Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840 by Rana A. Hogarth, and: Medical Bondage: Race, Gender, and the Origins of American Gynecology by Deirdre Cooper Owens (review)

Historians Rana Hogarth and Deirdre Cooper Owens have written compelling studies that examine black bodies as objects of medical inquiry and surgical experimentation. Drawing on an impressive range of archival sources, they illuminate the complex ways black people's bodies—through cycles of birth, disease, disability, and death—acquired clinical meaning. Taken together, their works offer fresh insight into understanding how sickness shaped the lived experiences of slaves, and how slavery framed meanings of sickness and health in the eighteenth and nineteenth centuries.

Hogarth's carefully researched book, Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840, explores a provocative question: when did being black become a medical problem—a condition demanding professional attention and specific forms of treatment? Deftly situating her analysis at the intersection of studies of slavery, race, and health, Hogarth locates the "medicalization" of blackness as a peculiar, pathological trait in the late eighteenth-century slaveholding Atlantic. As the book's title suggests, Hogarth is interested in process. The focus on medicalization links her methodological approach to interdisciplinary scholarship that has considered how traits like obesity and alcohol abuse come to be defined, and managed, as medical disorders. Hogarth builds on this framework, showing how skin color emerged as the hallmark feature for pathologizing people of African descent.

In tracing the origins and circulation of discourses about black health, Hogarth centers the Greater Caribbean, a region stretching from Kingston, Jamaica to Charleston, South Carolina. Within this space, characterized by similar climate and disease patterns, the West Indies, not Western Europe, functioned as the "font of medical knowledge" physicians turned to for guidance on treating slaves during the late eighteenth and first half of the nineteenth century (31). Through meticulous readings of treatises on "Negro diseases," planter manuals, medical texts, and newspaper advertisements, Hogarth demonstrates how physicians touted their expertise to advance their standing in a medical marketplace crowded with enslaved, spiritual, and amateur healers. Medical ideas about blackness spanned political contexts and views on slavery and the slave trade. Well-known abolitionists like Dr. Benjamin Rush of Philadelphia taught University of Pennsylvania's medical students that disease susceptibility could be explained by innate racial differences. Not until the 1850s would infamous diseases like drapetomania (the "mental disease" that caused slaves to run away) arise as blatant attempts to justify the continued enslavement of black people, hardening the link between "racial" diseases and proslavery beliefs.

Organized thematically and chronologically, Medicalizing Blackness explores diseases and institutions designated for black bodies. In part one ("Marking Difference"), Hogarth focuses on yellow fever, the "black vomit" that ravaged port towns across the American Atlantic. When epidemics struck, physicians observed that "something very singular in the constitution of Negroes" seemed to spare slaves and free blacks from falling victim to the deadly menace (22). The claim had origins in older ideas that Africans were "seasoned" to the diseases of tropical climates, and Hogarth reveals how this theory of innate immunity evolved to be mapped onto skin pigment. Yet in racializing yellow fever susceptibility, white physicians racialized suffering as well. Even when confronted with a terrifying outbreak—such as the 800 African naval recruits who arrived in Barbados in 1815 all struck with the fever—physicians and colonial officials remained convinced that black people could only be mildly afflicted with the disease. This denial and erasure of black suffering placed an "undue burden" on those who were expected to continue laboring and risk their own lives in the face of contagion and death (30).

Part two ("In Sickness and Slavery") turns from a disease to which black people were considered immune to one that struck them exclusively. Cachexia Africana was a mysterious disease whose hallmark...