Celebrating 125 Years of Publishing
Celebrating 125 Years of Publishing
These Observations determined me to try some Experiments.
—A. J. Alexander, planter, Bacolet, Grenada, 1773
In 1773, an extraordinary experiment pitted purported slave cures against European treatments in Grenada, a small island south of Barbados, just off the coast of South America (figure 1). The planter Alexander J. Alexander’s experiment with his “Negro Dr’s” “Materia Medica,” as he styled it, reveals how Europeans tested and evaluated what they deemed slave cures. The disease in question was yaws, a bacterial infection that produces horrid ulcers and lesions in its victims and, in advanced stages, excruciating pain, especially in the hands and feet. Yaws thrives in humid, tropical areas where overcrowding and poor sanitation prevail. Needless to say, slaves throughout the West Indies were plagued by it. Planters took note because slaves with yawey feet often could not walk and hence could not work. Jamaican physician James Thomson wrote, “Any proprietor of Negroes is well aware of the loss he sustains from the yaws. . . . The finest looking slave will . . . in a few months become a burden to himself and his master.”1
This book analyzes the eighteenth-century Atlantic World medical complex from the 1760s, when a robust experimental culture emerged in the British and French West Indies, to the early 1800s, when debates raged about banning the slave trade and, eventually, slavery itself. Three questions motivate this work. A first investigates the circulation of knowledge in the Atlantic World. When A. J. Alexander tested his slave’s medicine, what was he actually investigating? African cures transported to the Americas? Remedies developed by Amerindians—Arawaks, Tainos, and Galibis or Kali’na—and transmitted to African slaves, who, unlike Europeans, were familiar with what we today call tropical medicine? Cures developed by plantation slaves in the Americas? Or, by some great twist of irony, cures communicated by the French to the slave via the plantation complex?
A second overarching question digs into the ethics of experiments using enslaved bodies. How were human subjects chosen for experimentation? What ethical brakes kept scientific enthusiasm from overwhelming vulnerable populations?
A third question investigates race and the interchangeability of bodies. What notions of uniformity and variability across living organisms drove the testing of new drugs and medical techniques? Were tests done on white bodies thought to hold for black bodies (and vice versa)? Were male and female bodies considered interchangeable in this regard? We must remember that these were not purely scientific queries but questions fired in the colonial crucible of conquest, slavery, violence, and secrecy.
The sun-drenched sugar islands of the West Indies provide a fascinating setting for this study (figure 2). Still in the eighteenth century there was a robust mix of and competition between Amerindian, African, and European diseases, medicines, and practitioners. The West Indies—the string of islands in the Caribbean that constitute the Greater and Lesser Antilles—were embedded in what I call the Atlantic World medical complex. Here I borrow from Philip Curtin’s notion of the “plantation complex.” For Curtin, the plantation complex—stretching from Bahia, Brazil, to Charleston, South Carolina—was an “economic and political order centering on slave plantations in the New World tropics.”2 We add to Curtin’s analysis the medical order that melded people, plants, and their knowledges in the Atlantic World. Europe dominated the medical complex as it did the plantation complex economically, politically, and militarily, yet people, goods, labor, food, timber—and, we will add, disease, knowledge, and medical remedies—moved promiscuously between continents, masters and slaves, and imperial monopolies. Here we examine the dynamics of the Atlantic World and how that larger medical complex shaped experimental practices on the ground in the Caribbean.
Medical Experimentation in the Atlantic World
In step with the broader culture of experimentalism that arose across Europe in the seventeenth and eighteenth centuries, physicians in both Europe and its colonies developed new standards for observation and experimentation in medicine. Since antiquity, physicians and healers of all sorts had tried new and untested cures in the regular care and management of patients, and especially in desperate situations. By the late eighteenth century, however, as the historian Andreas-Holger Maehle has shown, medical treatments were increasingly tested according to a set of procedures—what we today call protocols—agreed upon by the European medical community at large. Physicians at the time self-consciously labeled these procedures “trials” or “experiments,” essais, épreuves, or expériences, and even “controlled experiments” (Regeln [sic] Versuche). Francis Home, royal physician and professor at the University of Edinburgh, wrote in his Clinical Experiments that “real experiments . . . tend to make medicine as certain as most other sciences.”3
While modern medical regimes have deep historical roots, eighteenth-century experimental practices differed significantly from those of today. Early modern experimental trials were not randomized, and although the historian of medicine Ulrich Tröhler has reported some therapeutic blind trials, they were not double or triple blind. By and large, experiments did not employ placebos, even though what would eventually be called the “placebo effect” was well understood (chapter 5). Physicians sparingly employed statistical or probabilistic statistical methods.4
Historians have begun to rigorously investigate experimentation in the eighteenth century. The canonical experiments are well known: the Newgate Prison experiment in 1721 launched the testing of the smallpox inoculation in Britain; James Lind’s 1747 controlled study of twelve sailors demonstrated that oranges and lemons could prevent and cure scurvy; John Hunter’s 1767 self-inoculation with gonorrheal pus proved that the disease was transmissible; and Edward Jenner’s 1798 experiments established the value of vaccination against smallpox. Historian Rolf Winau has examined to what extent eighteenth-century experimental practices were controlled and repeatable.5
This book examines medical testing with humans in French and British West Indian colonies. Colonial drug testing and human experimentation were driven by physicians’ desire to create scientific medicine. Tropical disease—a term that arose in this period—was something new to Europeans, and physicians struggled to find cures in the face of massive mortality.6 Thomas Dancer, longtime physician in Jamaica and island botanist, warned that whatever the merit of medical books imported from Europe, their findings “are not so well suited to . . . tropical climates, where diseases put on a different aspect and character; where they commonly run a shorter course, and have a more fatal tendency.”7 Fine educations in Europe could not guarantee success on the ground in the tropics.
I have written extensively elsewhere about European bioprospecting in the West Indies for Amerindian and African cures.8 Europeans, from the sixteenth through to the end of the eighteenth century, tended to value medical knowledge of the peoples they encountered around the world, including that of Africans and Amerindians. With the decline of Amerindian populations in the Caribbean, slave medicines took on an unexpected importance, even though in the first half of the eighteenth century Africans on the big sugar islands were no more native to the area than Europeans (at least 80 percent had been born in Africa). Unlike Europeans, however, Africans knew tropical diseases, their prevention, and their cures. Here we delve into how various new remedies were tested.
