’s frequent bathing with more standard treatments: good air, clean clothes, a moderate use of wine, and the bark. The man was soon restored to health.47 Despite his account, we learn, however, that Wright in fact did not “go first.” In a paper read to the Medical Society of London in 1779 but not published until 1807, Wright wrote that he had tested his cold bath on over five hundred subjects during the fatal smallpox epidemics of 1768 (the same epidemic that prompted Quier to perform his experiments with smallpox inoculation, chapter 4). Significantly, the test with these subjects was conducted nearly a decade before Wright tried it on himself. Although not explicitly stated, the large number suggests his subjects were slaves, most probably in the parish of Saint James, where he was a plantation doctor and slave owner. As soon as people were seized with the “variolous” smallpox fever, Wright ordered his assistant to throw “cold water on their naked bodies every four or six hours.” The results were good: patients were relieved of fever, headache, and back pain and also—more importantly—suffered a milder form of the disease. Wright recollected that not more than one patient out of five hundred treated in this manner experienced any ill effects from his cold “affusion.”48 Wright suggested that this 1779 report was suppressed because the Medical Society of London found his treatment “rash and daring” and would not sanction it. That may well be the case, but there were other aspects of the report they might not have wished to sanction. In this paper, Wright reported that his cold bath originated not from his own observations, as suggested in 1786, but from the classic European smallpox inoculators Thomas Sydenham, Robert and Daniel Sutton, Thomas Dimsdale, as well as, perhaps alarmingly, from Maroon Negroes. As we shall see later in some of James Thomson’s work, African origins of cures were often excised from European, though not Jamaican, publications (Conclusion). In this 1779 paper, Wright matter-of-factly stated that “the Maroon Negroes in Jamaica, and some nations on the coast of Guinea,

Medical Ethics

have the custom of plastering the bodies of such of themselves as are taken ill of the small-pox, and especially during the eruptive fever, with wet clay.” Their success “determined” Wright to try the cold bath. In this paper, Wright also reported adopting a second African practice: when the smallpox pustule was at its height, he punctured it with a sharp pointed instrument to discharge the pus, a practice “common on the coast of Guinea” but highly controversial in Europe. It may have been Wright’s faith in techniques of African origin, and not the cold bath itself, that alarmed his European colleagues. In later publications Wright pointed out that “the Savages in North America have long practiced the cold bath for the cure of fever.” As he described the technique, the Native Americans built a “fire in their narrow huts, where the sick man is, and the external air shut out. When the Indian is heated to the greatest degree, he suddenly plunges into a cold stream of water, and immediately returns to his hut where he falls into a profuse sweat.”49 Wright further tested his cold bath on slave bodies some eight years later. This time he used cold bathing for tetanus, a condition that plagued Africans in the West Indies and especially children. Wright found what he called a “fair opportunity” to test his technique in a twelve-year-old slave boy belonging to John Simpson, Esq., in the parish of Trelawny. The unnamed boy developed opisthotonos joined with tetanus after suffering sunstroke on a hot day in June. “He was soon afterwards taken speechless, and carried home to the estate, where he lay insensible, and at times much convulsed.” The boy was bled by the local surgeon, rubbed with camphorated spirits, and stimulated by smelling salts and enemas, then given a course of laudanum, sage tea, and gruel. Wright was sent for three days later when things appeared desperate.50 Wright judged this case a good opportunity to test his bathing technique because the boy’s situation seemed hopeless. Importantly, the plantation surgeon agreed to the experimental technique. The boy was stripped naked, and carried out into the open air: his body and limbs were so stiff, that it was with some difficulty we could place him in a sitting position. Two large pails of cold water were forcibly thrown on him at the same time. The shock from the water made him start on his feet, he recovered his senses in a great measure, and seemed surprised at what was done to him. After being rubbed with a dry cloth, a loose frock was put on, and a kindly glowing heat succeeded. By the help of a person he walked about for a little while, and was then suffered to lie down. His jaws already were greatly relaxed, and he swallowed some broth. I ordered him to lie in a cool airy place; that he should be covered with a single sheet, and that the cold water should be thrown on him once in four hours.

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This treatment was repeated every three hours and gradually reduced to twice daily. Approximately six days after Wright’s arrival “the cure was complete.”51 Wright tested his cure in four other slaves, three men and one woman between the ages of twenty-two and fifty-seven—all with good effect. This means that, far from “going first,” Wright had accumulated several years’ worth of positive cases and confirmation from several colleagues who also used this technique successfully before he experimented on himself in 1777. It is possible, of course, that Wright had no opportunity to auto-experiment because he was not ill. It is surprising, however, that he did not reference his tests on slave subjects in his report of self-testing (published as the second paper in the series).52 Slaves often went first. Jean-Baptiste-René Pouppé-Desportes in SaintDomingue reported that a “Negro” (we can assume a slave) was treated for gonorrhea with a decoction of “mal-nommée” (Chamaesyce hirta). When the master was assured that the Negro was cured, he used the same remedy on himself— with success. And a plantation mistress also in Saint-Domingue wrote to her daughter that she had been emboldened to have herself inoculated for smallpox after success with four hundred slaves.53 In Wright’s testing, we see a preference for slave subjects. It is significant that Wright had an opportunity to experiment on a white Jamaican, a cooper, in 1772, several years after his initial experiments with plantation slaves. In 1772, Wright was called to treat William Jewel, aged thirty, for fever. Wright cooled the man by throwing open the windows and doors, taking away his many bedclothes, and plying him with drafts of cold water—for drinking only. The man was grateful and offered him a “thousand thanks.” It is curious that Wright did not continue by dousing the man with cold water—perhaps the circumstances were not sufficiently dire.54 Wright reported further trials of his cold bath treatment—one, in 1784, involving a slave infant only seven days old. Wright was called to treat the child, one of his own slaves, suffering from the dread tetanus that carried off thousands— and had to inform the mother that the situation was hopeless. Because no options remained, Wright, with some difficulty, persuaded the mother to agree to the cold bath. The child was stripped and handed to Wright by the local midwife, according to Wright “a sensible woman of colour.” Wright plunged the child suddenly into a small tub of cold well water. Respiration stopped, and the child stiffened. The mulatto midwife accused Wright of having killed the baby. But he had her dry the skin and rub the body briskly with oil. Soon the child began to breathe and after an hour was put to the breast, where it sucked heartily. Wright expressed some dismay that the midwife took all the credit for the cure. This child lived two more years before dying of “worm fever.”55

Medical Ethics

Wright (or at least John Mitchell, said to be the editor of his Memoir) was anxious to secure Wright’s “indisputable priority” in the discovery of the use of cold water in fever. Wright worried that his legacy was slighted because the paper that would have established his reputation was read three times before the London Medical Society between 1779 and 1784 but its publication was “silently suppressed.”56 Wright’s claim to priority in discovery is all the more curious since the French knew well that slaves regularly used cold baths to lower fever. Bertrand Bajon in Cayenne reported that Pierre Barrère, working there in the 1740s, had cured tetanus with cold baths but that he himself and a M. de Chanvalon in Martinique had found no positive effect. Physicians used the technique in colonial military hospitals (without special comment) in 1778. Nicolas-Louis Bourgeois, a longtime resident in Saint-Domingue and secretary of the Chamber of Agriculture at Cap-Français, also reported that to cure fever “Negroes throw cold water on themselves and bathe in it.” Bourgeois reported that he had seen whites try the technique with good effect and had even tested the cure on himself. He noted that, in addition to bathing in cold water, the Negroes cooled their heads with pourpier sauvages and herbe-à-piment gathered from ravines or river bottoms. In Jamaica, Thomas Dancer wrote an essay on cold bathing in 1777, a practice he traced to the ancients, and its benefits for diseases of warm climates. Despite Wright’s claim to priority, cold bathing was, as he himself acknowledged, both an ancient and a modern practice.57 In Wright’s experiments, slaves went first, but this was not always the case. James Currie, physician at the Liverpool Infirmary in England, also tested the cold water treatments. He, interestingly, did not test first on himself but on women in a wing of the infirmary that served as a “lock-hospital” for those suffering from venereal disease. A contagious fever broke out in the winter of 1786 and spread quickly through the infirmary. The intensity of the cold had prevented proper ventilation, and, for reasons Currie did not discuss, the discipline and cleanliness in the ward had deteriorated. Currie was put in charge of eight of the sixteen infected women. He remarked that he had used for “the first time” the effusion of cold water in the “manner described by Dr. Wright.” When good effects followed, he employed the remedy in the remainder of the cases, save for one. This patient he judged too weak and impaired by venereal disease, and indeed she died a few days later. The cold bath brought excellent results, and by 1797, when Currie published his book, he had documented its good effects in 153 cases of contagious fever.58 It is interesting to look at the populations of patients used in Currie’s trials: 94 of the 153 were hospital patients (Currie was an attending physician at the

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Liverpool Infirmary), 32 were soldiers stationed in Liverpool, and remaining 27 were private patients. The patients were women (including hospital nurses who become infected) and men of arbitrary ages. By 1797, Currie and some of his colleagues had become so confident in this cure that they stopped documenting successful cases and noted only when cold baths failed. Currie also used cold bath therapy in convulsive disease and insanity.59 Currie reported to Wright in 1799 that the use of cold baths in fever was “universally received and admitted among the better classes” in London and was frequently used among the poor if “their miserable accommodations” permitted it. In the prestige wars that surrounded the introduction of new cures, Currie readily admitted Wright’s priority (which Wright was keen to claim). Wright, on his side, recognized Currie’s contribution in establishing more precise rules on the use of cold baths in humans through his innovative use of the clinical thermometer. When it was suggested many years later that Currie’s work, in fact, predated Wright’s, Wright (or his editor) vigorously countered those claims.60 James Gregory at Edinburgh commented on the ethical implications of what he called an “excessive zeal for science,” even among medical men willing to “go first.” He cautioned that a physician should never administer dangerous medicines or techniques merely to “gratify his own curiosity.” Many medical men were willing to try “severe” and “dangerous experiments” on their “own person” to advance science, which Gregory saw as their right. However, if “purely from zeal for science” these men were to try such experiments on patients, they would not be “guiltless.” For Gregory, an experiment to save the life of the patient was allowed—even required—but it was the “duty of a physician,” as expressed in doctors’ oaths, to exercise the principle of caution and not to expose patients to any unnecessary danger.61 SLAVES: A PROTECTED CATEGORY?

Given their unique legal category—as the human property of powerful masters—did slaves become a protected class in emerging codes of medical ethics? Slavery was a legal category that set enslaved people apart from other patients, even the poor and destitute in Europe. As James Gregory at Edinburgh stressed, the charity patients in the one-hundred-bed clinical ward in Edinburgh were not the “property” of hospital managers, physicians, or surgeons but human beings to be served and protected by the “supreme and indefeasible” duty physicians owed to their patients.62 Slaves, by contrast, were considered human chattel and, as such, required specific protections. Until slavery was abolished, two historical pathways existed that might have shielded slaves from

Medical Ethics

exploitation in experiments: medical ethics emerging from European centers, and the Codes noir legislating the reciprocal duties of masters and slaves. One might expect James Gregory’s 1800 Memorial to the Managers of the Royal Infirmary or Thomas Percival’s 1803 Medical Ethics to address the use of slaves in medical experimentation. Slavery was hotly debated in Europe and in medical circles. Historian Laurence McCullough has shown that Gregory’s father, John, took part in such discussions.63 James Gregory himself treated the question of abolishing the slave trade in his Memorial of 1800 (though not in his 1803 Additional Memorial). One might argue that medical men in Europe were unaware of experiments being done on slaves in the West Indies. It should be kept in mind, however, that the Atlantic World medical complex delivered this news directly to their doorstep. William Wright’s papers were read at the Medical Society of London. A. J. Alexander’s experiments were sent to Joseph Black in Edinburgh, and notice of them was published in the Medical and Philosophical Commentaries. James Gregory, as president of the Royal College of Physicians in Edinburgh from 1798 to 1801, was in a position to consider a wide range of social issues. William Wright, himself an experimenter in the West Indies, succeeded Gregory in this post in 1804. It is significant that none of the treatises that constitute the canon of Anglo-American medical ethics either permitted or condemned the experimental use of slaves. A second historical pathway that might have led to protections for slaves was the Codes noir. The French first implemented the Code noir, the royal edict that established the basic law of slavery in the French Empire, in 1685. The Jamaican Assembly implemented their own “Consolidated Code Noir,” using the French nomenclature, in 1788 (replacing the acts relative to slaves that had been passed since 1696). These codes touched only lightly on medical care. The French code set the tone for those to follow, stating that “slaves who are infirm due to age, sickness or other reason . . . shall be nourished and cared for by their masters.” In the case that a slave was abandoned, he or she was to be awarded to the colonial hospital for six sols per day paid by the master.64 This “Negro System of Jurisprudence,” as the Jamaican code was called, detailed both the subordination and control of slaves as well as specific duties required of masters. Slaves, for example, were prohibited from conspiring rebellion, wandering abroad, assembling, beating drums, or pretending to supernatural powers. Masters, for their part, were to provide particular items of clothing, provisions, housing, and religious instruction. The new British Code of 1788, in response to humanitarian movements in Europe, emphasized greater protections for slaves, for example, from arbitrarily harsh punishments. But masters

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still had a free hand to mete out unduly severe punishments. A master who administered more than thirty-nine lashes for a single offence, for instance, was fined a mere five pounds.65 Article 31 of the Jamaican Code most closely addressed medical issues. Legislators sought to encourage a “natural increase” in slave populations by offering a reward of twenty shillings to plantation overseers for every surviving slave born on a plantation in a particular year. This article also addressed plantation doctors and surgeons directly. They were to give an account annually of the death of each slave and the cause of death to the best of their knowledge under “penalty of 20 pounds.” This provision might have brought to light deaths from medical experiments. It was here, in these codes, that restrictions on the use of slaves for exploitative experimentation might have been implemented. But none were. The development of medical ethics or legislation specifically designed to protect slaves from medical experimentation remained a historical path not taken. My argument in this chapter has been that slaves were, to a certain extent, protected by slave masters’ economic interests.66 Masters sought to maximize investments while minimizing capital costs. Plantation owners submitted their workforce to experimental treatments—such as smallpox or yaws inoculation— rarely and only when not doing so threatened a greater economic loss. Exploitation of persons of African origins for the sake of science, as in the case of the Tuskegee experiments, simply was not part of plantation culture. This argument holds for the early modern Caribbean. A key question becomes: Was the American South “distinctive,” as John Warner has styled it, in exploiting slave populations?67 The US South was distinctive for the longevity of slavery: slavery continued until 1863 (slaves were emancipated in the British West Indies in 1833 and in some French holdings from 1794 to 1802 and, again, in 1848). Slavery in the American South still flourished in the 1830s, when medical schools were being established there. These medical schools fueled the need for human bodies for teaching and testing. Historian Stephen Kenny has documented how slave bodies were exploited in these institutions—for dissections, anatomy classes, and clinical experiments. In 1852, the Medical College of Georgia in Augusta, for example, purchased one Grandison Harris to serve as janitor by day and to rob graves by night. According to historian Todd Savitt’s account, Harris served in this capacity for fifty years.68 The need for protecting slaves and, after emancipation, persons of African origins becomes apparent in J. Marion Sims’s well-known experiments with six slave women to develop a successful surgical correction for vesicovaginal

Medical Ethics

fistulas, a tear between the vagina and bladder or rectum. Sims worked on these women for three years before he had any success, and he operated on some more than twenty times—all without anesthesia. The induced bladder infections alone would have been unbearable without the opium Sims provided to keep his subjects quiet for up to two weeks after surgery.69 In the United States, the American Medical Association (AMA) formulated its first code of ethics in 1848. Sims’s experiments—carried out from 1845 to 1849—seemingly fell completely within accepted ethics. In 1869, Sims was censured by the New York Academy of Medicine for violating the confidentiality of an upper-class patient—surprisingly not for his experiments on slaves (though these surgeries were done in Alabama).70 Far from being condemned by his colleagues, Sims was elected president of the AMA in 1876. I would suggest that this premier medical association failed dramatically by not protecting slaves. Had the AMA acted in 1848 to protect the vulnerable, history might have turned out differently. Why would owners let Sims or other doctors experiment on their slaves? With the rise of medical schools in the American South, a new economic logic emerged. The slave women Sims treated in his private hospital were of no value to anyone (including their masters), and, as Sims put it, not even to themselves. A vesicovaginal fistula is a rip, resulting primarily from childbirth but also from rape, between the bladder and vagina, and at times extending to the colon, so that urine and feces run “day and night.” The odor, Sims wrote, permeated every corner of the house. “Death,” he continued, “would have been preferable. But patients of this kind never die; they must live and suffer.”71 Sims’s ethics, as presented in his writing, hinged on the slave women’s consent. Sims praised the “heroic fortitude” of his patients, writing that they submitted to operations “not only cheerfully but with thanks.” Ethicist Robert Baker has pointed out, however, that these women did not have the power simply to “walk away,” as disgruntled surgical patients often did.72 Had they been uncooperative, they would have been returned to their masters or turned out to fend for themselves. For Sims, the linchpin of his moral stance was his “agreeing to perform no operation without the full consent of the patients” and to perform no surgeries that would “jeopardy[ize] life.” But for slaves, as we have seen, it was the master’s consent, not their own, that controlled doctors’ access to their bodies. Sims and the slave owners struck a deal: the owner would “give” the enslaved women to Sims for these experiments. Sims, in turn, would “keep them” (provide food, medicines, lodging, and nursing) at his own expense. Owner were required only to clothe them and to pay their taxes.73

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Plantation owners in the nineteenth-century American South thus followed a new economic logic with respect to medical care for slaves arising with the establishment of medical schools. To induce masters to send slaves, medical school officers waived doctors’ fees.74 Plantation owners were charged only for a slave’s food and nursing. This reduced masters’ costs overall. They did not need to hire plantation physicians, keep a plantation hospital of their own, or provide nursing staff from among their own slaves. Caribbean islands, in contrast to the southern United States, did not establish medical schools in the period before emancipation. Had British or French colonies in the West Indies founded medical schools, a similar logic might have prevailed. IN THE EIGHTEENTH-CENTURY British and French West Indies, then, slaves were no more exploited for medical experimentation than were the

poor, hospital patients, orphans, or the like. In desperate situations, physicians serving the poor or large populations of soldiers and sailors might experiment with new remedies as a last resort. In Europe, physicians’ enthusiasm to test new medical and surgical techniques was constrained by their concern for their reputation and, eventually, hospital committees. In the West Indies, physicians were held in check by powerful masters concerned to preserve their costly investment in slaves. These sorts of protections for the enslaved, resting as they did on economic interest, were not enough in the long run. As the economic logic changed, so too did the fortunes of slaves. The paths not taken—ethical shields or legal protections for slaves—opened the door to exploitation. Practices and failures of the past inform attitudes and behaviors in the present. Had medical ethics in the eighteenth century developed to protect slaves—and not simply ignored them—might we have avoided the rampant exploitation of poor African American and other vulnerable populations in the centuries to come?

Chapter 4

EXPLOITATIVE EXPER IMENTS The subjects, I every where speak of, were Negroes. —John Quier, Jamaican plantation physician, 1773

EIGHTEENTH-CENTURY MEDICAL EXPERIMENTS

fell into several categories: those such as Thomson’s on the anatomy of skin color, specifically searching for anatomical and physiological differences between the races (chapter 1); those such as Colin Chisholm’s on the constants of human nature (body temperature) that considered race as one variable among many (chapter 1); and those such as A. J. Alexander’s in Grenada on treatments for yaws that tested new medical interventions specifically for plantation slaves (chapter 2). Testing in this latter category could be nonexploitative, in that the subjects tested were precisely those who had the most to benefit from a particular treatment. Alexander’s yaws patients and naval surgeon Leonard Gillespie’s sailors (below) were tested in the context of seeking cures for large groups of like people (slaves in Alexander’s case and sailors in Gillespie’s) and were intended to be therapeutic for the specific patients treated. In these cases, subjects were observed as they proceeded through novel treatments, and results were recorded, sent by letter to other physicians, and often published in efforts to increase the efficacy of practice locally and globally within empire. Ethicists at the time accepted that therapeutic experiments were permissible when commonly used medicines failed, which was often in the tropics. John Gregory stated in his medical lectures that “desperate measures should be used in some cases, where every other method has been proved ineffectual. In such circumstance we should have recourse to medicine which under more favourable circumstances might be thought dangerous.”1 Gregory continued with the caveat that these experimental methods should be only those a physician would be happy to try on himself or his own child, invoking the principle that the physician or one dear to him should go first (chapter 3). Today informed consent would also be required. This was not the case for large experimental populations—the poor, soldiers, sailors, or slaves—in the eighteenth century. It was enough that physicians judged the treatment to be in a subject’s best interest or, in the case of slaves, that masters approved. 91

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The testing of new medical interventions, however, could also be exploitative. In this chapter we examine John Quier’s experiments with smallpox inoculation in slaves in Jamaica in the 1760s and James Thomson’s experiments with yaws inoculation done in slave children in the 1810s, also in Jamaica. These experiments were exploitative because they took risks beyond what was reasonable to cure the individual subject: that is, they intentionally risked making a healthy person sick or a sick person sicker.2 Quier’s and Thomson’s experiments were made to advance the scientific understanding of disease and were not necessarily made with the best interests of the individual patient at heart. Slaves, however, were not the only vulnerable populations in the Atlantic World medical complex. In the West Indies, soldiers and sailors were also used for experimentation when situations were desperate. Like the poor in Europe or slaves in the Caribbean, soldiers and sailors had little choice regarding their fate. Leonard Gillespie’s experiments are interesting in this regard. Overtaken by an epidemic of “putrid ulcers,” Gillespie employed all cures available to him in vain until he found an effective treatment suggested by slaves working with him in the military hospital on the island of Saint Lucia. Gillespie’s naval subjects had little choice in the manner of their treatment, but they were not directly exploited: each was treated, not to discover a cure for others or to answer a scientific question, but in efforts to cure the individual. What follows are case studies of exploitative experiments with slaves in the West Indies and the poor in Europe. The first looks at John Quier’s smallpox experiments. Quier’s experiments were done on large populations of plantation slaves and were clearly designed to answer questions that physicians chose not to address using European bodies. They also raised questions about race (coming from London, not from Quier himself ) and the interchangeability of bodies in experimentation. We turn then to James Thomson’s experiments with yaws in slave children. Despite his sensitivity to Africans, Thomson took unusual liberties with human bodies. We set Quier’s and Thomson’s experiments in context by analyzing how medical techniques were tested on soldiers and sailors, on the one hand, and on the poor in Europe, on the other. The chapter concludes by exploring notions of the interchangeability of bodies. Were experiments done on slaves considered valid for the elites of Europe? To what extent were men’s and women’s bodies viewed as distinct or interchangeable in this regard? QUIER’S SMALLPOX EXPERIMENTS

John Quier, a plantation physician working in the rural highlands in Jamaica, freely experimented with smallpox inoculation in a population of 850 slaves under his care, beginning with the epidemic of 1768 that swept across the island.3

Exploitative Experiments

Inoculation involved inducing smallpox in a healthy person by making small punctures in the arm or leg and “engrafting” variolous or infected matter from a pustule on a person suffering the disease (figure 16). The hope was that smallpox induced “artificially” was more survivable than the “natural” disease and that inoculation would immunize the person for life. Inoculation was not new when Quier did his experiments. It had been introduced into Europe with London’s Newgate Prison experiments in 1721 and into the West Indies as early as 1727. Quier’s experiments took place after the College of Physicians in London had endorsed the procedure in 1755. Faced with an epidemic, Quier and others in the colonies were persuaded to undertake inoculation because of the “extraordinary accounts” of success received from England. In Saint-Domingue, physicians inoculated slaves beginning in 1745; by 1772 they were inoculating “by the hundreds,” and by 1774 “by the thousands” ( par milliers). Yet the procedure was risky, and controversy still raged. Colonies such as South Carolina banned inoculation in 1738 and again in 1760.4 Interestingly, Charles-Marie de La Condamine, in his pro-inoculation tract of 1754 (translated into English in 1755), faced the dilemma Quier would encounter a decade later: whether American planters should inoculate entire

Figure 16. Lancet owned by the British vaccinator Edward Jenner. John Quier and James Thomson would have used similar lancets to make small punctures—generally four or five—in the arms or legs of their patients for the purpose of inoculation. Variolous or infected matter was inserted into these cuts.

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plantations when threatened by an epidemic. La Condamine considered smallpox inoculation a “sure preventive” confirmed by “reason” and “experience” and judged it “lawful” to introduce a “small” evil in order to secure the “greatest good.” He declared the issue one not of “morality” but of “calculation.” According to La Condamine, a planter would lose only one slave to inoculation as opposed to a “seventh part” of them to the natural smallpox. He added that the “trial . . . made upon Negro slaves” had produced more deaths than those on Europeans but that this was likely due to lack of care. “The advantage,” La Condamine averred, “is manifestly on the side of Inoculation.”5 Quier was employed by plantation owners who would have made similar calculations. And, importantly, masters had the final word when it came to “securing their property.” Individual slave consent was not part of the equation. As Quier remarked, a plantation physician was rarely able to choose his patients: sometimes dire circumstances, such as the dangers of smallpox in small, infective slave huts, and sometimes the will of a stubborn master required that a physician inoculate against his “judgment” and “will.”6 Given the circumstances, Quier would have inoculated whether he engaged in medical research or not. But Quier did not simply inoculate. We see from his reports that he used slaves to explore questions that doctors in Europe dared not. And he gathered his information with publication in mind. Quier sent his results in three detailed letters (1770, 1773, and 1774) to Donald Monro (son of the famed Alexander Monro), then active in London. These were read to the London College of Physicians, published in the Medical Transactions, and subsequently gathered together in book form.7 As an army physician, Monro was interested in managing disease in large populations, in his case soldiers. Monro and Quier had both served in Germany during the Seven Years’ War. Monro visited the West Indies in the 1760s (Quier had arrived only in 1767), and the London physician requested that Quier “communicate what observations he made” on tropical disease. Monro was a key player in the British medical complex: he was a fellow of the Royal Society of London and of the Royal College of Physicians of Edinburgh. Unfortunately, it seems that the papers of these two men have not survived, and we can glean the details of their exchange only from published accounts.8 What is of interest is that Monro was a hospital physician at Saint George’s in London and a member of the Edinburgh medical community, where clinical medicine was being developed. Quier wrote openly of his experiments—and called them just that, “experiments.”9 Quier began inoculation in March 1768. He studied, observed, documented, and prescribed procedures through the entire course of the induced disease, from the methods of preparation to the care of secondary fevers. Beyond merely

Exploitative Experiments

observing, however, he devised experiments to treat hot medical topics of the day—whether one could safely inoculate menstruating or pregnant women, newborn infants, or a person already suffering from dropsy, yaws, or fever, and the like. While most experiments were carried out in the course of his mass inoculations, some were done repeatedly on the same person and at his own expense.10 Throughout his experiments, when pressed, Quier followed the science. Quier’s trials were designed to be therapeutic not for the individual patient but for the class of patients he treated, namely, slaves. His goal was to devise “practical rules” for inoculation in warm climates, given that he was generally “obliged to inoculate all the slaves on a plantation at once.” An important question in this regard was whether repeated inoculation in the same person was safe: When faced with doubt about whether a slave had gone through the procedure before, could a physician safely inoculate? Quier noted that he had done “a large number of experiments” inoculating “no inconsiderable number” of people who had already suffered smallpox for the “sole purpose” of “observing the phenomena, which might be produced.”11 Quier also studied a related question: whether a person who had suffered a mild case of smallpox could catch the disease again or whether that person enjoyed lifetime immunity. For his experiment, Quier handpicked thirteen subjects—seemingly all male, since he referred to them by the masculine pronoun—who had been inoculated several years earlier (some by Quier himself ) and had suffered a light case of smallpox. He prepared his subjects with mercury and a purge as was his custom and then inserted the “variolous contagion” into incisions made for the purpose in each man’s right and left arms. All went well, and Quier was able to demonstrate that these patients were indeed protected by the initial inoculation. His goal, consistent with the needs of plantation owners (he himself owned a small plantation), was for practitioners to be able to pronounce “with certainty” whether a slave was immune to smallpox (which increased the price the slave could fetch).12 Quier’s experiments (or his reports of them) were bold, and his boldness increased with time. In 1774 he reported inoculating 146 persons; 120 of them were children and, of those, 50 were infants at the breast—a practice frowned upon in Europe. Thomas Dimsdale, one of the leading authorities on inoculation, made it clear that children under the age of two were not to be inoculated unless “at the pressing entreaties of their parents.”13 Quier’s work is interesting for the questions it raised concerning race— but, significantly, these were not Quier’s questions. They came from London and arose in response to Quier’s experiments with pregnant women. Quier designed trials to determine whether inoculation in pregnancy caused miscarriage.

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It was common practice in Europe not to inoculate pregnant women. This was a medical question of some urgency because pregnant women who contracted smallpox naturally generally miscarried, and pregnant women who were not inoculated during a mass engrafting were in danger of catching a severe form of the disease and dying. In his first letter of 1770, Quier provided his London colleagues good news: his experiments demonstrated that pregnancy presented no obstacle to inoculation, and physicians could freely inoculate pregnant women, at least in the first six or seven months. Back in London, however, Monro raised a potentially explosive question: whether medical experiments done on “Negro women” were valid for English women. “Some gentlemen,” he inserted in a lengthy note (his only such note in the text), “who have perused this paper in manuscript, have entertained some doubts about the propriety of inoculating gravid women in this country [England], and think that it ought not be attempted without an absolute necessity.” Monro was particularly concerned about “women of fashion, and of delicate constitutions,” and contrasted them to “Negro women,” whom he characterized as having a “hardy constitution,” as “much exposed to the open air, often bear[ing] children, and go[ing] about their daily labour in a day or two afterwards,” and as undergoing many other travails without the “least inconvenience.” Treatments appropriate for such women, he warned, might well destroy “those of delicate habits, who have been educated in European luxury.”14 Until queried, Quier had assumed the interchangeability of human bodies. Although Quier’s experimental subjects were all slaves (and hence persons of African origins), there is no suggestion that he intended to restrict his results to them. The overall purpose of his work, as stated in his first letter, was to discover cures of “advantage to mankind,” and to that end he had employed persons of African origins. It is indeed curious that Quier did not experiment with persons of European origins in his territory—plantation owners or managers and their wives and children, or, eventually, his own children of mixed race (his first child of mixed race, Joseph, was born in 1770 in the midst of his father’s experiments).15 In response to Monro’s note, Quier backpedaled somewhat in his letter of 1773: “The subjects, I every where speak of,” Quier wrote, “were Negroes; and from thence, if what I have wrote should be thought to merit imitation, persons might have been admitted to inoculation, to whom it never was my intention to recommend it; and I might unknowingly have occasioned mischief.”16 While Quier conceded that his experiments—on pregnant women (his other results went unquestioned)—might not be valid for delicate European women of the upper classes, he took issue with Monro’s and his colleagues’

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characterization of women of African origins, several of whom were his lovers and the mothers of his children. Quier considered slave women to be as delicate as European women in the matter of childbirth. He wrote passionately that “whatever hardiness Negroes may possess, I do not find, that the females enjoy that immunity from the evils of child-bearing, at least in this country, that you seem to imagine.” Slave women, he continued, are carefully nursed after childbirth and rest at home for up to a month. Modifying his stance a bit, Quier added that the dangers for slave women in childbirth were similar at least to the “rustic part [peasants and anyone whose livelihood depended on hard physical labor] of their sex in Europe.”17 In this second letter, Quier repeated his claim that his inoculations in pregnant women—whom he claimed made up a “very large proportion” of the population engrafted—had caused “not a single instance of abortion.” In his third and final letter sent a year later in 1774, however, having been pressed yet again on the subject by his colleagues back in England, Quier “took pains” to make a strict inquiry into the matter. In so doing, he discovered that two slave women had miscarried in his first rounds of studies, but given that childbearing, miscarriage, and similar female complaints were strictly supervised by a slave midwife, he had not been called to attend them and—even more extraordinary given that these women were subjects in his experiment—he had not been informed of the mishaps at the time. Because of the “many doubts and objections” raised by Monro and others, Quier launched yet another round of experiments. In this instance, one of the two women inoculated miscarried— but, Quier thought, as the result of other circumstances. Because of dissent from London, however, Quier advocated this only as his “private” opinion.18 Throughout his experiments, Quier reported the loss of few patients. He worked carefully to understand how best to adapt European inoculation techniques to plantation practice. Slaves lived together in large numbers, came from different places, and often did not speak a common language, making it difficult for plantation physicians to know if they were already immune to smallpox. Yet Quier had few reservations about his experiments. His interest in inoculation continued, and he noted that “whenever an opportunity offers again, I shall not fail to renew the experiment.”19 While Quier experimented extensively with slaves, he did not develop notions of racial differences. From time to time, he noted dissimilarities in how much medicine slaves could withstand compared to whites. In an experiment with three hundred slaves, for example, where he studied the types of patient preparation required before inoculation (whether mercury and purgatives were best administered before or after the procedure, or at all), he discussed how

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“Negroes” were unable to bear “frequent repetitions of strong purgatives.”20 Similarly, he found slaves unable to withstand mercury preparations because many of them were already being administered mercury for venereal disease. Quier did not, however, draw conclusions about racial differences from these remarks. Unlike Thomson after him, he was not interested in the physiology of race. Nor did he use his extensive inoculation experiments to study how inoculation worked differently in black and white bodies. He experimented on slaves and fully assumed (apart from the caveat noted concerning pregnant women) that his results held for “mankind.” Quier was not the only physician to experiment during the 1768 epidemic. William Wright, whose experiments with cold bathing we analyzed in chapter 3, inoculated large numbers of slaves, as did most Caribbean doctors. These physicians, too, joined observation with experiment to settle medical questions of the day. Physicians wondered, for example, if the pustules that arose on a person who had already suffered smallpox were infectious. Wright observed, along with many others, that pustules frequently appeared on the breasts and arms of smallpox-immune nurses when they suckled infants ill with the disease. Wright conducted an “experiment” to confirm this common observation: in 1768, six “valuable” Negroes were inoculated from a pustule Wright happened to have at the time on his left thumb. Wright had suffered smallpox in 1745 but found that random pustules arose when he inoculated or cared for others afflicted with the disease. The six slaves contracted smallpox in the usual fashion from this inoculation, proving, Wright noted, “beyond a doubt” that these random pustules carried active matter even though the donor was not ill.21 It is interesting that Quier evinced no interest in slaves’ own knowledge of smallpox or in their inoculation practices. This is curious given that Quier was a man who had put down deep roots in Jamaica, living there continuously from his arrival in 1767 until his death in 1822 and treating up to five thousand slaves per year in the parishes of Saint John, Saint Thomas in the Vale, and Clarendon. As Michael Craton has put it, Quier had gone “native.” By contrast, James Thomson, the son of Quier’s partner and active in Jamaica, stressed the African origins of smallpox inoculation, noting in his Treatise on the Diseases of Negroes that “inoculation for the small-pox has been known from the remotest ages in many parts of Africa.” Africans, he continued, “term it buying the small-pox, from the circumstance that the parent of the child, from whom matter is taken, always expects a small remuneration from the person to whom the disease is communicated: every practitioner knows that . . . mothers are greatly offended, if you neglect giving them some small gratuity, after having received lymph or a crust from the arm of their child.” “To the inhabitants . . . of this part of the globe,” he

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continued, “whom we are disposed to regard as the most degraded of our species, was revealed, at an early period, a plan that has saved the lives of millions.”22 Thomson blamed European notions of “superiority” for this ignorance. Never one to shun hyperbole, Thomson exclaimed, “What a different aspect might the history of human affairs have presented at this time, had the practice of the discovery sooner become general? What myriad lives might have been spared, what misery prevented, had it been known to the Spaniards ere they imprinted their cursed footsteps on the peaceful shores of the unsuspecting natives of America?” Interestingly, although Quier was to live and practice in Jamaica for another forty-eight years, he published nothing further. Perhaps he became more deeply embedded in life in rural Jamaica and ceased to experiment, or perhaps he was overtaken by what Thomson judged to be the “laborious duties” of a country doctor.23 THOMSON’S YAWS EXPERIMENTS

John Quier lived to see the end of the ravages of smallpox. James Thomson, Quier’s disciple who also practiced in Saint Thomas in the Vale, wrote: “Happily for the human race this loathsome malady has been disarmed of all its terrors. Even the practice of inoculation renders it comparatively mild, and vaccination supersedes it entirely, except in some anomalous instances.”24 Yaws, however, still raged throughout the West Indies, despite various cures, such as those tested by Alexander in Grenada in 1773 (chapter 2). Because yaws appeared to be similar to other venereal diseases, physicians first tried mercury, then a common treatment (though not a cure) for syphilis. By the end of the eighteenth century, it became increasingly clear that mercury was sending “thousands to their graves.”25 Given the success of inoculation in smallpox, physicians were emboldened to try experiments inoculating for yaws. The great success with smallpox inoculation had been that, although it induced disease, it rarely resulted in death, and successful inoculation provided lifetime immunity. By analogy, they reasoned, yaws inoculation might provide similar protection. In the eighteenth century, European-trained physicians tended to treat unfamiliar diseases first by analogy. Percival wrote in his Medical Ethics of 1803 that, in the development of new remedies and surgical practices, doctors should be governed by “sound reason, just analogy, or well authenticated facts.”26 Testing inoculation in yaws was of immediate importance to planters. Yaws was listed second (after tetanus) as the most common cause of mortality among slaves in Jamaica in the British House of Lords hearings on trade and

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foreign plantations in 1788. Moreover, planters were well aware that a slave who had formerly had yaws was more highly valued—by as much as a third of the price. And planters needed to be on their guard. Barbadian physician William Hillary reported the pernicious frauds practiced by surgeons on slave ships, whereby at the first appearance of yaws they applied strong repellents, such as the juice of roasted limes mixed with iron rust and sulfur or gunpowder, to erase the outward signs of the disease. Ships’ captains then rubbed the slaves’ skin with palm oil to make them look fresh and healthy for sale, a practice called “polish[ing] the Negroes for market.”27 Within a few days or weeks, however, yaws often erupted with renewed vigor, and planters were burdened with a poor investment. If, however, slaves could be inoculated, suffer a mild case, and enjoy lifetime immunity, planters would secure their labor force. Thomson’s experiments, like Quier’s, had great potential to bolster the West Indian economy. Physicians were pressed by masters to find a quick and effective cure or—in the case of inoculation—prevention for yaws. Many West Indian physicians understood that a plentiful and healthy diet, adequate housing, and protection from hard labor provided the surest protection against yaws. Masters, however, considered themselves “inconvenienced” by these lengthy, costly measures. Some pressed physicians to use a solution of corrosive sublimate much recommended by Gerard van Swieten, the great experimentalist in Vienna, and doctors employed these mercurials at times against their better judgment and, in their words, with “repugnance.” After seeing thirty slaves on one plantation die within two years from these medications, some physicians refused to administer them.28 Thus the race to find new cures was on. James Thomson, whom we saw in chapter 1 had a keen interest in the physiology of race, also did extensive experiments with yaws inoculation. He is interesting for the light his work sheds on the Atlantic World medical complex. Thomson melded European experimental techniques, African medical cures, and distinctively Jamaican experimental traditions. Thomson brought with him Edinburgh’s radical experimental approach to medicine. He self-consciously engaged in European-style experimentation with potentially effective Caribbean cures (many of them learned from slaves)—such as capsicum peppers, Zanthoxylum (the same prickly yellow wood Thomas Heney experimented with; see chapter 2), quassia, the bark of the lilac or hoop tree, and the bullet-tree, or unroasted coffee—first on himself in a healthy state and then on diseased subjects who might benefit from the cure. In this, Thomson saw himself as following in the footsteps of his Jamaican colleagues. He identified a “first generation” of West Indian physicians but

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accused them—Hans Sloane, Henry Barham, Rev. Griffith Hughes, Patrick Browne, and Robert Robertson—of having collected many interesting facts but leaving the real “treasure undiscovered.” In this early period, medicines became popular, he charged, often “on the assertion of an individual, or from their singular effects in some solitary case, which has been copied by every author, without any attempt to renew the experiment.” Even worse, the “most opposite qualities” were often ascribed to the same plant, and numerous stories were related of their miraculous cures. “Fashion,” he proclaimed, created “imaginary powers” in plants and bestowed the name of “specifics” on substances subsequently known to possess “no active properties whatsoever.” Thomson, along with others, called for a new empiricism (chapter 1). “The great object in my opinion,” he wrote, “is to ascertain by repeated experiments the effects of the substance, whose virtues we inquire into, on the healthy body: the alteration of every function is to be carefully noted down.”29 Thomson identified his own work with that of a second generation of West Indian experimentalists, namely John Quier and William Wright. Already during his medical studies at Edinburgh, Wright advised Thomson, should his “situation in life” ever lead to the West Indies, to make a careful study of the diseases of Negroes. Wright “put into” Thomson’s hands several of his own manuscripts on the topic in addition to a new edition of James Grainger’s Treatise on the Disorders of the West-Indies that Wright himself had edited.30 But Thomson considered himself primarily Quier’s successor, and indeed the liberties he took with slave bodies made him an infamous successor. He dedicated his Treatise on the Diseases of Negroes to Quier, the “Venerable Father of our Profession in this island.” Quier bequeathed his medical books to Thomson. Like Quier, Thomson was a plantation physician who also treated Europeans, people of color (free and slave), and plantation slaves. Thomson noted that he “communicated” questions about smallpox vaccination to his “venerable friend” Quier and was assured that his experience and care in vaccination matched Quier’s own.31 Despite these connections, Thomson, like Quier before him, worked alone. As far as we know, his experiments were not witnessed by others. He was not part of a learned society—either at home or abroad. Jamaica had no Cercle des Philadelphes or Society of Medicine; the Jamaican College of Physicians and Surgeons was founded only in 1833. Doctors and surgeons were not plentiful in the colonies, and learned physicians were rare. The image we have of Quier and Thomson is one of lone practitioners in rural Jamaica attempting to improve medical practice. They were plugged into networks through their publications, but their work was not overseen by any regulatory body or society of peers.

