The Use of Blacks for Medical Experimentation and

Transcription

The Use of Blacks for Medical Experimentation and
Southern Historical Association
The Use of Blacks for Medical Experimentation and Demonstration in the Old South
Author(s): Todd L. Savitt
Source: The Journal of Southern History, Vol. 48, No. 3 (Aug., 1982), pp. 331-348
Published by: Southern Historical Association
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The Use of Blacks for
Medical Experimentation
and
Demonstration in the Old South
By TODD L. SAVITT
"AN
ABUNDANCE
OF MATERIALS IN THE SOUTHERN MEDICAL JOUR-
nals reveals that slaves had a fairly significant role in medical
education and in experimentaland radical medical and surgical
practiceof the antebellumSouth," remarkedJ. WalterFisherin a
1968articledescribingsomeof the medicalusesto whichslaveswere
put in the Old South.' Furtherinvestigationinto this subjectindicates that southernwhite medicaleducatorsand researchersrelied
greatlyon the availabilityof Negro patientsfor variouspurposes.
Black bodies often found their way to dissectingtables, operating
amphitheaters,classroomor bedside demonstrations,and experimentalfacilities.Thisis not to denythat whitebodiesweresimilarly
used.2In northerncities and in southernport towns such as New
Orleans, Louisville, Memphis, Charleston, and Mobile, where
poor, transientwhites were abundant, seamen, Europeanimmigrants,and white indigentsundoubtedlyjoined blacksin fulfilling
' Fisher, "Physicians and Slavery in the Antebellum Southern Medical Journal," Journal
of the History of Medicine and Allied Sciences, XXIII (January 1968), 45. W. Montague
Cobb discussed a similar theme in "Surgery and the Negro Physician: Some Parallels in
Background," National Medical Association, Journal, XLIII (May 1951), 145-52, especially 147-48.
2 David C. Humphrey, "Dissection and Discrimination: The Social Origins of Cadavers in
America, 1760-1915," New York Academy of Medicine, Bulletin, XLIX (September 1973),
819-27; John B. Blake, "Anatomy," in Ronald L. Numbers, ed., The Education of
American Physicians: Historical Essays (Berkeley, Los Angeles, and London, 1980), 34-35,
37.
associate professor, Medical HumanitiesSection, East
CarolinaUniversityCollege of Medicine.An abbreviatedversionof the
paper was presentedat the forty-fifth annual meeting of the Southern
HistoricalAssociation,Atlanta,Georgia,November15, 1979.Theauthor
would like to thank Ronald L. Numbersand Eric Christiansonfor their
helpful suggestions.Researchfor this articlewas supportedby a grant
from the National Libraryof Medicine of the National Institutes of
Health, No. LM 02477.
MR. SAVITT is
THE JOURNALOF SOUTHERNHISTORY
Vol. XLVIII, No. 3, August 1982
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THE JO URNA L OF SO UTHERN
332
HIS TOR Y
the "clinicalmaterial"needsof the medicalprofession.But blacks
were particularlyeasy targets, given their positions as voiceless
slaves or "free persons of color" in a society sensitive to and
separatedby race. This open and deliberateuse of blacksfor medicalresearchand demonstrationwellillustratesthe racialattitudesof
antebellumwhite southerners.
Interestingly,people generallyassumedthat informationgained
from observationof Negro bodies was applicableto Caucasians.
Despitethe politicalrhetoricthen currentin the Old South about a
separatemedicine for blacks and for whites,3 the research and
teachingreflected, in fact, the opposite. Negroes did not seem to
differ enoughfrom Caucasiansto excludethem from extensiveuse
in southernmedical schools and in researchactivities.4
Use of blacks for medical experimentationand demonstration
wasnot the resultof a consciousorganizedplan on the partof white
southernersto learnmoreaboutthe differencesbetweenthe racesor
even how better to care for their black charges. The examples
relatedin this articlereflectthe actionsof individualresearchersand
medicalinstitutions.Takentogether, however,a patternemerges.
Blackswere consideredmore availableand more accessiblein this
white-dominatedsociety: they were renderedphysicallyvisible by
their skin color but were legally invisible because of their slave
status.
Throughouthistory medicinehas requiredbodies for teaching
purposes.Studentshad to learnanatomy,recognizeand diagnose
diseases,and treatconditionsrequiringsurgery;researchershad to
try out their ideas and new techniques;and practitionershad to
performautopsiesto confirmtheirdiagnosesandto understandthe
effects of diseaseson the humanbody. The need for humanspecimens became more recognizedand more emphasizedin America
duringthe first half of the nineteenthcenturyas the ideas of the
Frenchschool of hospitalmedicinereachedthis country.5Bedside
3John Duffy, "A Note on Ante-BellumSouthernNationalismand MedicalPractice,"
Journalof SouthernHistory,XXXIV(May1968),274-76; JohnS. Haller,Jr., "TheNegro
andthe SouthernPhysician:A Studyof MedicalandRacialAttitudes,1800-1860,"Medical
History,XVI (July 1972),247-51;ToddL. Savitt,Medicineand Slavery:TheDiseasesand
HealthCareof Blacksin AntebellumVirginia(Urbana,Chicago,andLondon,1978),7-17.