We must keep in mind that physicians’ desire to develop new cures in the Caribbean was largely driven by the political and economic ambitions of European states. Medicine of “warm” or “tropical” climates was necessary to keep slaves—as valuable commodities of powerful masters—alive on West Indian plantations. Tropical medicine was also required to keep large populations of soldiers and sailors healthy and ready for combat. In his Treatise on Tropical Diseases; or on Military Operations, Jamaican surgeon Benjamin Moseley highlighted how the failure of European cures led to political defeat. “It was chiefly owing to the ravages of . . . [dysentery] in the French armies,” Moseley wrote, “that the English islands were not invaded earlier; and it was also owing to the same cause, that the English forces were, in many instances, unable to defeat their enemies.” Moseley developed a cure for dysentery while stationed in the West Indies—a cure that was implemented everywhere that Britain had troops. Yellow fever also wreaked havoc when the British attempted to invade and take Saint-Domingue during revolution in the 1790s. The invasion was beaten back primarily by mortality rates as high as 70 percent—not by soldiers’ guns and bayonets.9
Finding new and effective cures requires testing new drugs in living organisms. A perennial question for doctors, patients, and ethicists is: Who will go first? On whose body will unknown and potentially dangerous drugs be tested? By whom, and for whose benefit? Today, such questions are mediated through carefully crafted codes of patients’ rights (chapter 3). Here we explore how drugs were tested in the eighteenth century, and specifically how human subjects were chosen for experiments.
In early modern Europe many poor souls were subjected to medical testing. Drug trials tended to overselect subjects from wards of the state, such as prisoners, hospital patients, and orphans. Most experimental subjects came from the same groups used for dissection: that is, persons with no next of kin to insist on Christian burials or, in the case of medical care, to seek out and pay for expensive cures. Because it was thought that these subjects owed their well-being to the state, it was generally accepted that they should repay their debt and benefit society more generally by being used in medical testing. Nine children from the Hôpital de la Pitié, for example, were used in an experiment for a remedy for the “itch” in the 1780s. As was often the case in experiments that were recorded, all were “perfectly” cured. (Publication bias to record only positive results ran rampant.)10 In addition to charity patients, physicians used their own bodies to evince their confidence in a cure and, rarely, royal bodies to promote public health measures, such as inoculation for smallpox. Experimentalists generally assumed an interchangeability of bodies, so that testing on charity patients was thought to provide valuable data for physicians’ private practice among the wealthy.
One population not available in Europe and used in colonial experiments was slaves. The question of underrepresented minorities in medical experimentation is still volatile today: minorities, especially African Americans in the United States, tend to be simultaneously underrepresented in medical research and historically exploited in experimentation.11 As the ethicist Robert Baker has written, modern bioethics arose from the need to protect vulnerable subjects, such as “racial minorities, the economically disadvantaged, the very sick, and the institutionalized,” who may be recruited as research subjects because of their “dependent status” and “their frequently compromised capacity for free consent” or “because they are easy to manipulate as a result of their illness or socioeconomic condition.” The 1979 Belmont Report was issued as a response to researchers’ exploitation of vulnerable populations, most notably the six hundred impoverished Alabaman African American sharecroppers recruited by the US Public Health Service in its Tuskegee Syphilis Study (1932–72). This study followed the natural progression of untreated syphilis in rural African American men, 399 of whom suffered from the disease and went untreated even after penicillin became widely available.12
The legacy of Tuskegee and other abuses persists today among many African Americans, who are understandably reluctant to participate in clinical trials. Some African Americans believe that researchers (the majority of whom are white) will expose them to unnecessary risk; others doubt that they, as a group, will benefit from the research. Yet US federal law requires that minority populations be included in clinical research to support their health and well-being.13
Historians of the US South have emphasized that slaves were exploited in medical experiments and dissections. Historian Todd Savitt’s excellent work has carefully documented that physicians in the American South, especially in the nineteenth century, often took advantage of African Americans by testing new techniques and remedies. In several instances, Savitt tells us, physicians purchased blacks for the “sole purpose of experimentation.” Though white subjects were included in some experiments, blacks constituted the overwhelming majority. The power of the master joined to the authority of medical men tended to render slaves vulnerable. “Blacks were considered more available and more accessible in this white-dominated society,” Savitt has concluded. “They were rendered physically visible by their skin color and were legally invisible because of their slave status.”14
Experimentation and the use of human subjects are specific to particular times and places. This book investigates medical practices in the late eighteenth-century Atlantic World. A major finding of this book is that, in many instances, European physicians in the British and French West Indies did not—as might be expected—use slaves as guinea pigs. Slaves were considered valuable property of powerful plantation owners whom doctors were employed to serve. The master’s will prevailed over a doctor’s advice, and colonial physicians did not always have a free hand in devising medical experiments to answer scientific questions. The overarching motive was economic: the profitability of the plantation complex depended on slave labor (chapter 5).15 Importantly, as we shall see, clinical wards of medical schools—epicenters of medical testing in Europe and the American South—were not established in the Caribbean in this period (chapter 1).
Persons of African descent in the Caribbean may have become more vulnerable after emancipation, when doctors had no masters to answer to. Discussing the legal status of free people of color, Jamaican Robert Renny stated that they were “placed in a worse situation than slaves, who have masters interested in their protection.”16 Much of Renny’s sentiment, however, was informed by his loyalty to the British crown and the colonial enterprise.
As we shall also see, some experiments with slaves in the eighteenth century were exploitative (chapter 4). But it is important to emphasize that in the eighteenth-century West Indies strong parallels emerged between slaves, soldiers, and sailors—as large populations in economies of few resources. Medical men might serve both populations—soldiers and sailors in time of war, and slaves in time of peace. Health was precarious: in desperate situations, physicians serving large populations often experimented with new remedies as a last resort.