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James Thomson was not the first to experiment with yaws. In 1773 Macgrudan in Jamaica published his results of yaws inoculation tests in the first volume of the Parisian Journal de physique. As subjects he chose a young “Negro” man— who “vigorously” pled to be inoculated—and an infant. The man suffered from an extremely painful case of yaws; the infant did not. Although eager to continue his expériences (as the French journal rendered his words), Macgrudan was forced to leave the islands because of bad health.32 Both Thomson and Thomas Dancer, island botanist and longtime Jamaican resident, experimented with inoculation in yaws, though they seemed unaware of each other’s work. Both men responded to claims made by the Joseph Adams, physician to the London Smallpox Hospital, in his 1807 Observation on Morbid Poisons. Both West Indian physicians ridiculed Adams, the Londoner, for writing extensively about yaws, a disease he had never observed save in one white nobleman returned from Jamaica to Europe. Yet both were intrigued by his notion that yaws, like smallpox, could be inoculated with success. West Indian practitioners suspected yaws was communicated through coitus, like venereal disease, or by a type of fly—which Thomas Winterbottom reported in the West Indies was known as the “yaw fly”—that fed from the variolous eruption on a sick person’s skin and then landed on an open sore to infect another.33 Adams, however, was discussing medically induced artificial inoculation—a preventive practice similar to inoculation for smallpox. Adams reported that Benjamin Moseley, surgeon general in Kingston in the 1760s, inoculated yaws “with success.” He also reported, in a passage lifted from Dancer’s 1801 Medical Assistant, that John Nembhard, a plantation doctor, had accidently inoculated Negroes suffering with yaws during the mass smallpox inoculation in the epidemic of 1784. Nembhard observed that “upon the decline of the small-pox . . . the yaws also gradually disappeared.” Adams added that ascertaining whether inoculation in yaws worked would be a “discovery little short of that of preventing the small-pox by the cow-pox.”34 Although Dancer reported Nembhard’s experience in his 1801 Medical Assistant, he did not report any experiments in this first edition. Responding directly to Adams, Dancer averred in the second edition of his work in 1809 that Adams’s challenges could “only be refuted or confirmed by experiment.” And these he undertook, making “upwards of fifty trials.” Dancer did not report on the status of his subjects, but we might assume they were slaves, since he considered the disease “endemial” to Africa.35 Dancer did not detail his experiments in his publications, but Thomson did. In his work, Thomson wrote that readers would find “for the first time” specific questions about yaws “satisfactorily answered.”36 Like Quier, Thomson

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went well beyond therapeutic measures for the individual patient to advance the science. Like Quier, he drew his subjects for these experiments exclusively from African slave populations that included a number of children. Although whites occasionally contracted yaws, none are identified as such among Thomson’s subjects for these trials. Thomson experimented to determine whether inoculation yielded a milder or shorter form of yaws, as it did in smallpox, and whether, like smallpox, having the disease rendered a person immune for life. He also sought to understand the overall mode of transmission, control, course, and cure of the disease. Ultimately, he sought to purge the plague from the islands.37 Thomson did not (unlike Alexander—see chapter 2) present his inoculation experiments as “testing” African practices but rather as advancing the natural history of “morbid poisons.” Nonetheless, he referred repeatedly to African medical knowledge and practices, suggesting that many were superior to those of Europeans who sought quick cures (convenient for masters). “Why,” he exclaimed, “will we not be instructed by the very people with whom the disorder is indigenous?” Thomson also relayed to his readers Bryan Edwards’s report, taken from one of his “faithful well-disposed” Koromantyn slave women, whom he called Clara, from the village of Anamaboe (in present-day Ghana), that the natives on the Gold Coast, in Africa, inoculated against yaws in young children by inserting some infectious matter into punctures in the thigh. Thomson reported that he had confirmed this with “several Guinea Negroes,” who verified that in their country they “bought” the yaws for their children in the same way they bought the smallpox, the idea being that the children would suffer a milder case than adults. Thomson’s mentor, Wright, also identified African origins of yaws prevention. “On the coast of Guinea,” Wright wrote, “the Negroes take no pains to avoid the yaws, they rather seem to invite it, by keeping the infected with the sound in the same family.” “It is probable,” he continued, “that the natives of Africa have a better way of treating the yaws than we have in the West Indies.”38 Thomson’s first set of inquiries investigated the length of the latent period—a key piece of information if physicians were to inoculate effectively. Thomson also wished to refute Adams’s report of the Danish nobleman who claimed to have experienced his first symptoms some ten months after having left the West Indies and thus any likely source of infection. As in many experiments, Thomson’s first observations responded to a natural experiment: a number of slave children who had been living in isolation in the mountains were moved to a sugar plantation. After mixing with others on the estate, they were seized by the fevers and pains of yaws. Soon thereafter eruptions appeared

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all over their bodies. At the end of ten weeks all the children showed symptoms of the disease.39 Not satisfied with this “accidental experiment,” as Thomson called it, he set to work inoculating—that is to say, willfully infecting—a child (we can assume a slave) with the disease. He was “allowed,” he wrote, to take yawey matter from the ulcers of an infected patient and insert it into five different punctures made for the purpose on a three-year-old child’s healthy body—a child who might have escaped the disease. Again, the latent period ran approximately seven weeks. Thereafter the child’s body was fully covered with “foul ulcers”—and he or she (the sex was not recorded) did not recover for nine months. From these experiments Thomson was satisfied that he could report that the latent period in yaws—from initial infection to eruption of the sores—was seven to twelve weeks.40 Thomson devised a second set of experiments to determine whether inducing yaws produced a mild form of the disease, as was the case with smallpox. Thomson’s experiment began when, during inoculations for smallpox, he accidentally took live matter from a girl also suffering from yaws. He observed that the inoculated child came down with yaws in addition to smallpox but that the yaws inoculation did not produce the desired effect of a mild form of the disease. From this and repeated “trials,” Thomson concluded that while inoculation allowed doctors to induce the disease when a subject was young and healthy (and at an appropriate time of the year), artificially inducing the disease did not produce a mild or short course of the disease.41 Thomson made additional trials with slave children. Seeking to see if blood, as opposed to pus, could induce yaws, Thomson “ordered” four or five children (his reports vary) to be injected with blood taken from a “subject covered with yaws.” It did not. Further, wishing to know if inducing smallpox or chicken pox in children already sick with yaws would speed their recovery, he ordered several yaws children to be vaccinated with cowpox. Seeing that this intervention yielded no positive effects, he did not inoculate further with the variolous matter they produced. “I did not feel myself warranted in doing so,” he said quietly.42 Practitioners generally agreed that having yaws bestowed lifetime immunity. The exceptions were mothers nursing yaws-infected infants. Even if a mother had suffered yaws before, she inevitably developed ulcers on her nipples and breasts, which, if not continuously treated, quickly proved fatal. Should the mother die, the child also perished because, as Thomson reported, it was “abandoned by every person.” He recommended that infants with yaws be spoonfed. John Williamson, also practicing in Jamaica, cautioned planters that “ill disposed” slave mothers sometimes infected their own babies with yaws as a form of infanticide.43

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Thomson did not experiment with a cure for yaws—his experiments were aimed at prevention through inoculation. For treatment, he followed slave practices, observing that “they never attempt to cure the disease, but only assist the powers of the body and accelerate its actions.” And he reported that “the practice now generally adopted in this island is to leave the disease to the efforts of nature.” An infected slave only needed to be fed well during the course of the disease and given light work. Slaves themselves took precautions to treat the ulcers with many sorts of astringents to avoid secondary infections. Thomson added that “indeed, it is impossible to prevent Negroes . . . from applying their various favourite means of cure.”44 It would seem from Thomson’s records that he had the free run of plantations and a free hand in conducting experiments of his own choosing. There were, however, some limits to his practices. Thomson wrote of a case of “a fine Negro boy, 10 years of age,” who died suddenly of worms, a common affliction. “The body was not allowed to be opened,” he noted, “though requested.” Who denied the physician’s request, we do not know.45 Thomson fully intended to continue to experiment with yaws. He did a few more experiments—one to test Bertrand Bajon’s experiments with animals. (Thomson mistakenly thought Bajon was German because, no doubt, he had read Winterbottom, who cited Bajon’s work in German translation—sources were promiscuous in the eighteenth century and not always confirmed.) Thomson implemented experiments to determine if yaws could be transmitted to cattle, dogs, rabbits, guinea pigs, pigeons, and domestic fowls. It could not. He reported in the Edinburgh Medical and Surgical Journal in 1822 that he had conducted “numerous experiments” inoculating people with yaws who had already “passed through the disease” in order to reconfirm that having yaws provided lifetime immunity to the disease. He also announced his intention to do further experiments on the latent period in yaws. Thomson intended to publish his experimental results as a second volume to Monro’s well-known Letters and Essays . . . by Different Practitioners, but it never appeared, most likely because he died in 1822.46 How would we judge the ethics of Thomson’s experiments? As we have seen above, both Quier and Thomson were working plantation doctors, charged with the health of valuable property of masters. As plantation physician John Hume remarked in reference to yaws, “It is the business of the Negro’s Master to seek for a cure, as well for the sake of the Negro affected, as for himself, family, and other Negroes on the estate.”47 Quier, as we have seen, was obliged to inoculate for smallpox. Although he took liberties with human bodies (often inserting variolous matter into the same person multiple times or engrafting pregnant women or nursing children), he would have inoculated with or with-

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out his experiments. Not so for Thomson. Thomson was not required by masters to inoculate for yaws. Although Thomson had established that Africans themselves inoculated for yaws, this was not standard practice in European-driven plantation medicine. It was precisely the question whether it should become a part of standard West Indian medicine that prompted Thomson’s experiments. The issues are complex. Quier’s smallpox experiments answered questions, such as whether pregnant women could be safely inoculated, helpful to white European populations. Further, Quier experimented in dialogue with contacts in London. Thomson, by contrast, appears to have directed his own scientific program. He was influenced by Quier, a plantation physician, and Wright, a member of the British medical complex, but he largely set his own agenda. We do not see the back and forth of letters characteristic of Quier’s work (but I was unable to locate Thomson’s papers). At the same time, it should be noted that Thomson’s experiments were applicable primarily to slave populations—precisely the population he tested. Whites rarely suffered yaws because it was slaves who suffered the poverty and poor living conditions that fueled the disease. Thomson did not experiment exclusively on slaves. His experiments with coffee and other “country remedies” were done on himself, a “young gentleman,” whom we can assume was white, and a “Negro woman,” whose legal status was not recorded. Thomson also prescribed medicines learned from slaves to white patients. He learned of a particular cure from a “sensible Negro, who had charge of the hospital on a large estate.” This man often mixed drugs for Thomson and seems to have accompanied him to see patients. One day Thomson was called to treat a “white patient” who had been seized with a “dreadful obstinate vomiting” that often proved fatal in the tropics. Thomson went to work with his medicines—an elixir of vitriol, effervescing drafts, and others— all with no effect. Because of the “robust habit” of the person, he dared not administer opium. Despairing, Thomson was at a loss (something, he wrote, that happened to “most medical men” in the tropics). At this point, the “Negro” at his side recommended a strong decoction of adrue (Guinea rush or Cyperus articulatus) “as a last resource.” The patient took a wine glass full along with some camphorated julep every half hour. The vomiting ceased within an hour and never returned. Thomson noted that after learning of the effectiveness of the adrue root, he used it frequently and “never without the greatest benefit.”48 SOLDIERS AND SAILORS

Donald Monro’s 1778 Letters and Essays . . . by Different Practitioners, where John Quier reported his research, is interesting because it treats experiments with slaves, soldiers, and sailors—but not with planters, free people of color, or whites.

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While slaves endured numerous experiments in the eighteenth century, soldiers and sailors were also freely used in this period in medical testing. James Adair, fellow at the Royal College of Physicians in Edinburgh and plantation owner in Antigua for over twenty years, argued in the 1780s not only that slaves were better off than poor Europeans but that they were better off than “seamen, soldiers, and other white persons on their first arrival” in the islands. The mortality of slaves should not, he emphasized, be blamed on “hard labour” or “harsh usage,” because the mortality of whites kept pace with that of slaves. Adair estimated that the annual loss of life for soldiers and sailors in the West Indies to disease alone (not counting war-inflicted wounds) was greater than 5 percent, while the mortality of slaves was only 1 to 2 percent. Adair’s rhetoric responded to threats of ending the slave trade and, no doubt, underestimated slave mortality. It is important, however, to appreciate that it was not slaves alone who endured medical experimentation in the West Indian medical complex. Soldiers and sailors suffered high mortality from fevers and other diseases resulting from long voyages, harsh tropical climates, poor nutrition, and inadequate housing. “Is the impressed seaman much less a slave than the African?” Adair asked rhetorically. “Or is the soldier . . . a freeman, in the just sense of the word?” Slaves were not free to choose medical treatments, as we have seen in Quier’s and Thomson’s experiments, but neither were soldiers. In 1776, in Canada, commanders ordered that all men in the king’s service be inoculated when faced with an epidemic.49 Atlantic World doctors and surgeons were anxious to find and test new cures. Soldiers and sailors were freely used—often in dire circumstances. James Lind’s iconic experiments for a cure for scurvy in 1747 were done at sea on twelve scorbutic sailors. A series of experiments on twenty-four soldiers at the Hôtel royal des Invalides in the 1770s in Paris tested a supposed “wonder drug” of unknown substances as a pluripotent cure for epilepsy, gout, rheumatism, cancer, and the like. To assure accurate results, the ward was guarded by a sentinel so that the patients could not deviate from the prescribed treatment. The treatment failed and even resulted in the death of one man.50 Experiments performed in the early 1780s by Leonard Gillespie, assistant surgeon to the naval hospital at Saint Lucia, were typical in this regard. Desperate to cure sailors’ “putrid ulcers,” Gillespie employed a lime treatment learned from some of the slaves working at the hospital; it was perhaps the same lime treatment employed by Alexander’s unnamed slave in Grenada (chapter 2). Putrid ulcers resulting from scurvy proved one of the most inveterate and dangerous afflictions of British seamen. In port at New York (where the British fleet had taken refuge from the hurricanes raging in the Carib-

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bean), Gillespie experimented with some two hundred men suffering from scorbutic ulcers.51 Surprisingly well supplied with food and medicines, the surgeons first attempted to cure the sores by merely keeping them clean with dry lint dressings while dosing the patient with bark (quinine), wine, and opium. When this proved ineffective, they turned to “cataplasms” (poultices), “fomentations” (compresses), and “precipitate powder” but found that these only made matters worse. Discouraged, surgeons amputated, but the infection reappeared on the stump and a “great many men lost their lives.” The medical team eventually composed a cure from vinegar and water mixed with a solution of “gummi kino” (a dark red gum from the kino tree imported regularly from the Malabar Coast in India). Gillespie soon shipped back to Saint Lucia and began treating a “crowd” of patients afflicted with the same complaint in the naval hospital there. To his chagrin, the disease progressed more rapidly in Saint Lucia’s tropical climate than in New York. Adding to the state of emergency, Saint Lucia had been ravaged by winter storms and his men encountered difficulty finding plants from which to compound medicines. The medical team went to work dosing patients with bark, wine, and opium in the “largest quantities ever administered.” When these failed, Gillespie began looking for alternatives. At this point, he made “some inquiries” among the Negroes employed in the hospital to learn what they used in the case of ulcers. He was “not greatly surprised” to hear that “their common practice in putrid sores was to apply thin slices of limes over the surface of the sore, which they repeated two or three times during the course of the day.” Gillespie and Mr. Bulcock, the hospital surgeon, immediately made “a trial” of this new application. They began by wetting compresses in lime juice and water but soon learned that they could apply slices of limes directly to the sores. The quickness of the cure was “astonishing.” Since they noticed that this remedy became less effective with use, Bulcock and Gillespie alternated it with a poultice of grated cassava root—a remedy possibly learned originally from the Amerindians. Cassava proved so useful and grew so extensively in the West Indies that Gillespie recommended that it be packed in sand and put on board ships for use by all naval surgeons. Bulcock’s and Gillespie’s treatments were successful and subsequently adopted by the British West India fleet. Even when impressed by African cures, medical practitioners in the West Indies usually combined them with standard European practices. Gillespie and Bullock treated the fevers accompanying the sailors’ ulcers with plenty of laxatives further supplemented with lemonade, opium, the bark, and ipecacuanha— these latter two treatments, of course, were of American origins and by the late eighteenth century were fully integrated into European medicine.

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CHILDREN AND THE POOR IN EUROPE

Children in both the West Indies and Europe were used to support the Atlantic World medical complex. Jamaican physician John Williamson told of slave children (he calls them “Negroes”; we can assume they were slaves) serving as human vessels to breed variolous lymph for vaccination. Vaccination, like inoculation before it, relied on a good supply of infectious matter for use in future patients. Williamson wrote that in and around 1801, when Edward Jenner’s vaccination was introduced into Jamaica, a Dr. Weston in Saint Ann’s Parish infected “any Negroes that might be sent to him, for the purpose of getting lymph on the spot, when it might be introduced immediately to the persons [black or white] to whom we were desirous to convey infection.” Williamson and his partner, Dr. Clarke, were able to procure the infectious matter by sending a “Negro child” to Dr. Weston. Clarke and Williamson then kept the matter alive “for a considerable time” through a human chain of infected children.52 Within Europe, too, poor children were used in unseemly ways to advance medical techniques. Dr. Thomas Houlston, physician to the Liverpool Infirmary in England, wished to determine how long physicians could store infectious material for smallpox inoculation. In 1768, Houlston took variolous matter from various subjects; some he stored on raw silk and some on cotton threads. Thirteen years later, he opened his lightly corked bottle and employed the matter in a two-year-old boy. When it failed to take, Houlston used fresh matter and the boy quickly contracted smallpox. The following year, Houlton tried again, this time on a four-year-old girl. He introduced infectious matter from both the silk and the cotton into incisions made in each of the girl’s arms. When the experiment failed, he tried a second time. When this did not work, he intended to inoculate the child with fresh matter, but “her parents objected.” Following up on the case, he reported that the girl caught smallpox naturally a while later and subsequently recovered.53 Houlston’s experiments contributed to the British project of inoculation throughout its empire. In large-scale state-sponsored medical interventions, British physicians attempted to transmit the variolous matter of smallpox to colonial populations in the East Indies. They experimented with preserving the matter—taken from a pustule between the seventh and ninth day of infection—in tinfoil, in a moistened bladder, or between small squares of glass. If small enough, these infectious parcels could be carried in a pocket or transmitted by letter. The heat of India, like that of Jamaica, however, destroyed the matter, and physicians turned instead to creating chains of infected children— carefully inoculated in succession to keep the potent matter alive. Historian

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Lydia Murdoch has documented how poor children, and not those of colonial elites, were recruited to this service. Children were preferred, she continues, because they were “pure”—not likely infected with syphilis or tuberculosis that might be transmitted along with the smallpox. Importantly, race, she writes, was not considered a barrier to transmission.54 It should be noted that Houlston was one of the few who recorded experiments that failed. Physicians in the eighteenth century, like physicians today, preferred positive to negative results. Houlston, however, considered it important information that inoculation required fresh matter. After these two failed attempts, Houlston “desisted from any [further] trial.”55 Houlston’s colleague at the Liverpool Infirmary, James Currie, also performed exploitative experiments—the purpose of which was to yield physiological information, not cure. Again, questions related to empire drove experiments. Prompted by a disastrous shipwreck where a number of sailors died of exposure, Currie experimented with the effects of cold and heat on a man by the name of Richard Edwards. We know nothing more about Edwards except that he was healthy, twenty-eight years of age, with black hair and a ruddy complexion. Currie had earlier experimented with the influence of cold on the “living body” as a student at Edinburgh; in 1779 he wrote a paper on the subject for a society of students of which he was a member. He built his experiments with cold water on those of William Wright (chapter 3). In his 1790s experiments, Currie immersed Edwards in 170 gallons of salt water cooled to a temperature of 44 degrees Fahrenheit at 4:00 p.m.—the hour, he noted, chosen for his own convenience rather than being most proper for the purpose. The conditions were set to simulate as nearly as possible those of the shipwreck. Before the naked man was plunged into the cold water, his body temperature measured 98 degrees. After a minute and a half of exposure, and after the “convulsive sobbings” occasioned by the shock subsided, Edwards’s temperature measured 87 degrees. After a further twelve minutes in water up to his shoulders, Edwards had a temperature of 93.5 degrees. The man was then removed from the water and left in the open air where a northeast winter wind blew sharply. Currie was surprised that Edwards’s body temperature in air dropped again—to 87 degrees. Variations on these experiments were repeated with Edwards five more times (with the water temperature taken down to 40 degrees, and the man immersed for a full forty-five minutes). They were also repeated with a “pale,” “feeble” male subject named Richard Sutton, who was removed from his cold bath after thirty-five minutes because Currie “did not think it safe to detain him longer” and because the man was “much under the impressions

Exploitative Experiments

of fear.” The experiments were repeated further with two unnamed men and eventually on Currie himself—who, it should be noted, did not go first—in the coldest water, at 36 degrees, but for only two minutes.56 Part of Currie’s excitement about these experiments was the use of a thermometer fashioned for him by the instrument maker Jesse Ramsden and modeled after one invented by the famous anatomist John Hunter for his experiments on the heat of animals. As we saw in Chisholm’s experiments (chapter 1), doctors used these new technologies to collect basic physiological data on human body heat. Currie applied his thermometers under the tongue (with the mouth closed in order to avoid the temperature being affected by the coldness of the breath) or the axilla. Currie later had a curved thermometer fashioned so that he and his staff could stand behind an infected patient and thus avoid contagion when measuring temperature. In a further innovation, he introduced a small piece of iron into the tube (after the manner of a Mr. Six) so that the patient’s highest body temperature was registered even after the thermometer had been removed. In this way experimenters did not need to even approach the patient and risk infection.57 From his experiments, Currie concluded that shipwrecked seamen should remain immersed when overboard, which, he reported, sailors already knew from experience at sea. Having tried his experiments with fresh water, then water mixed with vinegar, and finally salt water, Currie concluded that survival in salt water was more likely than in fresh. Currie noted that “it was my intention to have repeated and enlarged these experiments” but that the (unexplained) difficulty attending them and his professional duties deterred him.58 He does not mention any ethical concerns. According to his accounts, his experimental subjects, even the feeble Sutton, fully recovered their former heat and vigor after about four hours. Currie’s experiments contributed directly to the safety of “mariners,” particularly those aboard British naval vessels. The question was how shipwrecked sailors could best survive. Currie dedicated the second edition of his experiments to Prince Frederick, Duke of York and commander in chief of the British army. He considered his work important to military success— throughout the empire but particularly in the East and West Indies and on board African slavers.59 James Currie’s trials with cold water might be seen as precursors to the Nazis’ lethal hypothermia experiments. The Luftwaffe’s tests contributed to the war effort by testing conditions for pilots downed at sea and soldiers fighting on the Eastern front.60

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ARE BODIES INTERCHANGEABLE? THE MEDICAL CONTEXT

How were human subjects chosen for medical experiments in the eighteenth century? It is important to consider what notions of uniformity and variability across living organisms drove the testing of new drugs and medical techniques. Were tests done in black bodies thought to hold for white bodies (and vice versa)? Were male and female bodies considered interchangeable in this regard? To some extent, the choice of subjects was arbitrary. As with dissection, physicians and surgeons used any bodies they could lay their hands upon (perhaps legally and morally, perhaps not). But when they had choices, they were swayed, as we have seen, by traditions inherited from the ancients (the use of the poor, orphans, wards of the state, and prisoners). It is, indeed, remarkable that in early modern societies, with their strong class distinctions, medical testing on charity patients was considered valid for upper-class wealthy patients. Physicians in this period tended to see bodies as fully interchangeable in medical trials. This was precisely John Quier’s assumption. He viewed his smallpox experiments in slaves as valid for humans in general or, as he put it, advantageous to “mankind.”61 Experimentalists in this period, however, faced a paradox. In the second half of the eighteenth century, naturalists across Europe began focusing attention on what they perceived to be constitutional race. Petrus Camper’s newly developed theory of the facial angle of “higher” and “lower” races, and Samuel Thomas von Sömmerring’s comparative study of skeletons, for example, were aimed at detailing racial difference. At the same time medical experimentalists required that human bodies be interchangeable if results were to hold universally. The dilemma, then, was this: physicians tended to emphasize racial difference with respect to the science of race, yet they assumed uniformity across humans with respect to medical testing. We often see whites of different social stations and persons of African descent used interchangeably in testing. Brun, the dean of surgeons at Cap-Français in Saint-Domingue, observed the effects of his coffee bath on two ladies and “some Negroes.” All were cured of various maladies.62 European-trained physicians in this period assumed a gross unity of living organisms across the animal kingdom.63 This assumption was necessary if nonhuman animals were to serve as models for humans in toxicity and early-phase testing. As we have seen, Bertrand Bajon and James Thomson experimented with chickens, cows, dogs, and the like to answer questions relevant to humans, such as whether living organisms could be infected with yaws via inoculation. Testing in animals was part of the new procedures being developed in this period.

Exploitative Experiments

One factor driving the assumption of interchangeability was the need for the new experimental medicine to examine the safety of treatments in large populations—some of which were created by colonial expansion. In contrast to “old school” Galenic medicine, where private physicians provided individualized treatment to wealthy patients, the new medicine strove to find treatments that could be administered with constant effects across individuals. This was especially important for treating large populations of soldiers, sailors, plantation slaves, and populations in the countryside or colonies where university-trained physicians tended to be few and far between. In plantation and military medicine, physicians were pressed to develop a small number of effective drugs for large populations that could be deployed quickly and at a low cost.64 The new experimental medicine, however, also incorporated techniques and assumptions inherited from the ancients. Physicians understood that proper experimentation required repeated “trials” on persons of “different Ages, Sexes, and Constitutions, in different seasons of the year, and in different climates.” The Hippocratic creed, expanded by Galen, taught that age, sex, temperament, and climate profoundly influenced the course of disease in the body. French medical reformer Philippe Pinel wrote, “I believe that nature suggests a distribution according to age and sex. Every age has, so to speak, its own way of life and sickness, and demands fundamentally different therapy for the same disease. This holds equally true for the two sexes.” For men, the subdivisions included (1) boys up to puberty; (2) adults to about fifty years of age; and (3) men from the “climacteric” to senescence. For women, subdivisions were similar: (1)  girls up to menstruation; (2) women during the whole period of fertility, that is, from onset to the end of menstruation; and (3) women from menopause onward. For the French, l’un & l’autre sexe (the one and the other sex) was a catchphrase important to medical practices. French physician Jean-Barthélemy Dazille, for example, taught that observation in royal hospitals should be made with subjects of “all ages and sexes, healthy and sick.”65 Surprisingly to modern eyes, women were a required part of experimental design in eighteenth-century medicine. In contradistinction to today, tests were not unreflectively performed on male bodies and generalized to female bodies. In England, the iconic Newgate Prison trials to test the safety and efficacy of smallpox inoculation in 1721, for example, selected six condemned criminals, three women and three men, matched as closely as possible for age.66 In the colonies, as we have seen, Quier’s experiments included specific questions about women. In some instances, women were subjects of experiments to answer questions about what we today call “women’s health.” Edinburgh professor Francis Home and his colleagues were interested in the proposal of the man-midwife

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Dr. Alexander Hamilton to “bring on the menses” by compressing the crural artery. (This technique was also used to induce abortion.) Hamilton, Home reported, had experienced good success with this method. The main problem, however, was female noncompliance. Home noted that “young ladies” (presumably upper-class women) “would never submit to this operation, as a surgeon behoved to conduct it.” Ladies might object, but charity patients—or the “commonalty,” as Home called them—had little choice but to submit. Much as Quier’s experiments employed slave women to answer questions relevant to the care of English “women of fashion,” Home’s experiments employed charity patients to validate the treatment. He wrote, “It was amongst the commonalty that this method was to be tried and rejudged.”67 Home recorded six experiments with Hamilton’s technique between 1769 and 1778. “Experiment I” was conducted on an Elizabeth Graham, age fifteen, who had never menstruated. Home’s team compressed the arteries in both thighs with tourniquets (without stopping the circulation altogether). After an hour, the poor girl’s thighs were discolored; she had “great head-ach, difficult breathing, pain in her stomach, and violent pain in the lower part of her belly.” The tourniquets were removed, and the experiment ended in failure. “Experiment II” was performed on a Jean Mason, age twenty-two, whose menses had failed to appear for two months. This experiment failed as well. She was eventually cured by the powder of sabine ( juniperus sabina, a known abortifacient). Still concerned about Elizabeth Graham, Home listed her again as “Experiment XII.” To cure her amenorrhea he tried “the filings of steel, the tincture of hellebore, . . . and electricity” in addition to the powder of sabine that had cured Jean Mason. All was “in vain.” Home abandoned compression of the crural artery as a cure for amenorrhea because women objected to the pain and because it worked in one case only—which, in his words, was “not sufficient to support the character of any remedy.”68 Sex also figured as a variable in eighteenth-century experiments on issues beyond those of women’s health. Take, for example, Home’s experiments with cures for phthisis pulmonalis (tuberculosis). He noted that the disease was more common in women than in men and attributed this to women being warmly covered while indoors and less able than men to bear the cold when outdoors. But, he quickly added, few women of the “lower ranks” contracted the disease. Men of “that station,” with their irregular lifestyles, needed to be out in “every inclemency of the weather” and often fell sick. Further, he assured his medical colleagues that patients of all ages suffered from the disease. Home set out to try various cures. His case studies tracked the sex, age, and occupation (e.g., tailor, laborer, domestic servant) of individual patients.69

Exploitative Experiments

It would have been easy to add race to this list. Experimentalists in Europe did not in the eighteenth century; experimentalists in the West Indies did so in fits and starts. Many investigated the “diseases of negroes” as part of their business as plantation physicians. In this literature, physicians compared methods for treating Europeans (whom they had been trained to treat) and Africans (whom they were learning to treat). A very few, Colin Chisholm (chapter 1) being an example, incorporated race as a variable in human health outcomes. It was not until the nineteenth century that race was added to the traditional lists of human variables to be included in experimentation. As Claude Bernard wrote in 1865, experimentation uncovered differences “due to the influences of age, sex, species, race, or to state of fasting or ingestion, etc.”70 At the same time, however, the white male body was increasingly becoming the norm for experimentation and the development of human sciences. EIGHTEENTH-CENTURY

European physicians in the West Indies experimented with slaves, to be sure, but those experiments were not aimed primarily at identifying racial differences—as they might have been had they been carried out in Europe. Instead they were aimed at developing plantation medicine that could better cope with the ravages of tropical disease that Europeans poorly understood. Employed to keep slaves working within the plantation complex, literate doctors such as John Quier, Thomas Dancer, Bertrand Bajon, JeanBarthélemy Dazille, and James Thomson developed a literature on the “diseases of negroes” designed primarily to decrease death and disease for the large numbers of enslaved Africans under their care. In his Observations sur les maladies des nègres, Dazille, for example, discussed how standard European treatments, such as bleeding and the administration of jalap, ipecacuanha, and even mercury, needed to be modified for the treatment of slaves. He cautioned, in particular, that one must be “very reserved” in bleeding Negroes—and, of course, to bleed slaves who were frequently pitifully undernourished would have been disastrous.71 West Indian physicians focused their efforts (which were devastatingly underresourced) on treating a new class of patients, the massive populations of slaves brought in bondage from Africa and used to amass vast wealth for local plantation owners and growing European empires.

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Chapter 5

THE COLONIAL CRUCIBLE Debates over Slavery Negroes and persons of color, free or slave, [are expressly forbidden] from exercising medicine or surgery and from treating any illnesses under any circumstances on pain of a fine of five hundred livres for each infraction and corporeal punishment, depending on the particulars of the case. —Ordinance of 1764 (Article 16), Saint-Domingue THE CARIBBEAN

was not a scientific laboratory; its plantations were violent, often filthy places, where colonial doctors were employed to maximize slave labor. It was their job to keep the labor force working. As we saw in chapter 3, in the West Indies, medical ethics responded to economic imperatives. As we will see in this chapter, proper care of slaves as well as soldiers and sailors was a matter of moral concern but also a means to secure the wealth of nations. This chapter sets medical experimental practices in the context of colonial struggles, violence, and fears. The first sections consider clashing belief systems between European medical practices and what Europeans came to understand as African Obeah and vodou. In the violence endemic to slave societies, whites overwhelmingly came to fear the power of Obeah, poisonings, and rituals seen as firing slave insurrection (figure 17). Fear was so great that colonial administrators made shows of punishing those seen as lighting the fires of revolt by submitting them to “experiments”—with electricity, and with poisons and their antidotes. To repress revolution, Obeah was outlawed in Jamaica in 1760; in 1764 the French in Saint-Domingue went further, banning all persons of African origins from practicing medicine. As revolt and racism gathered steam, Europeans increasingly discounted African knowledge and cultural practices that they had earlier been keen to collect. West Indian colonial doctors were deeply implicated in the plantation complex. Slaves were valuable property of powerful plantation owners; doctors were employed by these men (and sometimes women) and served at their pleasure. A number of medical doctors, such as John Quier and William Wright, were themselves plantation owners. Elite French royal physicians and surgeons served king and state. They understood well, as we saw in chapter 3, that their charges—namely slaves—were the ultimate source of colonial wealth. In the words of royal physician Jean-Barthélemy Dazille, “Without Negroes there is no cultivation, no production, and no wealth.”1

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Figure 17. Burning of Cap-Français: the revolt of the blacks and massacre of the whites. Colonists feared revolution arising from mass enslavement.

In this chapter, we investigate an extraordinary document, the 890-page Report of the Lords of the Committee of Council (1789) on the “present state of the African trade,” which reveals doctors’ and surgeons’ practices, behaviors, and attitudes on the ground throughout the British West Indies.2 Here we learn that bodies that might have been considered interchangeable for the testing of novel medicines were not considered interchangeable when the question was about which bodies—those of Africans or Europeans—could withstand the grueling labor of Caribbean sugar cultivation. Doctors—nearly to a man— supported slavery with the argument that Africans flourished while Europeans withered and died under the tropical sun. Physicians served as “expert witnesses” in this governmental inquiry. No other professional group, apart from island agents, was asked for their views in the same way. OBEAH AND SORCERY

Europeans avidly collected and tested African medicines and techniques, yet they set strict limits on the types of knowledge they were willing to consider. As we have seen, Europeans, who increasingly took pride in their new empirical

The Colonial Crucible

methods, tested African herbal remedies and medical interventions, such as inoculation for smallpox and yaws. But they tended to ignore, deride, and ridicule the ritual and spiritual aspects prominent in slave healing regimes—identified variously as Obeah, conjuring, myalism, sorcery, and, eventually, vodou. Modern scholars have suggested that both sorcery (which would later also be called vodou) and Obeah emerged in the New World plantation complex as unique cultural forms with West African origins. Obeah and vodou are often considered analogous—spiritual practices developed in the Caribbean from African roots. Both worked by combining various herbal remedies with some sort of spiritualism; both were invoked to cure or to harm; both treated physical and social ills.3 But Obeah and vodou evolved along separate pathways as they responded to British versus French colonial cultural environments. Obeah emerged in the British Caribbean as a strong medical tradition. Jerome Handler and Kenneth Bilby have traced the first European mention of Obeah to letters in 1710 from Barbados. And, importantly, Handler and Bilby point out that in the seventeenth and eighteenth centuries the term Obeah was confined to the Anglophone Caribbean.4 Reports on Obeah in the British islands are widespread. Of particular interest is the intelligence on Obeah practices collected by the British government in its extensive 1788 inquiry from each of its West Indian possessions. This document, published in 1789, responded to growing antislavery sentiments in England fueled by the Society for the Abolition of the Slave Trade. The agent for the island in Antigua, William Hutchinson, defined Obeah as closely allied with medical practices. The Obeah men, he reported, were a “set of people who, being better acquainted with the qualities of herbs, and having a more perfect knowledge of the nature of simples, than the rest of the Negroes improve that advantage to acquire an awe and a superiority over them.” James Thomson, writing later from Jamaica, evinced a guarded admiration for Obeah men and women: “I must candidly acknowledge that the effects of my most laboured prescriptions have not unfrequently been superseded by the persevering administration of their most simple remedies.”5 Physicians also recognized, however, that “Obia Professors” threw a “veil of mystery” over their practices and took care to “keep secret their supposed arts, particularly from the whites.” Jamaican surgeon general Benjamin Moseley, not a friend of slave remedies, considered Obeah akin to quackery, but he also recognized its extraordinary power. If a slave was “bewitched,” Moseley taught, he or she surely died, though of a “disease that answers to no description in nosology.” Thomson also noted the “intimate union of medicine and magic in the mind of the African” and admonished those interested in slaves’

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welfare (medical men and plantation owners) to understand the hold Obeah had over Africans in order better to relieve their disorders, especially chronic illnesses. A medical man hardly stands a chance, he wrote, in the management of disorders where Obeah is involved. Thomson was mortified to see hundreds classed as invalids, who by “proper care and perseverance might not only be restored to the enjoyment of health, but prove themselves of permanent utility to their masters.”6 The 1788 government report included a story illustrating the power of Obeah. According to the report, a plantation owner returning to Jamaica in 1775 found that many of his slaves had died during his absence and that of those who remained at least one half were “debilitated, bloated, and in a very deplorable condition.” The mortality continued after his arrival; frequently two or three slaves were buried in one day. The worried plantation owner employed every medicine and the most “careful nursing” to preserve the lives of his slaves—but in vain. He and his physician suspected Obeah but could not prove it.7 Finally a “Negress,” who felt that she would soon die, revealed the “great secret” and identified her stepmother, a woman in her eighties, as the Obi causing the trouble. As soon as the other slaves on the plantation heard the news, they ran to the master to confirm that the old woman had terrorized the “whole neighbourhood” since her arrival from Africa. The master took six white servants to the old woman’s house, forced open the door, and found that the whole inside of the roof and every crevice of the walls were adorned with the “implements of her trade, consisting of rags, feathers, bones of cats, and a thousand other articles.” The house was immediately razed. As for the old woman, the master did not bring her to trial. “From a principle of humanity,” it was reported, he gave her to some Spaniards, who transported her to Cuba. From the moment of her departure, the plantation was free from death and illness. The master estimated that over the course of about fifteen years he had lost a hundred slaves to Obeah. A similar story was repeated in 1817 about an Obeah man, named Dick, by plantation physician John Williamson in Jamaica. Agnes, a slave at the Newhall estate, was recovering in the plantation hospital when she was “accosted by an oldish Negro, named Dick, belonging to the estate, who had established his name as a great Obi man.” Not long before, Agnes had declined his sexual advances, and Dick had threatened her. She was so shaken by seeing him that she fell senseless to the ground and, in a few days, died. The “outcry” among the slaves was so great that the overseer found it necessary to hold an inquiry. Again, the “instruments” of Obeah—including, in this case, “a small coffin”—

The Colonial Crucible

were found buried beneath the Obi’s floor. Dick was convicted and transported to an unnamed Spanish territory. Williamson’s remarks on the case were characteristic of European attitudes: It is incalculable what mischief is done by such designing crafty people as Dick, when they establish a superstitious impression on the minds of Negroes that they possess powers beyond human. Such persons gratify revenge against their own colour in a destructive manner; and, when bent on ruin to their masters, that malignant disposition is gratified by also destroying the Negroes, his property. Mineral poison has been sometimes artfully procured; and it is believed that there are vegetable poisons which are less likely to lead to a discovery. The agency of neither is often required; for the effect of a threat from an Obi man or woman is sufficient to lead to mental disease, despondency, and death.8

