Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia (review)

BOOK REVIEWS Medicine and Slavery: The Diseases and Health Care of Bhcks in Antebellum Virginia. By Todd L. Savitt. (Urbana: University of Illinois Press, 1978. Pp. 332. $12.95.) The traditional view of slave health was established by U. B. Phillips years ago when he argued thatsince slaves were valuable property, logic guaranteed that their owners would provide good medical care. Subsequently, W. D. Posteli, extrapolating on the basis ofa few well-run plantations, supported this view and concluded that slaves received better — or at least as good — care as did the average poor white. In recent years this view has been challenged, but Medicine and Shvery is the first systematic effort to prove or disprove this thesis. Todd L. Savitt, the first graduate of Duke University's combined program in history and medicine, has produced the most comprehensive study of slave health to appear so far. Unlike most other historians who have concerned themselves largely with the major contagious disorders among plantation slaves, Savitt examines almost all aspects of health among rural and urban slaves alike. Every intelligent observer of slaves noted that in their reaction to certain diseases blacks differed from whites. Some modern historians have disagreed, attributing the differences to the deplorable conditions of slave life. Savitt uses his medical background and an extensive reading in medical literature to demonstrate that in terms of immunological factors considerable variations do exist between blacks and whites. Savitt's approach is to describe medical problems in the context of the slave's environment. For example, in a chapter on the slave quarters he shows how the characteristic crowding, lack of windows for sunshine, and the damp earthen floors contributed to the growth of bacteria and intestinal parasites, as well as the spread of body lice, ringworm, pinworms, and so forth. The lack of privies in rural areas guaranteed a high rate of intestinal disorders, such as typhoid, salmoneUae (bacterial food poisoning), and bacillary and amoebic dysentery; and the situation was worse upon those plantations which used human waste as manure. Respiratory disorders, too, were rampant in both rural and urban environments, and tuberculosis and influenza took heavy tolls. The standard dietprovided for slaves, Savitt believes, was nutritionally inadequate, but he notes that slaves occasionally supplemented their food allotments and that the amount and quality of food depended 168 BOOK REVIEWS169 upon the slave owner. He does ask why, if the slaves had enough to eat, thievery of food was so common. Working conditions among slaves, as with their food, depended largely upon the whims of owners or employers; but it is clear that slaves who worked in iron furnaces, coal mines, and other hazardous occupations were much worse off than the average plantation worker. In the succeeding chapters Savitt takes up a variety of medical problems, starting with the effects of whippingand such topics as female disorders, infant mortality, insanity, tumors and cancers, hernias, and so forth. Medical care for slaves usually began with the master, mistress, or overseer administering home remedies, thefirst resort innearly all cases. When these remedies failed, a physician, either orthodox or unorthodox, was usually called in, but often not until the case was hopeless. A surprising number of slaves relied upon black medicines and black practitioners. Many of the latter combined African herbal remedies and conjure or voodoo medicine, while others modified African methods to include the prevailing white practices. Savitt concludes that blacks in one capacity or another played a significant role in health care for both whites and blacks in Virginia. Savitt shows that the Southern attitude towards slaves insured that dissection was largely performed on black subjects, that physicians had little regard for the personal dignity of blacks when exhibiting them as patients, and that doctors were more prone to use blacks for experimentation. While this situation has been recognized by other historians, Savitt documents it in detail. What comes through clearly from readingMedicineand Shvery is the degree to which the health of slaves, as with poor whites, depended upon their housing, clothing, food, and working conditions. Unlike whites, however, slaves had little choice with respect to any of these and hence were dependent upon the intelligence and humanity of their masters...