4Commenting on this irony,the anatomistW. MontagueCobb, himselfblack, wrotein
1951,
". .
. our [white] colleagues recognized in the Negro [on the dissecting table] a
perfectionin humanstructurewhichtheywereunwillingto concedewhenthatstructurewas
animatedby the vital spark." Cobb, "Surgeryand the Negro Physician,"148.
5 On the ideas and importanceof the Paris school of hospitalmedicinesee ErwinH.
Ackerknecht,Medicine at the Paris Hospital, 1794-1848 (Baltimore, 1967); Michel
Foucault,TheBirthof theClinic:An Archaeologyof MedicalPerception(NewYork,1973).
On the influenceof the Paris school on Americanmedicinesee RichardH. Shryock,The
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MEDICA L EXPERIMENTA
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experience,clinical-pathologicalcorrelations,and statisticalstudies
became increasinglyimportant.And medical schools throughout
the United States, includingthose in the South, attemptedto meet
the new demands of students for a modern education. Clinics,
infirmaries,and hospitalswere opened in conjunctionwith those
colleges;patients,however,werenot alwayswillingto enter.To fill
beds it becameessentialto use the poor and the enslaved.Medicine
thus capitalizedon the need of the indigent and the helpless for
medicalcare. In the Southwhiteattitudestowardblacksensuredthe
selectionof patientsof thisgroupas specimens,thoughsomewhites
were also used.
Competitionfor studentsamong southernmedical schools was
fierceduringthe thirtyyearsprecedingthe CivilWar,whichled each
institutionto publicizethe positiveaspectsof its programin newspapers, medical journals, circulars, and magazines. One of the
major requisitesof any school was an abundantsupply of clinical
material-living patientsfor medicaland surgicaldemonstrations
as well as cadavers for anatomical dissections and pathological
examinations.Institutionalreputationswere made and broken on
the basisof the availabilityof teachingspecimens.The Transylvania
UniversityMedicalDepartmentin Lexington,Kentucky,servesas a
casein point. Oneof the causesfor its declinefromeminenceduring
the 1830swasits purporteddifficultyin procuringbodiesfor clinical
teaching.Despitenumerousattemptsby both facultyand students
to dispel rumorsabout the shortageof specimensand demonstration materialsat the medicalschool, it was impossibleto reversethe
negative impressionsof students. On the other hand, a medical
school was established in nearby Louisville (Louisville Medical
Institute)in 1837,owing in partto the presenceof a largeblack (as
well as transient white) population, well suited to the needs of
teachinginstitutions.6
Developmentof ModernMedicine:An Interpretationof the Social and ScientificFactors
Involved(NewYork, 1947),170-91;GeraldN. Grob,EdwardJarvisandtheMedicalWorld
of Nineteenth-Century
America(Knoxville,Tenn., 1978), 37-38.
6 Robert Peter, The History of the Medical Departmentof TransylvaniaUniversity
(Louisville,1905),61; cataloguesof the MedicalDepartmentof TransylvaniaUniversity,
1829-1855,in the libraryat TransylvaniaCollege, Lexington,Kentucky;"Preambleand
Resolutionsof the DissectingClass[of TransylvaniaMedicalCollege,1837/38],"Appendix
to ThomasD. Mitchell,"TransylvaniaCatalogueof MedicalGraduates,withan Appendix,
Containinga ConciseHistoryof the SchoolfromIts Commencement
to the PresentTime,"
TransylvaniaJournal of Medicine and Associate Sciences, XI (January-March1838),
229-30. For a discussionof the historyof anatomyin antebellumKentuckysee WayneC.
Williams,"The Teachersand Teachingof Anatomyin the MedicalDepartmentof TransylvaniaUniversity,1799-1857,"(unpublishedpaperin author'sand Savitt'spossession),
7-16. Mr.Williamsis Directorof the AudiovisualDept., EastCarolinaUniversitySchoolof
Medicine.See also John H. Ellis, Medicinein Kentucky(Lexington,Ky., 1977), 13.