According to Williamson, on another occasion a plantation hospital “doctress” informed him that a slave woman, Countess, had complained to her that Oliver Cromwell (her husband, with whom she had quarreled) had, in her presence, taken her menstrual cloth and burned it. She told the hospital doctress that since that time she had not been well, nor ever expected to “remove the Obi laid for her.”9 James Adair, a physician testifying in Antigua, found reports of this sort much exaggerated. He drew analogies between West Indian Obeah and Franz Mesmer’s “animal magnetism” popular in Europe, noting that in both cases the “arts and means” employed operated on the mind rather than on the body. Although Adair suspected that Obeah men and women often employed poisons, he emphasized that the disease they induced resulted from “depraved imagination, or a powerful excitement or depression of the mental faculties.” In “no instance,” Adair judged, did Obeah cause the death of the patient. He pointed out nonetheless that “artful slaves” who hoped for a temporary exemption from labor sometimes pretended to be under the influence of an Obeah man’s or woman’s spell.10 Other Europeans acknowledged that Obeah could include good medicine. Charles Spooner, agent of the islands Grenada and Saint Christopher, testified that Obeah doctors often performed “extraordinary cures in diseases which have baffled the skill of regular [European] practitioners.” “I have myself,” he continued, “made use of their skill . . . with great success.” The agent for the Assembly in Barbados reported that Negroes formerly called “Obeah-men” were by the 1780s more commonly called “doctors.”11 Jerome Handler and Kenneth Bilby, in their extensive studies of these traditions, have pointed out that Obeah could mean different things to different

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people. It was a tradition that evolved rapidly over the course of the eighteenth and early nineteenth centuries. While colonists used the term Obeah in the early part of the eighteenth century, slaves may not have. Only in the late eighteenth century did colonists and slaves converge in their use of the term.12 Scholars often draw parallels between Obeah and vodou. It is important to note, however, that the term vaudoux did not appear in European sources until the 1780s—about a century and a half later than Obeah. Indeed, French colonial physicians did not report on beneficial healing aspects of African sorcery (or its cognates) to the same extent that British doctors did on Obeah—or if they did, this was not recorded. Vaudoux considered a “syncretic system” deeply rooted in African practices and colonial French Catholicism, was first mentioned in Médéric-Louis-Élie Moreau de Saint-Méry’s Description topographique, physique, civile, politique et historique de la partie française de l’isle Saint-Domingue, compiled in the 1780s and published in 1797 in Philadelphia, where Moreau fled to escape revolution. According to Moreau de Saint-Méry, vaudoux ran hot with an ecstatic snake cult fueled by spirit possession and convulsive trances. The French spoke of sorciers and empoisonneurs from the late seventeenth century onward, and indeed slave medicine was outlawed in the French Caribbean in 1764 (see below). A consolidated set of practices known as vaudoux, however, were not prominent in the French Caribbean until the nineteenth century.13 Medical men in the French Caribbean reported on these traditions only in passing. Bertrand Bajon, in French Guiana, mentioned “poisoners” and “charlatans” who, in his opinion, defrauded the public in the same way as popular healers in Europe. The administrator Nicolas-Louis Bourgeois, a promoter of slave remedies, also cautioned against the “great poisoners” among those who were “Médecins” (doctors) in their own country. In this context, he mentioned François Makandal, the slave condemned to death in 1758 for suspected mass poisonings.14 Since plantation doctors in French holdings rarely put pen to paper, it is possible that the earlier vodou traditions with medical implications were simply not recorded. This is not to say that robust vodou traditions did not flourish in the French island, but they may not have been made known to French physicians working in those areas to the same extent that Obeah was made known to British doctors. Occasionally, European cures were seen as “supernatural,” but French colonial physicians were never accused of sorcery or any form of vodou. Royal physician Jean-Barthélemy Dazille in Saint-Domingue developed an antidote to the pernicious manioc that could quickly kill its unlucky victim. He first employed his antidote—an alkaline solution followed by a mucilage—to save a

The Colonial Crucible

“handsome Negro named Antoine,” living in Morin. Called within a few hours of the accident, Dazille’s potion diminished the man’s convulsions, and he was soon completely cured. The navy surgeon called Dazille’s cure “supernatural.”15 EXPERIMENTS WITH PLACEBOS

Rather than seeking to understand Obeah’s purported power, Europeans attempted to destroy it (as they did witchcraft in their own countries) by every means possible—convicting, executing, or deporting practitioners—and even baptizing slaves into the Christian faith (although baptism was something of a scam for clerics, who received a fee for service, as it was for slaves, who received gifts as rewards). Physicians’ dismissal of Obeah is remarkable, since Europeans themselves recognized the power of the mind to heal or destroy the body. John Gregory, in his Lectures on the Duties and Qualifications of a Physician, noted the power of what he called “sympathy” to relieve a patient and contribute to a swift recovery. “Sympathy,” he wrote, “naturally engages the affection and confidence of a patient, which, in many cases, is of the utmost consequence to his recovery.” Further, British physicians debated whether a dying patient should be told the truth of his or her condition. Many held that the best hope for survival depended on keeping a patient’s spirits high. In his influential Medical Ethics, Thomas Percival argued that physicians should sacrifice their “delicate sense of veracity” to lift the spirits of the sick.16 Benjamin Rush in Philadelphia disagreed with Gregory and Percival in this regard, yet he, too, understood the power of the mind. “The extent of the influence of the will over the human body,” he wrote, “has not yet been fully ascertained.” Although he considered Franz Mesmer a quack, Rush ascribed to Mesmer’s notion that “imagination and will” could steer the course of a disease. In the struggle between life and death, Rush noted that he frequently prescribed remedies of “doubtful efficacy in the critical stage of acute diseases,” but not until he had secured a patient’s “confidence, bordering upon certainty, of their probable good effects.” In a similar vein, James Thomson in Jamaica wrote that one antidote to the power of Obeah was for the doctor “on every estate . . . to gain the confidence of those entrusted to his care.” He should, Thomson continued, when possible seek to gratify the patients’ wishes.17 European physicians recognized the power of the imagination and its hold on the body in other contexts as well. In this period, interestingly, mothers’ imaginations were deemed one factor contributing to skin color: black babies might be born to white families as a result of maternal impressions during conception or pregnancy. It was said that Lot’s daughters saw smoke as they fled burning Sodom and that their imaginations fixed that color upon their

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children. At the same time, an African queen who dreamed of snow was said to have borne a white child. In earlier centuries, the “royal touch,” whereby a king or queen cured by mere touch alone, also “worked” through the power of suggestion. The Parisian Royal Commission called to investigate Mesmer’s animal magnetism also recognized the power of the imagination to effect cures. The commission concluded in 1784 that “the influence of the imagination upon the animal frame” was a question of particular interest to metaphysics, but also of the greatest importance to medicine.18 Eighteenth-century European physicians even experimented with placebos. Historians have identified the Parisian Commission experiments of 1784 as the first placebo-controlled protocol, where treatment and no treatment were compared under blind conditions. Here we investigate the experiments of the well-known English physician John Haygarth, done in 1799 with devices fashioned by Elisha Perkins of Connecticut known as Perkins’s tractors—metallic conductors of electricity employed to cure a variety of diseases—that had become all the rage even, Haygarth reported, among “persons of rank and understanding” (figure 18). The very title of Haygarth’s book, Of the Imagination, as a Cause and as a Cure of Disorders of the Body, suggests the power of imagination to harm or to heal.19

Figure 18. Elisha Perkins’s patented metallic tractors. The tractors—or metal rods—about three inches in length, were passed over an ailing body to remove rheumatism, gouty affections, pleurisies, inflammations in the eye, erysipelas (or infections of the skin), tetters (itchy skin), epileptic fits, and locked jaws, along with a multitude of other complaints.

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To test the validity of the miraculous cures, Haygarth and his colleague William Falconer fashioned a pair of “false” wooden tractors painted to resemble the true, metallic device as closely as possible. Which were the “true” tractors was to be kept secret not only from the patient but from everyone involved in the experiment. Results from each device were to be recorded with complete impartiality and in the patients’ own words. Falconer provided five patients as subjects—each suffering from some sort of chronic rheumatism or gout—from the General Hospital in Bath (England). The first day the false tractors were employed. Four of the five patients assured the physicians that their pain was relieved. “One felt his knee warmer, and he could walk much better.” One was “easier” for nine hours. The next day the same patients were treated with the “true metallick Tractors of Perkins” and, again, four of the patients were much “relieved.” Remarkably, both the false and the true tractors yielded similar results.20 According to protocol, Haygarth’s “trials” were witnessed by Falconer, the hospital’s surgeons Mr. Nicholls and Mr. Phillott, and the apothecary Mr. Farnell. Haygarth concluded that the experiment proved that the “whole effect” of the tractors depended upon the power of the “patient’s imagination” to cause, as well as cure, disease. The experiments were repeated by doctors in London and Bristol with similar results. Physicians found that other random objects—even those lacking the magic “patent” stamp, such as pieces of bone, iron nails, pieces of mahogany, slate pencils, and tobacco pipes—yielded cures. Interestingly, one of the experiments in Bristol was done on a subject of African origins, Thomas Ellis, again with similar results. Haygarth approvingly quoted James Lind, who wrote concerning his use of fictitious scurvy remedies: “An important lesson in physic is here to be learnt, viz., the wonderful and powerful influence of the passions of the mind upon the state and disorders of the body. This is too often overlooked in the cure of diseases.” Despite these trials, Perkins’s tractors were so acclaimed that an Institute of Perkinism was founded in London and treatments were recommended by distinguished doctors, including Nathan Smith, the founder of Yale Medical School.21 European physicians often depended on what they called “medical faith” to sustain their reputations. Haygarth noted that he “never wished to have a patient who did not possess a sufficient portion of it.” Haygarth reported the experience of Richard Smith, surgeon at the Bristol Infirmary, who operated on a difficult case (of paralysis of the flexor tendons in both hands) that he feared would prove a “stumbling-block” to his reputation. To increase the possibility of success, Smith employed Perkins’s tractors. In the end, the patient

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recovered the use of his hands so that he could almost clench his fists. Smith implied that the man’s faith in the tractors augmented, and perhaps surpassed, the results produced by the surgical technique involved. Haygarth noted that the marvelous cures ascribed to “empirical remedies”—many of which, he alleged, were composed of “inert” substances—relied primarily on the power of patients’ imaginations for efficacy. Haygarth also recognized that great cures required patients to believe in their physicians and judged that the same remedy would do more to cure a patient when prescribed by a “famous physician” than by a person of lesser standing. By the same token, a physician’s ability to cure depended to a great extent on his own faith in his remedies.22 What is remarkable is that Europeans did not often see (or at least did not acknowledge) the continuities between their practices and those of Obeah doctors. As we have seen, Europeans understood well the power the mind held over the body, but what was diagnosed as “imagination” in Europeans was judged “superstition” in Africans. “In proportion as the understandings of the Negroes are less cultivated and informed and consequently weaker than those of the white men,” island agent Spooner judged, “the impressions made on their minds by Obeah are much stronger, more lasting, and attended with more extraordinary effects.” Europeans were disgusted by African slaves’ superstition and by the stuffs used in Obeah: grave dirt, hair, teeth of sharks and other animals, blood, feathers, eggshells, images in wax, bird hearts, mice livers, and potent roots, weeds, and bushes.23 John Williamson was more equivocal. He indicated that Obeah men and especially Obeah women often held the confidence of whites as well as blacks. Indignantly, he wrote that, despite the efforts of European doctors to introduce more effective medical practices in the islands, many Negroes put great faith in “old women” whom they imagined to be gifted with “supernatural powers.” This, he suggested, might be expected of slaves, but when those “of whom better might be expected” lent their “assent, approbation, and confidence to such ignorant pretenders,” European medical men simply could not do their jobs. Old women, he barked, “intrude themselves so often to the sick-room.”24 OU TLAWING SLAVE MEDICAL PRACTITIONERS

Whether slaves turned Obeah to ill use in the West Indies as part of their struggle against slavery, we cannot know. Whites, however, emphasized the evil powers of Obeah men and women to “bewitch” and “consume” people in lingering illnesses and to poison with greater skill than even the Amerindians, all calculated to bring on dreadful deaths in hours, days, weeks, or even years. Their powers were for the most part leveled against slaves in the islands—the

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property of masters whom Obeah men or women wished to destroy. Moseley wrote that the victims of this “nefarious art” were numerous. “No humanity of the master, nor skill in medicine,” he continued, “can relieve a Negro, labouring under the influence of Obi.” And, like empirics in Europe, Obeah men or women, sometimes called gree-gree men in Africa, were accused of being greedy and selling their nostrums in a “lucrative” trade.25 Government hearings listed Obeah as one of the reasons slaves did not replenish their populations on slave plantations. Referring specifically to Jamaica, island agents judged that a “very considerable portion of the annual mortality among the Negroes” must be attributed to “wicked acts.” But worse, Obeah was blamed for the power behind Tacky’s Rebellion, the 1760 insurrection of the Koromantyn or Gold Coast Maroons that broke out in the parish of Saint Mary and spread throughout the island. The British quickly captured some of the suspected Obeah men. One disclosed the (supposed) part Obeah men had taken in the rebellion in exchange for his life. One was convicted and sentenced to death. At the place of execution the Obeah man shouted defiantly that it was not within the power of white people to kill him. The crowd of “Negro” spectators, the British report continued, was astonished when they saw him expire.26 In a grisly end to this affair, other Obeah men were punished by being submitted to “experiments” (we are not told the details) made with “electrical machines and magic lanthorns” (lanterns). The report of the experiments noted that these “produced very little effect” except on one man who, after receiving “many severe shocks,” acknowledged that the white man’s Obeah exceeded his own.27 Historian Vincent Brown has made the interesting point that this experiment constitutes an early example of the use of electricity in torture. We must keep in mind, however, that it was common to experiment with condemned criminals in this period. Further, electricity was much used in medicine: physician Francis Spilsbury in London, for example, recommended the use of electricity twice daily along with eight grains of calomel in his cure for venereal disease. At Edinburgh in the late 1780s, electricity was applied as a cure for amenorrhea. Professor James Gregory stimulated a patient’s “females,” meaning her private parts. He cautioned that electricity “be applied in such a manner as not to shock the delicacy of the tender females.” The sparks were administered not directly to the skin but through a flannel nightgown.28 Nonetheless, the “severe shocks” to the condemned Obeah men in Jamaica may well have been torture. No results benefiting medicine were recorded or published from the so-called experiment. In Saint-Domingue, after François Makandal, the Maroon revolutionary and alleged poisoner, was captured and burned alive in 1758, experiments were done on three Negro men also sentenced

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to death for suspected poisoning. After obtaining official permission, royal physicians Lacq, Daubenton, Boyer, Allies, Pagès, and Keau, all active at Le Cap, tested various types of poisons and their antidotes on the condemned.29 The Tacky Rebellion led to the outlawing of Obeah in 1760 in Jamaica. The legislation that went into effect in 1761 condemned to death or transportation any “Negro or other Slave who shall pretend to any Supernatural Power, and be detected in making use of any Blood, Feathers, Parrots Beaks, Dogs Teeth, Alligators Teeth, Broken Bottles, Grave Dirt, Rum, Egg-shells or any other Materials relative to the Practice of Obeah or Witchcraft.” According to the agent of the island, this law sought to discredit Obeah men’s and women’s claims to “supernatural power” that might endanger the “health or lives” of the “superstitious.” It also sought to defuse the “witchcraft” used to promote “rebellion.” The 1760 law was confirmed in several of the consolidated acts passed by the Assembly in 1787 and 1788 and onward.30 Other British islands seem not to have passed laws banning Obeah. The island agent in Barbados responded to a query on the subject in 1788 that “I should think  .  .  . some law has been enacted to punish them [Obeah men]; but I can find none.” He continued that Obeah men have been considered too “despicable to come under the notice of any public law.” In Antigua, testimony of Mr. Hutchinson and physician James Adair differed concerning the existence of a law there. For his part, Hutchinson believed “there is no law in the Island of Antigua which specifies the crime of practicing these arts” because it was not an offense so frequently committed as to require the notice of the legislative council. Adair, by contrast, alleged that a law existed but that in practice it was difficult to convict suspects because the testimony of the “principal” (i.e., the slave) was not admitted into evidence. Mr. Spooner, agent for the islands of Grenada and Saint Christopher, affirmed that there were no laws in any of the Leeward or ceded islands concerning Obeah or its professors. Agents from Montserrat and Nevis provided no answers to the council’s questions on Obeah. Although only a few anti-Obeah laws were in place in 1789 when the British government surveyed its West Indian holdings, Handler and Bilby have pointed out that by the end of the slave period in the 1830s nearly all British territories in the Caribbean had criminalized Obeah.31 The British outlawed Obeah in Jamaica and often demonized its practices, but they did not bar slaves from practicing medicine. The French were more aggressive, attacking African practitioners, whom they called sorciers (sorcerers) and empoisonneurs (poisoners), already in the late seventeenth century. In 1682, the governor of Guadeloupe outlawed poisoning. This was reaffirmed by royal ordinance and was extended to Martinique in 1724. This law covered not only

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poisons that caused a “sudden and violent” death but also “simples” (medicines), natural or composed, that undermined health little by little to cause disease and death. In 1738, in Saint-Domingue, surgeons, apothecaries, and druggists were not allowed to entrust poisons to their slaves. The ordinance of 1764 (Art. 16) in Saint-Domingue went further, explicitly forbidding any “Negroes and persons of color, free or slave, from exercising medicine or surgery and from treating any illnesses under any circumstances.” The penalty was a fine of five hundred livres and corporeal punishment, depending on the “particulars of the case.” This law had two caveats: slaves were allowed to treat snakebite, and négresses and women of color were allowed to continue serving as midwives on plantations and also in town, where, as royal physician Charles Arthaud noted, many white women preferred women of color to their own European midwives.32 In Guadeloupe, as we saw in chapter 2, a 1767 law prohibited Amerindians from providing slaves with knowledge of plants. Taken together, these laws across French islands drove a wedge between the highly regulated French medical establishment and slave practitioners. These laws, however, had little impact in either British or French holdings. In Jamaica, Moseley called them “impotent and nugatory.” In practice, slaves continued to serve as medical personnel across the West Indies, especially in the countryside. In Saint-Domingue, Arthaud noted that Negroes and people of color called kaperlatas plied “crude, superstitious, and often harmful practices” on one another and sometimes on whites. The reality was that Europeans depended on persons of African origin for health care, especially the care of large slave populations. European physicians officially supervised medical care on plantations, diagnosing and prescribing medicines, but slave doctors and nurses were on the front lines in the war against disease. In the French islands, hospitalières were female slaves who were in charge of day-to-day responsibilities for dressing slaves’ wounds, administering medications, and following the course of their illnesses and fevers in slave hospitals. After 1785, every plantation was required to have a slave hospital. In many cases the hospitalière was assisted by younger female aides, infirmières (also slaves), and a midwife (either slave or free).33 Nicolas-Louis Bourgeois, a longtime resident of Saint-Domingue, wrote enthusiastically of these caregivers in 1788. Considering health a matter of state importance, he eulogized the “marvelous cures” abounding in the islands and remarked that les nègres were “almost the only ones who know how to use them”; they had, he wrote, more knowledge of these cures than the whites (les blancs). The most dangerous poisons, he continued, were “transformed into the most salubrious remedies when prepared by a skilled hand; I have seen cures that very much surprised me.” From Barbados in the 1790s, the military physi-

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cian George Pinckard also praised “Negro doctors” on plantations who “vie[d]” with Creole (meaning persons of European descent) “pretenders” in medical knowledge. He was also greatly surprised to see an “African slave perform” a surgical operation to remove subcutaneous chigoes “with greater dexterity than it could have been done by the most skillful surgeon of Europe!”34 From the planters’ point of view, these slave doctors were there to assist the European doctors by compounding and administering medicines, dressing sores, pulling teeth, and feeding and caring for the sick. British plantation hospitals typically had one or two “sensible Negroes” who served as doctors (men or women) and two slave nurses (again, men or women). One large plantation had fifty-one slave medical personnel: thirty-four women, many of whom served as midwives and infant nurses, and seventeen men. Williamson deemed these “Negro” men and women “important acquisitions” for every estate. Adair also advised that an aged female slave—one no longer fit for work in the fields— should be appointed nurse in the hospital. She should be “past child-bearing, sensible, prudent, and humane”; and she should be taught to read.35 Despite the deplorable state of plantation hospitals (chapter 3), slaves played a central role in plantation medicine. THE PROFESSIONAL EXCLUSION OF GENS DE COULEUR LIBRES

The 1764 ordinance excluding “Negroes and persons of color, free or slave” from practicing medicine did not stop plantation slaves from treating other slaves, but it did stop free people of color from being licensed as surgeons and physicians. We learn much about this issue from Julien Raimond, the ardent spokesperson for the rights of gens de couleur libres (free people of color, or mixed race). Raimond, a wealthy plantation and slave owner, noted that in Saint-Domingue two men of color had served as surgeons before 1764. These two men, known only as Huguet and Déscourbes, were educated in Paris and returned to work in the towns of Jacmel and Aquin, respectively. After 1764, Raymond complained, this “useful art” became a white monopoly.36 Writing in 1791, in the heat of the trans-Atlantic French revolution, Julien Raimond sketched the history of the growing prejudice against free people of color. In the period before 1744, when Saint-Domingue was wealthy, Raimond averred, whites had showed little prejudice against people of color. It was a time when “there was no dishonor in seeing gens de couleur living among the whites.” In the absence of virtuous European women, French colonists chose a partner from among their slaves and made her the mother of their children under the title of housekeeper (ménagère). Children of mixed race were free,

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inherited property (land and slaves), and often were commissioned as officers. Fathers sent their children of mixed race (both boys and girls) to France to be educated and, for sons, to learn the professions. Among these professions was medicine.37 According to Raimond, the 1764 ordinance against persons of African origin practicing medicine was part of the general crackdown on rights for free persons of color. Raimond, speaking against the ordinance, wrote that people of color were no longer allowed to enter France. Some whites, he complained, wanted them to give up their title as “free”; others wanted them to give up the names of their French fathers and take African ones instead. Whites who married people of color were stripped of their nobility and commission as officers. Those petty whites who had formerly worked for people of color now became their masters. Further regulations forbade free coloreds to “affect” the dress, hairstyles, or bearing of whites, ride in coaches, or keep indoor privies.38 Royal physician Charles Arthaud, speaking for the 1764 ordinance, argued that barring gens de couleur from the professions would encourage immigration of “useful and distinguished [white] talents” to Saint-Domingue. “If one were to give the gens de couleur all the civil rights to which they aspire,” he charged, “if the political prejudices against them were to vanish, they would mix even more with the whites and the time would come when they would become the sole proprietors in the colony.”39 Similar complaints came from the British West Indies, where social prejudice barred people of color from the professions; no law was needed. Jean-Baptiste Philippe, a man of color or “mulatto,” as he called himself, charged that incompetent whites were issued medical licenses—no questions asked—while well-trained men of color were denied the right to practice. “Every hungry adventurer,” Philippe wrote from Trinidad in the 1820s, came to the colonies and “without credentials from any college, carries on his trade of gain and death, to the disgrace of medicine and humanity.” “Let the white candidate be who he will,” Philippe continued, “his colour alone will pave the way for his admission by the Board. Certificates from colleges or universities are not essential. His immaculate colour will prove indubitably his acquaintance with all the arts and mysteries of medicine.” “Raw apprentices, and journeymen apothecaries,” Philippe charged, “are licensed to expermentalize on the bodies of their patients, with no other recommendation than the most brazen effrontery.” Under these circumstances, medicine became not a science aimed at relieving the sufferings of humanity, but merely a trade “by which a needy set of men gain a livelihood, at the risk of the lives and treasure of their patients.”40

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Should a “coloured man,” however, approach the tribunal, no matter how excellent his qualifications, Philippe went on, a thousand objections would be raised to his candidacy. Philippe, himself educated in London (in literature) and in Edinburgh (in medicine), became a champion of free people of color— many of whom were from prominent families and themselves owned slaves. He no doubt experienced these prejudices firsthand, yet he drew his example of race-based discrimination from the case of a Mr. Francis Williams. As was common for children from prominent families, Williams studied surgery in London and passed examinations at the Royal College of Surgeons. In 1822, Williams presented himself to the medical board. His examiners found his credentials in order; they alleged, however, that because he had been born a slave the “dignity of the profession” did not allow them to license him.41 Williams appealed the decision, saying that other people of color had been allowed to practice in the island and that it should be the credentials, not a person’s origin, that decided his worth. Philippe included documents in his text that had emerged from Williams’s case. One from an official in the Port of Spain argued that Spanish law (Britain took over Trinidad only in 1797) required any candidate seeking to matriculate into a college or university, or to sit for examinations, to provide proof of limpieza de sangre (purity of blood). Philippe pointed out that this requirement applied not only to those of African descent but equally to Jews, Moors, and Amerindians. The official continued that despite these regulations, free people of color had been allowed to study surgery at the king’s royal hospitals and had been allowed to practice as cirujanos romancistas—as traditional, not licensed, surgeons. These lesser practitioners were often employed by the government and allowed to wear uniforms, though never to serve on medical boards.42 The attorney general in Trinidad, George Knox, rendered a final decision ruling in Williams’s favor: “The rules and regulations of the Royal College of Surgeons of London, have of necessity, as to the diplomas granted by them, superseded all the [laws of Spain].” His reasoning was that if Trinidadians continued to be ruled by the laws of Spanish universities no British diploma would be valid in the island. Commenting on the issue of birth and race, he found “no express” law prohibiting a person from becoming a licensed surgeon on the basis of his birth. The attorney general judged that “a free person of colour, though born in slavery, and though his mother should unfortunately still continue in slavery, may well practice medicine or surgery, under any regular diploma he may have properly obtained from the Royal College of Surgeons of London.”43 Notwithstanding this ruling, barriers based on prejudice and innuendo remained in place.

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Despite the ardor of their arguments, neither Raimond nor Philippe was a friend of slaves. They argued for rights for free people of color, yet they both owned slaves. Raimond eventually argued for a scheme whereby slaves could purchase their own freedom, but Philippe never supported emancipation for slaves.44 ARE BODIES INTERCHANGEABLE? THE COLONIAL CONTEXT

The end of the eighteenth century witnessed vigorous debate about the abolition of the slave trade and slavery itself. In 1789, the year that revolution exploded in France, the British government published its extensive Report of the Lords of the Committee of Council on the “present state of the African trade.” Queries were sent to the governors of British holdings in the West Indies and on to various island councils, assemblies, and agents. Doctors and surgeons in the British West Indies were asked to provide essential testimony.45 We have already seen some of their testimony concerning Obeah above. European physicians’ primary job was to keep slaves healthy. They were, however, also deeply embedded in the colonial complex, and many, as we have seen, owned slaves. The majority of physicians, as noted earlier, never put pen to paper. They were working men with little time to write. Those who wrote did not often comment on slavery or on Africans’ physical, moral, or intellectual characters. Four physicians, however, responded to these governmental queries: James Chisholme, Adam Anderson, and John Quier, all active in Jamaica, and James Adair, active in Antigua.46 Adair began his testimony by establishing himself as what we today would call an expert witness. No longer owning slaves of his own, Adair claimed to have no stake in the trade one way or the other. He pledged to respond to government queries with “candour” and “impartiality” concerning the “unpopular and invidious” trade. Further, he established his expertise on the basis of twenty years’ experience in the field, where he had observed the “treatment and condition of the slaves” in his professional capacity as plantation physician and as a judge for the Supreme Court on the island. Some years later James Thomson wrote of physicians’ special insight into slave life: “Professional duties lead us to a knowledge of the most minute domestic arrangements, that are only known to those in habits of the closest intimacy.”47 The Report of the Lords was prepared in response to “a great number of petitions” presented to the British House of Commons on the subject of the slave trade and the treatment of “Negroes” in the king’s sugar colonies. In studying the questions, the council asked about everything from the spiritual beliefs of

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the slaves to the type of manure used in sugar cultivation.48 The same fiftythree queries were sent to the agent for each British island in the West Indies. A key question was whether African and European bodies were interchangeable when it came to the backbreaking labor of sugar cultivation in the tropics. Physicians in this period tended to see bodies as interchangeable in medical trials; for the most part, the bodies of the poor, displaced, and enslaved were considered representative of human bodies more generally (chapter 4). In the British government inquest, the question was whether slaves could be replaced by European laborers. The answer everywhere was a resounding “no.” In this instance, black and white bodies were not considered interchangeable. Bodily difference meant that working-class Europeans could not be imported to work the fields. The African body—and, in fact, skin—was judged far superior in this regard. In Jamaica, Stephen Fuller, agent of the island, Edward Long, a judge, and James Chisholme, a doctor in the parish of Clarendon and formerly a member of the House of Assembly, asserted, “So far as experience can determine, we find that the same exposure to the sun, which cheers the African, is mortal to the European; nine in ten of them would die in three years.” This was not the first time these questions had been posed. Africans’ bodily durability had been a strong argument when the English first enslaved Africans as colonial laborers in the late sixteenth century.49 What was termed the “European constitution” figured prominently in these discussions. Some agents found that the “nature and constitution of an European” were not so well adapted to retain even life, much less to support field labor, in either the climate of Guinea (West Africa) or that of the West Indies, which was considered analogous to it. Agents in Grenada and Saint Christopher suggested that even if a “white man” were to work only during the cooler hours of the day, his “constitution” would soon “wear out,” and he would perish. John Braithwaithe, the agent in Barbados, thought that a European might prove stronger at first and even do more work but that “he would die sooner,” not because the labor performed in the West Indies was greater than that performed by many in England, but because it must be performed in the “intense heat of the sun.” Lieutenant Governor Clarke of Jamaica invoked the language of “experiment” when investigating whether to replace Negroes with British seamen to clear land for a fort on Navy Island in 1733. This work cut down the “White Persons,” resulting in fatal fevers such that a man taken ill in the morning might be dead that night. Reporting in 1788, the lieutenant governor opined that “nature probably has ordained this disparity.”50 As evidence for the weakness of the European constitution in this regard, Mr. Hutchinson and Mr. Burton, joint agents for the island of Antigua, re-

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ported the mortality that the climate of the West Indies produced among British troops: “For whatever can be ascribed to the circumstances of soldiers as an additional cause of that mortality,” they wrote, “must be ascribed in a still higher degree” to the situation that Europeans would be in when forced to emigrate to the West Indies as “common labourers.” The agent in Nevis added that plantation overseers who came to the West Indies in the most “robust health” were all too often reduced to an “emaciated state” by the labor incidental to their employment, which was merely to oversee the labor of slaves. “The heat of the climate so congenial to the constitution of a Negro,” he added, “is too severe for an European.” Island agents generally agreed that it was “highly reasonable” to suppose that Europeans would die in alarming numbers were they “driven to the necessity of performing themselves the labour now imposed on the Negroes”—“European constitutions” simply could not bear it.51 Differences in skin played a role in these debates concerning the possibility of Europeans laboring the fields (as we saw in chapter 1, these were issues still plaguing Thomson some thirty years later). The agents for Grenada and Saint Christopher were adamant that “hard labour in the heat of the sun” would “sink” Europeans. The sun’s heat, they observed, blistered the skin of white men but rendered the skin of Africans “more fine and smooth” so as to heighten the “glossiness” of it. Colonial administrators invoked African bodily superiority for hard labor in tropical climates: “Negroes,” the agents confirmed, seemed fit “by nature” for labor in the “Torrid Zone.”52 Given that efforts to settle European peasants and day laborers in the Caribbean were doomed to fail, government agents turned to a second question: If the slave trade were to be abolished, could free blacks—either freed or free born—be hired to work the fields? Two considerations came into play. First, agents from Montserrat and Nevis noted the expense of hired labor—either European or African. “No estate is sufficiently productive” to bear this cost, they judged, and estates that had hired blacks had “generally been ruined.”53 More importantly, however, free blacks typically refused such work. Island agents Fuller and Long and Dr. Chisholme in Jamaica found free blacks “averse to labour the ground even for themselves.” “In Jamaica,” they continued, “no free Negro was ever yet known to hire himself, or be employed in agriculture upon the sugar plantations.” Agents from Nevis made it clear that “becoming free” among persons of African origin was considered an “exemption” from every form of field labor: “a free coloured person” would think himself “disgraced” by it to such an extent that no pecuniary or other considerations whatsoever would induce him to cultivate land. Further, agents warned that free blacks have “all the vices of slaves, and no planter could

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controul them.” Blacks, they concluded, “are universally disposed to be slothful and indolent.”54 British debates about the slave trade raged until the trade was outlawed in 1807. In this period physicians offered their opinion—expert or otherwise—on slavery and slaves. Physician and surgeon John Williamson was typical of these men. His journal, dedicated to the Earl of Harewood, whom he served in Saint Thomas in the Vale (where Quier worked and Thomson would after 1810), bristled with social commentary and medical observations. Like many European medical men, Williamson reported leaving Europe with a loathing of slavery. He was “overwhelmed with horror” when slave ships pulled into Jamaican harbors. The sounds emanating from these ships—the cracking whips and the howling humans running about naked on board—rang “harsh and unnatural” in his ears. “Nothing,” he declared, “can justify a state of bondage between man and man, as a natural right.” Williamson wrote with compassion that slaves aboard ships were “oppressed often by an apprehension that they were brought for the purpose of being made food for the whites.”55 But upon arriving in the West Indies in 1798, Williamson, like many of his confrères, soon became an impassioned apologist for slavery. He “lamented” the “numerous misapprehensions” and “impressions so opposite to truth” that ruled Britain on the condition of slaves and the “partial” and prejudiced information meted out by the antislavery movement. Those who visited the West Indies and saw things with an open mind soon, he asserted, understood that “a Negro, under a fair master, disposed to be industrious, and fond of comfort, enjoys his house, his family, his provision grounds, and many of the luxuries of life, to an extent which, undoubtedly, is not comprehended” in Europe. In the same way that Williamson distinguished good masters from bad masters, he differentiated “industrious” from “indolent good-for-nothing Negroes.” Industrious Africans were to him the salt of the earth—happy and productive. Lazy Africans were problematic; they required discipline, could not be trusted, and worked only under the crack of the whip and the “dread of punishment.”56 The crux of Williamson’s proslavery argument and that of other medical men was twofold: first, Africans were better off as slaves in the West Indies than as free people in their native Africa; and second, they were better off than free peasants in Europe. Williamson explained the slave trade as resulting from four factors: “the barbarous state of the great continent of Africa,” “the . . . civilized and powerful condition of Europeans,” “the want of labourers” in the West Indies, and the willingness of Africans themselves to provide “cargo” for European slave ships. He believed that newly arrived slaves who had the good fortune to become the property of a humane and dutiful master had “little

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reason to think it a grievance that they were nominally become the property of another.” On the settled estates of Jamaica, he wrote, slaves prided themselves not a little on the “antiquity of their families”; they were especially proud if any of the “females have been mistresses to the white proprietors.”57 Slaves, particularly those who had been forcibly transported from their African homes as adults, saw things very differently. Some ended their lives by committing suicide. In a remarkable passage, Williamson gave the example of two Eboe men who had disappeared from the mountain property of a Mr. G. R., only to be found “hanging dead on the same tree, hand in hand.” On examination, Williamson reported, “it was found that one of them had his penis cut off, which lay at a short distance.” Williamson commended those who decapitated suicides and, acting from “a humane principle,” placed the head of such an African in a prominent place to “deter the rest from conduct so destructive.” Africans were reported to believe that if the head was removed from the body the person could not journey to his or her native land even in death.58 As we saw in chapter 4, Donald Monro in London rejected John Quier’s notion that bodies were interchangeable and drew strong parallels between the bodies of slave women and the “labouring Poor in England.”59 Arguments about slavery extended this notion. British medical men contended that slaves in the West Indies fared much better than free peasants in Europe. Williamson wrote that the abolitionists in Europe should be careful not to disturb “the relatively good understanding which exists between Negroes and whites” in the Caribbean. If abolitionist do-gooders (in his view) wished to relieve want and poverty, they should turn to Ireland—a source of misery close to England’s doorstep and “a fairer field for the[ir] exertions.” Although he recognized abuses in the system, Williamson emphasized that slaves enjoyed the security of comforts beyond any peasantry in the United Kingdom. Proprietors in the West Indies could not “throw off ” an old, infirm, or lazy slave “as some masters do . . . old servants” in Europe. Masters supplied slaves’ needs, and in “helpless circumstances, there is probably more rendered, in the offices of tenderness to the distressed Negro, than to any description of peasantry in Europe, or any part of the world.” William Wright and James Adair concurred: in their view, sick and superannuated slaves in general enjoyed “more comforts and better accommodation” than the indigent sick or elderly in any country in Europe.60 Leaving no stone unturned, physicians argued against the emancipation of slaves. Williamson noted that persons of African origin in Jamaica did not beg in the streets or live in a state of privation unless they were free. He himself considered freeing one of his slaves whom he had taken with him to Europe as a servant, but the man refused his offer. According to Williamson’s report, his

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slave felt that, under a good master, “every necessary of life was better secured him.” James Adair put a different slant on the reluctance of Europeans to grant freedom to slaves. Many freed Negroes, he wrote, instead of benefiting from their new situation, became indolent and worthless. Worse, they often harbored runaway slaves or encouraged them to rob their former masters by buying the stolen goods. Freed Africans, Adair continued, were powerful, intent on gaining their fair share of wealth, and an immediate danger to colonists.61 This view of slavery, promulgated by proslavery physicians, was, of course, highly romanticized. Williamson readily acknowledged the cruelty and neglect of many masters. “I have already stated,” he wrote, “that those intentions [of perfect care] are not carried so fully into execution as might be wished.” Slaves were required to grow their own food on provision grounds. They worked these grounds the few evenings and weekends that they were not forced to cut cane in the fields. If hurricanes came or crops failed, they often went hungry. The French royal physician Dazille had plenty to say about the hunger and deprivation slaves endured. Many of his efforts to improve the health of slaves had to do precisely with cajoling masters to feed and clothe them properly.62 Physicians in the West British Indies rarely commented on the intellectual capacities of Africans. Their job was to keep slaves healthy; they tended not to engage in the debates about Africans’ moral and intellectual qualities that exercised many of their colleagues in Europe. There were, however, a few exceptions. Moseley opined that Africans lacked civilization: “Were the mighty plains of Africa the residence of philosophy,” he opined, “her children would not wear the chains of European slavery.” Moseley would have agreed with Williamson that Africans’ intelligence, “cunning” as they called it, was deployed for thievery and escape. For Moseley and others, the only hope for moral reform of Africans was the provision of religious instruction from the time of birth. In this, Moseley noted, Catholic islands, with their strong emphasis on religion, had more success with Creole slaves than their Protestant counterparts, who, apart from the few Moravian plantations, generally had no religion at all. Williamson, who believed Africans to be “fellow creatures” existing in a state of “degeneracy,” argued that blacks would not flourish if emancipated. “The mind of a Negro is not ennobled,” he wrote, “by those sensations which a state of freedom conveys.” Only once did Williamson remark that a “black” (not “Negro,” his usual parlance) exceeded his expectations. Upon his arrival in Jamaica, Williamson was surprised when a “black pilot” boarded their vessel off Port-Royal and guided them to shore in “perfect safety.” Williamson remarked that this man was very communicative and intelligent—“more so than my conceptions of the colour induced me to expect.”63

The Colonial Crucible

This cauldron of attitudes influenced colonial politics, economic development, and medical practices. In his treatise on coffee, Benjamin Moseley recommended increasing coffee cultivation for a number of economic and political reasons. First, he hoped the British could profit from it as greatly as had the French. He estimated that in 1781 duties and excises on coffee earned Jamaica £1,344,312. Furthermore, coffee was to be cultivated in the interior of the country (unlike sugar, which was grown in plantations that hugged the coast), and new plantations in the mountains would spread white vigilance to these areas. “Thus,” he wrote, the residents will “live in safety, and all sorts of property acquire a proportionate value and security. The retreats of fugitive Negroes are laid open; plunder and depredation prevented, and conspiracies for rebellion are deprived of their hiding-places.” Sugar plantations, although a great source of wealth, did not, in Moseley’s view, bring enough Europeans to Jamaica to guard “against the insurrections of the Negroes.”64 ADVOCATING BETTER LIVING CONDITIONS

The French government did not conduct an inquiry similar to the extensive British Report of the Lords of the Committee of Council. The royal physician in Saint-Domingue, Jean-Barthélemy Dazille, however, was particularly passionate on the subject of slave welfare. His Observations sur les maladies des nègres, leur causes, leurs traitemens et les moyens de les prévenir (Observations on the diseases of Negroes, their causes, their treatments, and the means to prevent them), published in 1776 and again in 1792, focused on treatment but also emphasized prevention of disease. “The art of healing is precious without doubt,” Dazille wrote, “but preventing illness is greatly to be preferred.”65 Dazille wished to persuade planters and naval ministers alike that it was not the heat of the climate that killed in the Torrid Zone but improper attention to the quality of water, food, and ways of living. Health, he taught, depended on a person’s individual temperament inherited from his or her parents, but temperament was modified by diet, air, ideas, and opinions, and these were something within the power of individuals, physicians, and governments to make as healthy as possible. And although Dazille occasionally noted diseases that were more common in blacks or in whites, he saw healthy living— consisting in adequate food, clean water, and good housing—as the same for all humans. His recommendations for slaves, on the one hand, and soldiers and sailors, on the other, were nearly identical (in fact, his books on the diseases of Negroes and on diseases of warm climates are highly repetitive).66 Physicians across the Caribbean produced a large literature for their literate country people on how to “preserve life” for all populations under their watch. For all