The Taxonomy of Experiments
To what extent were slaves exploited in eighteenth-century West Indian experiments? To answer this question I develop a taxonomy of the varieties of experiments within the context of eighteenth-century medical ethics: exploitative (taking undue risk with human life) versus nonexploitative (testing with care in the group likely to benefit from the cure); invasive versus noninvasive; therapeutic to the individual involved versus nontherapeutic. Today informed consent would also be a key consideration in judging the exploitative nature of experiments. This, however, was not the case for experimental populations—the poor, soldiers, sailors, or slaves—in the eighteenth century. It was enough that physicians judged the treatment to be in a subject’s best interest. Although patient consent was not required, physicians often complied with patients’ or parents’ wishes (chapter 3).
Chapter 1 focuses on two sets of experiments and how race was investigated in each: those by the Jamaican physician James Thomson, searching specifically for anatomical and physiological differences between the races, and those by Colin Chisholm, inspector general for troops in the British West Indies, examining human constants in both blacks and whites across temperature zones.
James Thomson is a complex character. The historian Richard Sheridan praised him for seeking to blend the “best elements” of African and European cultures. And, as we shall see throughout this book, Thomson was a strong advocate of Africans and their medical knowledge. Intimating his closeness to slaves, he insisted that physicians should consider “patients’ wishes, when they do not materially interfere with the actual state of disease.”17 Yet Thomson engaged in a grotesque set of experiments to understand skin color through dissection of persons of African origin. I focus on this experiment—done late in the period we investigate here—because it is what we expect to find. Motivated by debates on racial difference taking place in Europe, Thomson mounted a search to locate the ultimate physiological source of blackness in human skin. Thomson’s were among the most detailed experiments in the Caribbean at this time aimed at understanding racial differences.
Colin Chisholm, naval inspector and plantation owner in Demerara (later part of British Guiana) on the coast of South America, designed experiments to understand basic human nature and not, like Thomson’s, to uncover racial difference. Chisholm’s study included race as a variable, but his focus was “place,” specifically the birth and immigration status of patients. Were they born in Europe or Africa, and had they subsequently immigrated to the West Indies? Were they newly arrived or residents of long standing? Were they West Indian Creoles (persons of European or African origins born in the islands)? For Chisholm, these, and not race per se, were important factors predicting health.
Employing newly developed thermometers, Chisholm’s experiments were designed to answer questions crucial to the colonial enterprise. Specifically, he sought to determine whether “animal heat” changed dramatically with climate and whether a period of “habit or assimilation” was required for humans to regain their internal equilibrium. Chisholm’s experiments were not intended to be therapeutic. They were noninvasive (measuring only axillary temperature) and nonexploitative in the sense that they did not take undue risk with human life.18
Chapter 2 turns to experiments to test the enslaved African’s cure for yaws featured in A. J. Alexander’s experiment. One of my purposes in this book is to expand our knowledge of African contributions to science. Alexander considered his slave’s cure for yaws “Negro Materia Medica.”19 And indeed historians often write about “slave medicine,” tending to assume an African origin of a particular cure. One question we will explore is whether Africans brought their medicines and techniques with them from their homelands or whether they experimented with new plants and cures found in the West Indies. This raises methodological questions about how to trace the circulation of knowledge in the Atlantic World. In chapter 2, we attempt to identify the provenance of Alexander’s slave cure. When documents fail, I turn to the plants in the Negro doctor’s cure: Were they indigenous to Africa? The Americas? Or both? What can the plants tell us?
Alexander’s experiment was designed to test a cure, in this case for yaws. Ethicists at the time accepted that therapeutic experiments were permissible when commonly used medicines failed, which was often in the tropics. Edinburgh physician John Gregory stated in his medical lectures that “desperate measures should be used in some cases, where every other method has been proved ineffectual. In such circumstance we should have recourse to medicine which under more favourable circumstances might be thought dangerous.”20 (Gregory’s were lectures that numerous physicians in the British Caribbean would have known about because the vast majority were educated in Edinburgh; see chapter 1.) In Alexander’s account of his experiment, slaves were not exploited. He showed restraint by trying the new cure first in only two subjects before expanding the test group. And his first two subjects were precisely those who stood to benefit most from the treatment. He allowed the European physician’s control group to include four slaves. The physician’s cure followed standard European practice at the time.
Alexander’s yaws patients and Leonard Gillespie’s sailors (chapter 4) were tested in the context of seeking cures for large groups of like patients (slaves and sailors). These new treatments were intended to be therapeutic. Typically, subjects were observed as they proceeded through a treatment, and results were recorded, sent by letter to other physicians, and often published in efforts to increase the efficacy of practice locally and globally within the empire.
Chapter 3 investigates eighteenth-century ethical brakes to medical experiments in the Atlantic World. The first section looks at ethics in Europe, the second at ethics in the Caribbean. The question is: Did experiments with slaves give birth to new debates and discussion? Did slaves become an exploited or a protected category?
Although there was no fixed code of ethics in this period, physicians followed a standard format in testing (testing first in animals and then in humans, for example). They tested in specific populations (importantly, on themselves). They recognized certain limits to testing (such as patients’ requests and their own conscience).21
Self-experimentation—the notion that the physician “goes first”—was also an important part of the Atlantic World medical complex. William Wright, a learned physician and botanist in Jamaica as well as a member of the College of Physicians in Edinburgh, experimented with the therapeutic virtues of cold baths to treat fevers over the course of two decades. He fought hard to secure his “indisputable priority” in the discovery of this treatment. Part of his claim was that he had first tested this new therapy on himself.22
It was common in this period for physicians to go first. We see examples with Bertrand Bajon in Cayenne and James Thomson in Jamaica. A physician’s willingness to take a drug first served as a measure of faith in the treatment. Further, a physician considered himself a proficient subject, better able than others to provide reliable information about the effects of a cure on the body. It is not surprising, then, that Wright claimed to have tested his cold baths first in himself. We see, however, that, in fact, he first tested his technique in some five hundred subjects during the fatal smallpox epidemics of 1768—nearly a decade before trying it on himself.23 Although not explicitly stated, the large number suggests his subjects were slaves.