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THE JOURNAL
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OF SOUTHERN
HIS TORY
To train students in disease management,the better southern
medicalschoolseitherestablishedinfirmariesor arrangedwithlocal
authoritiesto treat patients in poor houses or city hospitals. In
Georgia, Kentucky,Alabama, South Carolina,Virginia,and presumablyin othersouthernstatesthe patientsused for the education
of studentswerefrequentlyblack.Newspaperadvertisementsby the
AtlantaMedicalCollege, for example,encouragedownersto send
theirsick and injuredslavesto the infirmaryfor treatment.There,
"An intelligentnurseand faithfulservantwillbe in constantattendance." No mentionof the presenceof medicalstudentswas necessary. The boardingfee was reasonable(fifteen cents per day), and
the doctor'sfee waswaivedif the caseturnedout to be incurableand
the slave had to be sent home.7Probablytypicalof patientuse for
demonstrationsat the AtlantaMedicalCollegeInfirmarywas what
a professor of materia medica termed "An interestingcase of
HepaticAbscessin a negroman" who "was subjectto the examination of the Studentsfor severalweeksduringthe courseof lectures,
and waslecturedupon andprescribedfor in presenceof the Class."
Similarly,he wrotethat a blackwomansufferingfromtuberculosis
"had been under our occasional observation for a year previously. 8
South Carolinamedical institutionswere even more explicit in
their public requests for black patients. In the late 1830s both
Charlestonmedicalschools operatedinfirmariesduringthe regular
teachingsessionsfromNovemberto March,andboth cateredto the
large black populationresidentin the city and surroundingarea.
The hospitalof the MedicalCollegeof the Stateof South Carolina
admittedslaves,poor whites, and freeblacks. As an inducementto
lure patients from the competing medical-schoolhospital, infirmary officials made owners of slaves liable for no professional
charges,the only accountrenderedbeingthat for food andnursing.
This was so, they explained,because "The sole object of the Faculty .
.
. [is] to promote the interest of Medical education within
theirnativeStateand City."9The surgeryestablishedby the faculty
of the other school, the MedicalCollegeof South Carolina,admitted slaves and free blacks only. An advertisementplaced in the
' Quotedin FranklinM. Garrett,Atlantaand Environs:A Chronicleof Its People and
Events(2 vols., Athens,Ga., 1954),I, 395-96 (quotationon p. 395), fromAtlanta Weekly
Intelligence, October12,1855.See also GeraldL. Cates,"MedicalSchoolsin Ante-Bellum
Georgia"(unpublishedM.A. thesis, Universityof Georgia, 1968),92-93.
1 J. G. Westmoreland,"Reportof MedicalClinic, Continued,"Atlanta Medicaland
SurgicalJournal,I (February1856),329(firsttwo quotations),331(thirdquotation).Onthe
use of blacksand indigentwhitesin Alabamasee W. Taylor,"AnnualOration,"Medical
Associationof the State of Alabama, Transactions,VIII (February1855), 121.
9 Charleston
Courier,November14, 1837.
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CharlestonCourierrequestedplanterswith servants"laboringunderSurgicaldiseases,"local physicianswithslavepatientsrequiring
surgicalintervention,and "Such [free]personsof color as may not
be able to pay for Medical advice . . . ," to call at the hospital.
"The object of the Faculty . . . ," the announcement continued,
"is to collect as many interestingcases, as possible, for the benefit
and instructionof their pupils."'"
By 1841the MedicalCollegeof the State of South Carolinahad
establisheda permanentyear-roundhospital with large wards for
black and white patients. College officials claimedthat they had
little trouble filling beds at this new infirmary,because "the slave
populationof the city, and neighboringplantations,is capableof
furnishingamplematerialsfor clinicalinstruction."Studentsat the
school saw not only "all the common diseasesof the climate"but
also a varietyof operativeprocedures,owing to the presenceof a
slave population "peculiarlyliable to surgicaldiseases requiring
operationsfor theirrelief."" The medicalcollege continuedto use
black patientsfor surgicaldemonstrationsthroughoutthe antebellum years. Duringthe late 1850s,for instance,surgicalcasesoccurringamongblackswhile school was in sessionwereadmittedto the
"ColouredWards"of a newlyconstructedpublichospitalandwere
reservedfor the exclusiveuse of studentdoctors.'2
The use of black patients for medical-schooltrainingwas not
confinedto the lower South. The Hampden-SydneyCollegeMedical Department(calledthe MedicalCollegeof Virginiaafter 1854)
locatedin Richmondemployedmanyof the sametechniquesas the
South Carolinaand Georgiainstitutionsto attractNegroesinto its
infirmarywards.Facultyphysiciansannouncedin an 1853publication that "The numberof negroesemployedin our factorieswill
furnish materials for the support of an extensive hospital, and
afford to the studentthat greatdesideratum-clinicalinstruction."
They placed ads in countryeditions of Richmondnewspapersinforming rural slaveholdersof the infirmary'sfacilities, charged
lower rates for blacks, and attempted(unsuccessfully)to establish
first a slave hospital, then a free hospital for all indigentsand for
Ibid., November16, 1837.
Annual Circular of the TrusteesandFaculty of the Medical College of the State of South
Carolina ... Session of 1840-41 (Charleston, 1840), 5-6.
0
12
"A Planof Organizationfor the RoperHospital.Adoptedby the MedicalSociety,Jan.
