The Journal of the Civil War Era

Rana A. Hogarth's Medicalizing Blackness examines how white physicians in the Greater Caribbean defined blackness as a clinically significant [End Page 140] marker of difference. Their efforts helped to sanction white control over black bodies, both slave and free. However, the writings of these physicians in the decades surrounding the turn of the eighteenth century were not simply a byproduct of the growing proslavery ideology. Although the claims physicians made about the perceived peculiarities of black bodies served those who wanted to justify slavery, Hogarth argues that, before the 1840s, professional authority and financial gain were the most important factors driving such claims.

Hogarth divides her study thematically into three parts. Part 1 demonstrates how physicians used blackness as a form of medical shorthand for understanding a person's susceptibility to yellow fever, widely recognized as a scourge of the Americas. In her first chapter, Hogarth shows how the medical theories of John Lining, a physician in South Carolina, were adopted by Benjamin Rush during the famous 1793 yellow fever outbreak in Philadelphia. Influenced by Lining's assertion that blacks were immune to yellow fever, America's preeminent physician begged Philadelphia's African Americans to remain in the city to assist its victims. The direct application of the black-immunity thesis proved tragic, and Rush later repudiated Lining's claim—though not as strongly as Absalom Jones and Richard Allen, two leaders in the city's black community. Nevertheless, the theory had remarkable staying power. Chapter 2 explores the attractiveness of the black-immunity claim to the British military, which sought to deploy black troops in service to Britain's Caribbean empire. When eight hundred Africans aboard the Regalia were stricken with yellow fever, British physicians, rather than invalidate the immunity thesis, blamed poor management. They concluded that "blackness, in conjunction with external factors, played a role in how bodies experienced disease" (62) and that diet and work regimens therefore could and should be properly manipulated by the British military. According to Hogarth, both cases—the 1793 epidemic and the Regalia episode—show how the growing corpus of medical knowledge worked to subjugate black bodies and silence black suffering and enabled white physicians to build a transnational professional network based on ideas about black health.

The collective gaze of white physicians fell most heavily on so-called slave diseases. Part 2 focuses on how one such disease, Cachexia Africana (also known as dirt eating), allowed physicians to pathologize blackness, earn professional credibility, and mandate tighter white control over enslaved bodies. Whereas the subject has been only a marginal note in many medical histories of slavery, Hogarth places Cachexia Africana at the center of a high-stakes contest. In chapter 3, she argues that white physicians used the disease "to secure their tenuous positions as medical [End Page 141] authorities in the face of competition from enslaved healers, skepticism on the part of overseers and owners, and resistance from the enslaved" (83). In Jamaica, the Afro-Caribbean spiritual practice known as Obeah threatened physicians' authority. Unable to master Cachexia Africana, Jamaican physicians blamed the disease on recalcitrant slaves influenced by Obeah and prescribed greater mastery over them. Helpless as these physicians were in treating Cachexia Africana, chapter 4 contends that the professional identities of Caribbean and southern physicians nevertheless "depended on the construction of racial pathologies" (106). By the 1830s, dissertations, medical journals, and plantation guidebooks brimmed with insider information on how to manage enslaved black bodies.

Part 3 moves beyond physicians' ideas about black health to explore medical spaces outside the plantation, from workhouses and public hospitals in Jamaica to private and teaching hospitals in the South Carolina Lowcountry. Chapter 5 argues that the Hospital and Asylum for Deserted Negroes in Kingston, Jamaica, became an apparatus of social control over the colony's black population as well as a convenient means to undercut abolitionist accusations of slavery's...