Chapter 4 lies at the heart of this study. This chapter focuses on the exploitation of slave bodies in eighteenth-century medical experiments, primarily John Quier’s experiments with smallpox inoculation and James Thomson’s inoculations with yaws. These physicians took risks beyond what was reasonable to treat the individual patient; they took unusual liberties with human bodies. As we shall see, Quier was employed by plantation owners and would have inoculated for smallpox with or without his experiments. Masters had the final word in decisions concerning their slaves. There was no issue of slave consent—or, for that matter, often physician consent. Quier remarked that “in Negro practice” a physician himself was rarely able to choose his patients.24
Slaves certainly did not go first in Quier’s experiments in the 1760s. Experiments had been carried out successfully with prisoners (who gained their freedom as a reward) at London’s Newgate Prison in 1721. Two English royal princesses had been inoculated in 1722 without mishap to prove the safety of the procedure.25 In fact, when epidemics raged, not inoculating incurred considerable risk.
But, as we will see, Quier took what he considered a rare opportunity to explore questions about inoculation still pressing within European medical circles. Quier used the slaves under his care to answer questions that doctors back in Europe dared not. He sought to advance science and not necessarily the best interests of the patient.26
It is interesting that Quier carried out his experiment one year after arriving in Jamaica. He reported implementing his experiments at the behest of Donald Monro, of the famed Edinburgh medical dynasty. Quier and Monro had served together in the British army stationed in Germany. Each found alternative employment after the war—Monro in London, and Quier in Jamaica.27 Quier’s results were sent to Monro in letter form. Monro read them before the College of Physicians in London and eventually published them in journal and book form. Heated controversy, however, arose between the two men about the interchangeability of bodies across race and social class. I find it significant that after this first extensive study Quier published no more—even though he practiced in Jamaica for nearly a half century until his death in 1822.
Chapter 4 sets Quier’s experiments in context by analyzing James Thomson’s experimental inoculation with yaws in slave children as well as experiments with other often exploited populations, such as soldiers, sailors (who, like slaves, had negligible agency in determining their own fate), and the poor in Europe. We also investigate Jean-Barthélemy Dazille’s experiments with water that arose from his efforts to implement public health measures in Saint-Domingue. Dazille was a French colonial physician par excellence, yet he railed against anatomists concerned with the minute intricacies of skin color while physicians and surgeons arrived in the colonies grossly ignorant of the causes and treatments of tropical disease. To remedy the situation he published his Observations sur les maladies des nègres (Observations on Negro diseases) in 1776 and 1792. For Dazille, the largest health problem was not bodily differences between Europeans and Africans but neglect in the care of slaves—insufficient nourishment, lack of proper clothing, and excessive labor that often exceeded their strength. He treated the ill under his care without regard for color and nearly lost his commission by insisting that slaves in royal hospitals receive the same rations of wine and blankets as soldiers.28
The Colonial Crucible
Chapter 5 pulls out to a larger frame to understand the violence and fears endemic to colonial struggles. This chapter explores aspects of African medicine that were not put to test, such as Obeah or healing practices (often joining the natural and supernatural) developed by slaves in the British West Indies.29 Europeans were interested in the material aspects of African healing traditions—the specific herbs or bathing techniques used—but they shied away from Obeah’s spiritual or mystical aspects.
This is surprising, since European physicians understood the potential benefits of what we today call the placebo effect. In 1799, the well-known English physician John Haygarth performed a placebo-controlled trial to understand the role imagination played in the “cause and cure of disorders of the body” and to unmask the fraud of Elisha Perkins’s tractors—metallic conductors of electricity purported to cure a variety of diseases.30 European physicians often depended on what they called “medical faith” to enhance the effects of their medicine. In the Caribbean, the British, however, did not often see (or at least did not acknowledge) the continuities between their beliefs and practices and those of Obeah doctors. What was diagnosed as “imagination” in Europeans was judged “superstition” in Africans.
The fear of Obeah, revolt, and revolution was so great that experiments with electricity were conducted on Obeah men alleged to have instigated Tacky’s Rebellion in Jamaica in 1760. The condemned men were submitted to “experiments” with electricity.31 While a strong tradition of experimenting with prisoners condemned to death still prevailed, no results benefiting medicine were recorded from these so-called experiments.
The Tacky Rebellion led to the outlawing of Obeah in Jamaica in 1760 (although not in other British-held islands in this period). Fears of slave practices were so great in Saint-Domingue that in 1764 all persons of African origin were banned from “exercising medicine or surgery and from treating any illnesses under any circumstances.”32 In practice, of course, slave practitioners remained on the front lines for slave care, especially in rural areas.
European physicians’ primary job in the colonies was to keep slaves healthy—to dole out, as one physician put it, “the balm of humanity to those unfortunate beings.”33 European physicians, however, were also deeply embedded within the colonial complex, and many were slave owners themselves. The majority of physicians, as we shall see, never put pen to paper. They were working men with little time to write. Those who did write often did not comment on their views of slavery or of Africans’ physical, moral, or intellectual characters. Chapter 5 investigates the views of the four physicians called as expert witnesses to testify in the British government’s extensive hearing on the “present state of the African trade.” The 1788 Report of the Lords of the Committee of Council—a massive 890-page document—treated queries relative to the slave trade and the treatment of slaves throughout the British West Indies.34 This document provides a rare view of ordinary physicians’ practices on the ground.
The Circulation of Knowledge
The Conclusion adumbrates patterns in the circulation of knowledge in the Atlantic World medical complex (figure 3).35 I characterize three major nexuses across which people and their knowledges moved: the colonial nexus linking Europe and the Americas, the slave trade nexus joining Africa and the Americas, and the conquest nexus that brought Amerindian practices into the plantation complex. Nexus identifies a plurality of connections linking various parts of the Atlantic World. Multidirectional trade in people, disease, plants, and knowledges between Europe, Africa, and the Americas sped along these interconnected nexuses to create the Atlantic World medical complex.
