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

In Medicalizing Blackness, Rana A. Hogarth argues that physicians in the eighteenth- and nineteenth-century Greater Caribbean advanced concepts of biological race by promoting the notion that black and white bodies differed medically from one another. In particular, they theorized differences between black and white susceptibilities to and proclivities for specific illnesses. These supposed disparities then became part of a public corpus of knowledge and “led to the universal acceptance among those with and without a vested interest in the slave system that the bodies of diasporic Africans were unquestionably different from whites” (4). Overall, Hogarth’s most notable contribution lies in her emphasis on physicians’ motivations, as she argues that they constructed medical notions of blackness “for their own intellectual, professional, and pecuniary gains” (3). The defense of slavery, she insists, was marginal to physicians’ interests in theorizing notions of racial difference. Instead, their conceptions of black and white bodies as medically, even biologically, different from one another served solely to further their own careers.

Hogarth’s story fits into a substantial existing historiography on the centrality of the Greater Caribbean region to the broader Atlantic world. She devotes attention to both Jamaica and South Carolina, places she describes as being “frontiers of knowledge production on the topic of racial difference” (10). Both had large plantation and slave societies with populations of British-trained physicians eager to demonstrate their abilities and produce new knowledge. Her examination straddles two time periods that are often separated: the eighteenth-century height of the colonial plantation complex, and the early nineteenth century, a period that simultaneously saw the gradual demise of the British slavery system in the Caribbean and the intensifying tenacity of slaveholding interests in the antebellum American South. This purview allows her to build on and modify existing scholarship on medicine and race, which she approaches through sections examining yellow fever; Cachexia Africana, or dirt eating; and hospitals. Though the section on yellow fever will be relatively familiar to historians of medicine and health in the West Indies and the American South, the material on Cachexia Africana is a fresh and welcome addition.

Hogarth’s discussion of yellow fever focuses heavily on the two most-cited eighteenth-century physicians who wrote on the topic, John Lining and Benjamin Rush. Lining speculated on the possibility of black immunity to yellow fever in an account of an outbreak in Charleston published first in 1754 and again (posthumously) in 1799, while Rush applied Lining’s theories to a Philadelphia outbreak of the fever in 1792.¹ As is well known, Rush revised his theory of black immunity after numerous African American caretakers of Philadelphia’s yellow fever victims fell ill themselves. Still, Hogarth writes, Rush “qualified the conditions under which black people fell ill, leaving intact the possibility that blackness was indeed a distinctive physiological feature” (27). In Hogarth’s telling, Rush loses some of the enlightened sheen with which historians too often endow him, reminding us that even after he acknowledged his erroneous assumption about black immunity, he downplayed the suffering of yellow fever’s black victims. For Hogarth, the enduring influence of Lining’s and Rush’s writings are essential to understanding the lasting impact of racialized views of yellow fever: because nineteenth-century physicians continued to cite their writings, she argues, racially driven theories of black immunity persisted among physicians even after they observed that black residents of the Greater Caribbean suffered from the disease.

Hogarth’s story of racial thinking about yellow fever thus follows a straight line from the mid-eighteenth century to the mid-nineteenth; though she acknowledges that not all physicians believed in theories of racial immunity, she depicts the supremacy of Lining’s theory as essentially unbroken for a century. This approach provides an alternative model to the discontinuous and contingent trajectories other recent historians have devised. For example, Urmi Engineer Willoughby’s work...