Working Cures: Healing, Health, and Power on Southern Slave Plantations (review)

If one were to drag a razor across America’s historic beard, under the stubble, one might see scar tissue from America’s well chronicled failure to address adequately many of the lamentable injustices that existed during slavery. The harrowing details of the infamous slave trade remain alive today throughout West Africa in the songs of village griots, or tribal storytellers who eloquently recreate the horrors generations of Africans endured during the slave trade.

In reading the opening pages of Working Cures by Sharla M. Fett the reader is swiftly overcome by a dreadful sense of how, for generations, the leaders of the American medical establishment were, in the eyes of the downtrodden African American slaves, complicit in their torture and disenfranchisement.

Based on exhaustive research conducted in various state archives, Working Cures paints a telling picture of how “overwhelmingly white and male in profile, orthodox medical practitioners” interacted with slaves, in a world where slave health was linked to the “economic success” (p. 143) of every plantation. Dr. Fett cites a dizzying array of sources including diaries of southern mistresses, weekly reports of White overseers, slave lists, family letters, medical journals, birth records, logs from slave auctions, and maintenance documents from plantations. These sources provide the reader with evidence of the central role that the physical health of enslaved men, women, and children played in society. By carefully analyzing these sources, Dr. Fett brilliantly unravels the different ways slaveholders as well as the enslaved viewed health and healing and the “many ways in which health and healing became arenas of struggle” (p. 12) between the two antagonists.

Although scholars have often argued that economic interests motivated slaveholders to provide a “high level of health care to their enslaved laborers” (p. 16), Dr. Fett’s meticulous study provides compelling evidence that, in fact, the opposite was true. At a time when physicians were expected to meet ethical obligations towards White patients, many African-Americans were not treated as patients with rights but, rather, like domestic animals or, more tellingly, “just like hogs” (p. 30). Whereas the White patient in antebellum America was offered treatment options, the African American warranted medical attention “only when the illness became serious enough to threaten the loss of life” (p. 33) and, by extension, represent a significant economic loss for the slave owner since “the negro was very valuable to his owner” (p. 28).

Despite not receiving adequate and timely health care, the enslaved were, in the interest of advancing a medical establishment that scorned them, expected to provide White physicians and their medical students unfettered access to their bodies. As if they lacked souls, enslaved men and women were regularly subjected—oftentimes against their will and despite their opposition—to act as “specimens” (p. 1) for students to learn from. Put simply, ante-bellum physicians bound the health of enslaved African Americans to “the chattel principle” (p. 29) which oftentimes placed the slave at the epicenter of endless episodes of “nonconsensual experimentation” (p. 29) which included, but was not limited to, being forced to function as “humiliating display[s] as medical specimens” (p. 1) for medical students and junior physicians. While only serious illness brought a physician to the aid of the slave, enslaved African Americans were often made available by their slave-owners for the sake of educating junior physicians at a time when access to live, naked White subjects for prodding, digital probing, or manual investigation was limited.

Furthermore, the physicians of the time displayed an alarming propensity to allow the welfare of the plantation to take precedence over the welfare of the patient (i.e., the slave). It is this prevailing concern with the welfare of the plantation that oftentimes led physicians to prescribe “Hickory oil” (p. 37) for slaves who were suspected of “feigned...