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Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840
In 1748, as yellow fever raged in Charleston, South Carolina, doctor John Lining remarked, “There is something very singular in the constitution of the Negroes, which renders them not liable to this fever.” Lining’s comments presaged ideas about blackness that would endure in medical discourses and beyond. In this fascinating medical history, Rana A. Hogarth examines the creation and circulation of medical ideas about blackness in the Atlantic World during the late eighteenth and early nineteenth centuries. She shows how white physicians deployed blackness as a medically significant marker of difference and used medical knowledge to improve plantation labor efficiency, safeguard colonial and civic interests, and enhance control over black bodies during the era of slavery.
Hogarth refigures Atlantic slave societies as medical frontiers of knowledge production on the topic of racial difference. Rather than looking to their counterparts in Europe who collected and dissected bodies to gain knowledge about race, white physicians in Atlantic slaveholding regions created and tested ideas about race based on the contexts in which they lived and practiced. What emerges in sharp relief is the ways in which blackness was reified in medical discourses and used to perpetuate notions of white supremacy.
Hogarth refigures Atlantic slave societies as medical frontiers of knowledge production on the topic of racial difference. Rather than looking to their counterparts in Europe who collected and dissected bodies to gain knowledge about race, white physicians in Atlantic slaveholding regions created and tested ideas about race based on the contexts in which they lived and practiced. What emerges in sharp relief is the ways in which blackness was reified in medical discourses and used to perpetuate notions of white supremacy.
290 pages, Paperback
First published October 9, 2017
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About the author
Rana A. Hogarth
1 book1 followerRana A. Hogarth is assistant professor of history at the University of Illinois, Urbana-Champaign.
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Displaying 1 - 6 of 6 reviews
February 16, 2021
In 1748 yellow fever consumed Charleston, South Carolina. White physician John Lining argued that Black people were not able to catch the fever by virtue of their race. This idea that Black people were immune from pain or disease was prevalent in 18th and 19th century medical literature. Professor of History Dr. Rana A. Hogarth argues that these pseudoscientific ideas of racial biological differences were essential to the justification of chattel slavery. In maintaining that Black and white people’s bodies were constitutionally different, white policy makers could justify the continued exploitation of Black people and protection of white people. Doctors and scientists were determined to create “medical research” that proved that slavery was necessary and that Black people were not capable of self-governance.
Enslaved Black people had long practiced their own modes of healthcare such as Obeah (a healing practice developed in the West Indies). Practitioners of Obeah aided rebellion against slavery in Jamaica. After the Tacky’s Rebellion in 1760, Obeah practitioners were criminalized and dismissed as practicing a dark art responsible for illness on plantations. White physicians began to peddle the false idea that there were Black-specific diseases like “Cachexia Africana” in order to reinforce the idea that race was a viable medical mark of distinction.
By the 19th century, white physicians began to fabricate more diseases as part of this political agenda. Black people were pathologized for straying from compulsory coercion. In 1851 white physician Samuel Cartwright defined “dyaesthesia aethiopica” an alleged mental illness that enslaved Black people who were “too lazy” had caught. He also invented “drapetomania” a mental illness that he felt was the cause of enslaved Africans fleeing captivity (he couldn’t fathom why else Black would want to be free).
Hospitals were an integral part of this project of controlling Black people. The colonial government of Jamaica believed that “unsupervised Black people were a threat to the stability of the island” (143). Accordingly, the Kingston Hospital – rather than treating patients – sought to instill discipline on Black people to increase their capacity for labor. Black patients were even referred to as “inmates.” “Charity” hospitals like this allowed white policy makers to disguise policing of Black people “under the guise of altruism” and ensured that “even Black persons outside the plantation felt the full extent of white authority” (157).
Similarly in the US hospitals also became sites for racist exploitation in the 19th century. As admissions became more competitive for medical schools, “slave hospitals” became attached to medical colleges where white physicians could develop specializations and specialize in slave health, “a lucrative niche in the southern medical practice” (186). The Medical College of South Carolina was apprehensive about using white cadavers for dissection in fear of public outcry, so they used Black bodies as “clinical teaching tools” instead (186). Dr. Hogarth argues that ultimately white physicians benefited more from these hospitals than actual Black patients.
Dr. Hogarth argues that we are still haunted by this persistent belief that Black and white bodies are innately different. She notes that even in current conversations of health disparities, physicians and scientists maintain that race is somehow the same as genetics. This is not scientifically correct. Genetic variety among Africans exceeds the sum total of genetic diversity for everyone else in the world combined. In order to do justice to this fraught history of medical racism, Dr. Hogarth reminds us that we expose the political and social conditions and systems (like environmental racism, incarceration, labor exploitation) that manifest disproportionate health outcomes.