3, 1846," Rules and Regulations for the Government of the Trustees and Officers of the
Roper Hospital (Charleston, 1861), 11-12; Annual Circular of the Trustees and Faculty of
the Medical College of the State of South Carolina ... Session of 1857-58 (Charleston,
1858), 17. See also Joseph I. Waring, A History of Medicine in South Carolina, 1825-1900
(Columbia, S. C., 1967), 75-76, 79n.
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THE JO URNA L OF SO UTHERN
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slaves.13Though none of the infirmary'srecords are extant, evidencefromcasehistoriesin the local medicaljournalsindicatesthat
a majorityof the patientswere black."4
Neitherwhitesnorblacksheldhospitalsin highesteemduringthe
antebellumperiod. Not only did patientsobject to havingmedical
studentsanddoctorstouchingandpokingthemanddiscussingtheir
illnessesand the meritsor problemsof particularmodes of treatment in theirpresence,but they also fearedthat experimentsmight
be performedon them and that they would be permittedto die so
autopsies could be undertaken.1INor were medical school announcements,circulatedto attractstudents,calculatedto encourage the sickly to request hospital admission. A Transylvania
UniversityMedical Departmentadvertisementfor the 1846-1847
session, though perhapsmore wishful than accurate,was typical:
"Clinicalinstructionsfully equalto the wantsof the class, aregiven
at the hospital.Experienceduringthe last sessionfullyattested,that
there were always patients sufficiently numerous for all useful
purposes.Valuableopportunitiesareherepresentedfor the studyof
the physicalsigns of ThoracicDiseases."16 Illiterateslavesdid not
haveto readsuchcircularsto learnaboutmedical-schoolhospitals;
their reputationsprecededthem.
Though fears about mistreatmentin southern hospitals were
generallyunfounded(doctorsandstudentsappeared,usually,to do
theirbest to curepatientson the wards),concernsregardingthe use
made of deceased patients were real. Autopsies and anatomical
I3 "An Addressto the Public in Regardto the Affairs of the MedicalDepartmentof
Hampden-Sydney
College,by SeveralPhysiciansof the Cityof Richmond,1853,"quotedin
WyndhamB. Blanton,Medicinein Virginiain the NineteenthCentury(Richmond,1933),
38-39 (quotation);RichmondEnquirer,May 8, 1860; "Notes of the Hampden-Sydney
MedicalDepartmentMinutes,"in WilliamT. Sanger,MedicalCollegeof VirginiaBefore
1925, and UniversityCollegeof Medicine1893-1913(Richmond,1973), 8; editorial,"A
State GeneralHospital," VirginiaMedicaland SurgicalJournal, I (April 1853), 173-74;
editorial,"TheVirginiaFreeHospital,"ibid., III(June1854),273-75. Formoredescriptive
detailssee Savitt,Medicineand Slavery,282-86.
14 Of 109patientsmentionedin Richmondmedicaljournalsbetween1851and 1860,63.3
percent(69)wereblack.Fora listingof thepertinentjournalarticlessee Savitt,Medicineand
Slavery,286.
1 See for exampleRichmondDaily Dispatch,July21, 1854;WilliamW. Brown,Clotel;
or, The President'sDaughter(London, 1853), 123-24, cited in Gladys-MarieFry, Night
Ridersin BlackFolk History(Knoxville,Tenn., 1975), 175-76; KeithA. Winsell,"Black
Identity:The SouthernNegro, 1830-1895"(unpublishedPh.D. dissertation,Universityof
Californiaat Los Angeles, 1971), 188.
16 Circular
of the TransylvaniaUniversityMedicalDepartment,Sessionof 1846-47,p. 4.
Fora vividdescriptionof the popularimageof distastefulhospitallife seeThomasJefferson
to James C. Cabell, May 16, 1824, in [NathanielF. Cabell, ed.], Early History of the
Universityof Virginiaas Containedin theLettersof ThomasJeffersonandJosephC. Cabell
(Richmond,1856), 310.
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dissectionswere(andare)integraland importantaspectsof a medical education,butpeopleexpressedgreataversionto the prospectof
havingtheir bodies minutelyinvestigatedafter death. Complained
one Georgiaphysician:"Thereis a superstitiousprejudiceexisting
in referenceto them [autopsies],and it is seldom we can securea
case, except where the light of science has made headway."1I7
In
1861 a residentdoctor at Charleston'sRoper Hospital made the
followingentryin his casebook afterone of his whitepatientsdied:
"No autopsy could be held in this case, as his friends by some
accidentheard of his death immediatelyon its taking place, and
The resultwas that physiciansand
forthwithcame for the body."1I8
studentshad to resortto graverobbing,hurrieddissectionsbefore
bodies wereclaimed,and deceptionto obtain cadaversfor autopsy
and anatomicalinvestigations.
