Slavery, Disease and Suffering in the Southern Lowcountry (review)

Disease and distinctiveness in the American south has been told at various levels and from a variety of perspectives. In Slavery, Disease and Suffering in the Southern Lowcountry, Peter McCandless brings a welcome new perspective to the story. McCandless provides a compelling and meticulously researched account of the impact of disease in the South Atlantic lowcountry—a region that extends from Cape Fear, North Carolina to northern Florida. He focuses primarily on South Carolina and Charleston from 1670 to 1860 and argues that the diseases that ravaged the lowcountry—malaria, yellow fever, and smallpox in particular—were not a natural result of the region’s climate and topography but rather human action and interaction and the pursuit of wealth that made South Carolina the unhealthiest and deadliest region in North America. McCandless argues that in creating the plantation economy, the elite brought together populations from different parts of Africa, the Americas, and Europe setting in motion a “global microbial migration” (12), including particularly deadly tropical diseases such as falciparum malaria and yellow fever, which flourished in the warm, wet southern climate. Though the early settlers did not at first know the economy they established would have detrimental epidemiological consequences, once the connection between disease, rice cultivation, indigo, cotton, and African labor became clear, lowcountry planter elites formed a powerful defense of the system by “distortion and denial of the epidemiological reality” (12).

The book is divided into two sections with fourteen chapters. In the first section of the book, McCandless delineates how various groups including doctors, alternative healers, patients, soldiers, and civilians experienced and dealt with “southern” diseases. He examines the incidence of disease within the context of the environment, war, the social role of the individual, and as a biological event. Throughout the study, McCandless does a nice job of highlighting the contradictions in behavior and policy. The region, McCandless argues, was promoted as healthy for whites but this contrasted with the key rationale for African slavery—that whites were unable to perform hard labor in such an unfavorable climate. Moreover, as the white elites fled north or to Europe to avoid the “sickly” season, they placed white workers and overseers in charge of their plantations claiming that whites could “earn” immunity to fevers by residing there. McCandless argues that African slavery was thus not necessary but rather “convenient and profitable” (274). McCandless traces the long debate about African differential immunities. By the nineteenth century, African Americans did seem to weather the disease environment better than whites, yet this was largely because more white immigrants migrated to the states with no prior immunity to southern diseases. Nevertheless, white elites used these statistics to craft an argument that would provide a rationale and justification for plantation slavery.

Within this broader context, lowcountry elites developed a “culture of denial” (273). Conventional scholarship suggests that yellow fever was largely absent from Charleston between the years 1760 and 1800. In contrast, McCandless argues that it was present but not acknowledged for fear that trade and commerce would be disrupted (72). This argument is highly speculative, but convincing. He has usefully examined death records looking for “oddities” and compared these records with newspaper accounts, official documents, and private letters. While he does recognize the problem in terminology, along with the fact that physicians believed one disease could mutate into another leading to misdiagnoses, he demonstrates that publicly the disease he suggests was yellow fever was routinely described as a “violent epidemic malignant fever” or “putrid bilious fever,” but in private correspondence, these cases were, in fact, reported to be “yellow fever” (75).

In perhaps one of the most interesting chapters, McCandless examines the patterns of disease during the Revolutionary War. This chapter offers a particularly lively analysis of various campaigns (including the less studied southern campaigns of 1781–82). Letters and documents describing “great sickness” and “ruined constitutions” were ubiquitous through the war. In 1781...