Medicalizing Blackness: Making Racial Difference in the Atlantic World 1780–1840 by Rana A. Hogarth (review)

The circulation of medical knowledge, particularly during the colonial period, is a vast field of potential study for the Caribbean historian of medicine. Given the number of publications in various languages across the region over the period, it is regrettable that more of the region’s scholarship has not been dedicated to knowledge formation and exchange among physicians in the region and beyond. Rana Hogarth’s comparative study of the racialization of medicine and the African body provides careful insight into the medical construction of race in Jamaica and South Carolina during the period of slavery.

Organized into three parts, Hogarth demonstrates how physicians, and planters, in Jamaica and South Carolina were engaged in an iterative process to construct not only medical definitions of race, but also to racialize the African body, particularly the enslaved body, and ailments “peculiar” to black bodies in the tropics. Another useful comparison is her evolution of public institutions, such as hospitals and workhouses, for the surveillance and control of sick black bodies in both Jamaica and the Antebellum South—or what she terms as the “Greater Caribbean”.

In Part I, Making Difference: Race and Yellow Fever, Hogarth traces some widely accepted views on the perceived race-based immunity of enslaved Africans to yellow fever. Even in the midst of dissenting views on the widely accepted notion that enslaved Africans were immune to the lethal effects of mosquito-borne yellow fever epidemics that swept the Greater Caribbean, leaving thousands dead, there was a consensus on the inalienable issue of racial difference between how disease afflicted the black versus the white body.

Part II, In Sickness and Slavery: Black Pathologies, Hogarth examines the perplexing racialized discourse around the disease Cachexia Africana (also known as dirt-eating, mal d’estomac, geophagy and pica). This was a well-known illness affecting enslaved African populations in the Caribbean, and described by enslavers/physicians. There have been many explanations for the descriptions and interventions that physicians have made about the disease. But Hogarth goes beyond these to establish that the very construction of the disease was one based on racial difference, helping to consolidate the medical authority of white men over other practitioners, including Obeah men and women, even though African practitioners were constantly contesting that authority. Part of the knowledge exchange among Jamaican and Antebellum Southern practitioners was over the diagnosis and treatment of the disease. There was a deepening sense that Africans were engaging in resistance to white authority over their own health and bodies. Therefore, there was less of an effort to “treat” the illness, and more to control and discipline the black body.

One of Hogarth’s most convincing discussions of the racialization of enslaved health is in Part III, Disciplining Blackness: Hospitals. Hogarth frames the evolution of public institutions for the treatment of black bodies within a continuing discourse of surveillance and control in slavery, even as the care and treatment of enslaved workers shifted from private estate-based plantation medicine to state/public intervention. This discussion is particularly useful in providing more insight into the systemic place of race in medical institutions.

Hogarth layers racialization of the black body from observation to pathologization to its ultimate surveillance and control, so at no point is the enslaved “patient” “object” “subject” ever free from the gaze of the white male physician conducting his research. Her examination of race-making in medicine in the Greater Caribbean provides fertile ground for further explorations of medical knowledge exchange both within and beyond the region. It is interesting that she pulls the Antebellum South into the ambit of influence of Caribbean-based physicians publishing on common diseases affecting enslaved populations. Contrary to our twenty-first-century notions of globalized medicine that often depict the balance of power in medical research weighed in favour...