The attitudesof whitesouthernersboth towardthe use of human
bodies in medical education and toward blacks were silently but
clearlyrevealedin the medicalprofession'sheavyrelianceon Negro
cadavers.Human anatomicaldissectionwas illegal in many states
duringthe antebellumperiod,19althoughmedicalschoolscontinued
to teach anatomy.Unless approachedby angryrelativesor friends
of deceasedpersonscity authoritiesrarelyquestionedmedicaleducators as to the sources of their anatomicalspecimens. Southern
blacks, because of their helpless legal and inconsequentialsocial
positions,thus becameprimecandidatesfor medical-schooldissections. Physiciansusuallyfound it much more convenientto obtain
black specimensthan white. "In Baltimore,"commentedHarriet
Martineauafter an 1834 visit, "the bodies of coloured people
exclusivelyare taken for dissection,'becausethe whitesdo not like
it, and the colouredpeople cannot resist."'20 Dr. HenryM. Dowling of Leesburg,Virginia,had little difficultyreceivingpermission
for an autopsyon a twelve-year-oldslavegirl with a suspectedcase
of worms becausethe victim's owner was "a gentlemanof intelligence, and unaffectedby the vulgarprejudicesentertainedon this
" Henry A. Ramsay, "Gastro-Enteritis of Twelve Months Duration, Exhibiting in Autopsy an Entire Absence of the Spleen, and Calcareous Depositions in Both Lungs,"
Charleston Medical Journal andReview, V (November 1850), 728-32 (quotation on p. 732).
18 Roper Hospital Case Book #2, 1858-62, p. 432, in possession of Dr. Robert Jordan,
Sanford, North Carolina (microfilm copy at Waring Historical Library, Medical University
of South Carolina, Charleston). See also, Walter Brice, "Typhoid Fever, as It Prevailed in
Fairfield District, South-Carolina," Charleston Medical Journal andReview, VI (September
1851), 671.
9 George B. Jenkins, "The Legal Status of Dissecting, "Anatomical Record,VII (November 1913), 387-88; John B. Blake, "The Development of American Anatomy Acts," Journal
of MedicalEducation,XXX (August 1955), 434.
20 Harriet Martineau, Retrospect of Western Travel (2 vols., London and New York,
1838), I, 140, quoted in Humphrey, "Dissection and Discrimination," 819.
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THE JO URNA L OF SO UTHERN
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subject . . ." by others.2'
When it came to obtaining Caucasianbodies for postmortem
examinations,however, even "gentlemen of intelligence" found
ways to refuse physicians.For example,of twenty-fourindividual
autopsiesreportedby whitesouthernphysiciansin the Transylvania
Journal of Medicine and the Associate Sciences (1828-1839) and the
TransylvaniaMedical Journal (1849-1851) nineteen were performed
on blacks and only five on whites, in a state where the white
population far exceeded the black. Also indicative of the race
differentialis an articlethat appearedin the Transactionsof the
Medical Association of the State of Alabama describing an 1853
typhoid-feverepidemicin the vicinity of Sumterville.Of the approximatelyforty-fiveblacksandtwentywhiteswho contractedthe
disease,it killeda youngwhitephysicianand his sisteras well as ten
other persons of both races. The three autopsies the reporting
physicianperformed,however, were all on slaves.22
Bondsmenwerenot entirelyvoicelessin the matterof autopsies.
Some mastershonored the wishes of deceasedslaves' relativesor
friends and refused permission for postmortem examinations.
ColonelS. B. Stevensof Quincy,Florida,objectedwhenDr. RichardJarrotproposedto performan autopsyon the body of 102-yearold Moses, dead of what appearedto be acute pleuritis.23The
masterof a large LowndesCounty, Alabama, plantationreleased
for postmortemexaminationthe body of only one of eight slave
childrenwho had died duringa violent dysenteryoutbreakin 1851
despitethe requestof the attendingphysiciansfor othercadavers.24
And a Virginiaslaveowner,"unwillingto do violenceto his [slave's]
prejudicesand feelings," withheld assent when a physician requestedan autopsy on the bondsman'swife.25
Occasionally,the prevailingattitude of whites-that dissection
was acceptablewhen confined to the black population-was expressed in print. A correspondentto the Milledgeville,Georgia,
StatesmanandPatriotin 1828agreedthat it wasnecessaryto dissect
corpsesto learnanatomybut opposed the use of whites for such a
21 Dowling, "Case of VerminoseDisease," Transylvania
Journalof Medicineand the
AssociateSciences,II (May 1829),250.
22 L. H. Anderson, "Report on the
Diseases of Sumtervilleand Vicinity," Medical
Associationof the State of Alabama, Transactions,VII (January1854),61-66.
23 Jarrot,"Amputation
for Gangreneof the Foot, SuccessfullyPerformedon a Negro,at
the AdvancedAge of One Hundredand Two Years," CharlestonMedicalJournaland
Review, IV (May 1849), 301-303.