Within this larger context, we will explore how medical practices from these disparate Atlantic traditions mixed within the Caribbean. The West Indies served as a “center of calculation” where knowledge was created to respond directly to challenges posed by plantation complexes, namely, how to cure new and persistent disease emerging from the collision of peoples on newly established, often poorly supplied, plantations.36 Doctors and healers—of all types—in the West Indies served as “knowledge brokers” culling valuable bits and pieces from these rich traditions to create new and, occasionally, effective cures. These knowledge brokers were not mere intermediaries or “go-betweens,” but men and women situated in the push and pull of life-and-death struggles for political, economic, cultural, and personal survival. Some, such as the European doctors and surgeons, were employees of empire—whether private contractors to plantation owners in the British islands or pensioners of the king in the French islands. Others, such as Alexander’s “Negro Dr,” were enslaved within various plantation complexes. Whoever they might be, these men and women took the vast empiry of empire to create knowledge responsive to local subsistence. Chapters 2 and 6, in particular, trace how knowledge of African and Amerindian origins—developed in the West Indies—shipped along with other cargoes into Europe, often transshipping out again back to the colonies and beyond. The Conclusion also investigates agnotology, or the types of cultural ignorance, that blocked specific knowledges from crossing from one nexus to the next.37
The Problem of Sources
This book began with a “find.” While researching Plants and Empire, I discovered John Quier’s smallpox experiments, which served not only to improve inoculation practices in the Caribbean but also to investigate questions that physicians in Europe would not. Investigating Quier’s practices led to my driving question in this current book: Were the myriad vulnerable slave bodies exploited in medical experiments? As I progressed, I became intrigued with the origins of modern medical testing. I also became intrigued to discover how Amerindians and persons of African origins in the Caribbean tested the remedies widely used on plantations.
I focus on two empires—the British and the French—to allow for comparison of attitudes toward non-European regimes of healing, experimental procedures (largely similar across Europe), and colonial medical infrastructure (which differed in essential aspects). Work across even greater swaths of territory, such as the Dutch, Danish, and Spanish empires, would further sharpen our understanding. Recent work on the Spanish Americas, for example, has unearthed Spanish Inquisition records that transcribed the testimony of condemned healers of African origins. Since Natalie Zemon Davis’s pathbreaking work on Martin Guerre, court records have held the promise of access to the lives of those who could neither read nor write. Although Inquisition court reporters understood themselves to be transcribing the accused’s words verbatim, testimony was filtered (consciously or unconsciously), first, through translation and, further, through Catholic cosmologies.38 Hence, our access to Amerindian and African-based medical practices—many actively collected—is filtered through European texts, whether those of the Inquisition in Spanish America or of naturalists and medical doctors across the Americas. This book consequently privileges European-style experimentation—in both the sources used and the ways “experimentation” is conceptualized. While we can glean much from European scribes, many African and Amerindian naturalists active in these areas remain faceless and nameless—often referred to as “slave doctors” or “Negro doctors.”
It is possible that native Amerindians (the Caribs, Arawaks, or Galibi) or enslaved Africans in the Caribbean—both women and men, as the French emphasized—forged methods for testing the drugs that Europeans were so eager to know about upon their arrival. Here we get only suggestions and fleeting clues. The ethnobotanist Tinde van Andel, for example, has argued that slaves tested plants by “trial and error,” as reported by Daniel Rolander in Suriname in the 1750s. According to van Andel’s account, these methods consisted mostly of testing for toxicity by tasting new plants. Historian Pablo Gómez has found instances of African-Cartagenan healers experimenting with potential cures—sometimes on themselves, sometimes on animals, and at other times using a special mat. Further, Bertrand Bajon, a royal naval surgeon and then private physician in Cayenne, reported that “sauvages” (by whom he meant Amerindians) knew many remedies but had not “the least idea of medicine.” He continued, however, that many of these remedies were successful. Whatever testing methods the Amerindians and slaves in Cayenne may have used, Bajon was not privy to them; he lamented that both Amerindians and enslaved Africans shrouded their cures in secrecy (see Conclusion).39
If there were independent experimental traditions in the West Indies among the indigenous or slave populations, these have yet to be discovered. Even when slaves had an effective cure, Europeans often insisted on testing it by their own methods. Thus cures, whether those of enslaved Africans or Amerindians, were tested by European medical establishments according to newly developing medical procedures throughout European holdings.
Although we do not have direct accounts of African medical techniques, we can glimpse African practitioners’ expertise in tropical medicines by working in new ways with traditional sources. Chapter 2, in particular, is inspired by Judith Carney and Richard Rosomoff’s fascinating work that offers new clues to how plants and knowledge of their uses circulated. Following their lead, I have shifted focus from the “republic of lettered men” to the “republic of plants.” What can the circulation of plants themselves tell us about the provenance of a cure? And about whose knowledge is embedded in that cure? Carney and Rosomoff have discussed in detail Africa’s botanical legacy in the Atlantic World. The African diaspora, they emphasize, is one of plants as well as people. Altogether, Carney and Rosomoff calculate, nineteen genera from fifteen botanical families moved from Africa to tropical America. These included yam, millet, banana, groundnut, tamarind, guinea squash, hibiscus, sesame, okra (used as food and also combined with Amerindian plants to produce abortifacients), lablab bean, sorghum, and a species of rice. In this way, they urge, “Slaves Africanized the food system of plantation societies of the Americas.”40
It is impossible to know with any precision how much African medical knowledge was transferred into the New World. Displaced Africans must have found familiar medicinal plants growing in the American tropics, and they must have discovered—through commerce with the Amerindians or their own trial and error—plants with virtues similar to those of plants used back home. They may also have carried seeds and African medical plants on board slave ships (chapter 2).
This book stands at the confluence of many streams of literature: the history of medicine, human experimentation, slavery, race, colonialism, empire, indigenous knowledge, and the circulation of people, plants, and knowledges. It could not have been written without some of the remarkable works that dug deep into existent sources and conceptualized large swaths of historical territory. Of special note are Richard Sheridan’s work on health care in the British Caribbean, Pierre Pluchon’s and Mark Harrison’s studies of colonial and military medicine, James McClellan III and François Regourd’s monumental work on science and medicine of all sorts in the French Antilles, Philip Curtin’s foundational work on the plantation complex, Judith Carney and Richard Rosomoff’s exquisite exploration of African ethnobotany, and Robert Baker’s synthesis of medical ethics across cultures and epochs.41
A NOTE ON TERMINOLOGY: peoples of African origins were called Negroes (in French, Nègres) or slaves (esclaves) in the eighteenth-century plantation complex. I will refer to them in this fashion. They were occasionally called blacks (noirs), but more often Negroes. It would be improper to call the enslaved Africans if they were, in fact, African Creoles born in the islands. Many people of African origins in the Americas were, in fact, Africans—but they hailed from such diverse cultures that to call them “African” reveals little about their specific knowledge or beliefs.42 European rarely specified slaves’ specific origins or provided names of any useful sort (chapter 1).