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humans in the West Indies—newly arrived, seasoned, or island born—Dazille emphasized that a warm climate was not itself debilitating if careful attention was paid to the conditions of life. Dazille wrote with respect to slaves that his “principal object” was to make known the true treatment for diseases produced by “insufficient nourishment, lack of clothing, and forced labor.” Dazille passionately argued that slaves need not die, that the decimation of the colonial workforce could be stopped—and that the means to do so lay in planters’ hands. Planters could serve the interests of the state, advance their own economic goals, and warm their hearts with acts of humanity by following his prescriptions and admonitions.67 According to Dazille, the principal cause of disease among slaves was their diet, which consisted of poorly prepared manioc, something known as brette, and calalou, or spicy curry. Autopsies of slaves who had died of dysentery found intestines full of worms. Secondary causes of disease included slaves’ love for strong drink; their lasciviousness, which led them to wander into the unhealthy night air to “satisfy their desire”; and their laziness, which disposed them to drink bad water near their homes rather than collect pure water from afar. The royal physician’s message to planters was that providing slaves with food, clothing, and drink was cheaper and also more humane than hospitalizing them.68 Following Dazille’s lead, the Gazette de médecine pour les colonies ran several articles on how to care for slaves, recommending diets rich in yams, potatoes, cassava, corn, and various nutritious grains. The editors also recommended that “handsome Negro children” (beaux Négrillons) be fed delicate morsels from the master’s own table. The Gazette supplemented Dazille’s suggestions with other practical directions to planters. Slaves should have sufficiently large and airy huts, constructed well away from wet and swampy lands. They should be given a good cooking stove and blankets, especially for the cold nights in the mountains.69 As a man of the state, Dazille was also responsible for the health and wellbeing of soldiers and sailors. His advice for their care paralleled in many ways his recommendations for slaves. Military wards of the state, Dazille noted, died at five times the rates of slaves because they were crowded into garrisons in swampy and marshy urban ports plagued with epidemic disease. Food was scarce and often foul from long-distance transport; the air in hospitals was infected and corrupt. Dazille urged state ministers to supply soldiers and sailors with adequate food and drink. He recommended in particular a drink made of taffia (a cheap rum), lemon juice, water, and sugar on the order of two pints per day per man. For food, Dazille recommended rice, vinegar, and greens, especially the watercress that could be collected fresh each day from river banks. The

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small price of these measures, Dazille urged, would easily offset the immense sums paid out for treatment in hospitals and replacement when recruits died. He reminded governmental ministers that experienced soldiers were more effective in warfare than new recruits. Drawing on his vast colonial experience, Dazille pointed out that commanders in the Île de France (now Mauritius) and Île Bourbon (now Réunion) who implemented these recommendations lost few soldiers and sailors to illness.70 Dazille also recommended his special taffia drink for slaves: alcoholic drinks, taken in moderation, he taught, benefited digestion. He was so persuaded of this truth that when a royal decree forbade treating Negroes with wine in royal hospitals, Dazille brewed and administered his taffia to achieve the same healing effects.71 Dazille’s special interest, like that of many in the eighteenth century, was water. Dazille realized that a primary cause of disease in warm climates was stagnant water often fouled by cesspools. During his commission in SaintDomingue, Dazille was faced with an epidemic of dysentery and fever that nothing—even quinine—could cure. One day, as one of his servants brought water for a slave, Dazille realized the water was polluted. He tested the well in question with a fixed alkaline; it turned the water white. He tested again with a mercurial substance that yielded considerable precipitation. Convinced the water was contaminated, Dazille insisted on drinking large quantities of it himself to substantiate his findings. He became fatigued and experienced colic, diarrhea, and fever of the same sort plaguing those who frequented the well. He instructed the owner of the well not to let his slaves drink there—and soon everyone was cured. Dazille then tested all the wells in Cap-Français and the surrounding plantations. While he found the city water unhealthy, the surrounding countryside was well supplied with potable water except during the rainy season.72 In 1783 Dazille was commissioned by the governor general (and, one suspects, at his own behest) to test all the water—simple and mineral—in Saint-Domingue. He particularly wished to test the healing powers of various bath waters, such as those of Eaux de Boynes in the northwest near Port-à-Piment. An analysis of the mineral waters at Boynes had been carried out in 1772 by M. M. Polony and Chatard in response to a French royal commission, but doubts lingered concerning the efficacy of the waters for various cures. Dazille noted that this indecision meant that the sick (most likely soldiers) had to be transported to France for treatment—which was “ruinous” to the king’s purse. He tested the waters in the presence of witnesses (using, among other things, Réaumur’s thermometer) and determined that, indeed,

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the waters—used externally and internally—were the “best remedy” for the numerous diseases of the skin.73 Water in the tropics was of such importance that the first volume of the journal published by the Cercle des Philadelphes was devoted to the subject. Again, the waters of Boynes were tested. Joseph Gauché, the administrator of the thermal baths, reported sixty-one observations on the effect of the waters on individuals—plantation owners and soldiers, old and young, free “quadroons” and slaves, and men and women. Slaves were treated for scrofula: Gauché’s treatments found that four were cured, three improved, two were unchanged, and one died. Similar mixed results occurred in cachexia, elephantiasis, syphilis, and other diseases. Only for yaws were the waters consistently useful.74 The Jamaican Benjamin Moseley strongly disagreed with Dazille and his notion that slaves suffered from want of food and clothing. Most physicians, however, agreed with Dazille’s assessment. William Lempriere, a royal apothecary, noted that typhus ravaged Negroes in Jamaica, who lived in crowded and confined apartments. This he blamed on “their indolence,” which allowed filth to accumulate. Further, John Williamson, writing of the British invasion of Saint-Domingue in the 1790s, complained that the port Môle-Saint-Nicolas was so filthy with stagnant waters in the street that troops died and the British were forced to withdraw.75 Questions concerning the health and welfare of slaves in Saint-Domingue, however, became a moot point for the French. By 1791 (a year before the second edition of Dazille’s Observations sur les maladies des nègres), the island was consumed by revolution. Further, slavery was abolished in French holdings, such as Guadeloupe, in 1794 (to be reinstated in 1802).76 EXPERIMENTS WITH BREEDING

A key question in the 1788 British governmental hearings on the slave trade concerned why slaves in the West Indies did not naturally increase their numbers. Plantations in the Caribbean, as opposed to the American South, still relied on yearly shipments of slaves to replenish the labor supply. In this inquiry, the British government asked: “Can any causes be assigned which impede the natural increase of Negro slaves?” While Thomas Malthus’s Essay on Population (1798) would devalue the supposed national benefits of unfettered population growth, the colonies were still in need of robust population, especially of forced labor.77 Physicians’ responses were many and varied. High on the list was disease: tetanus was said to carry away a quarter of newborns; yaws, venereal disease, guinea worms, menstrual obstructions, dysentery, pleurisy, measles,

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chin-cough, and smallpox played havoc among adults. Other reasons that slaves did not replenish their own numbers, according to island agents and physicians, had to do with the disproportionate number of men to women (women were estimated at only a third of the slave population in Jamaica), the practice of polygamy, slave women’s frequent attempts to procure abortion, and their practice of suckling their children for two or even three years (it was said, to prolong their absence from work). Hutchinson in Antigua added to this list the “infidelity of the women” and especially that ambition of the “comelier” part of them to be preferred by white men, who, he noted, frequently rewarded a “long connexion of that sort” with freedom. Quier in Jamaica emphasized the “want of maternal affection”—mothers, he charged, often abandoned the children fathered by a former husband or lover. He also mentioned the dangers of “promiscuous intercourse” that spread venereal disease throughout the population. But he warned that any attempt to curb “licentious intercourse” in Jamaica by introducing marriage among slaves would be “utterly impracticable.” Slaves, he judged, took it as their “right” to dispose of themselves sexually according to their “own will and pleasure, without any control from their masters.”78 Much has been written on the low rate of natural increase among West Indian slave populations. Some historians emphasize the high death rate: life expectancy for slaves in French colonies was between twenty-nine and thirtyfour years, compared to forty-six years for Europeans in this period in France. Other historians stress low female fertility rates among slaves. One Jamaican planter estimated that in 1794 and 1795 only half of his 240 resident female slaves at Worthy Park ever became pregnant. These 120 pregnancies produced only nineteen children who survived infancy.79 These types of questions led to what we might call the “calculus of life” in this period. One metric asked whether it was more economical to buy or to breed slaves. Before the end of the slave trade, planters overwhelmingly answered “buy.” Writing in 1776 in Saint-Domingue, the lawyer Michel-René Hilliard d’Auberteuil estimated the cost of breeding a slave to include the slave mother’s lost labor (some fifteen months) at a cost of 300 livres. High infant mortality meant that the children might die, and this could easily be labor wasted. Should the child live, a planter incurred the additional cost of feeding and clothing him or her for fifteen years. When finally fit for work, the child might fetch 2,000 livres (depending on whether it was male or female). A slave, however, could be purchased for something less than 1,670 livres. The economics were clear. Another metric asked whether it was more economical to buy or to cure. Cure was often considered much more

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expensive than the replacement costs. Depending on the malady, planters often chose to let their slaves die.80 In the 1780s and 1790s, as the slave trade was threatened, it became common for slave mothers to be given incentives to breed slaves. In this context the Antiguan physician James Adair produced his lengthy testimony that included a report on an experiment with the breeding of slaves. Adair’s purpose was to show that simple kindness and good treatment of slaves—as Dazille had recommended—would not increase their numbers. He deemed it his “duty” to vindicate the “native white or creolian inhabitants” of the charge that they treated their slaves harshly. Instances, he wrote, had been brought forward to prove that an increase in slaves followed from their mild treatment. From this a false and “unjust” inference had been drawn that the annual decrease in the number of slaves was caused by hard labor, lack of food, and harsh treatment. He further asserted that the white Creoles in the Leeward Islands were falsely accused of having inherited a “spirit of rapine and cruelty” from their forebears—buccaneers and convicts said to populate the Americas.81 Slave discipline, Adair continued, might be “rigid” under what he described as a “patriarchal” plantation system, but, he opined, it was not more so than that practiced in the navy and army. Finally, he held planters responsible for frequently purchasing adult male slaves in order to derive immediate advantage from their labor. Young slaves and females slaves, he suggested, though not immediately profitable, ensured a better workforce in the long run. Like many physicians, Adair recognized that acquired immunities rendered one slave born or reared in the colony equal in value to two of the same age imported.82 In many instances, according to Adair, slaves themselves were to blame for their high morbidity and mortality. Many were weakened by their “frequent migrations” to other plantations, often very distant, for the purpose of “merry-making” or of visiting their husbands or wives so that the “greatest part of the night is often consumed in traveling from and to their master’s estates.” But, when seeking causes of slaves’ failure to reproduce a workforce, Adair pointed first and foremost at slave women. It was not true, he asserted, that planters killed slave progeny because it was more profitable to purchase slaves fit for labor than to rear them. Rather, slave women rendered themselves sterile through their “frequent attempts to procure abortion” and their “debilitating” commerce in sex. Their “early” and “premature” sexual relations, along with the practice of polygamy, coupled with the “excessive indulgence of both sexes” in the use of alcohol and tobacco, destroyed their physical, mental, and moral strength.83

The Colonial Crucible

The British government, however, pressed physicians to recommend policies that, if implemented, might lead to a natural increase in the slave workforce. In this same testimony, Adair reported an experiment with breeding carried out by a Mr. Kerby, member of His Majesty’s Council of Antigua. Adair argued that slaves in Antigua suffered not at the hands of their masters, but from the rigors of climate. As he had noted earlier, excessive heat led to frequent abortion (he meant miscarriage, but physicians in this period did not make the distinction). Adair claimed that the “chief cause” of an annual increase among slaves was a healthy climate—a favorable warmth coupled with a “loose and productive” soil. As proof he offered Mr. Kerby’s experiment.84 Thomas Kerby, a prominent planter and member of the Council of Antigua, owned two plantations in different quarters of Antigua. On one estate the women bred prolifically; on the other they did not. In studying the situation, Kerby kept all conditions equal: the slaves on each plantation were worked, fed, clothed, and accommodated “in the same manner.” Only the overall climate of the estates differed, to such an extent that slave women in the favorable climate reproduced while those in the unfavorable climate were barren. To test whether climate was indeed the key factor, Mr. Kerby moved a “certain number of breeding females” from one estate to another. He found that the barren group moved from an unfavorable to a favorable climate became prolific and that the group moved in the other direction became barren. Adair concluded that a favorable climate improved the “constitutions of both sexes” and led to “constitutional vigour” and propagation.85 PRIORITIES FOR RESEARCH

in science and medicine respond to social and political contexts. Questions about who will—and who will not—benefit from a particular line of research, what counts as evidence, how evidence is interpreted— all depend on regimes of power. European physicians in the Atlantic World medical complex responded to the economic interests of planters as they debated whether black and white bodies were interchangeable in medical experiments and in the deadly labor systems that dominated tropical sugar plantations. European physicians responded to colonial power struggles and legal imperatives as they considered whether Obeah and the spiritual aspects of African healing practices were to be mainstreamed into colonial medicine as a whole. They responded to the fear of uprisings as they suppressed the rights of men and women of African origins to practice medicine. Knowledge, too, responded to the conditions of its creation. In the final chapter we investigate the circulation of knowledge in the Atlantic World

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medical complex, looking in particular at how commercial networks and trade routes shaped knowledge exchange.86 We also analyze how knowledge did not circulate: secrecy and revolt on the part of slaves and Amerindians fed colonizers’ prejudices and fears that reinforced agnotological barriers impeding the flow of knowledge in the Caribbean and beyond.

Conclusion

THE CIRCULATION OF KNOWLEDGE [Numerous local remedies are known only by] Indians and Negroes, who hide their preparations so that it is impossible to discover their secret. —Bertrand Bajon, military and civilian surgeon, French Guiana, 1777

THE FLOW OF KNOWLEDGE

in the Atlantic World medical complex was promiscuous and multidirectional. Knowledge had its origins with Amerindians, persons of African origins, and persons of European origins (in both Europe and its far-flung colonies). These knowledges mixed in the Caribbean plantation complex as Europeans frantically sought to develop tropical medicine to combat the ravages of colonial disease. The circulation of people, plants (as both foods and medicine), disease, and knowledge fueled medical testing in the eighteenth-century Atlantic World. Figure 3 in the Introduction shows the Greater Atlantic World in motion. Throughout this book I have highlighted three nexuses along which people and their knowledges moved: the well-defined colonial nexus linked Europe and the Americas, the slave trade nexus joined Africa and the Americas, and the conquest nexus selectively funneled Amerindian peoples and their knowledges into the plantation complex. Here we delve into each nexus—seeking to understand the mechanisms of knowledge exchange in the Atlantic World medical complex. Not all knowledge, however, circulated. We also investigate agnotology or ignorances induced by colonial conquest, slavery, and prejudice and seek to identify how and why specific knowledges were blocked, discredited, or held secret. Understanding the headwaters, flows, and countervailing ebbs and eddies of knowledge illuminates how Amerindian and African practices in the Atlantic Worldwere collected and curated by Europeans. THE EUROPEAN COLONIAL NEXUS

Colonial nexuses are best known to us because they are easily traced through documents in the form of letters and publications. We learn of medical experiments when European physicians encountered new cures—and usually ones that worked—because this was what was worth recording. A common pathway sped a colonial physician’s letter to a learned colleague in Europe, who in turn relayed it to a learned society, where the letter was read and often published in a 147

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journal, and perhaps later in book form. This pathway defines typical patterns of communication throughout both the British and the French medical complexes. Figure 19 shows how knowledge flowed between Europe and the Caribbean. Importantly, colonial physicians were educated in European hubs, such as Edinburgh, London, Paris, and Montpellier. Neither the British West Indies nor the French Antilles had medical schools. European doctors were typically educated in Europe and sent out to the colonies. We have a few reports of European Creoles (Europeans born in the islands) being educated in Europe— but this was rare. European hubs were places where the experimental techniques traced in this book were developed. Plantation owner Alexander J. Alexander in Grenada, for example, was educated in Edinburgh; he brought experimental techniques and equipment with him on board ship (chapter 2). Colin Chisholm carried from London to Demerara newly refined thermometers for his experiments on core body temperature (chapter 1). West Indian doctors also sent specimens of potentially useful drugs back to Europe. Alexander, for example, sent specimens of the bois fer to chemist Joseph Black in Edinburgh (though these appear to have been lost at sea). Specimens traveled in both directions: French surgeon Bertrand Bajon was

Figure 19. The European colonial nexus, the flow of knowledge between Europe and the Americas.

Conclusion

sent samples of eau de luce from Paris to test in Cayenne (see below). West Indian experimenters also sent their results to Europe. Alexander, for example, couriered his findings to Black, who dutifully included notice of them in the Medical and Philosophical Commentaries. Men like Donald Monro, Joseph Black, and William Wright in Britain, and Antoine Petit, Pierre-Isaac Poissonnier, and Antoine Poissonnier-Desperrières in France served as knowledge brokers. Knowledge was concentrated in repositories, such as the Edinburgh and London Colleges of Physicians, Edinburgh University, and the Société royale de médecine in Paris. Queries from these brokers were often sent out to the colonies. Donald Monro’s questions, for example, sparked John Quier’s experiments with smallpox (chapter 4). Questions and projects posed by the Ministry of the Navy and the Société royale de médecine drove the “medical research machine” in the French Antilles, as James McClelland and François Regourd have described it. This practice of learned men sending specific questions to voyagers was well established in naturalist traditions. Carl Linnaeus, sitting in Uppsala, commanded perhaps the broadest, most renowned network of informants. New World medical experiments were often designed to answer specific European concerns. Colonial physicians sent answers to these queries by letter to Europe, where their experiments were debated in learned societies. Closing the loop, European publications found their way back to the colonies to inform further research.1 British and French colonial nexuses followed similar patterns. On the ground in the Caribbean, however, experimental regimes diverged. British plantation doctors, such as John Quier and James Thomson in Jamaica, worked for the most part as private contractors employed by plantation owners; a few, such as Colin Chisholm, were also naval surgeons. Scientifically, these men had feet planted in numerous worlds. Their experimental work might respond to queries sent from Europe, as in the case of Quier. Or experiments might be projects physicians set for themselves, as in the case of Thomson’s inoculation for yaws (chapter 4), or they might be projects responding to immediate medical needs, such as Leonard Gillespie’s work with cures for putrid ulcers (chapter 4). French colonial physicians, by contrast to British, were pensioned by the crown as royal surgeons or physicians for service in the colonies. JeanBarthélemy Dazille was part of the French colonial machine par excellence. With a career in the navy, he served wherever France had colonies. He began as an assistant surgeon in Quebec in 1758, moved as surgeon major to Calcutta and Ceylon (now Sri Lanka) in the East Indies, then moved again to Cayenne and French Guiana in the West Indies. In 1766 he was called to serve as surgeon major in the Île de France and Île Bourbon in the Indian Ocean. After

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procuring a medical degree under Antoine Petit in Paris in 1769, he was called to Saint-Domingue, the jewel in the French colonial crown, to serve as royal physician in 1777.2 He eventually visited Martinique and Guadeloupe to complete his survey of the quality of waters—simple and mineral (chapter 5). Again, closing the knowledge loop in the Atlantic World medical complex, he served as correspondent to the Société royale de médecine in Paris. McClellan and Regourd have described the French colonial machine as a “research engine” that deployed experts to solve colonial problems. McClellan and Regourd detail the back and forth of specimens and analyses between colonial agents and scientific centers. The French, for example, desperately sought a colonial source of cinchona (the antimalarial Peruvian bark) that the Spanish monopolized to enrich their empire while draining the coffers of their rivals. Dazille reported that a type of cinchona-rich bark, called quinquina-piton, had been discovered in Guadeloupe and Martinique. In 1778, Barthélemy de Badier, then living in Guadeloupe, sent parts of the tree— leaves, flowers, fruit, and bark—to Noël-Nicolas Mallet at the medical faculty in Paris for testing. In Paris, Jean Descemet carried out the botanical examination and Laurent-Charles de la Planche the chemical analysis.3 These tests demonstrated that the quinquina-piton (with piton meaning the summit of the mountain where the tree grew plentifully in Martinique) offered the same medical virtues as the Peruvian bark. Assured by its likeness to the bark and observations made in Martinique and Guadeloupe, Mallet tested the new bark at the Hôtel-Dieu in Paris in “numerous patients” whose fevers had not responded to the usual treatments. Interestingly, Mallet had to abandon his first round of tests when his charity patients would not “consent” (“Ils ne voulurent point y consentir) to continue the medicine because of the highly unpleasant side effects induced. Tests were also carried out—now with an “indigenous quinquina of Saint-Domingue”—in the royal military hospital at Port-au-Prince in 1788 by royal physician Joseph Peyré. He provided fourteen “observations” using this bark along with cold baths, electricity (for which he lamented that he lacked a proper machine), and other remedies. One of his patients was an American soldier, one a Negro sailor. He concluded that “no doubt” remained that indigenous quinquina could be substituted for the Peruvian bark. Comte de La Luzerne, a former governor general of Saint-Domingue, pleaded with the Société royale de médecine in Paris to make “repeated experiments” (expériences répétées) with the bark and render a final judgment on its medical virtues.4 The French medical complex required that books published in France be approved by censors. Dazille, for example, was asked to remove his trenchant criti-

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cisms of colonial hospitals before publication. Nonetheless, even after censure, Dazille’s work remained highly critical of the French medical complex (chapter 3). He was nearly recalled from Saint-Domingue for offering slaves the same level of care he gave other hospital inmates. Throughout his career, he insisted on treating the ill equally—regardless of their color. Dazille had been recalled from the Île de France and Île Bourbon in 1768 for spending too much money on the sick. In Saint-Domingue, however, the governor general intervened so that Dazille could offer his full “help” and “relief ” to the “king’s slaves” (esclaves du Roi).5 Although Europe dominated colonial medicine, medical men in the colonies often took issue with armchair academicians in metropolitan hubs. Dazille was highly critical of the Société royale de médecine’s project to collect information on tetanus, whose results were published as Projet d’instruction sur une maladie convulsive, fréquente dans les Colonies de l’Amérique, connue sous le nom de tétanos (1786). Dazille complained that the Parisian authors of the project had “never seen” the disease. Because their knowledge was only secondhand, they published reports, in Dazille’s words, full of “errors.” Further, he charged the Parisian Society with promoting sensationalism: their propensity to report only the “new” and “marvelous,” he judged, perpetuated ignorance. Invoking standard Enlightenment rhetoric, Dazille continued that the only basis for science was firsthand expérience and numerous observations bien faites.6 It is unclear what Dazille’s relationship was to Charles Arthaud, convener and permanent secretary of the Cercles des Philadelphes. Arthaud’s Cercle, founded in 1784 and later reincorporated in 1789 as the Société royale des sciences et des arts du Cap-Français, sought to plug colonial learned men into the metropolitan academy system. The roster reveals a preponderance of members from Saint-Domingue (governmental administrators, royal physicians and surgeons, minister of agriculture, minister of commerce, directors of botanical gardens, veterinarians, lawyers, etc.) and representatives from Guadeloupe, Martinique, Louisiana (then a French colony), and Saint Lucia (also a French colony). Corresponding members in France, including a lone woman (the renowned naturalist Marie Le Masson Le Golft), networked colonials with their French counterparts. Benjamin Franklin and Benjamin Rush represented the young United States. Strikingly absent were representatives from Jamaica or other British islands. Jamaica lay only some three hundred miles by sea from Saint-Domingue, and one might argue that physicians in these islands had more in common with each other regarding their work and conditions than with physicians back in Europe.7 As was true across the colonies, the Cercle des Philadelphes responded to questions sent from Europe. The lengthy Dissertation et observations sur le tétanos,

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edited by Arthaud, directly answered the Société royale de médecine’s queries and built on the work of local plantation physicians in Saint-Domingue. The Cercle also set its own research to investigate issues for the “public good” aimed at enhancing plantations, commerce, and the state. Numerous prizes, in cash amounts of up to 1,650 livres, encouraged research testing fertilizers, constructing slave huts and sugar mills, manufacturing insect-resistant paper (the prize-winning essay by François de Neufchâteau was published in 1788), perfecting agriculture tools to diminish slaves’ labor, distinguishing species of mites, comparing the treatment of slaves in the colonies to that of peasants in Europe, and observing the diverse people of Africa, their forms of government, their manners of living, their diseases, the best way to transport them to the colonies, and the types of labor each excelled in, among other themes.8 One of the Cercle’s many European outlets was the Journal de médecine, chirurgie, pharmacie, etc. A good example of the organized research the Cercle carried out was its work on animal diseases, specifically the glanders (morve), an infectious disease too often, Arthaud complained, abandoned to “daring empiricism” (l’empirisme hardi) or “misleading quackery” (charlatanisme trompeur). In March 1787, the Cercle set out to experiment with inoculation to prevent glanders. Numerous mules across various plantations were inoculated (by having cotton tampons impregnated with pestilent matter placed in their nostrils or throat). These animals were necropsied at death. With careful procedures, the contagious nature of the disease and its natural history were detailed to dispel the notion that slaves had poisoned the animals. These experiments were conducted in the presence of the royal surgeon and other colonial officers.9 Slaves who cared for animals, ate the flesh of diseased animals, or assisted with their dissections also often came down with anthrax (charbon), glanders, and the like. Numerous observations and autopsies (l’ouverture du cadaver) of these slaves were carried out. No observations with humans other than slaves were reported.10 The Cercle dissolved in 1792 as revolution overtook the colony. Women, too, were part of the colonial nexus. As we saw in chapter 2, Bertrand Bajon learned about a remedy for worms from one Madame Rousseau, who in turn had learned about it from a “negress.” Madame Rousseau supplied Bajon with the materials for his experiments and repeated his experiments to bring exactitude to the study of this remedy. Joseph Gauché, administrator of Port à Piment mineral waters and plantation owner at Port de Paix, also noted that his wife had assisted him in his research on the causes of tetanus. In particular, she had aided him in discovering that premature detachment of the umbilical cord was one factor inducing tetanus among the newborn slaves on his plantation. Once he and his wife regulated this practice, they lost no more children.11

Conclusion

The European colonial nexus provided a highway for knowledge between Europe and the Americas. These well-documented routes allow historians to trace the mechanisms of exchange. We learn that knowledge followed trade and military routes: physicians, their letters, equipment, specimens, and diseases caught rides on merchant and navy ships.12 We learn that what was exchanged across the Atlantic—the pace and possibilities—was shaped by local and global ambitions of empire, naval strength, funding priorities, and disciplinary hierarchies in addition to professional networks and customs. We learn, too, that European knowledge was selective. As we shall see, certain knowledges transshipped from Africa via the Caribbean into Europe, but others, such as the spiritual aspects of Obeah (chapter 4), did not. Since the available historical documents are primarily European, historians cannot fully know what Europeans encountered but did not “see.” THE AFRICAN SLAVE TRADE NEXUS

Figure 20 considers the nexus between Africa and the Americas. People, plants, disease, and knowledge were carried from Africa to the West Indies on slave ships. Little knowledge returned from the West Indies to the west coast of Africa. The African diaspora moved massive numbers of slaves from Africa to the New World. Only a trickle of people, plants, and medicines returned. For one thing, ocean currents made a direct sea voyage nearly impossible in the eighteenth century. West Indian knowledge may well have transshipped to Africa via Europe, carried by naturalists, missionaries, adventurers, colonizers, and perhaps even slave ship captains. After 1787, free African Americans and Jamaicans, settled by the British in Sierra Leone, may have brought plants and medicines from the Americas into Africa. In the eighteenth century, however, the slave trade forced migration from Africa to the West Indies. Persons of African origins—sold or born into captivity in the Caribbean—often served on the front lines of medical care for plantation populations, whether black, white, or mixed. Unlike Europeans, Africans held significant knowledge of tropical diseases. We glimpse African healing regimes primarily through European eyes, and it is difficult to know exactly how these rich knowledge traditions transferred into the plantation complex. Some slaves clearly came from Africa with knowledge of plants and their medicinal qualities. A number of Africans were acknowledged as doctors: Alexander in Grenada called his slave a “Negro Dr” (chapter 2); Nicolas-Louis Bourgeois in Saint-Domingue spoke of Africans who were “Médecins” in their own country (chapter 5). Other slaves may have been ordinary people who relied on memories—precise or faulty—of treatments witnessed in their home countries.13

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Figure 20. The African slave trade nexus, the flow of knowledges, diseases, people, medicines, and plants from Africa to the Americas. The West Indies served as a “center of calculation,” discovering, testing, and evaluating African knowledges as these mixed with Amerindian, European, and Creole knowledge in the West Indies. Results might be reported to Europe in letters, manuscripts, and eventually (after about 1770) publications.

As we saw in chapter 2, slave practitioners may have employed plants carried in some fashion aboard ships from Africa or plants found in tropical America similar to those in tropical Africa. Africans may also have prospected for cures in their new home—learning what they could from Amerindians or Europeans, in this latter case either from European folk healers, plantation mistresses, or physicians or surgeons (as we have seen, a number of slaves served as medical assistants to doctors). Historians have tended to take at face value that the cures European learned from slaves represented “slave medicine.” And, indeed, slave remedies were actively deployed within the plantation complex. Historical scholarship has done much to document African healing regimes in the West Indies as recorded by European natural historians and colonial doctors.14 But there are complications: slaves, who responded to medical emergencies, may have had only passing knowledge of a particular healing tradition or may have remembered only symptoms or partial cures. Further, the medicines required may not have been available. Slaves may also have brought cures from one region of Africa that were not appreciated by peoples from competing regions with their own distinct languages, religions, and customs.

Conclusion

Looking more closely provides further clues to how knowledge circulated in the Atlantic World medical complex. A. J. Alexander, the Grenadian planter who experimented with his slave doctor’s cure for yaws, understood himself to be testing an African cure. As we learned in chapter 2, however, these categories were not pure in the eighteenth century, and it remains unclear if the cure the slave doctor practiced originated with Amerindians and passed directly to Alexander’s slave, or if it passed to the slave via European physicians working in the French plantation medical complex, or if the slave himself passed the cure from the French to the British. In any case, the plant employed, the bois fer, was a plant of American, not African, origin. What is interesting is that Africans in the Americas prospected for cures as much as Europeans did. African slaves used flora (herbs and woods) familiar to them or their forebears in Africa, and, importantly, they became expert in the use of new plants learned from the Amerindians. These Africans—the overwhelming majority of them slaves—no doubt tested and perfected the use of these plants: few people administer a cure that persistently harms or inflicts pain. These persons of African origin then “discovered” or revealed some of these cures to Europeans in a variety of ways. European physicians went on to test various of them according to their own standards. Successful cures (whatever their precise origins) frequently transshipped into Europe, sent by letter to a colonial center, such as Kingston in Jamaica or Cap-Français in Saint-Domingue, then on to London, Edinburgh, Paris, or elsewhere to be read before a learned society. The best of these (as judged by Europeans) were subsequently published in a medical journal and were introduced into practice in Europe or its many colonies. Such was the pathway for a presumably Amerindian remedy for “pox” made known to Europeans in the 1730s in Virginia. This story was relayed by letter in 1757 by a Mr. Dixon, then living in Bristol, England, to a Rev. Dr. Edward Heylin—and featured a “cure off ” similar to the one organized by Alexander in Grenada. As the story goes, Mr. Dixon, a medical man, and his partner, a Mr. Chamberlayn, received a shipload of slaves in 1730. They sold the majority but held on to those suffering from “the pox” (venereal disease). Chamberlayn, noting that Mr. Dixon was “famous for curing these distempers,” bet him that Mrs. Littlepage’s “Negro man,” called “Dr. Papaw,” could cure the slaves more quickly than Dixon. Dixon administered a mercurial, as was standard European practice at the time, to about seven slaves. After some months, Dixon was proud that he got them all “pretty well.” When he inquired about slaves treated by the “Negroe doctor,” Dixon found them all cured and more quickly than his own. When Dr. Papaw’s success became known, an “abundance” of patients

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flocked to him—“white people as well as black”—whom he cured. Although this colonial “trial” brought numerous patients to the man, Donald Monro in London noted, when recounting the story in the 1780s, that he did not know of any “proper trial” made of the cure “in Europe.”15 Dr. Papaw, like so many others, kept his remedy a secret. The Virginia Assembly, however, prevailed upon him to “discover” his nostrum in return for his freedom (his mistress was paid sixty pounds) and an annuity for life. Dr. Papaw revealed his recipe, which included “sumach root,” ground fine, mixed with hog’s fat and deer or hare dung. The recipe was published in the Virginia Gazette and was republished in various cookery books. As with bois fer, it is difficult to say whether Dr. Papaw brought knowledge of the sumac root from Africa or found it in the Americas, possibly aided by Native Americans in the area. Different varieties of sumac grow in both Africa and the Americas; its culinary and medicinal qualities had been well known in the Middle East and beyond since ancient times. By the 1780s, such cures circulated widely within the Atlantic World. Some were even printed for ladies, who were often in charge of household medicine.16 The great store Europeans set by African knowledge of tropical medicine in the eighteenth century was overwhelmed by fear and prejudice in the nineteenth. As we have seen in chapter 5, Europeans increasingly outlawed medicine practiced by slaves in the West Indies after the 1760s. Traditions that were outlawed, such as slave medicine or abortifacients, often went underground and rarely passed into mainstream global medicine.17 THE AMERINDIAN CONQUEST NEXUS

Figure 21 emphasizes Amerindian contributions to the Atlantic World medical complex. These are even hazier than those of Africans. Amerindian contributions are specific to time and place. The French royal physician Jean-BaptisteRené Pouppé-Desportes avidly collected what he called “Carib” knowledge in Saint-Domingue in the 1730s and 1740s. By correlating the Latin, French, and Carib names of drugs, he sought to integrate Amerindian knowledge into the Atlantic World pharmacopeia (chapter 2). Later in the century, however, Amerindian populations had largely been extinguished from the Greater Antilles (including Jamaica and Saint-Domingue). A mere half century after Pouppé-Desportes, Charles Arthaud, the founder of the Cercles des Philadelphes in Saint-Domingue, had never set eyes on a Carib, although he wrote several learned treatises on their marveled head shape (taking the position that their flat forehead was natural rather than an aesthetic artifice).18 Along with the peoples themselves, much Amerindian knowledge was exterminated.

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Figure 21. The conquest nexus, Amerindian knowledge in the plantation medical complex. The broken lines indicate imperfect knowledge transfer; the Atlantic World medical complex was one of colonial violence that threw up agnotological roadblocks to the free flow of healing regimes. The diminishing lines indicate the loss of knowledge: in the 1730s and 1740s Jean-Baptiste-René Pouppé-Desportes still had direct contact with “Caribs” (more likely, Taíno) in Saint-Domingue. But these people had been killed, run out, or exiled by the 1770s. Jean-Baptiste-Christophe Fusée-Aublet, Bertrand Bajon, the Bacolet plantation “Negro Dr,” and others still had firsthand encounters with Amerindians in the Lesser Antilles and French Guiana in the second half of the eighteenth century.

In the Lesser Antilles (to the south) and the Guianas, Europeans still often encountered native populations. French physician Jean-Marie-Esprit Amic in Guadeloupe corrected Arthaud’s account of Carib head shape when thirteen Caribs arrived by canoe from the nearby island of Saint Vincent, one of their strongholds. By Amic’s account, the group included nine “black” Caribs (those of both American and African ancestry) and one “red,” along with his wife and two children. Through a series of interviews, conducted in French, which two of them spoke “sufficiently,” Amic learned that primarily mothers flatten their infants’ foreheads with a board tied with cotton. This information was confirmed by some twenty black Caribs who arrived in a second canoe.19 Similarly, Bertrand Bajon was able still to come into direct contact with the Galibis in the 1760s and 1770s. And, as we saw in chapter 2, Alexander’s Negro doctor working in Grenada may have derived his remedy from Amerindian sources. European physicians in the West Indies—whether British or French— were overall more interested in African than Amerindian remedies because

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these were more available to them and because they treated large populations of African slaves, not Amerindians. While Europeans collected knowledge of tropical remedies wherever they could, these remedies had to serve plantation and military medicine. AGNOTOLOGY AND THE ATLANTIC WORLD MEDICAL COMPLEX

Colonial physicians avidly collected, cultivated, and tested African, Amerindian, and their own new cures. Yet not all knowledge was considered equal. While historians have focused on the circulation of knowledge, it is important to keep in mind that knowledge is fragile and often suppressed. The Atlantic World medical complex was one of colonial conquest, slavery, and prejudice that threw up agnotological roadblocks to the free flow of healing regimes. Here we explore the culturally induced ignorances fired in the colonial crucible of fear, arrogance, prejudice, and violence.20 Agnotology refocuses questions about how knowledge circulates to include questions about barriers that block certain knowledges. What knowledge did not circulate, and why not? Ignorance is often not merely the absence of knowledge but an outcome of cultural and political struggles. In the same way that the three nexuses (above) analyze how knowledge was made, below I identify the agnotological barriers that blocked the circulation of important bodies of knowledge among actors in the Atlantic World medical complex. The flow of knowledge in the Atlantic World was multidirectional, but it did not always move freely (figure 22). The first overarching agnotological rupture, discussed throughout this book, was the extermination of Amerindian peoples in the Greater Antilles over the sixteenth, seventeenth, and eighteenth centuries. Amerindians not killed were exiled to the islands of Dominica and Saint Vincent—and their knowledges pushed to the margins. A second structuring agnotological barrier was enslavement. While much medical knowledge traveled on slave ships, Africans were enslaved for their physiques and presumed value to plantation economies—not their medical knowledge. Médecins figured among the enslaved, to be sure, but the logic of the slave trade did not systematically recruit famed healers, their prized plants, or specific experimental techniques. European slave ships from Africa did not carry the bounty of voyages of scientific discovery; what knowledge traveled across the African slave trade nexus was unplanned, accidental, and arbitrary. Secrecy created a third agnotological barrier. Amerindians and enslaved Africans strategically held knowledge secret. Bajon, for example, envied the

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Figure 22. Agnotological barriers in the Atlantic World medical complex. The circulation of knowledge was blocked— along the European colonial nexus—by fear and prejudice that discounted African and American (both Amerindian and Creole) knowledges. The African nexus was built on the backs of the enslaved. Slavers did not sponsor scientific expeditions; what knowledge traveled with the people was arbitrary, incomplete, and unplanned. The Amerindian nexus was blocked by secrecy and the extermination and exile of peoples and their knowledges.

“numerous plant cures” known to “Indians and Negroes” but remarked that it was impossible to “discover their secrets.”21 Secrecy had profound consequences for the cures colonial Europeans could and could not submit to testing—knowledge they could and could not make—as revealed through Bajon’s experience in the wilds of French Guiana. In the late 1760s, Bajon was sent samples of eau de luce, a colonial cure for snakebite—a grave danger in the tropics—being tested throughout French holdings. The samples were sent from South Asia via the colonial machine, and French administrators asked Bajon to test the efficacy of this cure in his practice. Eau de luce, a volatile alkali, was also said to contain alcohol, ammonia, and the oil of amber. Its reputation was such that Alexander von Humboldt tried it as an antidote for the famous curare (used to poison the tips of arrows) during his travels into the interior of South America in the late 1790s.22 At his first opportunity, Bajon began a series of experiments to better understand how to administer eau de luce and in what dosages. In 1767, he was called to a plantation outside Cayenne to treat a Negro struck by a poisonous snake.