24 P. N. Cilley, "Diseasesof Lowndesboroand Vicinity,"MedicalAssociationof the
State of Alabama,Proceedings,V (December1851),91-95.
25 A Young Practitioner,"Report of a Case of Disease Supposedto be Peritonitis,"
MonthlyStethoscopeand MedicalReporter,I (June 1856),364.
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procedure.He endorseda proposalthen beforethe statelegislature
that permittedlocal authoritiesto releasebodies of executedblack
felons to medicalsocieties for the purposeof dissection, assuring
the safety of whitecorpses."The bodiesof coloredpersons,whose
execution is necessaryto public security,may, we think, be with
equity appropriatedfor the benefit of a scienceon which so many
lives depend, while the measurewould in a greatdegreesecurethe
sepulchralrepose of those who go down into the graveamidstthe
lamentationsof friendsand the reverenceof society."26
The KentuckyHouse of Representativesseriouslyconsidereda
similarproposal. It rejectedby the narrowmarginof sevenvotes a
bill "to authorizeand requirethe Judges of the different Circuit
Courtsof this state to adjudgeand awardthe corpsesof negroes,
executedby sentencesof saidjudges,to the Facultiesof the different
"127 In
charteredCollegesin this state, for dissectionandexperiment.
Virginiathe vast majorityof cadaversobtainedfor dissectionat the
five antebellummedicalschools werethose of Negroes.28The faculty of the MedicalCollege of Georgiain Augustahired, between
1834and 1852,severalslavesto act as intermediariesin the purchase
of bodies from mastersin the surroundingplantationcountry. In
1852it purchasedGrandisonHarrisin Charlestonto obtain cadavers and to performjanitorial duties. He robbed graves and also
boughtblackbodiesfor the next fifty yearsor So.29 And the Medical
College of South Carolinaopenly acknowledgedin its circularof
1831 that it obtained "Subjects . . . for every purpose" from the
blackratherthan the whitepopulationof Charlestonso as to carry
on "proper dissections
. .
. without offending any individ-
uals . .*.".3
This undisguiseduse of Negroes for dissection in
Charlestoncontinuedinto the postwarera.31
26 Milledgeville
Statesmanand Patriot, August 16, 1828. The author wishes to thank
ProfessorLarryMorrison,HistoryDepartment,VirginiaPolytechnicInstituteand State
University,for bringingthis newspaperarticleto his attention.
27 Journal of the House of Representatives of the Commonwealth of Kentucky
... (Frankfort,Ky., 1833),107(quotation),122-23, 177-78.Seealso JohnD. Wright,Jr.,
"RobertPeterand EarlySciencein Kentucky"(unpublishedPh.D. dissertation,Columbia
University,1955),61, 70; F. GarvinDavenport,Ante-BellumKentucky:A SocialHistory,
1800-1860(Oxford,Ohio, 1943),23.
23 Savitt,Medicineand Slavery,290-93; James0. Breeden,"Body Snatchers
and Anatomy Professors:MedicalEducationin Nineteenth-Century
Virginia,"VirginiaMagazineof
Historyand Biography,LXXXIII(July 1975),321-45.
29 Lane Allen, "GrandisonHarris, Sr.; Slave, Resurrectionist
and Judge," Georgia
Academyof Science,Bulletin,XXXIV (April 1976), 192-99.
30 Fry, Night Riders, 173-74.
1 FacultyMinutes,MedicalCollegeof the Stateof SouthCarolina,May8, 1876(Waring
HistoricalLibrary).For referenceto similarattitudesat the MedicalCollegeof Georgiain
Augustasee Cates,"MedicalSchoolsin Ante-BellumGeorgia,"32. Onthe use of blacksfor
dissectionin an Alabamamedical school see HowardL. Holley, "Dr. Phillip Madison
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Blacksusuallyknew full well how the bodies of theirfriendsand
relativeswerebeing used, and they wereboth offended and frightened. The ReverendRobertWilsonof Charlestonin 1856overheard
one aged Negro woman exclaim to her friend as they passed a
buildinghousingthe city's medicalschool, "Please Gawd, when I
dead, I hope I wi' deadin de summahtime."32Classesranonly from
Novemberto March,the cold monthswhen bodies did not decompose rapidly.A former slave, CharlieGrant, recalledmany years
after the event how, as an adolescentboy near Florence, South
Carolina,he was paid two dollarsby a local doctor to dig up and
carryto his office the body of a one- or two-year-oldslavechildwho
had just been buried.Though Grantdid not let on, he knew what
was happening:"Dr. Johnsonwantto cut dat childopen. Dat what
he want wid it."33 Black fear of medical schools and dissection
inevitablycarriedoverinto the postbellumperiod,whenwhites,as a
meansof maintainingcontrolover freedmen,reinforcedthe idea of
"night-doctors"who stole, killed, and then dissectedblacks.34The
accuracyof the belief that whites actuallykilled blacks for use in
dissectionis hardto verify.35But the fear blacksharboredwas well
known, as illustratedby four of the nine verses of the following
poem, probably written by a white in black dialect in the late
nineteenthor earlytwentiethcentury.It pokedfun at theseveryreal
concernsof blacks:
THE DISSECTING HALL
Yuh see dat house? Dat great brick house?