1. Society in Edinburgh, “Medical News,” Medical and Philosophical Commentaries 2 (1774): 90–92; James Thomson, “Observations and Experiments on the Nature of the Morbid Poison Called Yaws, with Coloured Engraving of the Eruption,” Edinburgh Medical and Surgical Journal 15 (1819): 321–28, esp. 326.
2. Philip Curtin, The Rise and Fall of the Plantation Complex (Cambridge: Cambridge University Press, 1990).
3. Andreas-Holger Maehle, Drugs on Trial: Experimental Pharmacology and Therapeutic Innovation in the Eighteenth Century (Amsterdam: Rodopi, 1999); Jean Astruc, Doutes sur l’inoculation de la petite vérole (Paris, 1756), 12–13; Richard, Munier, [and] Sabbatier, “Épreuves d’un remède contre l’épilepsie, etc.,” Journal de médecine, chirurgie, pharmacie, etc. 44 (1775): 37–56; Georg Friedrich Hildebrandt, Versuch einer philosophischen Pharmakologie (Braunschweig, 1786), 86; Johann Friedrich Gmelin, Allgemeine Geschichte der Gifte, 3 vols. (Leipzig, 1776), esp. 1:34; Francis Home, Clinical Experiments, Histories, and Dissections (London, 1782), vii. See also Susan Lederer, Subjected to Science: Human Experimentation in America before the Second World War (Baltimore: Johns Hopkins University Press, 1995).
4. Ulrich Tröhler, To Improve the Evidence of Medicine: The 18th Century British Origins of a Critical Approach (Edinburgh: Royal College of Physicians of Edinburgh, 2000), 36. See also Harry Herr, “Franklin, Lavoisier, and Mesmer: Origin of the Controlled Clinical Trial,” Urologic Oncology: Seminars and Original Investigations 23 (2005): 346–51; Abraham Lilienfeld, “Ceteris Paribus: The Evolution of the Clinical Trial,” Bulletin of the History of Medicine 56 (1982): 1–18. On placebos, see Arthur Shapiro and Elaine Shapiro, The Powerful Placebo (Baltimore: Johns Hopkins University Press, 1997); Anne Harrington, ed., The Placebo Effect: An Interdisciplinary Exploration (Cambridge, MA: Harvard University Press, 1997). On the use of statistical methods in medical research, see Andrea Rusnock, Vital Accounts: Quantifying Health and Population in Eighteenth-Century England and France (Cambridge: Cambridge University Press, 2002).
5. James Lind, A Treatise on the Scurvy (Edinburgh, 1753); John Hunter (1728–93), A Treatise on the Venereal Disease (London, 1791); Edward Jenner, An Inquiry into the Causes and Effects of the Variolæ Vaccinæ (London, 1798); Rolf Winau, “Experimentelle Pharmakologie und Toxikologie im 18. Jahrhundert” (Habil. Schrift, Johannes Gutenberg-Universität Mainz, 1971), excerpted in Winau, “Vom kasuistischen Behandlungsversuch zum kontrollierten klinischen Versuch,” in Versuche mit Menschen in Medizin, Humanwissenschaft und Politik, ed. Hanfried Helmchen and Rolf Winau (Berlin: Walter de Gruyter, 1986), 83–107.
6. Mark Harrison, “Disease and Medicine in the Armies of British India, 1750–1830: The Treatment of Fevers and the Emergence of Tropical Therapeutics,” in British Military and Naval Medicine, 1600–1830, ed. Geoffrey Hudson (Amsterdam: Rodopi, 2007), 87–119, esp. 90. See also Deborah Neill, Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (Stanford, CA: Stanford University Press, 2012); Gordon Cook, “History of Tropical Medicine, and Medicine in the Tropics,” in Manson’s Tropical Diseases, ed. Jeremy Farrar et al. (London: Elsevier, 2014), 1–8; Michael Osborne, The Emergence of Tropical Medicine in France (Chicago: University of Chicago Press, 2014).
7. Thomas Dancer, The Medical Assistant; or Jamaica Practice of Physic: Designed Chiefly for the Use of Families and Plantations, 2nd ed. (St. Jago de la Vega, Jamaica, 1809), ix. See also Jean-Barthélemy Dazille, Observations sur les maladies des nègres, leur causes, leurs traitemens et les moyens de les prévenir (Paris, 1776).
8. Londa Schiebinger, Plants and Empire: Colonial Bioprospecting in the Atlantic World (Cambridge, MA: Harvard University Press, 2004).
9. Benjamin Moseley, Treatise on Tropical Diseases; or on Military Operations; and on the Climate of the West-Indies (London, 1787), v–vi. See Kenneth Kiple, The Caribbean Slave: A Biological History (Cambridge: Cambridge University Press, 1981); Philip Curtin, Death by Migration (Cambridge: Cambridge University Press, 1989); J. R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (Cambridge: Cambridge University Press, 2010).
10. On subjects used in medical testing, see Londa Schiebinger, “Human Experimentation in the Eighteenth Century: Natural Boundaries and Valid Testing,” in The Moral Authority of Nature, ed. Lorraine Daston and Fernando Vidal (Chicago: University of Chicago Press, 2003), 384–408. On the Hôpital de la Pitié’s experiment, see “A New Remedy for the Itch,” Journal of the Practice of Medicine, Surgery, and Pharmacy, in the Military Hospitals of France 1 (1786): 63–73, esp. 68. On publication bias, see Paola Bertucci, “Shocking Subjects: Human Experiments and the Material Culture of Medical Electricity in Eighteenth-Century England,” in The Uses of Humans in Experiment: Perspectives from the 17th to the 20th Century, ed. Erika Dyck and Larry Stewart (Leiden: Koninklijke Brill, 2016), 111–38, esp. 137.
