Medicine and Medical Care

The doctor-patient relationship has always been dependent on trust. The 1847 version of the American Medical Association's Code of Ethics called on patients to defer to the judgment of their physicians, and for doctors in turn to "inspire the minds of their patients with gratitude, respect and confidence" (Fett 2002, p. 144).

Unfortunately, where medicine and slavery intersected, the situation was complicated by a third party: the owner. If a slave did not want a particular medical procedure, and the master did, the physician rarely took the slave's wishes into account. Forced mastectomies and castrations on slaves were occasionally reported in medical journals; although by no means a common occurrence, such incidents clearly showed how little the patients' desires were weighed under this arrangement (Fett 2002, p. 145). With ultimate power thus resting with the master, slaves were often not inclined to trust white physicians. Many preferred the ministrations of healers from their own communities, utilizing traditional (and, in the masters' eyes, superstitious) methods. Owners certainly did not always trust these traditional healers, although some did when other recourses had failed; beyond the matter of trust, however, planters desired their world to reflect their paternalistic values, something that would be compromised by investing social power in root doctors.

Planters felt that, as heads of their extended family, ultimate responsibility for that family's physical well-being rested in their control. Thus many planters tended sick slaves themselves. As one Georgia doctor put it in 1860, the "head of the family, should, in one sense, be the father of the whole concern, negroes and all" (Young 1993, p. 677). Hence one finds examples of planters such as Louis Manigault, who assured his father that he had developed a recipe to cure their slaves' pneumonia, and was "bound to get [them] well." In only the most desperate cases would a physician be called in (Young 1993, pp. 692-693). Indeed, planters sometimes evinced a powerful distrust even of white medical practitioners, feeling they could do a better job themselves. William Cooke noted that a doctor's "proximity even is hazardous" and concluded:

It pains my understanding that the laws of Christian and Civilized communities should permit ignorant men with the title of Dr. (which can be bought at any institution in the United States for $200 and $300) to practice upon the lives of their fellow men…. To speak truth, I have but a poor opinion of the medical profession. (McMillen 1994, p. 529)

When physicians were called in, the institution of slavery and its social implications sometimes stood in the way of optimally effective treatment. This was not so much the case, perhaps surprisingly, because of racial assumptions; practitioners seem to have regarded each case individually, without necessarily jumping to the conclusions that community beliefs might normally be expected to lead them to. Doctors at the time were, in fact, trained to look at the whole individual rather than at particular symptoms. This was demonstrated by such actions as looking at a patient's stool to acquire the best knowledge they could about the interior of the body, as well as observing the patient's environment, in order to understand the patient as a person, their habits, and those around them. All the usual physical clues were considered when examining a slave, but it was done, in the words of historian Steven Stowe, in "the absence of any social setting." The failure to consider the slaves as individuals "crippled this basic level of the doctor's work" (1996, p. 72). It is perhaps little surprise, therefore, that—when left to their own devices—slaves turned elsewhere for medical reassurance.

BIBLIOGRAPHY

Fett, Sharla M. Working Cures: Healing, Health, and Power on Southern Slave Plantations. Chapel Hill: University of North Carolina Press, 2002.

McMillen, Sally G. "Antebellum Southern Farmers and the Healthcare of Children." Journal of Southern History 60, no. 3 (August 1994): 513-532.

Savitt, Todd L. Medicine and Slavery: The Disease and Health Care of Blacks in Antebellum Virginia. Urbana: University of Illinois Press, 1978.

Stowe, Steven M. "Seeing Themselves at Work: Physicians and the Case Narrative in the Mid-Nineteenth-Century American South." American Historical Review 101, no.1 (February 1996): 41-79.

Young, Jeffrey R. "Ideology and Death on a Savannah River Rice Plantation, 1833–1867: Paternalism amidst 'a Good Supply of Disease and Pain.'" Journal of Southern History 59, no. 4 (November 1993): 673-706.

                                          Troy D. Smith