Enslaved Black people had long practiced their own modes of healthcare such as Obeah (a healing practice developed in the West Indies). Practitioners of Obeah aided rebellion against slavery in Jamaica. After the Tacky’s Rebellion in 1760, Obeah practitioners were criminalized and dismissed as practicing a dark art responsible for illness on plantations. White physicians began to peddle the false idea that there were Black-specific diseases like “Cachexia Africana” in order to reinforce the idea that race was a viable medical mark of distinction.
By the 19th century, white physicians began to fabricate more diseases as part of this political agenda. Black people were pathologized for straying from compulsory coercion. In 1851 white physician Samuel Cartwright defined “dyaesthesia aethiopica” an alleged mental illness that enslaved Black people who were “too lazy” had caught. He also invented “drapetomania” a mental illness that he felt was the cause of enslaved Africans fleeing captivity (he couldn’t fathom why else Black would want to be free).
Hospitals were an integral part of this project of controlling Black people. The colonial government of Jamaica believed that “unsupervised Black people were a threat to the stability of the island” (143). Accordingly, the Kingston Hospital – rather than treating patients – sought to instill discipline on Black people to increase their capacity for labor. Black patients were even referred to as “inmates.” “Charity” hospitals like this allowed white policy makers to disguise policing of Black people “under the guise of altruism” and ensured that “even Black persons outside the plantation felt the full extent of white authority” (157).
Similarly in the US hospitals also became sites for racist exploitation in the 19th century. As admissions became more competitive for medical schools, “slave hospitals” became attached to medical colleges where white physicians could develop specializations and specialize in slave health, “a lucrative niche in the southern medical practice” (186). The Medical College of South Carolina was apprehensive about using white cadavers for dissection in fear of public outcry, so they used Black bodies as “clinical teaching tools” instead (186). Dr. Hogarth argues that ultimately white physicians benefited more from these hospitals than actual Black patients.
Dr. Hogarth argues that we are still haunted by this persistent belief that Black and white bodies are innately different. She notes that even in current conversations of health disparities, physicians and scientists maintain that race is somehow the same as genetics. This is not scientifically correct. Genetic variety among Africans exceeds the sum total of genetic diversity for everyone else in the world combined. In order to do justice to this fraught history of medical racism, Dr. Hogarth reminds us that we expose the political and social conditions and systems (like environmental racism, incarceration, labor exploitation) that manifest disproportionate health outcomes.
October 13, 2021
This book examines how black people’s bodies became instrumentalized as an object in the mind of white physicians during the Atlantic slave trade. The critical intervention it makes is to argue that these physicians were “apolitical”, not believers in the righteousness of slavery but rather acting from self interest and ambition.
I wanted to love this book, but I did not and cannot say I particularly recommend it. The historiography is dispassionate and carefully refrains from condemnation to the point of lacking any real analysis about why it matters (beyond interest in the subject) to separate the intentions of these physicians from other slavers. By sticking primarily to one set of sources (journal articles), we lose a lot of opportunities to engage the broader contexts.
I wanted to love this book, but I did not and cannot say I particularly recommend it. The historiography is dispassionate and carefully refrains from condemnation to the point of lacking any real analysis about why it matters (beyond interest in the subject) to separate the intentions of these physicians from other slavers. By sticking primarily to one set of sources (journal articles), we lose a lot of opportunities to engage the broader contexts.
June 3, 2025
Read this for my Bioethics class, "Racism and the Institution of Medicine". Very interesting, made for good discussions in class. Helps provide a framework for what healthcare and medicine were built on. Great examples were provided to illustrate how Blackness became medicalized and became a subject over which doctors could assert expertise.
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January 14, 2025i appreciate the connections drawn between the development of plantation medicine in the Caribbean and the evolution of Southern medicine in the United States. I also found the examples of enslaved people’s healing practices very insightful, and am excited to read more work by Fett and others on this topic.
May 3, 2022
The book definitely was written well and was approached with an objective lens. I definitely learned a lot about the way that black bodies were treated in this time period, but mainly because I knew nothing about it coming into reading this book. I feel like this book could have been summarized in 20 pages but it is still worth the read.
December 16, 2023
It’s informative, it’s good in that way. It reads like a history PhD thesis - which is a TYPE of writing hard for non-academics to follow. I’m sure it’s great, but man is it hard to read.
Displaying 1 - 6 of 6 reviews