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Bajon dosed the slave with six drops of his remedy four times per day for eight days—at which time the slave was healed. This finding was sufficient for Bajon to publish a report in 1770 in the Journal de médecine, chirurgie, pharmacie, etc.23 Bajon experimented further on a dog. Again, Bajon went to work with six drops of his remedy. When this had no effect, he upped the dosage to twelve and then to fifteen drops. Again, no effect. The dog perished. This did not deter Bajon. He engaged a M. Clarac, former royal surgeon at Oyapoc, to try the remedy when an occasion arose. In 1773, one of Clarac’s slaves was bitten by a snake. Clarac gave the man eight to ten drops of a stronger version of the water. Seeing that the remedy was having no effect, Clarac increased the dosage to twenty drops, which he repeated with great frequency. But in vain. The slave died some four to five hours after the accident. Clarac used no other remedy. Bajon concluded that the eau de luce was not always reliable. He suggested that further experiments—“the mother of the progress of medicine”—would one day pronounce definitely for or against this particular remedy.24 Bajon was devoted to experimentation, but he could test only those remedies available to him. In this case, it was the colonial remedy eau de luce because Bajon could not crack local secrets. He reported that Clarac very much regretted that he had not entrusted his slave to an Indian woman in the neighborhood who “always” treated poisonous bites with success.25 In this case, the new empiricism was thwarted by colonial power struggles, fears, and secrecy. Bajon noted that especially “Negroes” possessed a multitude of cures that they kept secret. He pleaded that trials be made of these “astonishing” remedies—by, he wrote, “persons more educated than are the Negroes.” In a remarkable passage, he noted that a particular “Negro” (again, unnamed), who was owned by the former governor of Cayenne, M. d’Orvilliers, practiced a successful cure for tetanus made from local plants. But, alas, Bajon could not discover the active ingredient.26 Alluding to the violence and mistrust endemic to the Atlantic World medical complex, Bajon remarked that much controversy arose concerning slave cures in general and this one in particular. “Many colonists and a great number of Negroes,” he wrote, claimed this tetanus cure to be “infallible,” but, they cautioned, it was enough for a licensed physician or surgeon to prescribe it for it to lose all its value. Physicians, for their part, warned against the remedy and rejected it “without any examination.” Bajon pleaded that “for the good of humanity” the slave be obliged to “communicate the plants he used and the manner in which they are employed” to some local physicians for testing in the “most impartial” and unprejudiced manner by gens de l’art who sought nothing but the “public good.” This, Bajon

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proclaimed, was the only “means to know the truth.” In return, Bajon recommended that the slave be offered his freedom—but not until “a great number of experiments [expériences] confirmed the cure’s virtue.” Bajon was here perhaps thinking of Dr. Papaw in Virginia or, more famously, Graman Quassi, the slave in Suriname, for whom Quassia amara is named and who had won his freedom for revealing his cure.27 A fourth barrier—prejudice—created agnotological ripples in the Atlantic World. Obeah provides a prime example of African knowledge that did not circulate throughout the greater Atlantic. As we have seen in chapter 5, Europeans, rather than seeking to understand Obeah, attempted to destroy it. Although they recognized the power of a patient’s state of mind to heal the body, they tended to deride the spiritual aspects prominent in slave healing regimes. Fear of Obeah was so great, as we have seen, that it was outlawed in Jamaica in 1760. Yet Europeans working in the West Indies differed in their evaluations of American and African knowledges. One fault line among Europeans was the quality of their relationships with local peoples. These differing attitudes are evident in Charles-Nicolas-Sigisbert Sonnini de Manoncour’s and Bajon’s differing attitudes toward Amerindian and African knowledges. Sonnini, a navy engineer and naturalist, who traveled in French Guiana off and on from 1772 to 1776, ridiculed Bajon for his interest in “Negro” cures, even suggesting that Bajon’s own observations on the eau de luce would have been more valuable if he himself had been better educated. Not a shy man, Sonnini wrote that “the ignorance banished from Europe had found asylum among the ‘nonchalants of the colonies,’” namely the Creoles, who, he continued, were “so lacking in education that they embraced the superstitions of the Indians and Negros.” To counter Bajon, Sonnini told his own story. A young Indian was bitten by a snake. The local Indians tried all their cures “in vain.” When they saw Sonnini in the distance they exclaimed, “Here is a Frenchman, he will certainly have some remedies.” Sonnini administered the eau de luce in the amount of one coffee spoonful (cuillère à café ) internally, and also externally to the lanced wound. The young Indian was soon cured—not by his own people but by the learned European.28 Sonnini railed against the deceit of supposed Negro magicians, who, he claimed, performed a ceremony, known as “se faire piquer du serpent,” that Sonnini likened to a kind of inoculation against snakebite. And he ridiculed the European Creoles for being taken in by it. For his part, Bajon remarked quietly that Sonnini was not well acquainted with the inhabitants of Guiana.29 Another striking example of prejudice blocking the passage of African knowledge to Europe can be seen in James Thomson’s work. Although Thomson was most likely not a Creole, through his practice he grew close to the

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people he served. He fiercely defended African knowledge of smallpox and yaws; he was not afraid to collect and use “Negro” cures even in white patients, as we saw in the case of adrue (chapter 4). James Thomson is particularly interesting as a cog in the wheel of the Atlantic World medical complex. As we saw in chapter 4, his experiments consciously triangulated European, Jamaican, and African knowledge traditions. A university-educated plantation physician, he first and foremost responded to European learned traditions. In the case of his yaws experiments, he engaged with Joseph Adams, who published his second edition of Morbid Fevers in 1807, and Bertrand Bajon, who tested yaws inoculation in animals. Second, Thomson conspicuously traced his experimental lineage both to his Edinburgh professors and to Jamaican plantation doctors, particularly John Quier but also James Grainger, Benjamin Moseley, and William Wright. Third, Thomson valued African knowledge. He considered yaws primarily an African disease, for example, and for that reason assumed that Africans had “ages of experience and daily observation” concerning the disease, and he repeatedly checked his knowledge against theirs. When he did not share their language, Thomson interviewed “Guinea Negroes” (as he called them) “by means of an interpreter.”30 While Thomson did not present his experiments with yaws as testing African techniques (as did Alexander, chapter 2), he was well aware that Africans inoculated for yaws (see chapter 4). It is interesting to see how Thomson negotiated these traditions in his publications. We find curious differences in the way he reported his results in his Treatise on the Diseases of Negroes (1820), published for local consumption in Jamaica, and the way he presented the same results to his learned British colleagues in the scholarly Edinburgh Medical and Surgical Journal in 1819 and 1822. Europeans in the Americas and in Europe had different tolerances for non-European knowledge sources—and Thomson abided by those. In his Jamaican Treatise, Thomson valued “Negro” knowledge; in his European version, this knowledge often fell from view. If Thomson was the editor of the European publication (as most likely he was), it is clear that he expected African knowledge to be appreciated more on the ground in Jamaica than in Europe. In his Jamaican Treatise, Thomson attributed distinctions between the various types of yaws to peoples of African origins (although European physicians had recorded these before). “The Negroes have,” he wrote, “distinct names” for these eruptions: the “watery yaws” (sometimes called by others “confluent yaws”), “ring worm yaws,” “Guinea corn yaws” (said to resemble a grain of maize), and so on.31 He reported that the “Negroes,” whom he consulted on the matter, called the original fungal ulcer the “mamma-yaw.” For his European audience,

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Thomson translated this term into a more acceptable standard English, in this case, the “mother yaw.”32 In his European version, Thomson erased completely the African term “common master yaw,” given to the sores that “remain longer than the others and leave a broad scar.” Along with African terminology, Thomson erased mention of “expert” Negroes in his European publications. While, in his Treatise, Thomson spoke of an expert Negro who had assisted him in staunching hemorrhages of the breast in yaws, no expert Negro appears in his articles for the Edinburgh Journal.33 Further, Thomson reported different attitudes toward information collected from women slaves. In the course of his experiments, Thomson “endeavoured, by every means,” to discover if yaws was passed from “mothers to their infants in utero.” He did not report what these means were. Not satisfied, Thomson asked women, who in the Caribbean often supervised slave birthing, about their experience. In his Jamaican Treatise, Thomson wrote that “old and sensible Negro women” had assured him that a child born to a woman with yaws was born free of disease. Although Thomson found through various experiments that this was not the case, he reported these observations with respect. In his Edinburgh journal article, Thomson reported the same information but dismissed the “old Negro women,” writing that “no reliance can be placed on their testimony” (1819) and that the evidence provided was “very doubtful” (1822).34 Discounting women’s knowledge was, of course, standard practice in Europe at this time. The anatomist John Hunter, for example, dismissed out of hand the knowledge of midwives. Hunter published an essay investigating whether mothers passed smallpox to their children in utero. He collected information from learned men across Europe (not the colonies). One of his cases came from the famous Gottfried van Swieten but was founded “only on the relation of a midwife to a clergyman”—and therefore, Hunter concluded, was “not absolutely to be depended upon as accurately stated.”35 Women’s knowledge, especially in matters having to do with childbearing, was assiduously collected by scientific men in the eighteenth century but was not always taken as credible. Perhaps understandably, Thomson reported European physicians’ observations, such as Joseph Adams’s, with respect in his European but not necessarily in his Jamaican publications. We do not know who is responsible for the different attitudes Thomson expressed; neither Thomson’s papers nor the Edinburgh Journal archives could be located. It seems likely, however, that Thomson prepared all the manuscripts, because they are written in first person and publication ceased after his death. He could not, however, have proofread the Edinburgh Journal articles, because Quier, his good friend and “venerable” colleague, was rendered “Owen.”36

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What does appear in Thomson’s Treatise is a celebration of African management and cure of yaws. Thomson railed against the “numerous, busy, and trifling race of [European] practitioners” who went to work with mercury cures, hoping to “cut short” the progress of the disease (chapter 2). People of African origins, he continued, “never attempt to cure the disease,” and neither should plantation doctors “interfere with the operations of nature.”37 The final agnotological fissure in the Atlantic World medical complex was the cacophony of languages. As we have seen, plantation owners often mixed African peoples on their lands to minimize revolt. A perhaps unintended effect was that these Africans could not easily build on their knowledge traditions. As we have also seen, Europeans, such as Thomson in Jamaica, often worked with enslaved Africans through a translator. Amic in Guadeloupe relied on Amerindians’ ability to speak French. Much was lost, no doubt, in the conceptual mismatches and divergent worldviews embedded in different languages. THIS EXPLORATION of medical experiments with humans has opened a window onto the circulation of knowledge in the eighteenth-century Atlantic

World. Our investigation of European colonial physicians has allowed us to adumbrate Amerindian, African, and European contributions to tropical colonial medicine. It has also allowed us to begin to trace the flow of knowledge between Europe, Africa, and the Americas. There is, however, much more to know. It would be fascinating to detail daily exchanges between colonial physicians on the ground. It would be intriguing, for example, to know more about how John Quier, William Wright, and James Thomson influenced each other’s practices in Jamaica—although sources may not support such investigations. It would also be interesting to understand communications between islands. Did interisland trade and pirating influence the development of colonial medicine across islands? Or did the invisible boundaries of empire limit interisland intellectual exchange? Did language differences (colonial physicians were not always highly educated—and none, to my knowledge, spoke Amerindian or African languages) hamper communication? While British physician James Thomson cited his French counterpart Bertrand Bajon, one might have expected more commonality between, say, Jean-Barthélemy Dazille, working in Saint-Domingue, and William Wright, often active in Jamaica. We would also like to know much more about African and Amerindian contributions to the medical complex in the Americas. Sources limit greatly what we can know. It was beyond the scope of this book, for instance, to investigate manifests of slave ships to identify seeds of common medicinal plants

Conclusion

that might have been carried along with human cargoes. It would also be fascinating to devise new ways to study plantations, such as the Bacolet plantation in Grenada, seized in conquest—lock, stock, barrel, and slave workforce—from the French by the British. What more can we understand about the knowledge procured in these colonial property grabs? This book has documented experimental practices in the eighteenthcentury Atlantic World medical complex. The very populations West Indian medical men treated—slaves, soldiers, sailors—were created by the political and economic ambitions of European states. The diseases physicians sought to cure were bred in the mixing and melding of peoples, the disruption of environments, and the squalor of plantations and urban ports. As we have seen throughout this book, the Atlantic World set in motion people, plants, and medicine from three continents. The Atlantic World represents a step in globalization, the potential enrichment of the human experience when worlds collide. But the extinction of people, such as the Amerindians in the Greater Antilles, coupled with the fear and secrecy bred in the enslavement of Africans, carved contours into medical knowledge and practices that continue to shape our world.

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Appendix

FEATURED BR ITISH AND FRENCH DOCTORS IN THE WEST INDIES

British and French doctors in the West Indies featured in this book. The time line shows the years of their active practice. Jean-Baptiste-René Pouppé-Desportes wrote and published early in Saint-Domingue. Jean-Barthélemy Dazille was a colonial physician who practiced wherever the French had colonies. John Quier and James Thomson worked in adjoining parishes in Jamaica. They both died in 1822.

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NOTES

INTRODUCTION

1. Society in Edinburgh, “Medical News,” Medical and Philosophical Commentaries 2 (1774): 90–92; James Thomson, “Observations and Experiments on the Nature of the Morbid Poison Called Yaws, with Coloured Engraving of the Eruption,” Edinburgh Medical and Surgical Journal 15 (1819): 321–28, esp. 326. 2. Philip Curtin, The Rise and Fall of the Plantation Complex (Cambridge: Cambridge University Press, 1990). 3. Andreas-Holger Maehle, Drugs on Trial: Experimental Pharmacology and Therapeutic Innovation in the Eighteenth Century (Amsterdam: Rodopi, 1999); Jean Astruc, Doutes sur l’inoculation de la petite vérole (Paris, 1756), 12–13; Richard, Munier, [and] Sabbatier, “Épreuves d’un remède contre l’épilepsie, etc.,” Journal de médecine, chirurgie, pharmacie, etc. 44 (1775): 37–56; Georg Friedrich Hildebrandt, Versuch einer philosophischen Pharmakologie (Braunschweig, 1786), 86; Johann Friedrich Gmelin, Allgemeine Geschichte der Gifte, 3 vols. (Leipzig, 1776), esp. 1:34; Francis Home, Clinical Experiments, Histories, and Dissections (London, 1782), vii. See also Susan Lederer, Subjected to Science: Human Experimentation in America before the Second World War (Baltimore: Johns Hopkins University Press, 1995). 4. Ulrich Tröhler, To Improve the Evidence of Medicine: The 18th Century British Origins of a Critical Approach (Edinburgh: Royal College of Physicians of Edinburgh, 2000), 36. See also Harry Herr, “Franklin, Lavoisier, and Mesmer: Origin of the Controlled Clinical Trial,” Urologic Oncology: Seminars and Original Investigations 23 (2005): 346–51; Abraham Lilienfeld, “Ceteris Paribus: The Evolution of the Clinical Trial,” Bulletin of the History of Medicine 56 (1982): 1–18. On placebos, see Arthur Shapiro and Elaine Shapiro, The Powerful Placebo (Baltimore: Johns Hopkins University Press, 1997); Anne Harrington, ed., The Placebo Effect: An Interdisciplinary Exploration (Cambridge, MA: Harvard University Press, 1997). On the use of statistical methods in medical research, see Andrea Rusnock, Vital Accounts: Quantifying Health and Population in Eighteenth-Century England and France (Cambridge: Cambridge University Press, 2002). 5. James Lind, A Treatise on the Scurvy (Edinburgh, 1753); John Hunter (1728–93), A Treatise on the Venereal Disease (London, 1791); Edward Jenner, An Inquiry into the Causes and Effects of the Variolæ Vaccinæ (London, 1798); Rolf Winau, “Experimentelle Pharmakologie und Toxikologie im 18. Jahrhundert” (Habil. Schrift, Johannes Gutenberg169

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Universität Mainz, 1971), excerpted in Winau, “Vom kasuistischen Behandlungsversuch zum kontrollierten klinischen Versuch,” in Versuche mit Menschen in Medizin, Humanwissenschaft und Politik, ed. Hanfried Helmchen and Rolf Winau (Berlin: Walter de Gruyter, 1986), 83–107. 6. Mark Harrison, “Disease and Medicine in the Armies of British India, 1750–1830: The Treatment of Fevers and the Emergence of Tropical Therapeutics,” in British Military and Naval Medicine, 1600–1830, ed. Geoffrey Hudson (Amsterdam: Rodopi, 2007), 87–119, esp. 90. See also Deborah Neill, Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (Stanford, CA: Stanford University Press, 2012); Gordon Cook, “History of Tropical Medicine, and Medicine in the Tropics,” in Manson’s Tropical Diseases, ed. Jeremy Farrar et al. (London: Elsevier, 2014), 1–8; Michael Osborne, The Emergence of Tropical Medicine in France (Chicago: University of Chicago Press, 2014). 7. Thomas Dancer, The Medical Assistant; or Jamaica Practice of Physic: Designed Chiefly for the Use of Families and Plantations, 2nd ed. (St. Jago de la Vega, Jamaica, 1809), ix. See also Jean-Barthélemy Dazille, Observations sur les maladies des nègres, leur causes, leurs traitemens et les moyens de les prévenir (Paris, 1776). 8. Londa Schiebinger, Plants and Empire: Colonial Bioprospecting in the Atlantic World (Cambridge, MA: Harvard University Press, 2004). 9. Benjamin Moseley, Treatise on Tropical Diseases; or on Military Operations; and on the Climate of the West-Indies (London, 1787), v–vi. See Kenneth Kiple, The Caribbean Slave: A Biological History (Cambridge: Cambridge University Press, 1981); Philip Curtin, Death by Migration (Cambridge: Cambridge University Press, 1989); J. R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (Cambridge: Cambridge University Press, 2010). 10. On subjects used in medical testing, see Londa Schiebinger, “Human Experimentation in the Eighteenth Century: Natural Boundaries and Valid Testing,” in The Moral Authority of Nature, ed. Lorraine Daston and Fernando Vidal (Chicago: University of Chicago Press, 2003), 384–408. On the Hôpital de la Pitié’s experiment, see “A New Remedy for the Itch,” Journal of the Practice of Medicine, Surgery, and Pharmacy, in the Military Hospitals of France 1 (1786): 63–73, esp. 68. On publication bias, see Paola Bertucci, “Shocking Subjects: Human Experiments and the Material Culture of Medical Electricity in Eighteenth-Century England,” in The Uses of Humans in Experiment: Perspectives from the 17th to the 20th Century, ed. Erika Dyck and Larry Stewart (Leiden: Koninklijke Brill, 2016), 111–38, esp. 137. 11. There is a long history of medical exploitation, including Nazi concentration camp experiments, radiation experiments, prison experiments, and Guatemalan syphilis experiments, among others. Other populations, of course, were also exploited. See, for example, Robert N. Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge, MA: Harvard University Press, 1988); George Annas and Michael Grodin, The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation (Oxford: Oxford University Press, 1995); Paul Weindling, Victims and Survivors of Nazi Human Experiments: Science and Suffering in the Holocaust (London: Bloomsbury Academic Publishers, 2015); Lederer, Subjected to Science; Allen Hornblum, Acres of Skin: Human Experiments at Holmesburg Prison (New York: Routledge, 1998); US House of Representatives, Ameri-

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can Nuclear Guinea Pigs: Three Decades of Radiation Experiments on U.S. Citizens (Washington, DC: US Government Printing Office, 1986). 12. Robert Baker, Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution (New York: Oxford University Press, 2013), 254, 274–317. On the Tuskegee Syphilis Study, see James Jones, Bad Blood: The Tuskegee Syphilis Experiment (1989; repr., New York: Free Press, 1993); Susan Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina Press, 2009); Marcella Alsan and Marianne Wanamaker, “Tuskegee and the Health of Black Men,” working paper, National Bureau of Economic Research, June 2016. Experiments are now often done offshore. See, for example, Susan Reverby, “‘Normal Exposure’ and Inoculation Syphilis: A PHS ‘Tuskegee’ Doctor in Guatemala, 1946–1948,” Journal of Policy History 23 (2011): 6–28. 13. Bernard Lo and Nesrin Garan, “Research with Ethnic and Minority Populations,” in The Oxford Textbook of Clinical Research Ethics, ed. Ezekiel Emanuel et al. (New York: Oxford University Press, 2008), 423–30, esp. 423–24. See also Vicki Freimuth et al., “African Americans’ Views on Research and the Tuskegee Syphilis Study,” Social Science and Medicine 52 (2001): 797–808. The inclusion of women and minorities in publicfunded US clinical research was made law in 1993 (Public Law 103-43, Subtitle B, Clinical Research Equity Regarding Women and Minorities). 14. Todd Savitt, “The Use of Blacks for Medical Experimentation and Demonstration in the Old South,” Journal of Southern History 48 (1982): 331–48, esp. 332; Todd Savitt, Race and Medicine in Nineteenth- and Early-Twentieth-Century America (Kent, OH: Kent State University Press, 2007); Sharla Fett, Working Cures: Healing, Health, and Power on Southern Slave Plantations (Chapel Hill: University of North Carolina Press, 2002). 15. On this point, see James Makittrick Adair, Unanswerable Arguments against the Abolition of the Slave Trade (London, [1790]), 145–46. See also Paul Brodwin, Medicine and Morality in Haiti: The Contest for Healing Power (Cambridge: Cambridge University Press, 1996), 30. 16. Robert Renny, An History of Jamaica (London, 1807), 188. 17. Richard Sheridan, Doctors and Slaves: A Medical and Demographic History of Slavery in the British West Indies, 1680–1834 (Cambridge: Cambridge University Press, 1985), 40; James Thomson, A Treatise on the Diseases of Negroes, as They Occur in the Island of Jamaica ( Jamaica, 1820), 10. 18. Colin Chisholm, An Essay on the Malignant Pestilential Fever, 2 vols. (London, 1801), 2:461–72. 19. A. J. Alexander to Joseph Black, Bacolet, Grenada, July 26, 1773, in Joseph Black, The Correspondence of Joseph Black, ed. Robert Anderson and Jean Jones, 2 vols. (Surrey: Ashgate, 2012), 1:288. 20. Quoted in Baker, Before Bioethics, 74–75. See also Laurence McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine (Dordrecht: Kluwer Academic Publishers, 1998). 21. Schiebinger, “Human Experimentation.” 22. On self-experimentation, see also Susan Lederer, “Walter Reed and the Yellow Fever Experiments,” in Emanuel et al., Oxford Textbook, 9–17. See also Baker, Before Bioethics, 74–76; [William Wright], Memoir of the Late William Wright, M.D. (Edinburgh,

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1828), 342; William Wright, “On the External Use of Cold Water in the Cure of Fever,” London Medical Journal 7, pt. 2 (1786): 109–15. That Wright first tried this practice on himself was repeated in the medical literature (review of Medical Reports on the Effects of Water, Cold and Warm, as a Remedy in Fever and Other Diseases, by James Currie, Annals of Medicine 3 [1798]: 4). 23. [Wright], Memoir, 27, 348. 24. [Donald Monro], ed., Letters and Essays . . . by Different Practitioners (London, 1778), 18, 65. 25. Charles Maitland, Mr. Maitland’s Account of Inoculating the Small Pox (London, 1722); see also Hans Sloane, “An Account of Inoculation,” Philosophical Transactions 49 (1756): 516–20. 26. On the categories “therapeutic” versus “nontherapeutic” in relation to experiments, see also Baker, Before Bioethics, 74. 27. On Quier, see Michael Craton, Searching for the Invisible Man: Slaves and Plantation Life in Jamaica (Cambridge, MA: Harvard University Press, 1978), 259–64. 28. Jean-Barthélemy Dazille, Observations sur les maladies des nègres, leur causes, leurs traitemens et les moyens de les prévenir, 2 vols., 2nd ed. (Paris, 1792), 1: Avertissement, 3–4; 2:417–18. 29. On Obeah, see Jerome Handler and Kenneth Bilby, “Obeah: Healing and Protection in West Indian Slave Life,” Journal of Caribbean History 38 (2004): 153–83. 30. John Haygarth, Of the Imagination, as a Cause and as a Cure of Disorders of the Body: Exemplified by Fictitious Tractors, and Epidemical Convulsions (Bath, 1800). See also Franklin Miller et al., The Placebo: A Reader (Baltimore: Johns Hopkins University Press, 2013). 31. Great Britain, House of Commons, Report of the Lords of the Committee of Council Appointed for the Consideration of All Matters Relating to Trade and Foreign Plantations; .  .  .  ([London], 1789), Part III, Jamaica, following No. 26, C, paper delivered by Mr. Rheder; reprinted in Bryan Edwards, The History, Civil and Commercial, of the British West Indies, 5 vols. (1793; repr., London, 1819), 2:117–19. 32. Médéric-Louis-Élie Moreau de Saint-Méry, Loix et constitutions des colonies françoises de l’Amerique sous le vent, 6 vols. (Paris, 1784–85), 4:724; Charles Arthaud, Observations sur les lois concernant la médecine et la chirurgie dans la colonie de Saint-Domingue (Cap-Français, 1791), 76–78. See also Pierre Pluchon, ed., Histoire des médecins et pharmaciens de marine et des colonies (Toulouse: Bibliothèque historique Privat, 1985), 109–10. 33. John Williamson, Medical and Miscellaneous Observations, Relative to the West India Islands, 2 vols. (Edinburgh, 1817), 1:26. 34. Great Britain, House of Commons, Report of the Lords. 35. The circulation of knowledge is a robust theme in the history of science. See, among others, Steven Harris, “Long-Distance Corporations, Big Sciences, and the Geography of Knowledge,” Configurations 6 (1998): 269–304; Harold Cook, Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age (New Haven, CT: Yale University Press, 2007); Kapil Raj, Relocating Modern Science: Circulation and the Construction of Knowledge in South Asia and Europe, 1650–1900 (Houndmills, Basingstoke, Hampshire: Palgrave Macmillan, 2007); James Delbourgo and Nicolas Dew, eds., Science and Empire in the Atlantic World (New York: Routledge, 2008); Simon Schaffer

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et al., eds., The Brokered World: Go-Betweens and Global Intelligence, 1770–1820 (Sagamore Beach, MA: Science History Publications, 2009); Sven Dupré and Christoph Lüthy, eds., Silent Messengers: The Circulation of Material Objects of Knowledge in the Early Modern Low Countries (Berlin: LIT, 2011); Bernard Lightman, Gordon McQuat, and Larry Stewart, eds., The Circulation of Knowledge between Britain, India, and China (Leiden: Koninklijke Brill NV, 2013); Paula Findlen, ed., Early Modern Things: Objects and Their Histories, 1500–1800 (New York: Routledge, 2013). 36. Bruno Latour, Science in Action (Cambridge, MA: Harvard University Press, 1987), 232–37. 37. Robert Proctor and Londa Schiebinger, eds., Agnotology: The Making and Unmaking of Ignorance (Stanford, CA: Stanford University Press, 2008); Schiebinger, Plants and Empire. 38. Natalie Zemon Davis, The Return of Martin Guerre (Cambridge, MA: Harvard University Press, 1983); Pablo Gómez, “The Circulation of Bodily Knowledge in the Seventeenth-Century Black Spanish Caribbean,” Social History of Medicine 26 (2013): 383–402, esp. 388; Pablo Gómez, “Transatlantic Meanings: African Rituals and Material Culture from the Early-Modern Spanish Caribbean,” in Materialities of Ritual in the Black Atlantic, ed. Akinwumi Ogundiran and Paula Saunders (Bloomington: Indiana University Press, 2014), 125–42, esp. 127. See also James Sweet,  Domingos Álvares, African Healing, and the Intellectual History of the Atlantic World (Chapel Hill: University of North Carolina Press, 2011). 39. [Nicolas-Louis Bourgeois], Voyages intéressans dans différentes colonies françaises, espagnoles, anglaises, etc. (London, 1788), 470; Tinde van Andel, Paul Maas, and James Dobreff, “Ethnobotanical Notes from Daniel Rolander’s Diarium Surinamicum (1754– 1756): Are These Plants Still Used in Suriname Today?,” Taxon 61 (2012): 852–63, esp. 857–58; Tinde van Andel, “The Reinvention of Household Medicine by Enslaved Africans in Suriname,” Social History of Medicine 29 (2015): 1–19; Kathleen Murphy, “Translating the Vernacular: Indigenous and African Knowledge in the Eighteenth-Century British Atlantic,” Atlantic Studies 8 (2011): 29–48; Gómez, “Circulation of Bodily Knowledge,” 400; Gómez, “Transatlantic Meanings,” 131–32; Bertrand Bajon, “Observations sur quelques bon remédes contre les vers de l’isle de Cayenne,” Journal de médecine, chirurgie, pharmacie, etc. 34 (1770): 60–74, esp. 60; Bertrand Bajon, Mémoires pour servir à l’histoire de Cayenne, et de la Guiane françoise, 2 vols. (Paris, 1777–78), 1:361. 40. Judith Carney and Richard Rosomoff, In the Shadow of Slavery: Africa’s Botanical Legacy in the Atlantic World (Berkeley: University of California Press, 2009), 1–5. Natalie Davis also documents plants in slaves’ gardens that made the trip from Africa to Suriname (“Physicians, Healers, and Their Remedies in Colonial Suriname,” Canadian Bulletin of Medical History 33 [2016]: 3–34, esp. 13). 41. Sheridan, Doctors and Slaves; Pluchon, Histoire des médecins; Mark Harrison, Medicine in an Age of Commerce and Empire: Britain and Its Tropical Colonies, 1660–1830 (Oxford: Oxford University Press, 2010); James McClellan III, Colonialism and Science: Saint Domingue in the Old Regime (Baltimore: Johns Hopkins University Press, 1992); James McClellan III and François Regourd, The Colonial Machine: French Science and Overseas Expansion in the Old Regime (Turnhout: Brepols, 2011); Curtin, Rise and Fall; Baker, Before Bioethics; Robert Baker and Laurence McCullough, eds., The Cambridge

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World History of Medical Ethics (Cambridge: Cambridge University Press, 2009). See also Karol Weaver, Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue (Urbana: University of Illinois Press, 2006). 42. Stephan Palmié, ed., Africas of the Americas: Beyond the Search for Origins in the Study of Afro-Atlantic Religions (Leiden: Brill, 2008); John Thornton, Africa and Africans in the Making of the Atlantic World, 1400–1800 (Cambridge: Cambridge University Press, 1998). CHAP TER 1

1. Christopher Bulpitt, Randomised Controlled Clinical Trials (The Hague: Martinus Nijhoff, 1983), 5; Maehle, Drugs on Trial; Schiebinger, “Human Experimentation”; Guenter Risse, “Clinical Instruction in Hospitals: The Boerhaavian Tradition in Leyden, Edinburgh, Vienna and Pavia,” Clio Medica 21 (1987–88): 1–19, esp. 2; Günter Risse, New Medical Challenges during the Scottish Enlightenment (Amsterdam: Rodopi, 2005), 47–48. Laurence Brockliss and Colin Jones have pointed out that no French faculty, even Paris or Montpellier, provided the kind of clinical training established in the second half of the eighteenth century at Edinburgh, Vienna, and Pavia (The Medical World of Early Modern France [Oxford: Clarendon Press, 1997], 502). As Marie-Jose Imbault-Huart put it, hospital physicians in France were indifferent to therapy (“Concepts and Realities of the Beginning of Clinical Teaching in France in the Late 18th and Early 19th Centuries,” Clio Medica 21 [1987–88]: 59–70). See also Ann La Berge and Caroline Hannaway, eds., Constructing Paris Medicine (Amsterdam: Rodopi, 1998). For early experiments in French hospitals, however, see Sigrun Engelen, “Die Einführung der Radix Ipecacuanha in Europa” (MD diss., Institut für Geschichte der Medizin, Universität Düsseldorf, 1968), 38–41. The Abbé Nollet was given some “proper subjects” for his experiments with electricity from the Hôtel royal des Invalides in Paris. See Thomas Southwell, Medical Essays and Observations, 4 vols. (London, 1764), 3:168; James Gregory, Additional Memorial to the Managers of the Royal Infirmary (Edinburgh, 1803), 379. See also Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M. Sheridan Smith (New York: Pantheon Books, 1973). 2. Félix Vicq d’Azyr, Nouveau plan de constitution pour la médecine en France, présenté à l’Assemblée nationale par la Société royale de médecine (Paris, 1790), 82; Brockliss and Jones, Medical World, 674, 499–515, 671–77. See also Mary Lindemann, “The Discourses of Practitioners in Eighteenth-Century France and Germany,” in Baker and McCullough, Cambridge World History, 394. 3. Home, Clinical Experiments, v–viii; Risse, New Medical Challenges, 239. 4. Claude Bernard, An Introduction to the Study of Experimental Medicine [1865], trans. Henry Greene (New York: Collier, 1961), 130. 5. James Gregory, Additional Memorial, 447–48. Denis Diderot and Jean Le Rond d’Alembert, eds., Encyclopédie, ou Dictionnaire raisonné des sciences, des arts et des métiers (Paris, 1751–76), s.v. expérience. See also Nicolas Philibert Adelon’s Dictionnaire de médecine, 30 vols. (Paris: Béchet Jne et Labé, 1832–46), s.v. expérience; Brockliss and Jones, Medical World, 672. Claude Bernard made similar distinctions in his Introduction to the Study, 32ff. See Steven Piantadosi, Clinical Trials: A Methodologic Perspective (New York: John Wiley, 1997), 65–67. 6. Brockliss and Jones, Medical World, 689–700; Harold Cook, “Practical Medi-

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cine and the British Armed Forces after the ‘Glorious Revolution,’” Medical History 34 (1990): 1–26; Harrison, “Disease and Medicine,” 87–119, esp. 89. 7. John Hunter (1754–1809), Observations on the Diseases of the Army in Jamaica (London, 1788), viii. 8. Dazille, Observations sur les maladies [1776], x, 3; Jean-Barthélemy Dazille, Observations générales sur les maladies des climats chauds (Paris, 1785), 2; Bajon, Mémoires, 1:ii, iii, iv, xv. 9. Home, Clinical Experiments, viii. 10. Sheridan, Doctors and Slaves; Williamson, Medical and Miscellaneous Observations, 1:44–48, 60; Fraser’s letter is in [Monro], Letters and Essays, 105–6, 110. 11. McClellan, Colonialism and Science, 128–46; McClellan and Regourd, Colonial Machine; Pouppé-Desportes, Histoire des maladies, 1:320–21; Bajon, Mémoires. 12. Julien-François Duchemin de l’Étang, ed., Gazette de médecine pour les colonies (Le Cap, Saint-Domingue, 1778–79); Frank Cundall, “Jamaica in the Past and Present,” Journal of the Society of Arts 44 (1896): 104–30, esp. 113; Jamaica Physical Journal 1 (1834): 1. See also K. R. Hill and I. S. Parboosingh, “The First Medical School of the British West Indies and the First Medical School of America,” West Indian Medical Journal 1 (1951): 21–25. For physicians trained in Europe, see Sheridan, Doctors and Slaves; Douglas Hamilton, Scotland, the Caribbean and the Atlantic World, 1750–1820 (Manchester: Manchester University Press, 2005), chap. 5. Printing presses were established in Jamaica in 1718, in Martinique in 1726, in Cap-Français in 1763, and in Port-au-Prince in 1765. See McClellan, Colonialism and Science, 97–98, 181–205; Kenneth Banks, Chasing Empire across the Sea: Communication and the State in the French Atlantic, 1713–1763 (Montreal: McGill-Queen’s University Press, 2003), 180. 13. Moseley, Treatise on Tropical Diseases, 137–38. 14. Pouppé-Desportes, Histoire des maladies, 3:59. 15. Joyce Chaplin has summarized much of the literature for the British Atlantic. See “Race,” in The British Atlantic World, 1500–1800, ed. David Armitage and Michael Braddick, 2nd ed. (Basingstoke: Palgrave Macmillan, 2009), 173–90. For the French Atlantic, see Sue Peabody and Tyler Stovall, eds., The Color of Liberty: Histories of Race in France (Durham, NC: Duke University Press, 2003); Christopher Miller, The French Atlantic Triangle: Literature and Culture of the Slave Trade (Durham, NC: Duke University Press, 2008). See also Nancy Stepan, The Idea of Race in Science: Great Britain, 1800–1960 (London: Macmillan, 1982); Londa Schiebinger, Nature’s Body: Gender in the Making of Modern Science (Boston: Beacon Press, 1993); Jacques Roger, Buffon: A Life in Natural History, trans. Sarah Bonnefoi (Ithaca, NY: Cornell University Press, 1997); Ivan Hannaford, Race: The History of an Idea in the West (Baltimore: Johns Hopkins University Press, 1996); Michael Banton, Racial Theories (Cambridge: Cambridge University Press, 1998). 16. Joyce Chaplin, “Natural Philosophy and Early Racial Idiom in North America: Comparing English and Indian Bodies,” William and Mary Quarterly 54 (1997): 229–52, esp. 230; Joyce Chaplin, Subject Matter: Technology, the Body, and Science on the AngloAmerican Frontier, 1500–1676 (Cambridge, MA: Harvard University Press, 2001). 17. Jorge Cañizares-Esguerra, “New World, New Stars: Patriotic Astrology and the Invention of Indian and Creole Bodies in Colonial Spanish America, 1600–1659,” American Historical Review 104 (1999): 33–68.