11. There is a long history of medical exploitation, including Nazi concentration camp experiments, radiation experiments, prison experiments, and Guatemalan syphilis experiments, among others. Other populations, of course, were also exploited. See, for example, Robert N. Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge, MA: Harvard University Press, 1988); George Annas and Michael Grodin, The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation (Oxford: Oxford University Press, 1995); Paul Weindling, Victims and Survivors of Nazi Human Experiments: Science and Suffering in the Holocaust (London: Bloomsbury Academic Publishers, 2015); Lederer, Subjected to Science; Allen Hornblum, Acres of Skin: Human Experiments at Holmesburg Prison (New York: Routledge, 1998); US House of Representatives, American Nuclear Guinea Pigs: Three Decades of Radiation Experiments on U.S. Citizens (Washington, DC: US Government Printing Office, 1986).
12. Robert Baker, Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution (New York: Oxford University Press, 2013), 254, 274–317. On the Tuskegee Syphilis Study, see James Jones, Bad Blood: The Tuskegee Syphilis Experiment (1989; repr., New York: Free Press, 1993); Susan Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina Press, 2009); Marcella Alsan and Marianne Wanamaker, “Tuskegee and the Health of Black Men,” working paper, National Bureau of Economic Research, June 2016. Experiments are now often done offshore. See, for example, Susan Reverby, “‘Normal Exposure’ and Inoculation Syphilis: A PHS ‘Tuskegee’ Doctor in Guatemala, 1946–1948,” Journal of Policy History 23 (2011): 6–28.
13. Bernard Lo and Nesrin Garan, “Research with Ethnic and Minority Populations,” in The Oxford Textbook of Clinical Research Ethics, ed. Ezekiel Emanuel et al. (New York: Oxford University Press, 2008), 423–30, esp. 423–24. See also Vicki Freimuth et al., “African Americans’ Views on Research and the Tuskegee Syphilis Study,” Social Science and Medicine 52 (2001): 797–808. The inclusion of women and minorities in public-funded US clinical research was made law in 1993 (Public Law 103-43, Subtitle B, Clinical Research Equity Regarding Women and Minorities).
14. Todd Savitt, “The Use of Blacks for Medical Experimentation and Demonstration in the Old South,” Journal of Southern History 48 (1982): 331–48, esp. 332; Todd Savitt, Race and Medicine in Nineteenth- and Early-Twentieth-Century America (Kent, OH: Kent State University Press, 2007); Sharla Fett, Working Cures: Healing, Health, and Power on Southern Slave Plantations (Chapel Hill: University of North Carolina Press, 2002).
15. On this point, see James Makittrick Adair, Unanswerable Arguments against the Abolition of the Slave Trade (London, ), 145–46. See also Paul Brodwin, Medicine and Morality in Haiti: The Contest for Healing Power (Cambridge: Cambridge University Press, 1996), 30.
16. Robert Renny, An History of Jamaica (London, 1807), 188.
17. Richard Sheridan, Doctors and Slaves: A Medical and Demographic History of Slavery in the British West Indies, 1680–1834 (Cambridge: Cambridge University Press, 1985), 40; James Thomson, A Treatise on the Diseases of Negroes, as They Occur in the Island of Jamaica (Jamaica, 1820), 10.
18. Colin Chisholm, An Essay on the Malignant Pestilential Fever, 2 vols. (London, 1801), 2:461–72.
19. A. J. Alexander to Joseph Black, Bacolet, Grenada, July 26, 1773, in Joseph Black, The Correspondence of Joseph Black, ed. Robert Anderson and Jean Jones, 2 vols. (Surrey: Ashgate, 2012), 1:288.
20. Quoted in Baker, Before Bioethics, 74–75. See also Laurence McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine (Dordrecht: Kluwer Academic Publishers, 1998).
21. Schiebinger, “Human Experimentation.”
22. On self-experimentation, see also Susan Lederer, “Walter Reed and the Yellow Fever Experiments,” in Emanuel et al., Oxford Textbook, 9–17. See also Baker, Before Bioethics, 74–76; [William Wright], Memoir of the Late William Wright, M.D. (Edinburgh, 1828), 342; William Wright, “On the External Use of Cold Water in the Cure of Fever,” London Medical Journal 7, pt. 2 (1786): 109–15. That Wright first tried this practice on himself was repeated in the medical literature (review of Medical Reports on the Effects of Water, Cold and Warm, as a Remedy in Fever and Other Diseases, by James Currie, Annals of Medicine 3 : 4).
23. [Wright], Memoir, 27, 348.
24. [Donald Monro], ed., Letters and Essays . . . by Different Practitioners (London, 1778), 18, 65.
25. Charles Maitland, Mr. Maitland’s Account of Inoculating the Small Pox (London, 1722); see also Hans Sloane, “An Account of Inoculation,” Philosophical Transactions 49 (1756): 516–20.
26. On the categories “therapeutic” versus “nontherapeutic” in relation to experiments, see also Baker, Before Bioethics, 74.
27. On Quier, see Michael Craton, Searching for the Invisible Man: Slaves and Plantation Life in Jamaica (Cambridge, MA: Harvard University Press, 1978), 259–64.
28. Jean-Barthélemy Dazille, Observations sur les maladies des nègres, leur causes, leurs traitemens et les moyens de les prévenir, 2 vols., 2nd ed. (Paris, 1792), 1: Avertissement, 3–4; 2:417–18.
29. On Obeah, see Jerome Handler and Kenneth Bilby, “Obeah: Healing and Protection in West Indian Slave Life,” Journal of Caribbean History 38 (2004): 153–83.
30. John Haygarth, Of the Imagination, as a Cause and as a Cure of Disorders of the Body: Exemplified by Fictitious Tractors, and Epidemical Convulsions (Bath, 1800). See also Franklin Miller et al., The Placebo: A Reader (Baltimore: Johns Hopkins University Press, 2013).
