Cover

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Title Page, Copyright, Dedication

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pp. i-vi

Contents

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pp. vii-viii

List of Illustrations

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pp. ix-x

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Prologue

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pp. xi-xvi

In 1803, a British practitioner known only as Dr. Collins set out to offer the best advice for maintaining the health and productivity of the enslaved African laborers that toiled on plantations across the Atlantic World. Collins’s words, however, did much more than advise; they revealed the very real ways that Atlantic World slavery became essential to modern conceptions of race and racial difference.1 With a stroke of his pen, Collins hinted at a complex and pressing question that had nagged at physicians and anatomists for years: Was there something physiological that made the black race...

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Acknowledgments

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pp. xvii-xxii

The craft of writing history is a collective enterprise. Even when lost in the archives, the library, or the quiet of my office, I was never truly alone when writing this book. My thoughts often drifted to the wonderful advice given to me by mentors, peers, friends, and advisers when I was in graduate school, when I was a postdoctoral fellow, and when I became a newly minted assistant professor. The comments on chapter drafts; casual conference banter; workshop critiques; and suggestions from writing partners, colleagues, friends, and family all resonated with me at some point or another as I...

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Introduction

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pp. 1-14

By the late eighteenth century, the Atlantic slave trade had reached its zenith, and slavery in the Greater Caribbean had become a deeply entrenched, albeit contested, labor system based on race. The advent of the slave system had, by this time, transformed the distinct geographies and disease environments of this region, which stretched as far north as the Carolinas, extended as far south as the northern coast of South America, and encompassed the Greater and Lesser Antilles. At the same time, slavery also nurtured cultural syncretism in this region, formed through resistance, accommodation, and...

Part I. Making Difference: Race and Yellow Fever

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1. Black Immunity and Yellow Fever in the American Atlantic

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pp. 17-47

In the eighteenth century, death stalked the Caribbean and southeastern Atlantic coast of North America in the form of fevers that claimed vast numbers of European and African lives. Both locales garnered a reputation as unhealthy—a characterization supported by gripping accounts from visitors, residents, and extant death records. Yellow fever, also known as the black vomit, was an especially notorious killer. The first outbreak of yellow fever in the Anglophone Atlantic occurred on the Caribbean island of Barbados in 1647 and remains one of the earliest records of the disease.1...

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2. An African Corps in a Most Distressed and Sickly Condition: Yellow Fever in the West Indies

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pp. 48-78

On a typically hot and humid September day in 1815, William Fergusson wrote to General Sir James Leith, the commander in chief of the Leeward Islands, to brief him on the arrival of eight hundred sickly African recruits at Barbados. As a seasoned inspector general of British army hospitals, Fergusson had likely seen his fair share of ill recruits, but there was something particularly alarming about these sickened men, which immediately caught Fergusson’s attention. While it is true that the Africans arrived on the transport ship Regalia in a terrible state, suffering from “fluxes, ulcers, and other...

Part II. In Sickness and Slavery: Black Pathologies

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3. Incorrigible Dirt Eaters: Contests for Medical Authority on Jamaican Plantations

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pp. 81-103

James Maxwell, a physician and longtime resident of Jamaica, had grown frustrated by the shortcomings of his fellow practitioners. It was not their lack of skill or training that Maxwell lamented. Rather, it was their failure to treat Cachexia Africana, also known as mal d’estomac or dirt eating—a troublesome slave disease that had plagued plantations of the Greater Caribbean for years. Aside from living and working in Jamaica as a physician, Maxwell became a slave owner through marriage. Before his arrival in Jamaica in 1816, he became a licentiate of the Royal College of Surgeons in...

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4. Of Paper Trails and Dirt Eaters: West Indian Medical Knowledge in the Antebellum South

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pp. 104-130

Poised to make Cachexia Africana a household name among southern physicians, William Carpenter published “Observations on the Cachexia Africana” in the New Orleans Medical and Surgical Journal in 1844. Carpenter, an enterprising physician and professor at the Medical College of Louisiana, had high hopes for his article. With it, he aimed to shine a light on an age-old scourge of plantations that American physicians had for too long neglected. The article offered his own musings on Cachexia Africana but largely consisted of decades’ worth of medical knowledge on the disease,...

Part III. Disciplining Blackness: Hospitals

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5. That the Asylum for Deserted Negroes Is Now Complete for Their Reception: Surveillance and Sickness in Jamaica

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pp. 133-158

In the spring of 1788, white parishioners in Kingston, Jamaica, met to discuss the establishment of a new public hospital.1 According to the Kingston vestry minutes, the parishioners “procured a lease of the land and premises intended as a Hospital and Asylum for deserted Negroes and have had the same enclosed and put in compleat [sic] order for their reception.” The minutes further advised “that a doctor be appointed to administer such medical and surgical assistance as may be required by the patients.”2 This new hospital was not the first to cater to Kingston’s black population; the...

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6. For the Acquisition of Practical Knowledge: Genealogies of Medical Exploitation in the South

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pp. 159-186

In the summer of 1784, James Clitherall, a Lowcountry physician with Loyalist leanings, attempted to rebuild his medical practice in the aftermath of the American Revolution. Clitherall trained at the University of Edinburgh under the illustrious Dr. William Cullen but did not receive a degree. Nevertheless, he enjoyed a successful practice in Charleston before the outbreak of the war and even served as a surgeon to a regiment of South Carolina Tories, although he left shortly after Cornwallis’s surrender.1 Clitherall would eventually return to Charleston and attempt to resurrect his neglected...

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Epilogue

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pp. 187-194

In 1809, at around sixty-three years of age, Benjamin Rush was still actively lecturing at the University of Pennsylvania’s medical school. According to the notes taken by a young medical student, Thomas Duché Mitchell, Rush lectured on a variety of diseases his students might encounter in their careers. Dysentery, Rush told his students, “is more fatal to children and old people than to those of a middle age.” But, he cautioned, “it spares no age nor will any mode of life be exempt from it, it is more common among the blacks of the West Indies than the Whites.”1 Rush very predictably...

Notes

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pp. 195-232

Bibliography

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pp. 233-252

Index

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pp. 253-268