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18. Guillaume Aubert, “‘The Blood of France’: Race and Purity of Blood in the French Atlantic World,” William and Mary Quarterly 61 (2004): 439–78. See also Stewart King, Blue Coat or Powdered Wig: Free People of Color in Pre-Revolutionary Saint Domingue (Athens: University of Georgia Press, 2001), 8. 19. David Brion Davis, “Constructing Race: A Reflection,” William and Mary Quarterly 54 (1997): 7–18; George Fredrickson, Racism: A Short History (Princeton, NJ: Princeton University Press, 2002); Nicolas Hudson, “From ‘Nation’ to ‘Race’: The Origin of Racial Classification in Eighteenth-Century Thought,” Eighteenth-Century Studies 29 (1996): 247–64. 20. Charles White, An Account of the Regular Gradation in Man, and in Different Animals and Vegetables and from the Former to the Latter (London, 1799), 99; MédéricLouis-Élie Moreau de Saint-Méry, Description topographique, physique, civile, politique et historique de la partie française de l’isle Saint-Domingue, 2 vols. (Philadelphia, 1797–98), 1:71–89. On Moreau’s categories, see Doris Garraway, “Race, Reproduction and Family Romance in Moreau de Saint-Méry’s Description . . . de la partie française de l’isle SaintDomingue,” Eighteenth-Century Studies 38 (2005): 227–46. See also Edward Long, The History of Jamaica, 3 vols. (London, 1774), 2:260–61. 21. Alexander von Humboldt, Political Essays on the Kingdom of New Spain, 2 vols., trans. John Black (New York, 1811), 1:185. 22. It is possible, as Richard Sheridan has suggested, that Thomson grew up in Jamaica (Doctors and Slaves, 37–40, esp. 37). Thomson stated that he was the son of one of Quier’s partners, yet it seems that he was not a Creole. He referred to Europe as “home,” and he discussed going out to the West Indies as something new. Since we lack his paper, Thomson’s biography remains sketchy. He studied medicine at the University of Edinburgh probably in and around 1813; he dates his time at Edinburgh in “On the Substitutes That May Be Used for Cinchona,” Edinburgh Medical and Surgical Journal 16 (1820): 27–31, esp. 28. See also Thomson, Treatise, 1; Rana Hogarth, Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780–1840 (Chapel Hill: University of North Carolina Press, 2017). 23. Thomson, Treatise, 2–3. 24. Moreau de Saint-Méry provided numerous stereotypes of physical and behavioral distinctions among African nations; see Description, 1:24–35. See also Charles Arthaud, Recherches, mémoires et observations sur les maladies épizootiques de Saint-Domingue (CapFrançois, 1788), 46–47; King, Blue Coat, 95–97; [ James Grainger], An Essay on the More Common West-India Diseases; and the Remedies Which That Country Itself Produces (London, 1764), 7–8. Pouppé-Desportes in early eighteenth-century Saint-Domingue noted that “Negroes or blacks, who are transported to the colonies, come from different countries of Africa, whose people, similarly to those of Europe, appear to differ by temperament, character, morals, and customs.” He noted that the Senegalese were “ingenious, but lazy and have weak chests.” The “Negresses” among the Congolese worked the earth and were much esteemed. The “Congos des terres” (Congolese from the interior of the country) were said to be cannibals (Histoire des maladies, 2:267–73). Bryan Edwards also provided a lengthy passage on the cultures of enslaved African peoples (History, 2:70–106). On the African origins of slaves in Saint-Domingue, see Gabriel Debien, Plantation et esclaves à Saint-Domingue (Dakar:  Université de Dakar, 1962), 44–47; Gabriel Debien,

Notes to Chapter 1

Les esclaves aux Antilles françaises, XVIIe–XVIIIe siècles (Basse-Terre: Société d’histoire de la Guadeloupe, 1974), 64–65; and James Sweet, “Mistaken Identities? Olaudah Equiano, Domingos Álvares, and the Methodological Challenges of Studying the African Diaspora,” American Historical Review 14 (2009): 279–306. See also Thornton, Africa and Africans; John Thornton, “The Coromantees: An African Cultural Group in Colonial North America and the Caribbean,” Journal of Caribbean History 32 (1998): 161–78; John Thornton, A Cultural History of the Atlantic World, 1250–1820 (Cambridge: Cambridge University Press, 2012). 25. Great Britain, House of Commons, Report of the Lords, III, Jamaica, No. 2; Williamson, Medical and Miscellaneous Observations, 1:177–78. 26. A type of lingua franca of African languages developed in some parts of the Caribbean. The língua geral de Mina developed in Brazil, for example. Sweet, “Mistaken Identities?,” 288; David Geggus, “The French Slave Trade: An Overview,” William and Mary Quarterly 58 (2001): 119–38; Laurent Dubois, A Colony of Citizens: Revolution and Slave Emancipation in the French Caribbean, 1787–1804 (Chapel Hill: University of North Carolina Press, 2004), 30–53. 27. William Lempriere, Practical Observations on the Diseases of the Army in Jamaica, 2 vols. (London, 1799), 1:230–31. 28. Andrew Curran, The Anatomy of Blackness: Science and Slavery in an Age of Enlightenment (Baltimore: Johns Hopkins University Press, 2011), 1–4, 120–22. See also Cristina Malcolmson, Studies of Skin Color in the Early Royal Society: Boyle, Cavendish, and Swift (Surrey: Ashgate, 2013); Bernhard Albinus, Dissertatio secunda de sede et caussa coloris Aethiopum et caeterorum hominum (Amsterdam, 1737); Renato G. Mazzolini, “Anatomische Untersuchungen über die Haut der Schwarzen (1700–1800),” in Die Natur des Menschen: Probleme der physischen Anthropologie und Rassenkunde (1750–1850), ed. Gunter Mann and Franz Dumont (Stuttgart: Fischer, 1990), 169–87; Renato G. Mazzolini, “Für eine neue Geschichte vom Ursprung der physischen Anthropologie, 1492–1848,” Jahrbuch 1996 der Deutschen Akademie der Naturforscher Leopoldina 42 (1997): 319–41. 29. Curran, Anatomy of Blackness, 2; [Pierre Barrère], Dissertation sur la cause physique de la couleur des nègres . . . (Paris, 1741), 4; John Mitchell, “An Essay upon the Causes of the Different Colours of People in Different Climates,” Philosophical Transactions 43 (1744): 102–50; James Delbourgo, “The Newtonian Slave Body: Racial Enlightenment in the Atlantic World,” Atlantic Studies 9 (2012): 185–207 (on Mitchell); Jean-Baptiste Labat, Nouveau voyage aux isles de l’Amérique, 6 vols. (Paris, 1722), 2:126; Moseley, Treatise on Tropical Diseases, 111–13; John Hunter (1754–1809), Disputatio inauguralis, quædam de hominum varietatibus, et harum causis . . . (Edinburgh, 1775). 30. Johann Friedrich Blumenbach, Beyträge zur Naturgeschichte (Göttingen, 1811), 60; White, Account, 100; James Prichard, Researches into the Physical History of Man (1813; repr., Chicago: University of Chicago Press, 1973), 233–39; Thomson, Treatise, 5. 31. Johann Friedrich Blumenbach, On the Natural Varieties of Mankind, ed. Thomas Bendyshe (New York: Bergman, 1865), 205, 210–15. While Blumenbach generally attributed physical variations in humans to climate, diet, and mode of life, he viewed skin color as primarily determined by climate. For a review of European views of the cause of skin color, see Mazzolini, “Anatomische Untersuchungen”; Miriam Meijer, Race and Aesthetics in the Anthropology of Petrus Camper (1722–1789) (Amsterdam: Rodopi, 1999),

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68–75. The Thomson quote is from Treatise, 4. For arguments against climate producing variety in skin color, see White, Account, 99–118. 32. Thomson, Treatise, 3, 5, 29; James Thomson, “Dissections in Convulsive Diseases,” Edinburgh Medical and Surgical Journal 14 (1818): 614–18. Sheridan reported that Thomson opened white bodies in addition to black, but Thomson’s text did not mention white bodies. Sheridan, Doctors and Slaves, 39. 33. Thomson, Treatise, 3, 4; Meijer, Race and Aesthetics, 70. 34. Thomson, Treatise, 1, 145. 35. Ibid., 4, 7; Lempriere, Practical Observations, 1:272. 36. Thomson, Treatise, 5. 37. Pouppé-Desportes, Histoire des maladies, 1:201–16. See also Arthaud, Observations sur les lois, 38; J. F. Lafosse, Avis aux habitans des colonies, particulière a ceux de l’Isle S. Domingue (Paris, 1787), 76–77; Autopsy of Étienne Lefèvre-Deshayes, Société royale de médecine, Paris, 136, d1, pièce 16; James Gregory, Additional Memorial, 407. On dissection, see Helen McDonald, Human Remains: Dissection and Its Histories (New Haven, CT: Yale University Press, 2005); Ruth Richardson, The Making of Mr. Gray’s Anatomy (Oxford: Oxford University Press, 2008); Risse, “Clinical Instruction,” 7. For Dazille’s threat regarding autopsies to prove infanticide, see Jean-Barthélemy Dazille, Observations sur le tétanos (Paris, 1788), 75–77. I thank Rebecca Wilbanks for calling this passage in Dazille to my attention. 38. Thomson, Treatise, 5. See Schiebinger, Nature’s Body. 39. Thomson, Treatise, 5–6, 35, 73. 40. Great Britain, House of Commons, Report of the Lords, III, Jamaica Appendix, No. 6; Williamson, Medical and Miscellaneous Observations, 1:189; Lempriere, Practical Observations, 2:196–97. 41. Currie, Medical Reports, 1:277–28. 42. Harrison, Medicine, 4. See also David Livingstone, Putting Science in Its Place: Geographies of Scientific Knowledge (Chicago: University of Chicago Press, 2003). On acclimatization, see Sheridan, Doctors and Slaves; David Arnold, ed., Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900 (Amsterdam: Rodopi, 1996); Michael Osborne, “Acclimatizing the World: A History of the Paradigmatic Colonial Science,”  Osiris 15 (2000): 135–51; Eric Jennings,  Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas (Durham, NC: Duke University Press, 2006); Osborne, Emergence of Tropical Medicine. 43. Chisholm, Essay, 2:461–72. 44. Ibid., 2:463. 45. Antoni de Haen, Ratio Medendi (Vienna, 1757); Carl Wunderlich, On Temperature in Diseases: A Manual of Medical Thermometry, trans. D. B. Woodman (London, 1871), 19–47. See also Audrey Davis, Medicine and Its Technology (Westport, CT: Greenwood Press, 1981), 65–69; Hasok Chang, Inventing Temperature: Measurement and Scientific Progress (Oxford: Oxford University Press, 2004); J. Pearce, “A Brief History of the Clinical Thermometer,” QJM 95 (2002): 251–52; Chisholm, Essay, 1:69. 46. Chisholm, Essay, 2:461–62. 47. Ibid., 2:462. 48. Ibid., 1:140–41.

Notes to Chapter 1

49. Gazette de médecine pour les colonies 3 (December 1, 1778): 13. For “bossal[e]s,” see Moreau de Saint-Méry, Description, 2:408. See also [Grainger], Essay, 15; Great Britain, House of Commons, Report of the Lords, III, No. 29. 50. Lisbet Koerner, Linnaeus: Nature and Nation (Cambridge, MA: Harvard University Press, 1999), 121. 51. William Falconer emphasized that although in a natural state humans were the least likely species to survive in various climates, their rational faculties allowed them to reign with “the lion and the tyger under the Equator, and associate with the bear and rein-deer beyond the Polar Circle” (Remarks on the Influence of Climate, Situation, Nature of the Country, Population, Nature of Food, and Way of Life on the Disposition and Temper, Manners and Behaviour, Intellects, Laws and Customs, Form of Government, and Religion [London, 1781], 1–2). 52. On the movement of plants, see Emma Spary, Utopia’s Garden: French Natural History from Old Regime to Revolution (Chicago: University of Chicago Press, 2000); Schiebinger, Plants and Empire; Londa Schiebinger and Claudia Swan, eds., Colonial Botany: Science, Commerce, and Politics (Philadelphia: University of Pennsylvania Press, 2005). For Lind’s discussion of human transplantation, see James Lind, An Essay on Diseases Incidental to Europeans in Hot Climates (London, 1768), 2–3. John Atkins also likens humans and plants in their response to changes in climates, soils, and way of life (The Navy Surgeon [London, 1742], 368). 53. Chisholm, Essay, 2:462–63. 54. Ibid., 2:468–72. 55. Ibid. 56. Ibid., 2:461, 472–73. De Haen had shown that the elderly had normally elevated temperatures (Ratio Medendi). 57. Dazille, Observations sur le tétanos, 318. Thomson, “On the Substitutes,” 27–30. 58. [Grainger], Essay, 8–13. On acclimatizing or seasoning slaves, see also Sheridan, Doctors and Slaves, 131–34. For similar themes in India, see Mark Harrison, Climates and Constitutions: Health, Race, and Environment and British Imperialism in India 1600–1850 (New Delhi: Oxford University Press, 1999). 59. Gazette de médecine pour les colonies, May 29, 1778, 14–15; Lafosse, Avis, 95. 60. [Grainger], Essay, iv–v. 61. Zabdiel Boylston, An Historical Account of the Small-Pox Inoculated in New England upon All Sorts of Persons, Whites, Blacks, and of All Ages and Constitutions (London, 1726); Mitchell, “Essay upon the Causes.” In her recent book Medical Apartheid, Harriet Washington stated that “of the first 251 experimental inoculations of smallpox by Dr. Zabdiel Boylston [in 1721] in predominately white . . . Massachusetts, all but one of the subjects were black” (New York: Doubleday, [2006]), 57. In fact, nine of Boylston’s 280 inoculation patients were identified as “Negroes,” four were “Indians” (of whom one died), and a large number were women. But these subjects did not go first. Boylston, unable to try the experiment on himself (we are not told why), chose as the first subject his “own dear child,” a son six years old. His next two subjects were members of his household, his “Negro” man Jack and Jack’s son, Jackey, aged two and a half (he inoculated white children younger than this). Boylston inoculated households (it was dangerous not to), and he inoculated servants—both African and Native American—in those households.

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62. Charles-Marie Emerigon, “Sur la goutte,” Journal de médecine, chirurgie, pharmacie, etc. 47 (1777): 424–41, esp. 426, 429. CHAP TER 2

1. A. J. Alexander to Joseph Black, Bacolet, Grenada, July 26, 1773, in Black, Correspondence of Joseph Black, 1:288; Brodwin, Medicine and Morality, 40–41. 2. Carney and Rosomoff, In the Shadow, 1–5. See also Candice Goucher, Congotay! Congotay! A Global History of Caribbean Food (Armonk, NY: M. E. Sharpe, 2014); Robert Voeks and  John Rashford, eds., African Ethnobotany in the Americas (New York: Springer, 2013); Elizabeth DeLoughrey, “Globalizing the Routes of Breadfruit and Other Bounties,” Journal of Colonialism and Colonial History 8, no. 3 (2007), DOI: 10.1353/cch.2008.0003. For a vivid description of the Middle Passage, see Stephanie Smallwood, Saltwater Slavery: A Middle Passage from Africa to American Diaspora (Cambridge, MA: Harvard University Press, 2007). 3. Pierre Barrère, Essai sur l’histoire naturelle de la France Equinoxiale (Paris, 1741), 50; Pouppé-Desportes, Histoire des maladies, 3:59. See also Bernard Weniger et al., “La médecine populaire dans le Plateau Central d’Haïti,” Journal of Ethnopharmacology 17 (1986): 1–30. 4. Carney and Rosomoff, In the Shadow. Natalie Davis has also discussed these dynamics in Suriname (“Physicians, Healers,” 3–34, esp. 13). See also [Grainger], Essay, 12. 5. Hans Sloane, Catalogus Plantarum quæ in Insula Jamaica sponte proveniunt . . . (London, 1696), 122; Hans Sloane, A Voyage to the Islands Madera, Barbados, Nieves, S.  Christophers, and Jamaica; with Natural History, etc., 2 vols. (London, 1707–25), 2:253–54. Also see Henry Barham, Hortus Americanus (Kingston, 1794), 6; Williamson, Medical and Miscellaneous Observations, 1:133; Chisholm, Essay, 193; William Sturtevant, “History and Ethnography of Some West Indian Starches,” in The Domestication and Exploitation of Plants and Animals, ed. Peter Ucko and G. W. Dimbleby (Chicago: Aldine, 1969), 177–99, esp. 184–89; Jerome Handler, “The History of Arrowroot and the Origin of Peasantries in the British West Indies,” Journal of Caribbean History 2 (1971): 46–93. 6. Richard Shannon, Practical Observations on the Operation and Effects of Certain Medicines in the Prevention and Cure of Diseases to Which Europeans Are Subject in Hot Climates, and in These Kingdoms (London, 1794), 380; Brodwin, Medicine and Morality, 40. 7. Thomas Heney, “On the Efficacy of the Zanthoxylon,” Memoirs of the Medical Society of London 5 (1799): 44–52, esp. 45. James Thomson also experimented with prickly yellow wood (Treatise, 151–56). 8. Heney, “On the Efficacy,” 49–50. 9. Ibid., 45, 50–51. 10. Ibid., 49, 52. 11. Bajon, “Observations,” 60–74, esp. 60, 64; Bertrand Bajon, “Du Figuier de Cayenne,” Journal de médecine, chirurgie, pharmacie, etc. 36 (1771): 241–47. 12. Sheridan, Doctors and Slaves; Brodwin, Medicine and Morality, 41. 13. Cercle des Philadelphes, “Histoire et analyse des eaux thermales du Port-àPiment,” Mémoires du Cercle des Philadelphes 1 (1788): 70–71. 14. [Monro], Letters and Essays, 60; Thomson, Treatise, 86. See also Miles Ogborn,

Notes to Chapter 2

“Talking Plants: Botany and Speech in Eighteenth-Century Jamaica,” History of Science 51 (2013): 251–82; Williamson, Medical and Miscellaneous Observations, 1:57; 2:19. 15. Alexander to Black, April 21, 1773, in Black, Correspondence, 1:282–84, 288; Society in Edinburgh, “Medical News,” 90–92. See also Sheridan, Doctors and Slaves. I touched on this experiment in Londa Schiebinger, “Scientific Exchange in the EighteenthCentury Atlantic World,” in Soundings in Atlantic History: Latent Structures and Intellectual Currents, 1500–1825, ed. Bernard Bailyn (Cambridge, MA: Harvard University Press, 2009), 294–328. 16. Alexander to Black, April 21, 1773, in Black, Correspondence, 1:283; Appendix 1: Biographies, 2:1395–96. 17. Society in Edinburgh, “Medical News,” 90–92. 18. Alexander to Black, April 21, 1773, in Black, Correspondence, 1:283. 19. Ibid., 1:284; the editors of “Medical News,” expanded on the surgeon’s caustics (91). 20. Alexander to Black, July 26, 1773, in Black, Correspondence, 1:288. 21. F. G. Cassidy and R. B. Le Page, Dictionary of Jamaican English (Cambridge: Cambridge University Press, 1980), s.v. “yaws.” William Hillary claimed that yaws is an African word (Observations on the Changes of the Air and the Concomitant Epidemical Diseases in the Island of Barbados [London, 1766], 339). For pian, see Émile Littré, Dictionnaire de la langue française: Supplement (Paris: Hachette, 1872–77), s.v., pian.-étym.; it is also claimed that pian is a “Carib word conserved in all languages” to designate this disease. See also Société de médecins et de chirurgiens, Dictionnaire des sciences médicales (Paris: Panckoucke, 1820), 42, s.v. “pian.” Sauvages’s nomenclature is in François Boissier de la Croix de Sauvages, Nosologia methodica sistens morborum classes, 2 vols. (Amsterdam, 1768), 2:554–57. 22. Thomas Stedman, ed., Twentieth Century Practice: An International Encyclopedia of Modern Medical Science by Leading Authorities of Europe and America, 20 vols. (New York, 1899), 16, s.v. “yaws.” 23. Hillary, Observations, 346; Thomas Winterbottom, An Account of the Native Africans in the Neighbourhood of Sierra Leone, 2 vols. (London, 1803), 1:139; A New Universal History of Arts and Sciences, Shewing Their Origin, Progress, Theory, Use, and Practice, 2 vols. (London, 1759), s.v. “yaws.” 24. A robust literature treats the origins of syphilis. See, for example, Kristin Harper et al., “The Origin and Antiquity of Syphilis Revisited: An Appraisal of Old World Pre-Columbian Evidence for Treponemal Infection,” American Journal of Physical Anthropology 146 (2011): 99–133. See also Katherine Paugh, “Yaws, Syphilis, Sexuality, and the Circulation of Medical Knowledge in the British Caribbean and the Atlantic World,” Bulletin of the History of Medicine 88 (2014): 225–52. For Sauvages’s two species, see Sauvages, Nosologia, 2:555. Wright claimed that sivvens in Scotland and Ireland is akin to yaws: “As this disorder was first brought to the Highland of Scotland by the Protector’s soldiers,” he wrote, “I beg leave to denominate it Frambaesia Cromwelliana” ([Wright], Memoir, 404). The 1.5 million years estimate is in Andrea Rinaldi, “Yaws: A Second (and Maybe Last?) Chance for Eradication,” Public Library of Science Neglected Tropical Diseases 2 (2008): 1–6. 25. Thomas Trapham, A Discourse of the State of Health in the Island of Jamaica (London, 1679), 113–14. See also Sheridan, Doctors and Slaves, 87–88. Benjamin Moseley writes

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on the origin of yaws in A Treatise on Sugar with Miscellaneous Medical Observations, 2nd ed. (London, 1800), 184–89, esp. 184. 26. Alexander Anderson, Linnaean Society of London, untitled manuscript, MMS Drawer 30, MS No. 616. 27. [ John Hume], “A Description of the African Distemper Called Yaws, with the True Method of Cure,” Medical Essays and Observations 5, pt. 2 (1747): 272–86. Many British medical encyclopedias repeat aspects of Hume’s description. Hume is identified as the author in [Wright], Memoir, 400. 28. Edward Bancroft, An Essay on the Natural History of Guiana, in South America (London, 1769), 386. 29. Views on this differed. Jean-Barthélemy Dazille emphasized that pian attacked both Negroes and whites (Observations sur les maladies [1776], 255–61). Dazille provided a longer treatment of yaws in the 1792 edition of this work. 30. Williamson, Medical and Miscellaneous Observations, 2:146. 31. [Wright], Memoir, 400. 32. Williamson, Medical and Miscellaneous Observations, 2:143. 33. James Thomson, “Remarks on Tropical Diseases,” Edinburgh Medical and Surgical Journal 18 (1822): 31–48, esp. 33; Thomson, Treatise, 88. See also James Maxwell, Observations on Yaws (Edinburgh, 1839). 34. Thomas Dancer, The Medical Assistant; or Jamaica Practice of Physic: Designed Chiefly for the Use of Families and Plantations (Kingston, 1801), 221; Société de médecins, Encyclopédie méthodique 12 (Paris, 1827), s.v. “pian.” 35. Moseley, Treatise on Sugar, 187–88; Bajon, Mémoires, 1:287–88. 36. Thomson, “Observations and Experiments,” 321; [Wright], Memoir, 411; Brodwin, Medicine and Morality, 31. 37. Black, Correspondence, 1:286n2. 38. Society in Edinburgh, “Medical News,” 90–92; Black, Correspondence, 1:283; Appendix 1: Biographies, 2:1395. 39. Trans-Atlantic Slave Trade Database: www.slavevoyages.org (accessed April 15, 2015). On the French slave trade, see Geggus, “French Slave Trade.” 40. [Hume], “Description,” 276; Douglas Hall, In Miserable Slavery: Thomas Thistlewood in Jamaica, 1750–1786 (London: Macmillan, 1989), 38. See also Richard Sheridan, “Slave Medicine in Jamaica: Thomas Thistlewood’s ‘Receipts for a Physick,’ 1750–1786,” Jamaican Historical Review 17 (1991): 1–18, esp. 11; Trevor Burnard, Mastery, Tyranny, and Desire: Thomas Thistlewood and His Slaves in the AngloJamaican World (Chapel Hill: University of North Carolina Press, 2004). William Wright discusses the hog-plum in [Wright], Memoir, 272. 41. Alexander to Black, July 26, 1773, in Black, Correspondence, 1:288. See Christopher Parsons and Kathleen Murphy, “Ecosystems under Sail: Specimen Transport in the Eighteenth-Century French and British Atlantics,” Early American Studies 10 (2012): 503–29. 42. Winterbottom, Account, 2:157. 43. Pouppé-Desportes, Histoire des maladies, 2:80–95, esp. 81; 3:105–7. 44. Ibid., 3:186–87, 193, 291 (see also 107). Wright recorded no medicinal use of this plant (Memoir, 257).

Notes to Chapters 2 and 3

45. Raymond Breton, Dictionnaire caraïbe-français (Auxerre, 1665), s.v. “yaya”; “chipíou”; “mibi”; Jean-Barthélémi-Maximilien Nicolson, Essai sur l’histoire naturelle de l’isle de SaintDomingue (Paris, 1776), 174–75. 46. Jean-Baptiste-Christophe Fusée-Aublet, Histoire des plantes de la Guiane françoise, rangées suivant la méthode sexuelle, 4 vols. (London, 1775), 2:768–70; 4: plate 307. He wrote an interesting section entitled “Observations sur les Galibis,” in Histoire des plantes, 2:105–9, esp. 108. 47. Kit Candlin, The Last Frontier, 1795–1815 (New York: Palgrave Macmillan, 2012); Michel-Étienne Descourtilz, Flore pittoresque et medicale des Antilles, ou Histoire naturelle des plantes usuelles des colonies françaises, anglaises, espagnoles et portugaises, 8 vols. (Paris, 1821–29), 7:9–13, plate 454. 48. Descourtilz, Flore pittoresque, 7:10. 49. Richard Ligon reported one Indian property owner still living in Barbados—a man named Salymingoe who lived on Canoe Hill. He was known for his thirty-five-foot canoe that would have required fifteen to twenty paddlers. See P. F. Campbell, “Richard Ligon,” Journal of the Barbados Museum and Historical Journal 37 (1985): 215–38, esp. 236. The Spanish had destroyed the Amerindians on Jamaica; Nicolas-Louis Bourgeois noted that native populations no longer existed on Saint-Domingue (Voyages intéressans, 67). See also Irving Rouse, The Tainos: Rise and Decline of the People Who Greeted Columbus (New Haven, CT: Yale University Press, 1992). On the government ordinance banning Caribs’ transmission of medical plant knowledge, see Lucien Peytraud, L’esclavage aux Antilles françaises avant 1789 (Paris: Hachette, 1897), 321–22; Christiane Bougerol, La médecine populaire à la Guadeloupe (Paris: Karthala, 1983). Bajon writes about Raimond in Mémoires, 1:352–53. 50. Peter Goldblatt, ed., Biological Relationships between Africa and South America (New Haven, CT: Yale University Press, 1993), 8; Winterbottom, Account, 2:156–57. 51. [Bourgeois], Voyages intéressans, 470; Carney and Rosomoff, In the Shadow. 52. Shannon, Practical Observations, 380. 53. Dancer, Medical Assistant [1801], 223. Dancer also recommended bathing yaws patients in warm water and railed against the “general practice of negroes . . . of washing in the cold rivers” (A Short Dissertation on the Jamaica Bath Waters [Kingston, 1784], 81–82). See also Thomson, “Observations and Experiments,” 322; Thomson, Treatise, 93. 54. Dancer, Medical Assistant [1801], 223. See also Dazille, Observations sur les maladies [1792]; Thomson, Treatise. CHAP TER 3

1. Albert Jonsen, A Short History of Medical Ethics (Oxford: Oxford University Press, 2000), 1–3. See also Baker and McCullough, Cambridge World History; Baker, Before Bioethics. 2. Lederer, Subjected to Science; Jay Katz, Experimentation with Human Beings (New York: Russell Sage Foundation, 1972); Irving Ladimer and Roger W. Newman, eds., Clinical Investigation in Medicine (Boston: Boston University, Law-Medicine Research Institute, 1963). 3. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protec-

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tion of Human Subjects of Research (Washington, DC: US Department of Health and Human Services, 1979). Important guidelines are also set by the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). See also Gert Brieger, “Human Experimentation,” in Encyclopedia of Bioethics, ed. Warren Reich, 5 vols. (New York: Free Press, 1978), 2:683–92; Ruth Faden and Tom Beauchamp, A History and Theory of Informed Consent (Oxford: Oxford University Press, 1986); Stuart Spicker et al., eds., The Use of Human Beings in Research (Dordrecht: Kluwer, 1988); Emanuel et al., eds., Oxford Textbook; World Medical Association, “Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects,” JAMA 310 (2013): 2191–94. 4. Maehle, Drugs on Trial; Thomson, Treatise, 146. 5. John Leake, An Account of the Westminster New Lying-in Hospital (London, 1765), 1; Paul Pfeiffer, Das Allgemeine Krankenhaus in Wien von 1784 (Munster: LIT, 2012). Support for unmarried mothers would be reversed in late eighteenth-century England. See Lisa Cody, Birthing the Nation: Sex, Science, and the Conception of Eighteenth-Century Britons (Oxford: Oxford University Press, 2005). 6. Home, Clinical Experiments, v–vi; Guenter Risse, Hospital Life in Enlightenment Scotland (Cambridge: Cambridge University Press, 1986), 21–22; Brockliss and Jones, Medical World, 673–700; Harrison, Medicine, 84, 103; Osborne, Emergence of Tropical Medicine. 7. Home, Clinical Experiments, vvii. For context, see also Robert Baker, Dorothy Porter, and Roy Porter, eds., The Codification of Medical Morality, 2 vols. (Dordrecht: Kluwer, 1993), vol. 1; Lindemann, “Discourses of Practitioners,” 391–98; Lisbeth Haakonssen, Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival, and Benjamin Rush (Amsterdam: Rodopi, 1997). 8. According to Home, a physician “can try different and new methods of cure, provided he has a probability of success, and proceeds with proper caution” (Clinical Experiments, vi). Thomas Gisborne’s statement is in An Enquiry into the Duties of Men in the Higher and Middle Classes of Society in Great Britain (London, 1784), 407. Gisborne also wrote An Enquiry into the Duties of the Female Sex (London, 1797). For earlier statements on research ethics, see Laurence McCullough, “The Discourses of Practitioners in Eighteenth-Century Britain,” in Baker and McCullough, Cambridge World History, 403–13, esp. 410. John Gregory also wrote A Father’s Legacy to His Daughters (London, 1774). 9. Thomas Percival, Medical Ethics (Manchester, 1803), 14–15, articles 12 and 13. 10. James Gregory wrote that clinical professors’ oaths “make no distinction between rich patients and poor; between those in private houses and those in a great hospital; between those in the common wards and those in the clinical wards of this infirmary” (Additional Memorial, 385–87). On Percival, see Robert Baker, “Deciphering Percival’s Code,” in Baker, Porter, and Porter, Codification of Medical Morality, 1:179–211; Percival, Medical Ethics, 48–49, article 28. 11. William Withering, An Account of the Foxglove and Its Medical Uses (Birmingham, 1785), 2–3. On the use of experimental subjects, see Schiebinger, “Human Experimentation,” 384–408; William Bynum, “Reflections on the History of Human Experimentation,” in Spicker, Use of Human Beings, 29–46, esp. 32.

Notes to Chapter 3

12. [ J. F. Coste], “An Account of Some Experiments with Opium in the Cure of the Venereal Disease,” London Medical Journal 9 (1788): 7–27. 13. Ibid. 14. Bernard, Introduction to the Study, 130. 15. Percival, Medical Ethics, 14–15, article 12. See also Brockliss and Jones, Medical World, 675. 16. James Gregory, Memorial to the Managers of the Royal Infirmary (Edinburgh, 1800), 141; Gregory, Additional Memorial, 429–30, 343. 17. James Gregory, Additional Memorial, 379, 425. Haakonssen, Medicine and Morals, 151–52. 18. Hippocratic Oath, para. 6: “Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slave.” See also Heinrich von Staden, “The Discourses of Practitioners in Ancient Europe,” in Baker and McCullough, Cambridge World History, 352–58, esp. 355–56; Jonsen, Short History, 1–12. On prisoners, see Pierre-Louis Moreau de Maupertuis, Lettre sur le progrès des sciences (Dresden, 1752), sec. 11, “Utilités du supplice des criminels”; Schiebinger, “Human Experimentation.” 19. Great Britain, House of Commons, Report of the Lords, 1789, III, Further Evidence, “A General View of the Principles on Which This System of Laws Appears to Have Been Originally Founded”; Antigua, Grenada, and Saint Christopher, No. 12; Williamson, Medical and Miscellaneous Observations, 1:190. 20. Sheridan, Doctors and Slaves, 178–82; Schiebinger, Plants and Empire, 109; Vincent Brown, The Reaper’s Garden: Death and Power in the World of Atlantic Slavery (Cambridge, MA: Harvard University Press, 2008). 21. Williamson, Medical and Miscellaneous Observations, 1:169, 190; [Wright], Memoir, 330, 369. 22. [Monro], Letters and Essays, 107–8; Williamson, Medical and Miscellaneous Observations, 1:65; Leonard Gillespie, “Observations on the Putrid Ulcer. Communicated in a Letter to Samuel Foart Simmons, MD F.R.S.,” London Medical Journal 6 (1785): 373–400, esp. 373. 23. M. Macgrudan, “Médecin à la Jamaïque, sur l’inoculation du Pians,” Journal de physique, de chimie, d’histoire naturelle et des arts 1 (1773): 37–47, esp. 30; Thomson, Treatise, 94. 24. Great Britain, House of Commons, Report of the Lords, III, No. 12. See also Sheridan, Doctors and Slaves, 296. 25. Paul Kopperman, “The British Army in North America and the West Indies, 1755–1783: A Medical Perspective,” in Hudson, British Military and Naval Medicine, 51– 86, esp. 55; Sheridan, Doctors and Slaves; Williamson, Medical and Miscellaneous Observations, 1:189–90. 26. Williamson, Medical and Miscellaneous Observations, 1:120. 27. Great Britain, House of Commons, Report of the Lords, III, No. 12. A law in 1784 required planters in French islands to provide suitable slave hospitals; see Pluchon, Histoire des médecins, 423. On urban hospitals for destitute blacks in Jamaica, see Rana Hogarth, “Charity and Terror in Eighteenth-Century Jamaica: The Kingston Hospital

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and Asylum for Deserted ‘Negroes,’” African and Black Diaspora: An International Journal (2016): 1–18. Grainger’s description of a plantation sick house is in [Grainger], Essay, 71–73. An ideal French plantation hospital is described in P. J. Laborie, The Coffee Planter of Saint Domingo (London, 1798), 94–95. Thomson’s advice is in his Treatise, 11. 28. Dazille, Observations sur le tétanos, 19, 317, 390–425; John Luffman, Brief Account of the Island of Antigua (London, 1789), 96. On plantation hospitals, see Debien, Esclaves, 327–33; Sheridan, Doctors and Slaves, 268–87; Weaver, Medical Revolutionaries, 45–46. 29. Adair, Unanswerable Arguments, 118, 250–52; Laborie, Coffee Planter, 94; Thomson, Treatise, 93; [David Collins], Practical Rules for the Management and Medical Treatment of Negro Slaves in the Sugar Colonies (London, 1803), 252–66. See also Justin Robert, Slavery and the Enlightenment in the British Atlantic, 1750–1807 (Cambridge: Cambridge University Press, 2013), 164–67. European hospitals were traditionally charitable and religious institutions and served to confine poor beggars, vagrants, and women of ill repute (Brockliss and Jones, Medical World, 682–83). 30. [Monro], Letters and Essays, 41, 53; Thomson, Treatise, 10. 31. Williamson, Medical and Miscellaneous Observations, 1:97–98. 32. McClellan, Colonialism and Science, 128–46; McClellan and Regourd, Colonial Machine; Pluchon, Histoire des médecins, 92. 33. Charles Arthaud, Dissertation et observations sur le tétanos (Cap-Français, 1786). See McClellan and Regourd, Colonial Machine, 263. 34. Dazille, Observations sur le tétanos, 2, 8–10; Bajon, Mémoires, 1:261. On Malthus, see Cody, Birthing the Nation, 269–92. 35. Dazille, Observations sur les maladies [1776], iv, x, 1–3. The message remained unchanged in the 1792 edition of his work (1–3). 36. Dazille, Observations sur les maladies [1776], 2–3. For similar views, see MichelRené Hilliard d’Auberteuil, Considérations sur l’état présent de la colonie française de SaintDomingue, 2 vols. (Paris, 1776), 2:52. See also Diderot and d’Alembert, eds., Encyclopédie, 13, s.v. “Nègres (Commerce),” 80; Arthaud, Dissertation et observations, 57. Three female slaves of the same age and perfect constitution equaled one nègre pièce d’Inde. The term referred to a slave fit for the Indies trade before the trade to the Americas commenced. For this citation, the article is a review of a book. Review of Dictionnaire géographique, historique et politique des Gaules et de la France &c., vol. 5, by Jean-Joseph Expilly, Journal encyclopédique, dédié à son altesse sérénissime, Mgr. le Duc de Bouillon 3 (May 1768): 64–76, esp. 69–71. Diderot and d’Alembert’s Encyclopédie, however, defined pièce d’Inde as either a man or a woman (12:567). 37. Boylston, Historical Account, vi. On self-experimentation, see also Lederer, “Walter Reed,” 9–17, and Baker, Before Bioethics, 74–76. 38. Anton Störck, An Essay on the Medicinal Nature of Hemlock (London, 1760), 12–13; Bajon, Mémoires, 1:433–60. See also Charles-Marie de La Condamine, Relation abrégée d’un voyage (Paris, 1745), 208–10. On animal experiments, see Gisborne, Enquiry into the Duties of Men, 408; Andreas-Holger Maehle, Kritik und Verteidigung des Tierversuchs: Die Anfänge der Diskussion im 17. und 18. Jarhundert (Stuttgart: F. Steiner, 1992); Schiebinger, “Human Experimentation”; Anita Guerrini, Experimenting with Humans and Animals: From Galen to Animal Rights (Baltimore: Johns Hopkins University Press, 2003); David Perkins, Romanticism and Animal Rights (Cambridge: Cambridge University Press, 2003).

Notes to Chapter 3

39. Johann Ritter, cited in Stuart Strickland, “The Ideology of Self-Knowledge and the Practice of Self-Experimentation,” preprint 65, Max-Planck-Institut für Wissenschaftsgeschichte, Berlin, 1997, 25; Albrecht von Haller, “Abhandlung über die Wirkung des Opiums auf den menschlichen Körper,” Berner Beiträge zur Geschichte der Medizin und der Naturwissenschaften 19 (1962): 3–31. 40. Hildebrandt, Versuch einer philosophischen Pharmakologie; Lawrence Altman, Who Goes First: The Story of Self-Experimentation in Medicine (New York: Random House, 1986), 12; Störck, Essay, 12–14. 41. Benjamin Bell, A Treatise on Gonorrhoea Virulenta and Lues Venerea, 2 vols. (Edinburgh, 1797), 1:32–33. 42. Thomson, Treatise, 145–46. Thomson dates these experiments in “On the Substitutes,” 27–31, esp. 28. On self-experimentation among students associated with the Royal Medical Society of Edinburgh, see Guenter Risse, “Debates and Experiments: The Royal Medical Society of Edinburgh,” Clio Medica 78 (2005): 67–104, esp. 83–84. 43. Bajon, Mémoires, 1:433–60. 44. [Wright], Memoir, 342, 347; William Wright, “Remarks on Malignant Fevers; and Their Cure by Cold Water and Fresh Air,” London Medical Journal 7, pt. 2 (1786): 109–15. Wright’s claim was repeated in the medical literature (Currie, Medical Reports, 1:5). 45. [Wright], Memoir, 342–43. 46. Ibid., 342–46; Wright, “Remarks on Malignant Fevers,” 109–15. 47. [Wright], Memoir, 344. 48. Ibid., 27, 347–50. 49. Ibid., 347–50, 415. 50. Ibid., 330–39; William Wright, “On the Use of Cold Bathing in the Locked Jaw,” Medical Observations and Inquiries 6 (1784): 143–62. 51. [Wright], Memoir, 332. 52. Ibid., 342–50. 53. Pouppé-Desportes, Histoire des maladies, 2:83–84; Debien, Esclaves, 315. 54. [Wright], Memoir, 415–16. 55. Ibid., 92, 418. 56. Ibid., 45. Wright’s Memoir appears to have been prepared with notes by Dr. John Mitchell and published by his three nieces. William Fawcett, “William Wright, A Jamaican Botanist,” Journal of Botany 60 (1922): 330–34. 57. Bajon, Mémoires, 1:157–58; Joseph Capuron, Traité des maladies des enfants (Paris, 1820), 457. On Chanvalon in Martinique, see Société royale de médecine, Paris, 191B, d31, pièce 3. Bourgeois’s comments are in [Bourgeois], Voyages intéressans, 487– 89; Thomas Dancer’s in A Short Essay on Cold Bathing (Saint Jago de la Vega, 1777); Wright’s admission in Memoir, 331, 344–45. See also John Floyer, Psychrolousia; Or, the History of Cold Bathing: Both Ancient and Modern (London, 1715); Henri-Mathias Marcard, De la nature et de l’usages des bains (Paris, 1801). 58. Currie, Medical Reports, 1:6–7. 59. Ibid., 1:7–8. 60. [Wright], Memoir, 110, 117, 162–63. 61. James Gregory outlined “universally understood” duties of a physician in his Memorial to the Managers, 129–47.

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62. Ibid., 133. The teaching or clinical ward at the Edinburgh Infirmary was expanded from fifty beds in the 1780s to one hundred beds in the 1790s. Risse, “Clinical Instruction in Hospitals,” 1–19, esp. 6–7. 63. Laurence McCullough, John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine (Dordrecht: Kluwer Academic Publishers, 1998), 104. 64. Code noir, Article 27, reprinted and translated in Sue Peabody and Keila Grinberg, Slavery, Freedom, and the Law in the Atlantic World (New York: Palgrave, 2007), 31–36. See also Elsa Goveia, “The West Indian Slave Laws of the Eighteenth Century,” Colegio de Ciencias Sociale de la Universidad de Puerto Rico (1960): 75–105. 65. Stephen Fuller, New Consolidated Act, 1788, . . . Being the Present Code Noir of That Island (London, 1789). 66. As Christopher Brown has argued, even antislavery was self-interested, whether economically or morally (Moral Capital: Foundations of British Abolitionism [Chapel Hill: University of North Carolina Press, 2012], 25–30). 67. John Warner, “The Idea of Southern Medical Distinctiveness: Medical Knowledge and Practice in the Old South,” in Science and Medicine in the Old South, ed. Ronald Numbers and Todd Savitt (Baton Rouge: Louisiana State University Press, 1989), 179–205. 68. Stephen Kenny, “‘A Dictate of Both Interest and Mercy’? Slave Hospitals in the Antebellum South,” Journal of the History of Medicine 65 (2010): 1–47; Stephen Kenny, “The Development of Medical Museums in the Antebellum American South: Slave Bodies in Networks of Anatomical Exchange,” Bulletin of the History of Medicine 87 (2013): 32–62; Todd Savitt, “The Use of Blacks for Medical Experimentation and Demonstration in the Old South,” Journal of Southern History 48 (1982): 331–48, esp. 334, 339. 69. J. Marion Sims, The Story of My Life (New York, 1888), 245; J. Marion Sims, “On the Treatment of Vesico-Vaginal Fistula,” American Journal of the Medical Sciences 23 (1852): 59–82. 70. Baker, Before Bioethics, 108. Despite the failure of the AMA to protect slaves, it opened its doors to women and “colored” men during Sims’s presidency. 71. Sims, Story of My Life, 240. 72. J. Marion Sims, “Two Cases of Vesico-Vaginal Fistula, Cured,” Journal of Health 5 (1854): 1–7, esp. 1. See Baker’s excellent account in Before Bioethics, 245–55. 73. Sims, “Two Cases,” 1; Sims, Story of My Life, 236. 74. Savitt, “Use of Blacks,” 334. As early as 1982 Savitt called for studies to compare practices in the North and South and to understand how slaves, the poor, transient whites, seamen, European immigrants, and white indigents were used in nineteenthcentury hospitals. CHAP TER 4

1. John Gregory quoted in Baker, Before Bioethics, 74–75. 2. See also ibid., 74. 3. The Medical Register for the Year 1783 (London, 1784) lists all West Indian physicians, by island and territory, s.v., “Section IV, West Indies.” 4. On the Newgate Prison experiments, see Schiebinger, “Human Experimentation,” 396–97; Sheridan, Doctors and Slaves, 252. See also Genevieve Miller, The Adoption

Notes to Chapter 4

of Inoculation for Smallpox in England and France (Philadelphia: University of Pennsylvania Press, 1957); Rusnock, Vital Accounts; [Monro], Letters and Essays, 6. The literature on smallpox inoculation is vast, see, e.g., Sloane, “Account of Inoculation”; Peter Razzell, The Conquest of Smallpox: The Impact of Inoculation on Smallpox Mortality in Eighteenth-Century Britain (Firle: Caliban Books, 1977). Siméon Worlock, an English Creole from Antigua, began the mass inoculations. He became a naturalized citizen in Saint-Domingue in 1779. See Moreau de Saint-Méry, Description, 1:218–19, 247, 536. See also McClellan, Colonialism and Science, 144; Thomas Cooper, The Statutes at Large of South Carolina, 10 vols. (Columbia, 1838), 3:513–15; Claire Gherini, “Rationalizing Disease: James Kilpatrick’s Atlantic Struggles with Smallpox Inoculation,” Atlantic Studies: Global Currents 7 (2010): 421–46. 5. Charles-Marie de La Condamine, A Discourse on Inoculation, Read before the Royal Academy of Sciences at Paris, the 24th of April 1754 (London, 1755), 2, 42, 44, 49–50. 6. [Monro], Letters and Essays, 6, 18, 65. 7. Ibid., xiii–xiv. 8. A search for correspondence between Monro and Quier led from Special Collections at the Edinburgh University Library to the Monro Collection at the University of Otago Medical Library, New Zealand, and back to a descendant of the family in Cambridgeshire, United Kingdom. I was not able to locate what must have been a fascinating exchange of letters. 9. Great Britain, House of Commons, Report of the Lords, III, Jamaica Appendix, No. 8; [Monro], Letters and Essays, 87, 97, 98, 99, 100. 10. [Monro], Letters and Essays, 56. 11. Ibid., 13, 41, 86–95. 12. Ibid., 86–88. 13. Ibid., 64. Others, too, inoculated nursing infants. See Louis Lapeyre, Mémoire instructif sur l’inoculation des petites véroles (London, 1771), 16; Thomas Dimsdale, The Present Method for Inoculating the Small-Pox (London, 1767), 9. 14. [Monro], Letters and Essays, 11–12. See also Schiebinger, Plants and Empire, 172–77. 15. “White people” were among Quier’s patient group. [Monro], Letters and Essays, xxxi, 2; Craton, Searching, 259–64. 16. [Monro], Letters and Essays, 54–55. 17. Ibid., 55. For attitudes concerning slave women and childbirth, see Jennifer Morgan, Laboring Women: Reproduction and Gender in New World Slavery (Philadelphia: University of Pennsylvania Press, 2004); Barbara Bush, Slave Women in Caribbean Society, 1650–1832 (Bloomington: Indiana University Press, 1990); David Gaspar and Darlene Hine, eds., More Than Chattel: Black Women and Slavery in the Americas (Bloomington: Indiana University Press, 1996). 18. [Monro], Letters and Essays, 56, 67–70. 19. Ibid., 98. 20. Ibid., 23. 21. [Wright], Memoir, 365–66. 22. John Quier settled in Lluidas Vale and owned a 250-acre estate called Shady Grove. Craton, Searching, 259–64; Thomson, Treatise, 69.