31. Great Britain, House of Commons, Report of the Lords of the Committee of Council Appointed for the Consideration of All Matters Relating to Trade and Foreign Plantations; . . . ([London], 1789), Part III, Jamaica, following No. 26, C, paper delivered by Mr. Rheder; reprinted in Bryan Edwards, The History, Civil and Commercial, of the British West Indies, 5 vols. (1793; repr., London, 1819), 2:117–19.
32. Médéric-Louis-Élie Moreau de Saint-Méry, Loix et constitutions des colonies françoises de l’Amerique sous le vent, 6 vols. (Paris, 1784–85), 4:724; Charles Arthaud, Observations sur les lois concernant la médecine et la chirurgie dans la colonie de Saint-Domingue (Cap-Français, 1791), 76–78. See also Pierre Pluchon, ed., Histoire des médecins et pharmaciens de marine et des colonies (Toulouse: Bibliothèque historique Privat, 1985), 109–10.
33. John Williamson, Medical and Miscellaneous Observations, Relative to the West India Islands, 2 vols. (Edinburgh, 1817), 1:26.
34. Great Britain, House of Commons, Report of the Lords.
35. The circulation of knowledge is a robust theme in the history of science. See, among others, Steven Harris, “Long-Distance Corporations, Big Sciences, and the Geography of Knowledge,” Configurations 6 (1998): 269–304; Harold Cook, Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age (New Haven, CT: Yale University Press, 2007); Kapil Raj, Relocating Modern Science: Circulation and the Construction of Knowledge in South Asia and Europe, 1650–1900 (Houndmills, Basingstoke, Hampshire: Palgrave Macmillan, 2007); James Delbourgo and Nicolas Dew, eds., Science and Empire in the Atlantic World (New York: Routledge, 2008); Simon Schaffer et al., eds., The Brokered World: Go-Betweens and Global Intelligence, 1770–1820 (Sagamore Beach, MA: Science History Publications, 2009); Sven Dupré and Christoph Lüthy, eds., Silent Messengers: The Circulation of Material Objects of Knowledge in the Early Modern Low Countries (Berlin: LIT, 2011); Bernard Lightman, Gordon McQuat, and Larry Stewart, eds., The Circulation of Knowledge between Britain, India, and China (Leiden: Koninklijke Brill NV, 2013); Paula Findlen, ed., Early Modern Things: Objects and Their Histories, 1500–1800 (New York: Routledge, 2013).
36. Bruno Latour, Science in Action (Cambridge, MA: Harvard University Press, 1987), 232–37.
37. Robert Proctor and Londa Schiebinger, eds., Agnotology: The Making and Unmaking of Ignorance (Stanford, CA: Stanford University Press, 2008); Schiebinger, Plants and Empire.
38. Natalie Zemon Davis, The Return of Martin Guerre (Cambridge, MA: Harvard University Press, 1983); Pablo Gómez, “The Circulation of Bodily Knowledge in the Seventeenth-Century Black Spanish Caribbean,” Social History of Medicine 26 (2013): 383–402, esp. 388; Pablo Gómez, “Transatlantic Meanings: African Rituals and Material Culture from the Early-Modern Spanish Caribbean,” in Materialities of Ritual in the Black Atlantic, ed. Akinwumi Ogundiran and Paula Saunders (Bloomington: Indiana University Press, 2014), 125–42, esp. 127. See also James Sweet, Domingos Álvares, African Healing, and the Intellectual History of the Atlantic World (Chapel Hill: University of North Carolina Press, 2011).
39. [Nicolas-Louis Bourgeois], Voyages intéressans dans différentes colonies françaises, espagnoles, anglaises, etc. (London, 1788), 470; Tinde van Andel, Paul Maas, and James Dobreff, “Ethnobotanical Notes from Daniel Rolander’s Diarium Surinamicum (1754–1756): Are These Plants Still Used in Suriname Today?,” Taxon 61 (2012): 852–63, esp. 857–58; Tinde van Andel, “The Reinvention of Household Medicine by Enslaved Africans in Suriname,” Social History of Medicine 29 (2015): 1–19; Kathleen Murphy, “Translating the Vernacular: Indigenous and African Knowledge in the Eighteenth-Century British Atlantic,” Atlantic Studies 8 (2011): 29–48; Gómez, “Circulation of Bodily Knowledge,” 400; Gómez, “Transatlantic Meanings,” 131–32; Bertrand Bajon, “Observations sur quelques bon remédes contre les vers de l’isle de Cayenne,” Journal de médecine, chirurgie, pharmacie, etc. 34 (1770): 60–74, esp. 60; Bertrand Bajon, Mémoires pour servir à l’histoire de Cayenne, et de la Guiane françoise, 2 vols. (Paris, 1777–78), 1:361.
40. Judith Carney and Richard Rosomoff, In the Shadow of Slavery: Africa’s Botanical Legacy in the Atlantic World (Berkeley: University of California Press, 2009), 1–5. Natalie Davis also documents plants in slaves’ gardens that made the trip from Africa to Suriname (“Physicians, Healers, and Their Remedies in Colonial Suriname,” Canadian Bulletin of Medical History 33 : 3–34, esp. 13).
41. Sheridan, Doctors and Slaves; Pluchon, Histoire des médecins; Mark Harrison, Medicine in an Age of Commerce and Empire: Britain and Its Tropical Colonies, 1660–1830 (Oxford: Oxford University Press, 2010); James McClellan III, Colonialism and Science: Saint Domingue in the Old Regime (Baltimore: Johns Hopkins University Press, 1992); James McClellan III and François Regourd, The Colonial Machine: French Science and Overseas Expansion in the Old Regime (Turnhout: Brepols, 2011); Curtin, Rise and Fall; Baker, Before Bioethics; Robert Baker and Laurence McCullough, eds., The Cambridge World History of Medical Ethics (Cambridge: Cambridge University Press, 2009). See also Karol Weaver, Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue (Urbana: University of Illinois Press, 2006).
42. Stephan Palmié, ed., Africas of the Americas: Beyond the Search for Origins in the Study of Afro-Atlantic Religions (Leiden: Brill, 2008); John Thornton, Africa and Africans in the Making of the Atlantic World, 1400–1800 (Cambridge: Cambridge University Press, 1998).