Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia (review)
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Journal of the History of Medicine and Allied Sciences 58.4 (2003) 475-476

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Todd L. Savitt. Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia. 1978; reissued, Urbana, Illinois, University of Illinois, 2002. 332 pp., illus. Bibliographical notes and index. $18.95 (paper).

It has been nearly twenty-five years since the initial publication of Todd Savitt's monograph Medicine and Slavery. The product of Savitt's dissertation on black health care in the antebellum South, Medicine and Slavery came out at a time when historians were setting their analytical sights on what Kenneth Stampp had dubbed the South's "peculiar institution." Following on the heels of Robert W. Fogel and Stanley L. Engerman's controversial Time on the Cross: The Economics of American Negro Slavery (1974), Savitt provided the first thorough treatment of disease and health care within the context of Southern slavery. Thus, when Savitt's book appeared, it received the general praise of a book long overdue. (See reviews by James O. Breeden, J. Southern Hist. 45, 435–36; Donald J. D'Elia, William Mary Q. 3rd ser., 37, 343–44; Kenneth and Virginia Kiple, Am. Hist. Rev. 34, 1154–55; Michael P. Johnson, J. Interdisc. Hist. 11, 333–34; James Polk Morris, J. Hist. Med. Allied Sci. 34, 375–76; and Ernest C. Hammond, Jr., Bull. Hist. Med. 54, 288–92.) This consensus of approval extended to Stanley Engerman (J. Am. Hist. 66, 651–52). True, the reviewers noted that Savitt's assumption that disease and health care in Virginia reflected conditions elsewhere in the South was questionable; true also that he drew almost exclusively from the accounts of the slaveholder and overseer; but both criticisms pale in the face of the author's thorough documentation and masterful presentation of the topic.

Savitt establishes his scope and purpose early on: "This book is not merely an analysis of the kinds of diseases which afflicted the Old South's black population. It is a description of medical conditions as they existed at the time, and a history of the relationship between black health and white society" (p. 2). In the nine chapters to follow, this theme is adroitly managed in the hands of a historian both knowledgeable about the facts and confident of his methodology. Chapter one covers the interesting, if somewhat disturbing, attempts of slavery's apologists to construct a medical "science" of Caucasian superiority. The next eight chapters cover the basics of antebellum medicine, which include discussions of housing, clothing, food, labor, diseases (both endemic and epidemic), urban blacks, free blacks, insanity, and medical experimentation. In an informative afterword, Savitt gives a general historiographical review that places his own work within the context of his colleagues and peers. [End Page 475]

In the final analysis, Savitt tells his reader that, because disease affects not only the individual but all aspects of society, "a study of medical care and illness in the antebellum South can illustrate, through the reactions of people in that society, the attitudes and interactions of masters and slaves" (p. 312). In that regard, Medicine and Slavery has succeeded well largely because Savitt's assertions regarding health care for antebellum blacks remain judicious and balanced throughout. Paternalism was an uncommon, though not unprecedented, motivation for most masters and white physicians. They delivered care primarily out of economic self-interest. If Savitt uncovered motives more dominated by pragmatism than Christian purity, he did not seek to demonize the providers of that care with presentist assumptions and strained conclusions ill-suited to the context in which that care was administered. Savitt writes confidently that the narrow-minded, pseudoscientific speculation of those responsible for medical care in this anachronistic herrenvolk democracy will expose its own weaknesses; and clearly it does throughout this book. Readers will not be subjected to the muckraking journalistic prose that has characterized so much of the historiography on black health care in America.

Michael P. Johnson concluded upon reviewing the original publication of this work...