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23. Thomson, “Remarks on Tropical Diseases,” 31–48, esp. 31. 24. Thomson, Treatise, 69, 85. 25. Thomson, “Observations and Experiments,” 321–28, esp. 322. 26. Percival, Medical Ethics, 14–15, article 12. 27. Great Britain, House of Commons, Report of the Lords, III, Jamaica, No. 7, 15, “What Impedes the Natural Increase of Negro Slaves?”; [Wright], Memoir, 401; Hillary, Observations, 344–45; Thomson, Treatise, 90–91. See also Larry Stewart, “The Edge of Utility: Slaves and Smallpox in the Early Eighteenth Century,” Medical History 29 (1985): 54–70. 28. Williamson, Medical and Miscellaneous Observations, 2:146. Gottfried Schilling experimented with van Swieten’s cure in Suriname in the 1760s; see also [Hume], “Description,” 272–86, esp. 279; and Winterbottom, Account, 2:159. 29. Thomson, Treatise, 144–56; Schiebinger, Plants and Empire, 172. 30. Thomson, Treatise, 1. 31. Ibid., 72; Craton, Searching, 262. 32. Macgrudan, “Médecin à la Jamaïque,” 37–47. 33. Winterbottom, Account, 2:142. 34. Joseph Adams, Observations on Morbid Poisons, 2nd ed. (London, 1807), 211–13. 35. Dancer, Medical Assistant [1801], 221; Thomas Dancer, The Medical Assistant; or Jamaica Practice of Physic: Designed Chiefly for the Use of Families and Plantations, 3rd ed. (London, 1819), 190n; Dancer, Medical Assistant [1809], 230n. 36. Thomson, Treatise, 86. 37. Thomson, “Observations and Experiments,” 321–28; Thomson, “Remarks on Tropical Diseases,” 31–48; and Thomson, Treatise, 81–97. 38. Thomson, Treatise, 81, 86, 88–89, 92. See Edwards, History, 2:80–81. Winterbottom, who worked in Sierra Leone, repeated Edward’s passage but reported that inoculation was “unknown to the natives round Sierra Leone” (Account, 2:156). On African knowledge of inoculation, see Eugenia Herbert, “Smallpox Inoculation in Africa,” Journal of African History 16 (1975): 539–59; [Wright], Memoir, 411. 39. Thomson, Treatise, 86. 40. Ibid., 86–87. 41. Thomson reports using five subjects in Treatise, 87–88, and four in his “Observations and Experiments,” 324. 42. Thomson, “Observations and Experiments,” 325. 43. Ibid.; Thomson, Treatise, 85; Williamson, Medical and Miscellaneous Observations, 2:146. 44. Thomson, “Observations and Experiments,” 326; Thomson, Treatise, 93. 45. Thomson, “Remarks on Tropical Diseases,” 44. 46. Winterbottom, Account, 2:153; Thomson, Treatise, 89–90. Jean-Barthélemy Dazille held the view that yaws could be transmitted to animals but did not report experiments to support his view (Observations sur les maladies [1792], 1:246). Thomson, “Remarks on Tropical Diseases,” 31, 35. He also had William Wright’s manuscript in his possession. 47. [Hume], “Description,” 274. 48. Thomson dates these experiments in “On the Substitutes,” 27–31, esp. 29. See also Thomson, Treatise, 147, 153–54.

Notes to Chapter 4

49. Adair, Unanswerable Arguments, 114–15, 127, 141–43. See also Philip Curtin, Disease and Empire: The Health of European Troops in the Conquest of Africa (Cambridge: Cambridge University Press, 1998). Whether a soldier was allowed to choose was decided by commanding officers. Kopperman, “British Army,” 51–86, esp. 69. 50. Lind, Treatise on the Scurvy; Richard, Munier, [and] Sabbatier, “Épreuves d’un remède,” 37–56, esp. 39. 51. Limes were much used by Africans in Africa and the West Indies. See Sheridan, Doctors and Slaves, 76; Long, History of Jamaica, 2:381; Gillespie, “Observations,” reprinted in Leonard Gillespie, Observations on the Diseases Which Prevailed on Board a Part of His Majesty’s Squadron, on the Leeward Island Station (London, 1800), 221–39. 52. Williamson, Medical and Miscellaneous Observations, 2:165–67. 53. Thomas Houlston, “Some Experiments Made with a View to Ascertain the Duration of the Infectious Power of Variolous Matter,” London Medical Journal 7 (1786): 7–10, esp. 7–8. 54. Lydia Murdoch, “Carrying the Pox: The Use of Children and Ideals of Childhood in Early British and Imperial Campaigns against Smallpox,” Journal of Social History 48 (2015): 1–25. 55. Houlston, “Some Experiments,” 9. A few others recorded failed experiments. A French experiment attempted to inoculate animals with glanders by thrusting cotton impregnated with the virulent matter into the nose of a mule. But dissection of the animal proved that the experiment failed. Arthaud, Recherches, mémoires, 123–25. In 1813, an anonymous British physician wrote concerning failed experiments: “Being of the opinion, that the faithful publication of errors in the cure of diseases, are of no little importance to the improvement of the science of medicine, I make no apology for laying before your readers the following case of unsuccessful practice” (“On the Dangerous Effects of the Infusion of Tobacco Administered as a Glyster,” Edinburgh Medical and Surgical Journal 9 [1813]: 159–60). On publication bias, see Kay Dickersin and Yuan-I Min, “Publication Bias: The Problem That Won’t Go Away,” Annals of the New York Academy of Sciences 703 (1993): 135–48; Daniele Fanelli, “Negative Results Are Disappearing from Most Disciplines and Countries,” Scientometrics 90 (2012): 891–904. 56. Currie, Medical Reports, 1:iii, 35–36, 198–209, 216–20. 57. Ibid., 1:35–36. 58. Ibid., 1:225. 59. Ibid., 1:i–ii, v–vii. 60. The Nazis experimented with Dachau prisoners in freezing water, recording their reactions until they died, to understand the effects of hypothermia suffered by pilots downed at sea. See Paul Weindling, “The Nazi Medical Experiments,” in Emanuel, Oxford Textbook, 18–30. 61. [Monro], Letters and Essays, 2, 8. 62. For a fuller discussion, see Londa Schiebinger, “Medical Experimentation and Race in the Eighteenth-Century Atlantic World,” Social History of Medicine 26 (2013): 364–82. Todd Savitt has also addressed this point (“Use of Blacks,” 331–48, esp. 332). See also Stepan, Idea of Race in Science; Schiebinger, Nature’s Body; Meijer, Race and Aesthetics; Curran, Anatomy of Blackness; Malcolmson, Studies of Skin Color; “Observation sur

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l’usage du café appliqué extérieurement dans les maladies du genre nerveux,” Affiches américaines, July 20, 1772, 365–67. 63. Schiebinger, “Human Experimentation.” 64. H. Cook, “Practical Medicine”; Harrison, Medicine. 65. William Wagstaffe, A Letter to Dr. Freind; Shewing the Danger and Uncertainty of Inoculating the Smallpox (London, 1722), 4; Philippe Pinel, The Clinical Training of Doctors, ed. and trans. Dora Weiner (1793; repr., Baltimore: Johns Hopkins University Press, 1980), 78–79. See also Percival, Medical Ethics, 15–16; Dazille, Observations sur le tétanos, 23, 39; Arthaud, Dissertation et observations, 7. 66. Sloane, “Account of Inoculation,” 517. See details in Schiebinger, Plants and Empire, 166–67. 67. Home, Clinical Experiments, 411. 68. Ibid., 411–13, 420. For the use of electricity to “bring on the menses” and potentially induce abortion, see Bertucci, “Shocking Subjects,” 111–38, esp. 123. 69. Home, Clinical Experiments, 112–13. 70. Bernard, Introduction to the Study, 128. 71. Dazille, Observations sur les maladies [1776], 42–43. See also Bajon, Mémoires; Thomson, Treatise. CHAP TER 5

1. Dazille, Observations sur les maladies [1792], 1:2. 2. Great Britain, House of Commons, Report of the Lords, III, “Treatment of Slaves in the West Indies, and All Circumstances Relating Thereto, Digested under Certain Heads.” 3. The British considered the sorcery reported by Jean-Baptiste Labat in Martinique similar to Obeah in Jamaica; see Great Britain, House of Commons, Report of the Lords, III, Jamaica, Nos. 22–26. See Labat, Nouveau voyage, vol. 2, chap. 21, “Histoires de quelques nègres sorciers.” The literature on Obeah and vodou is vast. On Obeah, see Handler and Bilby, “Obeah”; Kelly Wisecup, Medical Encounters: Knowledge and Identity in Early American Literatures (Boston: University of Massachusetts Press, 2013), 138– 42; Danielle Boaz, “Instruments of Obeah: The Significance of Ritual Objects in the Jamaican Legal System, 1760 to the Present,” in Ogundiran and Saunders, Materialities of Ritual, 143–58; Paula Saunders, “Charms and Spiritual Practitioners: Negotiating Power Dynamics in an Enslaved African Community in Jamaica,” in Ogundiran and Saunders, Materialities of Ritual, 159–75. On vodou, see Alfred Métraux, Voodoo in Haiti, trans. Hugo Charteris (New York: Oxford University Press, 1959); Michel Laguerre, Voodoo Heritage (Beverly Hills, CA: Sage Publications, 1980), esp. 25–57; David Geggus, “Haitian Voodoo in the Eighteenth Century: Language, Culture, Resistance,” Jahrbuch für Geschichte von Staat, Wirtschaft, und Gesellschaft Lateinamerikas 28 (1991): 21–51; Brodwin, Medicine and Morality; Kate Ramsey, The Spirits and the Law: Vodou and Power in Haiti (Chicago: University of Chicago Press, 2011), 39–42. For Brazil, see Sweet, “Mistaken Identities?,” 279–306, esp. 293; Sweet, Domingos Álvares. 4. Jerome Handler and Kenneth Bilby, “On the Early Use and Origin of the Term ‘Obeah’ in Barbados and the Anglophone Caribbean,” Slavery and Abolition 22 (August 2001): 87–100. See also Vincent Brown, “Spiritual Terror and Sacred Authority in

Notes to Chapter 5

Jamaican Slave Society,” Slavery and Abolition 24 (April 2003): 24–53. Sharla Fett notes these traditions in the American South in her Working Cures, 41–42. 5. On abolitionism, see C. Brown, Moral Capital; Great Britain, House of Commons, Report of the Lords, III, reports from Jamaica, Barbados, Antigua, Grenada and Saint Christopher (Montserrat and Nevis did not return answers) in response to questions 22–26; Thomson, Treatise, 10. 6. Great Britain, House of Commons, Report of the Lords, III, Jamaica, Nos. 22–26. Bryan Edwards attributes this lengthy account of Obeah to Edward Long. The Report credits Stephen Fuller, agent of the islands, Long, and James Chisholme with authorship. Edwards reprints the whole of this testimony in his History, 2:106–19. See also Moseley’s exceptionally long treatment of “Obi” in Moseley, Treatise on Sugar, 190–205, esp. 194; Thomson, Treatise, 8–10. 7. Great Britain, House of Commons, Report of the Lords, III, Jamaica, Following No. 26, A, “The Paper Referred to in the Preceding Account.” Reprinted in Edwards, History, 2:114–17. Vincent Brown has made the interesting point that an analysis of slave trials for Jamaica from 1814 to 1818 revealed that Obeah practitioners were more often women than men but that men were found guilty more often than women (“Spiritual Terror,” 39–40). 8. Williamson, Medical and Miscellaneous Observation, 1:114–16. 9. Ibid., 1:139–40. 10. Great Britain, House of Commons, Report of the Lords, III, Antigua, Nos. 22–27. 11. Ibid., III, Grenada and Saint Christopher, Nos. 22–27. 12. See Jerome Handler, “Slave Medicine and Obeah in Barbados, ca. 1650 to 1834,” New West Indies 74 (2000): 57–90. See also Diana Paton and Maarit Forde, eds., Obeah and Other Powers (Durham, NC: Duke University Press, 2012). 13. Vaudou, vaudoux, sorcier, and sorcellerie do not appear in Poupée-Desportes, Bajon, Dazille, or Arthaud. Michel-Étienne Descourtilz included a short passage, but it does not relate to medicine (Voyage d’un naturaliste en Haiti, 1799–1803, ed. Jacques Boulenger [Paris: Plon, 1935], 115–19). Descourtilz also reported on a narcotic, the stramoine épineuse (known variously as the thorny apple, the poison apple of Guadeloupe, the herb of sorcerers), that he claimed was used by the makendals, or sorcerers of the colonies, as a drug of forgetfulness and sleep (Flore pittoresque, 3:99–100). On the relationship between vodou and Catholicism, see Sue Peabody, “‘A Dangerous Zeal’: Catholic Missions to Slaves in the French Antilles, 1636–1800,” French Historical Studies 25 (2002): 53–90. Médéric-Louis-Élie Moreau de Saint-Méry’s is the first mention of vaudoux (Description, 1:45–51). Alasdair Pettinger has made the important point that vodou is one of the few words in Kreyol that is “demonstrably” of African origin. Moreau de Saint-Méry rendered this in French as vaudoux (using it as a singular noun); Descourtilz wrote vaudoux (using it as a plural noun) (“From Vaudoux to Voodoo,” Forum for Modern Language Studies 40 [2004]: 415–25, esp. 415, 422). 14. Bajon, Mémoires, 1:363–65. Here Bajon opposed Charles-Nicolas-Sigisbert Sonnini de Manoncour and his talk of “supposed magicians” (“Observations sur les serpens de la Guianne, & sur l’efficacité de l’Eau de Luce pour en guiérir la morsure,” Journal de physique, de chimie, de’histoire naturelle et des artes 8, no. 2 [1776]: 469–76)—see also Conclusion below. See Bourgeois’s discussion in Voyages intéressans, 470. On Makandal,

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see Pierre Pluchon, Vaudou, sorciers, empoisonneurs de Saint-Domingue à Haïti (Paris: Karthala, 1987); Jill Casid, “‘His Master’s Obi’: Machine Magic, Colonial Violence, and Transculturation,” in  The Visual Culture Reader, ed. Nicholas Mirzoeff,  2nd ed. (New York: Routledge, 2002), 533–45; Weaver, Medical Revolutionaries, 89–97; McClellan and Regourd, Colonial Machine, 284–87. 15. Dazille, Observations générales, 204–6. 16. James Adair noted that clerics in Antigua charged a baptismal fee and, for that reason, were happy to baptize and rebaptize slaves (Unanswerable Arguments, 160). Edward Long claimed that slaves sought out baptism to protect themselves from Obeah (History of Jamaica, 2:416). Further, the British accused the French of baptizing slaves into Catholicism to attach them to the “interests of their masters,” cement the “union,” and produce “advantages to the French planter”; see Thomas Atwood, The History of the Island of Dominica (London, 1791), 259–60. On the power of “sympathy,” see John Gregory, Observations on the Duties and Offices of a Physician (London, 1770), 19. On the power of the mind over the body, see Thomas Percival, Medical Ethics (Manchester, 1803), 165–66. See also John Gregory, Lectures upon the Duties and Qualifications of a Physician (London, 1772), 34; Baker, Porter, and Porter, Codification of Medical Morality, vol. 1; Tom Beauchamp, “Worthington Hooker on Ethics in Clinical Medicine,” in Baker, Porter, and Porter, Codification of Medical Morality, 2:105–19, esp. 106–8. 17. Benjamin Rush, Medical Inquiries and Observations, 2nd ed., 4 vols. (Philadelphia, 1805), 1:394–95. On Mesmerism, see François Regourd, “Mesmerism in Saint Domingue: Occult Knowledge and Vodou on the Eve of the Haitian Revolution,” in Delbourgo and Dew, Science and Empire, 311–32; Robert Darnton, Mesmerism and the End of the Enlightenment in France (Cambridge, MA: Harvard University Press, 1968). On a good doctorpatient relationship as the antidote to Obeah, see Thomson, Treatise, 10. 18. Winthrop Jordan, White over Black: American Attitudes toward the Negro, 1550–1812 (Chapel Hill: University of North Carolina Press, 1968), 12, 242; Marie-Hélène Huet, Monstrous Imagination (Cambridge, MA: Harvard University Press, 1993). See also Daniel Turner, A Treatise of Diseases Incident to the Skin, 3rd ed. (London, 1726), 169–70, 173; Marc Bloch, Royal Touch: Sacred Monarchy and Scrofula in England and France (London: Routledge, 1973). For the commission’s report, see [Benjamin Franklin], Report of Dr. Benjamin Franklin, and Other Commissioners, Charged by the King of France, with the Examination of the Animal Magnetism, as Now Practiced at Paris (London, 1785), xvi–xvii. 19. Placebo is listed in George Motherby’s A New Medical Dictionary; or, General Repository of Physic, 2nd ed. (London, 1785), s.v. “placebo.” James Gregory used the term in its modern sense as an ineffective but harmless medicament or procedure used to comfort a patient until an effective cure could be found (Additional Memorial, 392). See also Herr, “Franklin, Lavoisier, and Mesmer,” 346–51; Shapiro and Shapiro, Powerful Placebo, 17, 19–20; F. Miller et al., Placebo, 1–9; Haygarth, Of the Imagination, 2–3; Benjamin Perkins, The Influence of Metallic Tractors on the Human Body (London, 1798). 20. Haygarth, Of the Imagination, 2–3. On Perkins’s tractors, see also James Delbourgo, A Most Amazing Scene of Wonders: Electricity and Enlightenment in Early America (Cambridge, MA: Harvard University Press, 2006), 239–77. 21. Haygarth, Of the Imagination, 4, 6–24, 28; J. P. Bull, “The Historical Development of Clinical Therapeutic Trials,” Journal of Chronic Diseases 10 (1959): 218–48, esp. 228.

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22. Smith cited in Haygarth, Of the Imagination, 10–11, 16, 29–30. 23. Great Britain, House of Commons, Report of the Lords, III, Nos. 22–26; Spooner in Saint Christopher and Granada; Adair in Antigua. 24. Williamson, Medical and Miscellaneous Observations, 1:97–98. 25. Moseley, Treatise on Sugar, 194; Thomson, Treatise, 9. 26. See Long’s account of Tacky’s Rebellion in History of Jamaica, 2:445–71. See also Great Britain, House of Commons, Report of the Lords (1789), III, Jamaica, following No. 26, C, paper delivered by Mr. Rheder, and “Obiah Trials,” reprinted in Edwards, History, 2:117–19. 27. Great Britain, House of Commons, Report of the Lords, III, Jamaica, following No. 26, C, paper delivered by Mr. Rheder, and “Obiah Trial,” reprinted in Edwards, History, 2:117–19. 28. Vincent Brown, lecture presented to the History Department, Stanford University, October 7, 2008. See also Brown, The Reaper’s Garden; Schiebinger, “Human Experimentation”; Hildebrandt, Versuch einer philosophischen Pharmakologie, 77–78; Francis Spilsbury, Advice to Those Who Are Afflicted with Venereal Disease (London, 1790), 38; James Gregory, Case of Euphemia McKay, from his Clinical Cases, 1785–1786, cited in Risse, New Medical Challenges, 297. 29. Moreau de Saint-Méry, Loix et constitutions, 4:229–31; Pluchon, Vaudou, 146. On Makandal, see Weaver, Medical Revolutionaries, 76–97. 30. An Act to Remedy the Evils Arising from Irregular Assemblies of Slaves, Jamaica 1760, in CO 139/21, National Archives, Kew, Richmond, Surrey. The fullest treatment of anti-Obeah legislation is Jerome Handler and Kenneth Bilby, Enacting Power: The Criminalization of Obeah in the Anglophone Caribbean, 1760–2011 (Kingston: University of the West Indies Press, 2012). See also Diana Paton, “Witchcraft, Poison, Law, and Atlantic Slavery,” William and Mary Quarterly 69 (2012): 235–64; Stephen Fuller, The Act of Assembly of the Island of Jamaica (London, 1788), 10, 20. 31. Great Britain, House of Commons, Report of the Lords, III, Jamaica, Appendix, “Abstract of the Jamaica Laws for the Government of the Negro Slaves,” 1760, Act 24, Section X, and 1781, Act 91; Jamaica, Barbados, Antigua, Grenada and Saint Christopher No. 26. See also Handler and Bilby, Enacting Power, 16. 32. Code de la Martinique (Saint-Pierre, 1767), 431–35; Moreau de Saint-Méry, Loix et constitutions, 3:492; 4:724; Arthaud, Observations sur les lois, 76–78. See also Pluchon, Histoire des médecins, 109–10. 33. Moseley, Treatise on Sugar, 194; Arthaud, Observations sur les lois, 76–77; Brodwin, Medicine and Morality, 31; Weaver, Medical Revolutionaries, 48–60. 34. [Bourgeois], Voyages interessans, 458, 470; George Pinckard, Notes on the West Indies, 3 vols. (London, 1806), 1:389; 2:62. 35. Thomson, Treatise, 147; Handler, “Slave Medicine and Obeah”; Sheridan, Doctors and Slaves, 89–96; Williamson, Medical and Miscellaneous Observations, 2:189; Adair, Unanswerable Arguments, 111–12, 251–52. 36. Julien Raimond, Observations sur l’origine et les progrès du préjugé des colons blancs contre les hommes de couleur (Paris, 1791), 8. 37. Ibid., vii, 1–7. 38. Ibid., 8; King, Blue Coat, 168; Peabody and Stovall, Color of Liberty; Dubois,

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Colony of Citizens; John Garrigus, Before Haiti: Race and Citizenship in French SaintDomingue (New York: Palgrave Macmillan, 2006). 39. Arthaud, Observations sur les lois, 76. 40. [ Jean-Baptiste Philippe], Free Mulatto, intro. Selwyn Cudjoe (1824; repr., Wellesley, MA: Calaloux, 1996), 114–17. See also Selwyn Cudjoe, Beyond Boundaries: The Intellectual Tradition of Trinidad and Tobago in the Nineteenth Century (Amherst: University of Massachusetts Press, 2003). 41. [Philippe], Free Mulatto, 114–17. 42. Ibid., 252–53. For the French islands, see Aubert, “‘Blood of France.’” 43. [Philippe], Free Mulatto, 253–54. 44. John Garrigus, “Opportunist or Patriot? Julien Raimond (1744–1801) and the Haitian Revolution,” Slavery and Abolition, 28, no. 1 (2007): 1–21, esp. 10; Selwyn Cudjoe, introduction to Free Mulatto, xiv–xv. 45. Great Britain, House of Commons, Report of the Lords, III, “Treatment of Slaves in the West Indies, and All Circumstances Relating Thereto, Digested under Certain Heads.” 46. Williamson, Medical and Miscellaneous Observations, 1:26; testimony of Chisholme, Anderson, and Quier in Great Britain, House of Commons, Report of the Lords of the Committee of Council, III, Jamaica Appendix, Nos. 6, 7, 8; Adair, Antigua, No. 11. 47. Great Britain, House of Commons, Report of the Lords, III, Antigua, No. 11. Despite attestations of his neutrality, Adair took a very clear stance in these debates. He expanded this testimony and published it as a book, Unanswerable Arguments, in 1790. Thomson writes on physicians’ knowledge of slave life in Treatise, 4. 48. Great Britain, House of Commons, Report of the Lords, III; see, e.g., Nos. 27 and 51. 49. Ibid., III, Jamaica, No. 37. On the plan to settle the West Indies with white farmers, see Philip Curtin, The Image of Africa: British Ideas and Action, 1780–1850 (Madison: University of Wisconsin Press, 1964), 85. On regimes of labor on British plantations, see Robert, Slavery and the Enlightenment. On Africans’ bodily durability as an argument for slavery, see Chaplin, Subject Matter, 123. 50. Great Britain, House of Commons, Report of the Lords, III, Jamaica, Grenada, and Saint Christopher, No. 39; Barbadoes [sic], Nos. 37 and 39; Jamaica, “pieces of evidence,” following appendix. 51. Ibid., III, Antigua, Nevis, No. 39. 52. Ibid., III, Grenada and Saint Christopher, No. 39. 53. Ibid., III, Montserrat, Nevis, No. 37. 54. Ibid., III, Jamaica, Nos. 37 and 38; Grenada and Saint Christopher, Antigua, No. 37. 55. Williamson, Medical and Miscellaneous Observations, 1:v, 26, 79; 2:215. 56. Ibid., 1:xvii, 135, 344–45; 2:219. 57. Ibid., 1:314–15; 2:215–16. 58. Ibid., 1:92–93, 178. 59. These latter are Quier’s words: Great Britain, House of Commons, Report of the Lords, III, Jamaica, Appendix, No. 8. 60. Williamson, Medical and Miscellaneous Observations, 1:135–36. According to Wright, not only slaves’ physical circumstances but also their culture and mores improved with transport from Africa to European Caribbean colonies. The Africans

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Wright knew, perhaps his own slaves, reported that in Africa they had lived as “savages,” with mechanically sharpened teeth, the better to enjoy “an inhuman banquet on the bodies of their captive foes.” Several nations, he continued, “have their teeth filed as sharp as those of dogs,” the better to “bite and devour their enemies.” [Wright], Memoir, 15–17, 88. See also Adair, Unanswerable Arguments, 119. 61. Williamson, Medical and Miscellaneous Observations, 1:382; Adair, Unanswerable Arguments, 113–14. 62. Williamson, Medical and Miscellaneous Observations, 1:64; Sheridan, Doctors and Slaves, 164–69; Dazille, Observations sur les maladies [1776 and 1792]. 63. Moseley, Treatise on Tropical Diseases, 105, 109–10; Adair, Unanswerable Arguments, 155; [Wright], Memoir, 419; Williamson, Medical and Miscellaneous Observations, 1:36. 64. Benjamin Moseley, A Treatise Concerning the Properties and Effects of Coffee, 4th ed. (London, 1789), iii–x. 65. Dazille, Observations générales, 24. This book includes a chapter on the “means to prevent the diseases of Negroes.” On Dazille, see Christiane Reusch, “Die medizinische Versorgung auf den französischen Westindischen Inseln im 18. Jhd. im Spiegel des Werkes von J. B. Dazille” (MD diss., Institut für Geschichte der Medizin, Universität Düsseldorf, 1982). 66. Dazille, Observations sur les maladies [1792], 1:4–5; Dazille, Observations générales. Dazille was part of the eighteenth-century public health movement; see James Riley, The Eighteenth-Century Campaign to Avoid Disease (New York: St. Martin’s Press, 1987). The historians Laurence Brockliss and Colin Jones have characterized a historical shift from the “great confinement” of the late seventeenth century, where “disease and impurity” were considered to reside in the poor, who were best “segregated in hospitals,” to the “great clean-up” of the eighteenth century, concerned with collective health and public movements to clean the environment (Medical World, 750–60, esp. 751). See also George Rosen, A History of Public Health (Baltimore: Johns Hopkins University Press, 1993), 107–67. Dazille’s work also participates in the vast literature on acclimatization (chapter 1, note 42, above). 67. Dazille, Observations sur les maladies [1776], x; [1792], 1:1–4. 68. Dazille, Observations sur les maladies [1792], 1:24–30. 69. Duchemin de l’Étang, Gazette de médecine, May 29, 1778. 70. Dazille, Observations générales, vii, 61; Dazille, Observations sur les maladies [1776], 25n8, 271; [1792], 1:415–21. 71. Dazille, Observations sur les maladies [1776], 274; [1792], 1:418. 72. Dazille, Observations générales, 4, 22–24. See Brockliss and Jones, Medical World, 756. Thomas Dancer in Jamaica similarly analyzed the waters of Bath (Dissertation). 73. Dazille, Observations générales, 84–117. On mineral waters, see also McClellan, Colonialism and Science, 142–43, 244; McClellan and Regourd, Colonial Machine, 268. 74. Joseph Gauché, “Des observations sur l’usage des eaux thermales de Boynes,” Mémoires du Cercle des Philadelphes 1 (1788): 116–45. 75. Moseley, Treatise on Tropical Diseases, 512; Lempriere, Practical Observations, 2:25; Williamson, Medical and Miscellaneous Observations, 1:33–34. 76. Slavery was abolished with Haitian independence in 1804 and in all of French territories in 1848.

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77. Great Britain, House of Commons, Report of the Lords, III, No. 15; for Antigua answered by Adair in No. 11. For shifting governmental positions on the value of population to states, see Cody, Birthing the Nation, 269–92. 78. Great Britain, House of Commons, Report of the Lords, III, No. 15, Jamaica, Appendix, Nos. 6–8, 11, and 15, Antigua. On abortion and abortifacients in the West Indies, see Schiebinger, Plants and Empire, 105–49. 79. Records from the Worthy Park plantation books are cited in Michael Craton and James Walvin, A Jamaican Plantation: The History of Worthy Park, 1670–1970 (Toronto: University of Toronto Press, 1970), 134. See also Marietta Morrissey, Slave Women in the New World: Gender Stratification in the Caribbean (Lawrence: University Press of Kansas, 1989); Bush, Slave Women; Gaspar and Hine, More Than Chattel; Geneviève Leti, Santé et société esclavagiste à la Martinique (Paris: Éditions L’Harmattan, 1998); Hilary McD. Beckles, Centering Woman: Gender Discourses in Caribbean Slave Society (Kingston: I. Randle, 1999); Bernard Moitt, Women and Slavery in the French Antilles, 1635–1848 (Bloomington: Indiana University Press, 2001); Morgan, Laboring Women; Lucille Mair, A Historical Study of Women in Jamaica: 1655–1844 (Kingston: University of the West Indies Press, 2006). 80. Hilliard d’Auberteuil, Considérations, 1:65; David Geggus, “The Slaves and Free People of Color of Cap Français,” in The Black Urban Atlantic in the Age of the Slave Trade, ed. Jorge Cañizares-Esguerra, Matt Childs, and James Sidbury (Philadelphia: University of Pennsylvania Press, 2013), 101–21, esp. 113. 81. Great Britain, House of Commons, Report of the Lords, III, No. 11, Antigua; Adair published his testimony verbatim along with elaborations and further reflections in his Unanswerable Arguments, 122–23, 124, 129–30, 150. 82. Great Britain, House of Commons, Report of the Lords, III, No. 11, Antigua. 83. Adair, Unanswerable Arguments, 121–23. 84. Ibid., 121, 125–27. On proposals to engineer race from Saint-Domingue, see William Max Nelson, “Making Men: Enlightenment Ideas of Racial Engineering,” American Historical Review 115 (2010): 1364–94. 85. Adair, Unanswerable Arguments, 126. 86. Banks, Chasing Empire; Schiebinger, Plants and Empire; Schiebinger and Swan, Colonial Botany; Raj, Relocating Modern Science, 224–25. CONCLUSION

1. For knowledge brokers, see Schaffer et al., Brokered World; Delbourgo and Dew, Science and Empire. See also McClellan and Regourd, Colonial Machine, 255–68; Koerner, Linnaeus; Sverker Sörlin, “Globalizing Linnaeus: Economic Botany and Travelling Disciples,” Tijdschrift voor Skandinavistiek 29 (2008): 117–43; Hanna Hodacs, Kenneth Nyberg, and Stéphane Van Damme, eds., A Global History of Linnaean Sciences in the Long Eighteenth Century (Oxford: Oxford University Press, forthcoming). 2. Reusch, “Die medizinische Versorgung.” 3. Dazille, Observations générales, 200–202. See also McClellan and Regourd, Colonial Machine, 255, 259–62. 4. Noël-Nicolas Mallet, “Mémoire sur le quinquina de la Martinique,” Mémoire de la séance publique de la Faculté de medicine, 1779 (Paris, 1780), 102–15, esp. 113; JeanBarthélemy Dazille, Observations générales sur les maladies des climates chauds (Paris,

Notes to Conclusion

1785), 200–202; Société royale de médecine, Paris, 191B, d31, pièce 3. See also McClellan and Regourd, Colonial Machine, 259–62, esp. 261. The testing of simarouba earlier in the century offers a similar example (chapter 2, above). Samples of this potential specific against dysentery were sent from Cayenne to Paris beginning in 1713. The small amounts received impeded experimentation. It was not until 1722, when the medical botanist Pierre Barrère returned to Cayenne, that large shipments could be secured. Antoine de Jussieu, who wrote up the report, concluded that the plant could be dangerous and was not the best cure for dysentery (“Recherches d’un specifique contre la dysenterie,” Mémoires de l’Académie royale [1729]: 32–40); Société royale de médecine, Paris, 191B, d31, pièce 9. 5. Jean-Barthélemy Dazille, Observations sur le tétanos (Paris, 1788), 417–19. Though controversial, Dazille’s books were ultimately approved by the Société royale de médecine (see, for example, 126, d13, pièce 28). 6. Ibid., 121–22, 430. 7. Cercle des Philadelphes, Tableau du Cercle des Philadelphes (Cap-François, 1787). 8. Arthaud, Dissertation et observations. See McClellan and Regourd, Colonial Machine, 263; Cercle des Philadelphes, “Extrait d’un prospectus & d’un programme,” Journal de médecine, chirurgie, pharmacie, etc. 69 (1786), 182–86; Cercle des Philadelphes, “Prix proposés par le Cercle des Philadelphes, à son assemblée publique du 20 juin 1786,” Journal de médecine, de chirurgie, et de pharmacie 69 (1786): 187–90; Cercle des Philadelphes, Dissertation sur le papier, dans laquelle on a rassemblé tous les essais qui ont été examinés par le Cercle des Philadelphes (Port-au-Prince, 1788). 9. Slaves who were erroneously blamed were often submitted to “criminal prosecution and heinous punishment.” Arthaud, Recherches, mémoires, 162, 123–45. See also Weaver, Medical Revolutionaries, 83–84. 10. Arthaud, Recherches, mémoires, 185–91. 11. Arthaud, Dissertations et observations, 48. 12. See, e.g., Schiebinger and Swan, Colonial Botany; H. Cook, Matters of Exchange; Harrison, Medicine. 13. Some Africans may have been highly trained healers enslaved through capture or military defeat; enslaving of doctors had been known since antiquity. Paul Carrick, Medical Ethics in the Ancient World (Washington, DC: Georgetown University Press, 2001), 13; Michel Laguerre, Afro-Caribbean Folk Medicine (South Hadley, MA: Bergin and Garvey, 1987), 16–20. 14. See Sheridan, Doctors and Slaves; McClellan, Colonialism and Science; McClellan and Regourd, Colonial Machine; Kiple, Caribbean Slave; Schiebinger, Plants and Empire; Weaver, Medical Revolutionaries. 15. Donald Monro, A Treatise on Medical and Pharmaceutical Chymistry, and the Materia Medica, 3 vols. (London, 1788), 3:234–35; Donald Monro, Observations on the Means of Preserving the Health of Soldiers, 2 vols. (London, 1780), 2:243. The slave may have been known as “Dr. Papaw” because this was knowledge of the “Papaw Negroes”; see Barham, Hortus Americanus, 19. 16. Monro, Treatise, 3:234–35; Richard Bradley, The Country Housewife (London, 1762), 321; Stephen Freeman, The Ladies’ Friend, and Family Physical Library (London, 1788), 465–69.

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17. On abortifacients, see Schiebinger, Plants and Empire. 18. Charles Arthaud, Recherches sur la constitution des naturels du pays (Cap-Français, 1786); Charles Arthaud, “Sur la conformation de la tête des Caraïbes & sur quelques usages bisarres attribués à des nations sauvages,” Observations et mémoires sur la physique, l’histoire naturelle et sur les arts et métiers 34 (1789): 250–55. 19. Jean-Marie-Esprit Amic, “Lettre de M. Amic è M. de La Métherie sur les têtes des Caraïbes,” Observations et mémoires sur la physique, l’histoire naturelle et sur les arts et métiers 39 (1791): 132–36, plates 1 and 2. The plate is reproduced in Schiebinger, Nature’s Body, 137. The Caribs on Saint Vincent waged numerous wars against the British in the second half of the eighteenth century to defend their claim to the island. 20. Proctor and Schiebinger, Agnotology. 21. Bajon, Mémoires, 1:361. 22. Bertrand Bajon, “Observation sur une morsure de serpent, guérie par l’usage de l’alkali volatile,” Journal de médecine, chirurgie, pharmacie, etc. 33 (1770): 146–48; Alexander von Humboldt, Personal Narrative of Travels to the Equinoctial Regions of America, during the Years 1799–1804, trans. Thomasina Ross, 3 vols. (London, 1852), 2:447. 23. Bajon, “Observation sur une morsure.” 24. Bajon, Mémoires, 1:357–60, 362–63. 25. Ibid., 1:360. 26. Ibid., 1:196–97. 27. Ibid., 1:193–98. On the point of slavery secrecy, see also Hillary, Observations, 341, 347–52. On Graman Quassi, see Schiebinger, Plants and Empire, 211–14. Others were set free in exchange for a remedy; see Laguerre, Afro-Caribbean Folk Medicine, 29–30. Other “Negroes” sold secrets, apparently for large sums of money. Edward Milward reported such a case in “A Letter from Edward Milward, M.D., to Martin Folkes, Esq: President of the Royal Society, Concerning an Antidote to the Indian Poison in the West-Indies,” Philosophical Transactions 42 (1742): 2–10. Another emancipation for a cure was reported in the South-Carolina Gazette 24–31 (1733): 3. I thank Steve Behrendt for this reference. 28. Sonnini de Manoncour, “Observations sur les serpens,” 469–76. Jorge CañizaresEsguerra has provided an excellent analysis of differing scientific and political attitudes held by European Creoles in New Spain versus Europeans (How to Write the History of the New World: Histories, Epistemologies, and Identities in the Eighteenth-Century Atlantic World [Stanford, CA: Stanford University Press, 2001]). James Delbourgo has made the important point that some American Creoles of European origins, such as John Mitchell in Virginia, were imperialists—their interests were closely allied with empire (“Newtonian Slave Body,” 185–207). 29. Sonnini de Manoncour, “Observations sur les serpens,” 472–73; Bajon, Mémoires, 1:365–66, 368. 30. James Thomson, Treatise, 89, 91. 31. Ibid., 83. In his European publication Thomson referred twice to “Guinea-corn yaws” and attributed the term to Africans, but he did not produce the full set of their distinctions (“Remarks on Tropical Diseases,” 31–48, esp. 34). 32. Compare Thomson, Treatise, 84, and Thomson, “Remarks on Tropical Diseases,” 35. 33. Thomson, Treatise, 84, 86: “I have directed an expert Negro to secure the bleeding vessels” of a woman who caught yaws from suckling an infant.