Way yonder down de street?
Dey used to take dead folks een dar
Wrappedeen a long white sheet.
An' sometimeswe'en a nigger'dstop,
A-wonderingwho was dead,
Dem stujentmen would take a club
An' bat 'im on de head.
Shepard and His Medical School," De Historia Medicinae, II (February 1958), 1-5. For an
instancein Kentuckyseethe "Autobiographyof Dr. CharlesA. Hentz"(typescript),X, 108,
HentzFamilyPapers(SouthernHistoricalCollection,Universityof NorthCarolina,Chapel
Hill, N. C.).
32 Robert Wilson, "Their Shadowy Influence Still Hovers About Medical College,"
CharlestonSundayNews Courier,April 13, 1913.The authorwishesto thank Mrs. Anne
Donato of the WaringHistoricalLibrary,MedicalUniversityof SouthCarolina,Charleston, for bringingthis articleto his attention.
I GeorgeP. Rawick,ed., The American Slave: A Composite Autobiography (19 vols.,
Westport,Conn., 1972),II: SouthCarolinaNarratives,Part2, pp. 175-76(quotationon p.
176).
Fry, Night Riders, 170-211.
" Thereis evidenceto indicatethatblackbodiesfromthe Southwereregularly
shippedto
northernmedicalschoolsduringthe post-Civil Warera. See FrederickC. Waite, "Grave
Robbingin New England,"MedicalLibraryAssociation,Bulletin,XXXIII (July 1945),
283-84; Cobb, "Surgeryand the Negro Physician," 148.
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MEDICAL
EXPERIMENTA
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341
An' drag dat poor dead niggerchile
Right een dat 'sectin hall
To vestigate 'is liver-lightsHis gizzardan' 'is gall.
Tek off dat nigger'shan's an' feetHis eyes, his head, an' all,
An' w'en dem stujent finish
Dey was nothin' left at all.36
The abolitionist Theodore Dwight Weld was not exaggerating
whenhe claimedin his 1839polemicalwork,AmericanSlaveryas It
Is: "'Public opinion' would tolerate surgicalexperiments,operations, processes, performedupon them [slaves], which it would
execrateif performedupon theirmasteror otherwhites."37Southernmedicalschoolscould and did boast that theircities'largeblack
populations provided ample supplies of clinical and anatomical
material.And whitephysicianstrainedat these institutionscarried
with them into theirown careersthis idea of the medicalusefulness
of blacks. Whennew techniquesor treatmentsrequiredexperimentation doctors tested them on readily availableand legally silent
slaveor free blackpatients.Therewas little fear of retribution,and
as long as deathor debilityattributableto the new techniquedid not
resultthe cost was negligible.Blacks,therefore,did havereasonfor
fearingmisuse at the hands of southernwhite physicians.
Generallyspeaking,in the era prior to acceptanceof the germ
theory there was only a fine line between seeking an appropriate
treatmentand engagingin actual experimentation.38
A physician
confrontedwith sick patientsadministeredwhatevertreatmentshe
had found efficacious from previousexperiencewithoutreallyunderstandingtheiractualoperationwithinthe body. If the standard
remedyfailedanothercompoundwastried,regardlessof its "scientific" merit. Few practitionersattemptedto perform controlled
experimentsto determinethe propertiesand effects of the drugs
they used or to establishbasic physiologicalor surgicalprinciples
that would serve as guides for the medical profession. Medical
practice at this time was basically empirical, as southern white
doctors indicatedin their journal articles. And here blacks often
servedas the test subjectsfor new remedies.Dr. T. S. Hopkins of
Waynesville,Georgia,for instance,prescribednitricacid solutions
36 Scribe,I (December1951), 17. The authoris againindebtedto Mrs. Anne Donato for
this reference.
37Weld,
American SlaveryasIt Is: Testimony of a Thousand Witnesses(New York, 1839),
170.
3' For a broad overviewof this subjectsee RichardH. Shryock, "Empiricism
Versus
Rationalismin AmericanMedicine,1650-1950,"AmericanAntiquarianSociety,Proceedings, N.S., LXXIX, Part 1 (April 15,1969),99-150.
