It is 1840, and you wake up feeling ill. You are a black adult living, like about 70 percent of Virginia's African-Americans, on a white owned farm with ten or more other blacks. Blacks constitute between 40 and 50 percent of the total population of the state, though only about 10 percent of your number are free. How do you handle your sickness?
(We will not discuss free blacks in the Old Dominion because of their small number and our limited space but will concentrate on the remaining 90 percent of the state's black population. In general, free blacks had little money to use for professional medical care when home remedies did not work. Some Virginia physicians provided them with medical care gratis, and some whites paid for free black medical care or took the cost of providing such care from their free black employees' salaries. Eastern Lunatic Asylum admitted free blacks throughout the antebellum period.)
The major issue you confront this morning as a sick slave is, Who controls your body? It is, after all, your body that ails. By caring for your own illness you are making a statement of autonomy. You know that the rule of this plantation is to report all illnesses to the master or the overseer, or face the consequences. You risk at least a reprimand if not physical punishment for your action. All you want to do is get relief from illness in your own way.
Then, too, you really prefer the gentler, herbal treatments that circulate in the slave quarters of this and nearby plantations. Though white medicines and treatment regimens do sometimes seem to cure, they are different from the ones you have learned in the quarters; nor do you particularly like the white physician who comes when ailments do not respond to the master's ministrations. Besides, whites do not understand that sometimes sickness and injury result from conjuring and rooting, things their medicines cannot cure. You decide to treat yourself.
The symptoms persist, however, and your self-help approach fails. Now you're getting worried both because your health is worsening and because you cannot ask your fellow slaves to cover for you much longer. You swallow hard and turn to the master, trying to look as healthy as possible, though it is obvious from the seriousness of your symptoms that you have been sick for a while and have waited to inform him.
Such delays in informing slaveholders of illnesses only confirmed white Virginians' stereotypes of black self-care. In letters about health matters masters typically observed, "I know that negroes especially, are very inattentive to such [health] matters as require attention and trouble." Owners wished to keep their slave investments healthy; they tended to see blacks as people unwilling to care for themselves and their children and incapable of doing so.
Masters, mistresses, and sometimes trusted servants treated ailing slaves in a hospital or cabin in the slave quarters. The quarters actually formed a small village where blacks encountered a variety of public health problems. Close contact in the confined space of the quarters, especially in winter, allowed respiratory diseases to spread easily. If people followed unsanitary waste disposal practices and allowed waste to seep into wells or flow into streams from which drinking water was drawn, parasitic worm and intestinal diseases occurred. Children played close to the earth and put dirty fingers that sometimes contained tiny parasite eggs into their mouths. Insects attracted to decaying garbage and human waste sometimes passed infections to the humans on whom they landed. Poorly cooked food contained parasites or bacteria that could infect all who ate it. Not surprisingly, under these conditions disease was a major factor in slave life. When plantation remedies failed, slaveholders, without the advice or consent of the enslaved patients, turned to physicians:
Betty a negro woman of mine is very sick, and I am fearful in a very dangerous situation. There had been no appearance of the Mensus (menstrual period) for upwards of three months or probably more, till a fortnight ago, Since which time it has continued to flow very largely attended occasionally with extreme pain in the ear, jaw and teeth. I wish you to visit her as soon as you can, or prescribe.
Physicians used the same approach for all patients, though with some modifications based on whites' medical ideas about blacks. The editor of a prominent Richmond medical journal openly declared in 1855 that "the African constitution sinks before the heavy blows of the 'heroic school"' that advocated, like Benjamin Rush, large doses of medicines and treatments such as bleeding, purgatives, and emetics that depleted the body. Blacks, physicians argued, were more susceptible than whites to certain diseases and more resistant to others. Still, the power of the humoral system often outweighed other considerations for both physicians and slaveholders. Wrote one master to a physician in Hanover County:
Sir, 'Boston took a dose of Salts (a laxative) & was bled on friday. We took nearly a pint; we stopped because he complained of being fainty. The salts operated three times that day & he had not another passage till last night, which was by injection. I think he is something better than usual this morning, no fever. He wants to eat milk & mush. May he? His cough is not so violent nor so frequent.
In some instances, slaveholders sought the aid of physicians outside their own communities, practitioners such as John Peter Mettauer of Prince Edward County, whose reputation at curing stubborn ailments traveled by word-of- mouth across the commonwealth:
I have heard that you have been successful in curing some cases of Scrofula ( a form of tuberculosis). I have taken the liberty to send my man Washington to you in the hope that he may be another evidence of your skill. If, after examination, you think that you will be able to relieve him, you will please retain him as long as necessary. ... My object is the benefit of the negro.
Though masters frowned upon them, black practitioners, both slave and free, were active all over Virginia. Some were herbalists, such as the man owned by Robert Carter of Nomini Hall in Westmoreland County. William Dawson, a neighbor, informed Carter in 1788: "Some of the negroe Children is very Sick. (Janey's youngest). please to let Bro' Tom Coachman come and See it this morning. The Black people at this place hath more faith in him as a doctor, than any white Doctr. and as I wrote you in a former letter I can not expect you to loan your mans time &c for nothing But am very willing to pay for the Same."
Herbal practitioners were one thing, conjurers another. Conjuring originated in Africa, where traditional medicine and religion were bound together, and came to America with slavery. In Virginia, conjurers gained power among slaves by playing on these African traditions and superstitions. They did succeed in curing some slaves.
If slaves began acting oddly they might be judged insane and admitted to the Eastern Lunatic Asylum. There Dr. John Minson Galt accepted blacks for treatment. Though they received the same sort of "moral-treatment" approach to insanity as did the white patients, blacks were put to work on much more strenuous tasks and placed in less desirable living quarters.
From Fevers, Agues, and Cures: Medical Life in Old Virginia. By Todd L. Savitt
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