Notes to Conclusion

34. Thomson, Treatise, 86. Interestingly, both John Quier in Jamaica and a Dr. Watson in Britain had conducted experiments to answer this question for smallpox. Watson, after “obtaining permission of the parents,” inoculated a “girl” and found that, although her brother who had been inoculated at the same time with the same variolous matter went through the smallpox, she was immune. John Quier did a similar trial with a “Negro girl” in Jamaica. Quier generally inoculated infants born to mothers who had suffered smallpox while pregnant, but he reported one case of an infant girl who had developed her immunity to smallpox while in the womb. [Monro], Letters and Essays, 102–4. See also John Hunter (1728–93), “Account of a Woman Who Had the Small Pox during Pregnancy,” Philosophical Transactions of the Royal Society of London 70 (1780): 128–42, esp. 138; the 1819 and 1822 articles are Thomson, “Observations and Experiments,” 321–28, esp. 325, and Thomson, “Remarks on Tropical Diseases,” 31–48, esp. 36. 35. John Hunter (1728–93), “Account of a Woman,” 136–37. William Wright sent a letter to Hunter in response to his report adding a case of his own from his Jamaica practice (Memoir, 340–41). 36. On Adams, for example, compare Thomson, Treatise, 83, 88, and Thomson, “Remarks on Tropical Diseases,” 32, 36. 37. Thomson, Treatise, 91–92, 94.

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IMAGE CREDITS

Figures 1, 2, 3, 13, 19, 20, 21, 22, Appendix. Copyright Londa Schiebinger and Erik Steiner. Figure 4. French Archives nationales d’outremer, Carte F 3 296D, n0 8. With kind permission. Figure 5. Description topographique, physique, civile, politique et historique de la partie française de l’isle Saint-Domingue, 2 vols. (Philadelphia, 1797–1798), 1:71. By courtesy of the Biodiversity Heritage Library. Figure 6. By courtesy of the Wellcome Library, London, L0012323. Figure 7. Colin Chisholm, An Essay on the Malignant Pestilential Fever, 2 vols. (London, 1801), 2:468. By courtesy of the Stanford Medical History Center. Figure 8. Colin Chisholm, An Essay on the Malignant Pestilential Fever, 2 vols. (London, 1801), 2:468–472. Figure 9. James Thomson, “Observations and Experiments on the Nature of the Morbid Poison called Yaws, with coloured Engraving of the Eruption,” The Edinburgh Medical and Surgical Journal, vol. 15 (1819): color insert between page 328 and 329. By courtesy of the Stanford Medical History Center. Figure 10. Image created from Jean-Baptiste Pouppé-Desportes’s “Catalogue des plantes de S. Domingue, avec leurs noms tant François, Caraïbes que Latins, & leurs propriétiés & usages,” in Histoire des maladies de S. Domingue, 3 vols. (Paris, 1770), 3:181–183; 186–187. By courtesy of the Biodiversity Heritage Library. Figure 11. From Jean-Baptiste-Christophe Fusée-Aublet, Histoire des plantes de la Guiane françoise, rangées suivant la méthode sexuelle, 4 vols. (London, 1775), vol. 4, plate 307. By courtesy of the Biodiversity Heritage Library. Figure 12. Copyright Erik Steiner. Figure 14. Memoir of the Late William Wright, M.D. (Edinburgh, 1828), frontispiece. By courtesy of the Biodiversity Heritage Library. Figure 15. Image courtesy of Cambridgeshire Archives, Tharp papers, doc. ref.  R55/7/121/16. Figure 16. By courtesy of the Wellcome Library, London, L0057752. 223

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Figure 17. Saint-Domingue, ou Histoire de ses révolution; contenant Le récit effroyable des divisions, des troubles, des ravages, des meurtres, des incendies, des dévastations et des massacres qui eurent lieu dans cette île, depuis 1789 jusqu’à la perte de la colonie (Paris, 1820), facing title page. Courtesy of the John Carter Brown Library at Brown University. Figure 18. By courtesy of the Wellcome Library, London, L0010940.

INDEX

abortion, 114, 143, 144 Académie Française, 26 Adair, James: on baptism of slaves, 194n16; on breeding of slaves, 144, 145; on care of slaves, 137, 144; on freeing slaves, 138; on Obeah, 121, 128; as plantation owner, 75, 107; on slave nurses, 75, 77, 130; on slavery, 107, 133 Adams, Joseph: Observation on Morbid Poisons, 102, 162; on yaws inoculation, 102, 162; on yaws latent period, 103 adrue, 106, 162 African Americans, 90; attitudes regarding clinical trials, 6–7; Tuskegee Syphilis Study, 6, 65, 72, 88 African Creoles, 9, 17, 37, 39, 41, 55, 144 agnotology, 14, 146, 147, 157, 158–64 Albinus, Bernhard, 30, 32 Alby, Antoine-Raymond-Jean-GualbertGabriel de Sartine, comte d’, 78 Alexander, Alexander J.: experiment with cure for ulcers, 51; experiment with cure for yaws, 1, 9–10, 50–51, 55, 56, 59, 61, 62, 63–64, 91, 99, 103, 153, 155, 157, 162; as plantation owner, 55, 148; relationship with Black, 50, 56, 87, 148, 149; relationship with “Negro Dr”, 1, 14, 45, 50–51, 55, 62, 63, 64, 107, 153, 157, 167; vs. Thomson, 64, 103 amenorrhea, 113–14, 127 American Medical Association (AMA) code of ethics, 89, 188n70 American Philosophical Society, 22

Amerindians, 126, 129, 146; Amerindian conquest nexus, 13, 14, 147, 156–58, 164; contributions to colonial medicine, 1, 5, 13, 14, 15–16, 24, 43, 46–47, 48, 49, 51, 57–60, 63–64, 83, 108, 147, 155, 156–58, 157, 164, 183n49; experiments with, 43; extermination of, 156, 158, 165, 183n49; mortality among, 25; secrecy among, 159–60. See also Arawaks; Caribs; Galibis; Taínos Amic, Jean-Marie-Esprit, 157, 164 Anderson, Alexander: on yaws, 52 animal experimentation, 79, 81, 105, 112, 160, 191n55 Antigua, 37, 119, 134–35, 145, 189n4, 194n16; physicians in, 22, 72, 75, 77, 107, 121, 128, 133, 143, 144 apothecaries, 70, 142 Arawaks, 1, 15, 46 arrowroot (Maranta arundinaceae, L.), 46 Arthaud, Charles, 129, 131, 151, 152, 156, 157 assimilation/acclimatization, 35, 36–41, 42 Aubert, Guillaume, 25 Bacolet plantation, 55, 63, 157, 165 Badier, Barthélemy de, 150 Bajon, Bertrand, 22, 115, 122, 152, 157, 164, 167; on Amerindian remedies, 15–16, 59; on care of slaves, 54, 78; on cold bathing, 85; on experimental empiricism, 21, 160; experiments with animals, 79, 81, 105, 112, 162; experiments with eau de luce, 148–49, 159–60, 161; 225

226

Index

experiments with manioc poisoning, 79, 81; experiment with fig trees, 48; on slaves and wealth, 78–79 Baker, Robert, 6, 17, 89 Bancroft, Edward, 52–53 Barbados, 46, 100, 119, 121, 128, 129–30, 134 Barbot, Jean, 62 Barham, Henry, 101 Barrère, Pierre, 46, 85, 199n4; Dissertation sur la cause physique de la couleur des nègres, 30 Behrendt, Steve, 200n27 Bell, Benjamin, 80 Belmont Report, 6, 65–66 Bernard, Claude, 20, 69–70, 115 Bernier, François, 24 Bilby, Kenneth, 119, 121–22, 128 Black, Joseph, 50, 56, 62, 87, 148, 149 Blumenbach, Johann: on race, 24; on skin color, 30, 31, 177n31 Boerhaave, Hermann, 19, 36 bois fer/bois de fer, 45, 50–64, 148, 155, 156 bois royale, 45, 50–51, 55 Bordeaux: Académie royale des sciences, 30, 42 Bourgeois, Nicolas-Louis, 61, 85, 122, 129, 153, 183n49 Boylston, Zabdiel, 43, 179n61 Braithwaithe, John, 134 breast cancer, 79 Breton, Raymond: Dictionnaire caraïbefrançais, 57–58 British Guiana, 8, 38 British West Indies: vs. French West Indies, 3, 7, 14, 15, 21, 22, 23, 35, 37, 42, 62–63, 75, 77, 78, 81, 85, 87, 88, 90, 93, 117, 119, 122, 128–29, 131, 139, 148, 149–50, 155, 157–58, 164, 167, 192n3; vs. US South, 72, 88, 90, 142. See also Antigua; Grenada; Jamaica; Montserrat; Nevis; Obeah; Saint Christopher Brockliss, Laurence, 19, 20, 174n1, 197n66 Brodwin, Paul, 45, 47 Brown, Christopher, 188n66 Brown, Vincent, 127, 193n7

Browne, Patrick, 101 Brun (dean of surgeons in SaintDomingue), 112 Buffon, Georges-Louis Leclerc, comte de, 24 Camper, Petrus, 32, 33, 112 Cañizares-Esguerra, Jorge, 25, 200n28 capsium peppers, 100 Cárdenas, Juan de, 25 Caribs, 15, 51, 200n19; contributions to colonial medicine, 24, 43, 46, 57–59, 63, 156, 157, 183n49; language of, 51, 181n21; and Pouppé-Desportes, 57–59, 63, 156, 157 Carney, Judith, 16, 17, 45, 46, 62 cassava root, 79, 108 Cayenne, 3, 199n4; physicians in, 16, 21, 22, 30, 46, 48, 54, 78, 79, 85, 148, 149, 159–60, 167 Chaplin, Joyce, 24–25 charity patients: experimentation on, 6, 68, 71, 112, 114, 150 Chisholm, Colin, 149, 167; experiments regarding temperature, 8, 9, 34, 35–41, 43, 91, 111, 148; as plantation owner, 38, 40; and race, 8, 9, 35, 37, 40, 43, 91, 115; vs. Thomson, 35, 43; on West Indian fever epidemic, 37 Chisholme, James, 34, 133, 134, 135 cinchona, 47, 150 circulation of knowledge, 1, 3, 9, 45–64, 145–46; African slave trade nexus, 13, 14, 147, 153–56, 158, 159, 164–65; Amerindian conquest nexus, 13, 14, 147, 156–58, 164; and bois fer, 50–64; European colonial nexus, 13, 14, 147–53, 159, 164; impediments to, 14, 146, 147, 157, 158–64, 165; role of knowledge brokers in, 13, 64, 149 class distinctions, 66–67, 68, 71, 96–97, 112 Code noir, 87 cold bathing, 10, 72, 81–86, 87, 98, 110–11, 183n53 colonial physicians: in Antigua, 22, 72, 75,

Index

77, 107, 121, 128, 133, 143, 144; attitudes regarding slavery, 7, 28, 107, 136–39; in British vs. French West Indies, 77–78; in Cayenne, 16, 21, 22, 30, 46, 48, 54, 78, 79, 85, 148, 149, 159–60, 167; duties of, 13, 22, 28, 99, 101, 115, 117, 133, 139; fees for, 55, 74; in Grenada, 35, 50, 55, 59, 91, 99, 107, 121, 148, 153, 155–56, 157, 167; in Jamaica, 1, 3, 4–5, 8, 10, 11, 21, 22, 23, 24, 28, 30, 32, 34, 43, 46, 49, 52, 54, 56, 62, 66, 72, 73, 74, 75, 77, 80, 81, 82, 85, 92, 98–99, 100–102, 104, 109, 119, 120, 123, 133, 134, 135, 136–37, 138–39, 142, 143, 149, 151, 162, 164, 167, 189n22, 197n72, 201n34; as plantation owners, 13, 22, 36, 38, 40, 55, 73, 75, 77, 82, 95, 117, 133; reputation of, 72; in Saint Christopher, 28, 75, 121, 167; in SaintDomingue, 3, 11, 21, 22, 23, 33, 42, 46, 57, 59, 75, 77, 78, 84, 85, 93, 112, 127–28, 139, 141, 150–51, 152, 156, 164, 167, 176n24; self-experimentation by, 6, 10, 41–42, 48, 79–82, 84, 85, 86, 91, 100, 106, 110, 141; sense of humanity among, 13, 42, 72–73, 78, 160; training of, 9, 23, 24, 30, 32, 36, 41, 48, 50, 72, 73, 74, 78, 80, 101, 110, 113, 115, 130, 148, 162, 164, 176n22 Craton, Michael, 98 Currie, James, 36; experiments with cold bathing, 85–86, 110–11; on perspiration among Europeans, 34–35 Curtin, Philip: on plantation complex, 3, 17 Dancer, Thomas, 115, 167, 197n72; on cold bathing, 85, 183n53; experiments with yaws inoculation, 102; Medical Assistant, 102; on nurses with yaws, 54; on tropical diseases, 4–5; on yaws cures, 62, 63 Davis, Natalie Zemon, 15 Dazille, Jean-Barthélemy, 33, 113, 149–50, 164, 167, 199n5; antidote to pernicious manioc, 122–23; on care of slaves, 11–12, 75, 138, 139–40, 141, 144, 151; on

care of soldiers and sailors, 140–41; on colonial hospitals, 75, 150–51; on experimental empiricism, 21, 151; experiments with water, 11, 141–42, 150; on human temperature, 41; on manioc antidote, 122–23; Observations sur les maladies des nègres, 12, 78, 115, 139, 142, 182n29; on slavery and wealth, 78–79, 117; on taffia, 141; on tetanus and Société royale de médicine, 151; on yaws, 182n29, 190n46 de Haen, Anton, 36, 179n56 de la Planche, Laurent-Charles, 150 Delbourgo, James, 200n28 Demerara, 8, 38, 39, 40, 148, 167 Descemet, Jean, 150 Descourtilz, Michel, 59, 63, 193n13 digitalis, 68 Dimsdale, Thomas, 65, 82, 95 dissection and autopsy, 6, 21, 67, 68, 112; of slaves, 7, 8, 30, 31, 33, 34, 88, 140, 152, 178n32; by Thomson, 8, 31, 33, 34 Dissertation et observations sur le tétanos, 78, 151–52 Dominica, 46, 158 dropsy, 68 dry bellyache, 47–48 Dutch Guiana, 52 dysentery, 5, 34, 46, 140, 141, 142, 199n4 eau de luce, 148–49, 159–60, 161 Edinburgh, 19, 52, 62, 86, 100, 113, 149, 155, 174n1; colonial physicians trained in, 9, 30, 32, 41, 50, 73, 80, 101, 110, 148, 162, 176n22; Royal College of Physicians, 10, 87, 94, 107; Royal Infirmary, 66, 67, 70, 188n62; Royal Society, 73; University of Edinburgh, 4, 32, 50, 67, 149 Edinburgh Medical and Surgical Journal, 105, 162–63 Edwards, Bryan, 103, 176n24, 190n38, 193n6 electricity, 117, 124–25, 127 Europe: charitable hospitals in, 66, 75, 186n29; clinical medicine in, 19–20,

227

Index

228

167, 174n1; European colonial nexus, 13, 14, 147–53, 159, 164; teaching hospitals in, 19, 66–67, 68, 75; vs. West Indies, 11, 21–22, 23, 24, 33, 69, 72, 75, 77, 79, 83, 87, 90, 92, 94, 95–97, 109–11, 115 European Creoles, 148, 161, 189n4, 200n28 experimental practices, 3, 165; control groups, 9; cure verification, 69; empiricism in, 21; ethical principles in, 65–66, 69–70, 71–75, 105–6, 117; in Europe, 4, 9, 15, 16, 20, 43, 49–50, 66–71, 77; and experimental infrastucture, 22, 50; exploitative vs. nonexploitative, 7–8, 9–11, 15, 64, 72, 86–87, 88, 90, 91–92, 110; invasive vs. noninvasive, 8, 9, 81; reports/records of experiments, 6, 11, 20, 21, 22, 23, 24, 50, 73, 77, 80–81, 82–83, 84, 85, 87, 89, 91, 94, 95, 96–97, 101, 104, 105, 110, 114, 125, 147–49, 154, 155, 162–63; therapeutic vs. nontherapeutic, 8, 9, 10, 20. See also hospital patients; orphans; poor, the; prisoners; self-experimentation by physicians; slaves; soldiers and sailors Fahrenheit, Daniel, 36, 43 Falconer, William, 38, 125, 179n51 fevers, 35, 81–82, 84, 85–86, 134, 141 foxglove, 68 Franklin, Benjamin, 151 Fraser, Thomas, 22, 72 free people of color, 101, 106–7, 129; in British West Indies, 131–33, 135–36, 137–38; in French West Indies, 117, 130–31; vs. slaves, 7, 135–36, 137–38 French Guiana, 59, 122, 149, 157, 161. See also Cayenne French West Indies: vs. British West Indies, 3, 7, 14, 15, 21, 22, 23, 35, 37, 42, 62–63, 75, 77, 78, 81, 85, 87, 88, 90, 93, 117, 119, 122, 128–29, 131, 139, 148, 149–50, 155, 157–58, 164, 167, 192n3; chief royal medical officers in, 77–78; free people of color in, 117, 130–31; medical regulation in, 77–78; slave

life expectancy in, 143; slave practice of medicine outlawed in, 12–13, 117, 122, 129, 130; vs. US South, 88. See also French Guiana; Guadeloupe; Martinique; Saint-Domingue Fuller, Stephen, 134, 135 Fusée-Aublet, Jean-Baptiste-Christophe, 63, 157; Histoire des plantes de la Guiane françoise, suivant la méthode sexuelle, 59 Galenic medicine, 56, 113 Galibis, 1, 15, 46, 51, 59, 63, 157 Gauché, Joseph, 142, 152 Gazette de médecine pour les colonies, 22, 42, 140 Gillespie, Leonard, 10, 73, 91, 92, 107–8, 149 Gisborne, Thomas: on ethical standards, 67 glanders, 152, 191n55 Gómez, Pablo, 15 gonorrhea, 4, 57, 80, 84 Grainger, James, 46, 162, 167; on acclimatization, 42; on Africans, 28–29, 42; on care of slaves, 42; on prizes for discoveries, 42–43; on sick houses, 75; Treatise on the Disorders of the WestIndies, 101 Gregory, James: Additional Memorial, 87; on autopsies, 33; on clinical medicine, 19, 70–71, 86, 184n10; on ethics and medical institutions, 67, 86; on experiments with electricity, 127; Lectures on the Duties and Qualifications of a Physician, 123; Memorial to the Managers of the Royal Infirmary, 87; on observation vs. experiment, 20; on placebo effect, 194n19; as president of Royal College of Physicians, 87; on self-experimentation, 86, 91; on sympathy, 123 Gregory, John, 9, 33, 67, 87 Grenada, 1, 3, 37, 128, 134, 135; Bacolet plantation, 55, 63, 157, 165; physicians in, 35, 50, 55, 59, 91, 99, 107, 121, 148, 153, 155–56, 157, 167

Index

Guadeloupe, 3, 59, 128–29, 142, 150, 151, 157, 164 Guerre, Martin, 15 Guinea (West Africa), 28, 54, 82–83, 134 Guinea rush, 106, 162 Guinea worms, 49, 142 Haller, Albrecht von, 80 Handler, Jerome, 119, 121–22, 128 Harrison, Mark, 17, 21, 35 Haygarth, John: experiments with Perkins’ tractors, 12, 124–25; on medical faith, 125, 126; Of the Imagination. . . , 124 Heney, Thomas, 167; experiments with Zanthoxylum, 47–48, 100 Hillard d’Auberteuil, Michel-René, 143 Hillary, William, 100 Hippocrates, 35, 65, 71, 113, 185n18 Home, Francis: Clinical Experiments, 4; on ethical standards, 67–68; on experimentation, 4, 19, 20, 21, 184n8; experiments to induce menstruation, 113–14; experiments with tuberculosis cures, 114; on hospitals, 19–20, 67 hospital patients, 19–20, 70–71, 77, 85–86, 90; experimentation on charity patients, 6, 68, 71, 112, 114, 150 hot baths, 48–49 Houlston, Thomas, 109, 110 Hughes, Rev. Griffith, 101 Humboldt, Alexander von, 26, 159 Hume, John: on yaws, 52, 56, 105, 182n27 Hunter, John (1728–93), 4, 111, 163 Hunter, John (1754–1809), 21, 30 Hutchinson, William, 119, 128, 134–35, 143 Île Bourbon, 140, 149, 151 Île de France, 140, 149, 151 informed consent, 8, 65–66, 91 insect-resistant paper, 152 interchangeability of bodies: as assumed by experimentalists, 6, 96–98, 112–15, 118, 137; and race, 2, 11, 112, 115, 118, 133–35, 145; and sex, 2, 92, 113–14; and social class, 11

ipecacuanha, 47, 108, 115 jalap, 47, 115 Jamaica: Amerindians exterminated on, 156, 183n49; Assembly, 87, 128; coffee cultivation in, 139; College of Physicians and Surgeons, 23, 101; Consolidated Code Noir, 87–88; economic conditions, 3; Good Hope hospital, 75, 76; Kingston, 155; Naval Hospital, 56; Obeah in, 12, 117, 127–28, 161, 192n3, 193n7; parish of Saint James, 82; physicians in, 1, 3, 4–5, 8, 10, 11, 21, 22, 23, 24, 28, 30, 32, 34, 43, 46, 49, 52, 54, 56, 62, 66, 72, 73, 74, 75, 77, 80, 81, 82, 85, 92, 98–99, 100–102, 104, 109, 119, 120, 123, 133, 134, 135, 136–37, 138–39, 142, 143, 149, 151, 162, 164, 167, 189n22, 197n72, 201n34; prices of slaves in, 37; slave mortality in, 29, 99–100, 127; slave prices in, 37; smallpox epidemic of 1768, 10, 82, 92, 98; Tacky’s Rebellion, 12, 127, 128 Jamaica Physical Journal, 23 Jenner, Edward, 4, 93, 109 Johnson, Samuel: dictionary of, 26 Jones, Colin, 19, 20, 174n1, 197n66 Journal de médicine, chirurgie , pharmacie, etc., 43, 152, 160 Journal de physique, 102 Kali’na, 1, 46 Kenny, Stephen, 88 Kerby, Thomas: experiment with climate, 145 Kingston Medical Society, 22–23 knowledge brokers, 13, 64, 149 Labat, Jean-Baptiste, 62, 192n3 La Condamine, Charles-Marie de: on smallpox inoculation, 93–94 Lafosse, J. F., 33 lancets, 93 language differences, 29, 45, 97, 105, 162, 164, 177n26

229

230

Index

Le Masson Le Golft, Marie, 151 Lempriere, William, 29, 34, 142 limes, 75, 100, 107–8, 191n51 limpieza de sangre (purity of blood), 26, 132 Lind, James: experiments regarding scurvy, 4, 107; on place and health, 38 Linnaeus, Carolus, 24, 38, 149 Liverpool Infirmary, 34, 85–86, 109, 110 London, 66, 148, 155; College of Physicians, 52, 93, 94, 132, 149; College of Surgeons, 132; Institute of Perkinism, 125; Medical Society, 73, 82, 85, 87; Medical Transactions, 94; Newgate Prison experiments, 4, 11, 93, 113; Royal Society, 35, 73, 94; Smallpox Hospital, 102 Long, Edward, 134, 135, 194n16 Louisiana (French colony), 151 Macgrudan (physician), 74, 102 Maehle, Andreas-Holger, 4 Makandal, François, 122, 127 Mallet, Noël-Nicolas, 150 Malpighi, Marcello, 29 Malthus, Thomas, 78; Essay on Population, 142 manioc, 79, 81, 122–23, 140 Maroon Negroes, 82–83, 127, 139 Martinique, 3, 43, 54, 85, 128, 150, 151, 192n3 Mazzolini, Renato, 30 McClellan, James, III, 17, 149, 150; Colonial Machine, 77 McCullough, Laurence, 87 Medical and Philosophical Commentaries, 50, 62, 87, 148 Medical Essays and Observations, 52 mercantilism, 78 mercury, 50, 57, 62, 74, 95, 96, 97, 115; in venereal disease treatment, 98, 99, 155; in yaws treatment, 62, 100, 164 Mesmer, Franz, 121, 123, 124 midwives, 75, 84, 129, 130, 163 military and naval hospitals, 20–21, 67, 69, 85, 92, 107 Mitchell, John, 30, 43, 85, 200n28

Monro, Alexander, 94 Monro, Donald, 156; Essays and Letters by Different West Indian Practitioners, 105, 106–7; relationship with Quier, 11, 94, 96–97, 137, 149, 189n8 Montpellier, 148, 174n1 Montserrat, 128, 135, 193n5 Moreau de Saint-Méry, Médéric-LouisÉlie: Description topographique, physique, politique et historique..., 122; on race and skin color, 26, 27; on vaudoux, 122, 193n13 Moseley, Benjamin, 102, 162, 167; on coffee cultivation, 139; on dysentery, 5; on medicine in Jamaica, 24; on Obeah, 119, 127, 129; on skin color, 30; on slavery, 138; Treatise on Tropical Diseases, 5; on yaws, 52, 54 Murdoch, Lydia, 110 Nazi hypothermia experiments, 111, 191n60 nègre pièce d’Inde, un, 79, 186n36 “Negro Dr”: relationship with Alexander, 1, 14, 45, 50–51, 55, 62, 63, 64, 107, 153, 157, 167; use of bois fer in treating yaws, 45, 50–64, 148, 155, 156 Nembhard, John, 102 Neufchâteau, François de, 152 Nevis, 128, 135, 167, 193n5 Newgate Prison experiments, 4, 11, 93, 113 New York Academy of Medicine, 89 Nicolson, Jean, 58 Obeah, 118–23, 126–30, 133, 145, 153, 193n6, 194n16; Adair on, 121, 128; in Jamaica, 12, 117, 127–28, 161, 192n3, 193n7; Moseley on, 119, 127, 129; Thomson on, 77, 119–20, 123; vs. vodou, 117, 119, 122, 192n3; Williamson on, 120–21, 126 opium, 69, 80, 89, 108 orphans, 6, 68, 70, 71, 90, 112 Paris, 148, 155, 199n4; Hôtel Royal des Invalides, 107, 174n1; Royal Commis-

Index

sion, 124; Société royale de médicine, 149, 150, 151, 152, 199n5 Percival, Thomas: Medical Ethics, 87, 99, 123; on medical ethics, 67–68, 70, 123; on the poor, 70; on public good, 70 Perkins, Elisha: metallic tractors of, 12, 124–26 Peruvian bark, 81, 150 Petit, Antoine, 149, 150 Peyré, Joseph, 150 Philippe, Jean-Baptiste, 131–32 Pinckard, George, 130 Pinel, Philippe, 113 place: assimilation/acclimatization to, 35, 36–41, 42; and human nature, 9; origin of slaves, 28–29, 37, 38, 40, 55, 176n24; vs. race, 35; relationship to health, 35; relationship to temperature, 35–38 placebo effect, 4, 12, 123–26, 161, 194n19 plantation complex: Curtin on, 3, 17; physicians as plantation owners, 13, 22, 36, 38, 40, 55, 73, 75, 77, 82, 95, 117, 133; plantation hospitals, 21, 46, 49, 75–77, 129–30; relations between plantation owners and physicians, 7, 11, 13–14, 21–22, 28, 51, 54, 72, 74–75, 88, 90, 91, 94, 95, 105–6, 117, 145, 149; relations between plantation owners and slaves, 1, 5, 11, 28–29, 45, 50, 54, 71–72, 74–75, 86, 87–88, 89–90, 91, 93–94, 99–100, 105, 117, 120, 127, 129, 130, 136–37, 139, 140, 144, 154, 158; relations between plantation physicians and slaves, 7, 28, 49–50, 62, 64, 71, 72, 77, 91, 115, 133, 155; slaves as source of wealth in, 7, 43, 78–79, 115, 117. See also British West Indies; circulation of knowledge; French West Indies; slaves; slave trade Pluchon, Pierre, 17, 78 poisons, 117, 121, 122, 126, 128–29 poor, the: experimentation on, 8, 19, 66, 68, 69, 71, 90, 91, 92, 109–11, 112, 134; poor children, 109–10

Pouppé-Desportes, Jean-Baptiste-René, 22, 33, 167; on bois de fer, 57, 58–59, 63; and Caribs, 57–59, 63, 156, 157; Histoire des maladies de S. Domingue, 46; on self-experimentation, 84; on slaves’ place of origin, 176n24 Prichard, James, 30–31 prickly yellow wood, 47–48, 100 principle of beneficence, 66 principle of justice, 69–70 prisoners: experimentation on, 6, 11, 12, 66, 68, 69, 70, 71, 112, 113, 127 private patients, 6, 67, 68, 71, 86 Projet d’instruction sur une maladie convulsive . .. , 151 Quassi, Graman, 161 Quier, John, 49, 73, 115, 133, 136, 163, 164, 167, 189n15; vs. Alexander, 64; experiments with smallpox inoculation, 10–11, 14–15, 82, 92–99, 105–6, 112, 113, 114, 149, 201n34; as plantation owner, 117, 189n22; as plantation physician, 101, 117, 149; and race, 92, 95–98; relationship with Donald Monro, 11, 94, 96–97, 137, 149, 189n8; on slave mothers, 143; on slave sexuality, 143; vs. Thomson, 32, 33, 64, 77, 92, 93, 98, 99, 100, 101, 102–3, 105–6, 107, 149, 162 quinquina-piton, 150 race: and Chisholm, 8, 9, 35, 37, 40, 43, 91, 115; and colonialism, 24–25; differences based on, 8, 9, 33, 35, 40, 43, 91, 97–98, 112, 115; and interchangeability of bodies, 2, 11, 112, 115, 118, 133–35, 145; origins of modern concepts, 24–26; vs. place, 35; and Quier, 92, 95–98; relationship to purity of blood, 25; relationship to skin color, 26, 27, 29–30; and Thomson, 30, 33, 91, 100 Raimond, Julien, 130–31, 133, 183n149 Ramsden, Jesse, 111 Réaumur’s thermometer, 41, 141

231

Index

232

Regourd, François, 17, 149, 150; Colonial Machine, 77 Renny, Robert, 7 Report of the Lords of the Committee of Council (1789), 13, 99–100, 118, 119, 133–34, 139 Ritter, Johann, 80 Robin, Jean, 60 Robinia panacoco, 59, 60, 63 Rolander, Daniel, 15 Rosomoff, Richard, 16, 17, 45, 46, 62 Rush, Benjamin, 123, 151 Saint Christopher, 3, 37, 72, 128, 134, 135; physicians in, 28, 75, 121, 167 Saint-Domingue: Amerindians exterminated on, 156, 183n49; British attempt at invasion, 5, 142; CapFrançais, 22, 23, 46, 75, 85, 112, 118, 128, 141, 155; Cercle des Philadelphes, 22, 78, 142, 151–52, 156; economic conditions, 3; ordinance of 1764 (Art. 16), 12–13, 117, 129, 130–31; physicians in, 3, 11, 21, 22, 23, 33, 42, 46, 57, 59, 75, 77, 78, 84, 85, 93, 112, 127–28, 139, 141, 150–51, 152, 156, 164, 167, 176n24; race in, 25, 26, 27; as Republic of Haiti, 3, 197n76; slave revolt in, 118, 127, 142; thermal baths at Port-à-Piment, 48–49 Saint Lucia, 92, 107, 108, 151 Saint Vincent, 52, 157, 158, 200n19 sanctity of life, 65 Sauvages, François Bossier de la Croix de, 51–52 Savitt, Todd, 7, 88, 188n74 Schilling, Gottfried, 190n28 scurvy, 4, 107–8, 125 self-experimentation by physicians, 6, 10, 41–42, 48, 79–82, 84, 85, 100, 106, 110, 141; James Gregory on, 86, 91 sex: and interchangeability of bodies, 2, 92, 113–14; male-female ratio among slaves, 143 Shannon, Richard, 47, 62

Sheridan, Richard, 17; on Thomson, 8, 176n22, 178n32 Sierra Leone, 52, 56, 61, 153, 190n38 simarouba, 46, 1994 Sims, J. Marion, 88–89, 188n70 skin color: and climate, 32, 135, 177n31; Moreau de Saint-Méry on, 26, 27; relationship to race, 26, 27, 29–30; Thomson’s experiments regarding, 8, 9, 28, 30–32, 43, 91, 135 slavery: abolition of, 1, 32, 133, 142, 197n76; breeding of slaves, 119, 142–45; Code noir, 86, 87–88; Jamaican Consolidated Code Noir, 87–88; and labor in sugar cultivation, 118, 134–35; physicians’ attitudes regarding, 7, 28, 136–39; as race based, 24–25 slaves: attitudes regarding slavery, 136–37; baptism of, 123, 194n16; children among, 31, 33, 34, 37, 40, 78, 83–84, 92, 95, 103–4, 109, 140, 143, 144, 152, 201n34; contributions to colonial medicine, 1, 5, 9, 14, 15–16, 24, 45, 46, 47, 48–49, 50–57, 59, 61, 62, 63, 63–64, 85, 98–99, 103, 105, 108, 119, 129–30, 147, 152, 153–56, 157, 164, 167, 199n13; dissection of, 7, 8, 30, 31, 33, 34, 88, 140, 152, 178n32; European attitudes regarding, 28, 71–73; vs. Europeans, 5, 28, 29, 32–33, 34–35, 37–41, 93, 95–97, 106, 107, 109, 114, 115, 118, 126, 134–35, 137, 139, 143, 163; experimentation on, 1, 7–8, 10–11, 15, 21, 72, 77, 82–84, 85, 86–90, 91, 92–99, 101, 102, 103–4, 106–7, 115, 127–28, 134; and food, 42, 45, 46, 62, 140; infanticide by slave mothers, 33, 104; insurrections by, 117, 118, 127, 139, 145, 146; mortality of, 107, 142, 143; perspiration of, 33–34; place of origin, 28–29, 37, 38, 40, 55, 176n24; prices of, 37, 95, 100; purchase of, 28–29, 37, 100, 143–44; secrecy among, 16, 47–48, 119, 147, 156, 158–59, 160–61, 200n27; as source of wealth, 7, 43, 78–79, 115, 117; suicide among,

Index

137; women as, 29, 41, 47–48, 49, 54, 77, 84, 88–89, 95–97, 103, 114, 120, 121, 126, 129, 130, 137, 143, 144, 163, 186n36, 193n7; yaws inoculation by, 103, 106, 119, 162. See also Obeah; plantation complex; slave trade; sorcery; vaudoux; vodou slave trade, 2, 26, 111, 136–37, 144, 196n60; abolition of, 1, 67, 87, 107, 133, 135, 136; and circulation of knowledge, 1, 13, 14, 147, 153–56, 158, 159, 164–65; slave ships, 45, 100; Trans-Atlantic Slave Trade Database, 55. See also Report of the Lords of the Committee of Council Sloane, Hans, 46, 101 smallpox, 81, 82–83, 143, 163; inoculation for, 4, 11, 43, 65, 82, 84, 88, 92–99, 102, 103, 104, 105–6, 109–10, 112, 113, 119, 179n61, 189n4, 190n38, 201n34; Jamaican epidemic of 1768, 10, 82, 92, 98; and pregnancy, 95–97, 106, 201n34; vaccination for, 4, 99, 101 snakebite, 59, 159–60, 161 Society for the Abolition of the Slave Trade, 119 soldiers and sailors, 5, 20–21, 37, 67, 111, 113, 117, 134, 135, 139, 140–41; experimentation on, 4, 7–8, 10, 11, 68, 70, 71, 86, 90, 91, 92, 106–8, 191n49 Sömmerring, Samuel Thomas von, 112; Über die körperliche Verschiedenheit des Negers vom Europäer, 33 Sonnini de Manoncour, Charles-Nicolas-Sigisbert, 161, 193n14 sorcery, 119. See also vaudoux; vodou South Carolina: smallpox inoculation banned in, 93 Spanish Americas, 15, 25, 132, 200n28 Spilsbury, Francis, 127 Spooner, Charles, 121, 126, 128 Störck, Anton von, 79 Strickland, Stuart, 80 sumac root, 156 Suriname, 15, 161, 190n28 Sutton, Richard, 110, 111

sweating, 45, 50–51, 56, 59, 62 Sydenham, Thomas, 82 syphilis, 6, 52, 57, 99 Tacky’s Rebellion, 12, 127, 128 Taínos, 1, 46, 157 tetanus, 31, 34, 78, 81, 83, 84, 142, 151, 152, 160 thermometers, 36, 38, 39, 40, 41, 43, 86, 111, 141, 148 Thistlewood, Thomas, 56 Thomson, James, 115, 136, 164, 167, 176n22, 180n7; abrue used by, 106, 162; on Africans, 8, 28, 30–34, 62, 161–64; on Africans and smallpox inoculation, 98–99; vs. Alexander, 64, 103; vs. Chisholm, 35, 43; dissection used by, 8, 31, 33, 34; experiments regarding skin color, 8, 9, 28, 30–32, 43, 91, 135; experiments with animals, 105, 112; experiments with human pulse, 41– 42; experiments with unroasted coffee, 80, 100; experiments with yaws inoculation, 11, 92, 99–106, 149, 162; on Jamaican colleagues, 100–101; on knowledge of slave life, 133; on lack of human subjects, 66; on midwives, 75; on Obeah, 77, 119–20, 123; on perspiration among Africans, 33–34; as plantation physician, 62, 101, 149, 162; vs. Quier, 32, 33, 64, 77, 92, 93, 98, 99, 100, 101, 102–3, 105–6, 107, 149, 162; and race, 30, 33, 91, 100; on relations with slaves, 77; on repeated experiments, 101; self-experimentation by, 10, 80–81; on smallpox inoculation by Africans, 98–99; Treatise on the Diseases of Negroes, 98, 101, 162–64; vs. Wright, 73, 82, 101, 103, 106, 162; on yaws, 1, 32, 49, 53, 54, 62, 162–64, 200nn31,33 tobacco, 47 Trapham, Thomas, 52 Trinidad, 59, 131–32 Tröhler, Ulrich, 4

233

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234

tropical disease, 4–5, 12 Tuskegee Syphilis Study, 6, 65, 72, 88 ulcers, 47, 51, 52, 58, 61, 92, 104, 105, 107–8, 149 US South: vs. British West Indies, 72, 88, 90, 142; experimentation on slaves in, 7, 72, 88, 89–90; longevity of slavery in, 88; medical schools in, 7, 88, 89, 90 van Andel, Tinde, 15 van Swieten, Gerard, 36, 100, 163, 190n28 vaudoux, 122, 193n13. See also vodou venereal disease, 69, 71, 72, 85, 127, 142, 143, 155–56; gonorrhea, 4, 57, 80, 84; syphilis, 6, 52, 57, 99; treatments using mercury, 98, 99, 155; and yaws, 50, 62, 99, 102 vesicovaginal fistulas, 88–89 Vicq d’Azyr, Félix: Nouveau plan de constitution pour la médecine en France, 19 Vienna, 19, 174n1; Allgemeines Krankenhaus, 66 vodou, 193n13; vs. Obeah, 117, 119, 122, 192n3. See also sorcery; vaudoux Walker, James, 46 wards of the state, 6, 66, 70, 112, 140 Warner, John, 88 Washington, Harriet: Medical Apartheid, 179n61 West Indies: acclimatization to, 35, 36–41, 42; cure verification in, 69; ethical standards in, 71–75, 117; vs. Europe, 11, 21–22, 23, 24, 33, 69, 72, 75, 77, 79, 83, 87, 90, 92, 94, 95–97, 109–11, 115; fever epidemic of 1793–95, 37; location, 2–3. See also British West Indies; French West Indies White, Charles, 26, 30–31 Williams, Francis, 132 Williamson, John, 22, 49, 77, 130, 142, 167; on arrowroot, 46; on care of slaves, 72, 75, 137; on female slaves, 29, 104;

on intelligence of slaves, 139; on Obeah, 120–21, 126; on perspiration among slaves, 34; on physicians in Jamaica, 74; on slave children, 109; suicide among slaves, 137; support for slavery, 136–38, 139 Winau, Rolf, 4 Winterbottom, Thomas, 52, 56, 61, 102, 105, 190n38 Withering, William, 68 worms, 48, 105, 140, 152 Wright, William, 56, 57, 149, 164, 167, 182n44, 190n46; on care of slaves, 137; experiments with cold bathing, 10, 72, 81–85, 86, 87, 98, 110; experiments with smallpox inoculation, 98; on ironwood, 57; as plantation owner, 55, 117, 196n60; portrait of, 73; as president of Royal College of Physicians, 87; reports to Medical Society of London, 72, 85, 87; on reputation of physicians, 72; self-experimentation by, 10, 81–82; vs. Thomson, 73, 82, 101, 103, 106, 162; on yaws, 53–54, 181n24 yaws, 32, 49, 74, 88, 142, 181n21; Alexander’s experiments regarding, 1, 9–10, 50–51, 55, 56, 59, 61, 62, 63–64, 91, 99, 103, 153, 155, 157, 162; Dancer’s inoculation experiments, 102; European attitudes regarding, 52–54; Hume on, 52, 56, 105, 182n27; inoculation by Africans, 103, 106, 119, 162; latent period, 103–4, 105; Macgrudan’s inoculation experiments, 102; origin of, 1, 52–53, 181n24; Thomson on, 1, 32, 49, 53, 54, 62, 162–64, 200nn31,33; Thomson’s inoculation experiments, 11, 92, 99–106, 149, 162; use of bois fer in cures for, 45, 50–64, 148, 155, 156; and venereal disease, 50, 62, 99, 102; wet nurses with, 54 yellow fever, 5, 33 Zanthoxylum, 47–48, 100