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342
THE JO URNA L OF SO UTHERN
HIS TOR Y
in sevencases (five blackand two white)of asthmaafter a medical
friend in an adjoiningcounty had had success with an accidental
administrationof this medicineto a sick child. He "deemed [the]
experimentjustifiable,particularlywhen it could resultin no harm
to the patient."39Similarly,a MadisonCounty, Alabama, practitioner, JosephEvelynMay, faced with a severecase of malariain a
slave, administeredas a last resortextremelylargedoses of quinine
combinedwith calomel. It worked, so May felt justified in having
attemptedso radicaland unorthodoxa procedure.40
Empiricaltrialsof remedieson patientswere not unusualin the
practiceof medicineanywherein antebellumAmerica,but outright
experimentationupon living humans may have occurred more
openlyand perhapsmore often in the South owing to the natureof
the slave society. No studiesof humanexperimentationand use of
white medical specimensin the North or South presentlyexist to
substantiatethis claim. Comparativestatistics of this nature are
difficult to obtain. Certainly,the indigent and socially voiceless
wereusedby medicalpeople for theirown endsin the North and, as
Ronald Leslie Numbers has pointed out in a recent article, in
Europeat that time. The social status of Dr. WilliamBeaumont's
experimentalsubject, a poor French-Canadiantrapper named
Alexis St. Martin,is illustrativeof this attitude.Beaumontinduced
St. Martinby force and by various legal and financial means to
submitto somenineyears(1824-1833)of intermittentexperimentation on the physiologicalactivityof his stomach,partof whichhad
been permanentlyexposed in a gunshot accident. The ethics of
human experimentationwere not establishedat this time-people
generallyacceptedthe researchof Beaumont and others without
questioningtheirethicsor the patient'srights.41It did not seemodd
39 Hopkins,"On NitricAcid in the Treatment
of Asthma," CharlestonMedicalJournal
and Review, V (November1850),749-52 (quotationon p. 750).
40 May, "On the RemedialUse of Sulphateof Quininein LargeDoses," Transylvania
Journalof Medicineand the Associate Sciences,X (April-June 1837), 218-19. See also
AlbertRussell,"Remarkson the Use of ColdWaterin the CongestiveandCollapsedForms
of Fever,"ibid., VI (January-March1833),96-97; RichardD. Arnold,"On the Epidemics
of Savannah,Geo., in 1847and 1848,"CharlestonMedicalJournalandReview,IV (March
1849),149;AlexanderSomervail,"OntheEfficacyof a Mixtureof CamphorandMuriateof
Ammoniain the Treatmentof Suppressionof Urine," AmericanJournalof the Medical
Sciences, XIV (May 1834), 113-15; Savitt, Medicine and Slavery, 298-301.
41 Numbers,"WilliamBeaumontandthe Ethicsof HumanExperimentation,"
Journalof
the Historyof Biology, XII (Spring1979), 113-35. See also ChesterR. Burns, "Medical
Ethicsin the UnitedStatesBeforethe Civil War" (unpublishedPh.D. dissertation,Johns
HopkinsUniversity,1969), 83. For an earlyexpressionof this attitudetowardblacks as
experimentalsubjectsin SouthCarolinaseeEdmundBerkeleyandDorothyS. Berkeley,Dr.
AlexanderGardenof CharlesTown(ChapelHill, N. C., 1969),95-96. Fora full description
of Beaumont'swork see JamesT. Flexner,Doctors on Horseback;Pioneersof American
Medicine(New York, 1937),237-89.
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MEDICA L EXPER IMEN TA TION
WI TH BL A CKS
343
or unusualthento use blacksas a numberof physiciansin the South
did. Somewhitestook advantageof southernblacksby testingnew
techniquesor remediesin the name of medicalprogress.In several
instancesphysicianspurchasedblacksfor the sole purposeof experimentation;in othersthe doctorsused free blacksand slavesowned
by others. Thoughwhitesubjectswereincludedin one or two cases
of experimentation,blacksalwaysmade up the overwhelmingmajority of patients. A few major medicalbreakthroughsdid result
from the researchperformedupon Negroes, for which the physiciansinvolvedreceivedfame and glory. The slaves, identified,if at
all, by first name only, are unknownnow to their descendantsand
to the generalpublic.
A tale passed down by residents of the Alabama Black Belt
illustratesthe inclinationof some southernwhitesto use blacksfor
experimentalpurposesand to discountthe worth of slave lives in
theirsociety.Whenthe regionaroundMarionwas firstbeingsettled
people were unsure of its healthfulness. They feared the mists,
swampgases,andmiasmatathatrose fromthe low ground.According to tradition,a numberof farmerspurchaseda slave, set him up
in a hut with tools, supplies, and food, and left him there for a
period of time to see if he could survive.Findinghim still healthy
when they returned,the settlersmoved in, and the area grew rapidly.42Whether true or not, the story describes some southern
whites' attitudestoward using blacks in experiments.
A numberof doctorshad similarinclinations.Dr. T. Stillmanof
Charleston,for example,operateda privateinfirmaryin the 1830s
that specializedin the treatmentof skin diseases,althoughhe also
cared for patients with a variety of other disorders. During the
monthof October1838Stillmanconcludedhis usuallengthyadvertisementin the CharlestonMercurywith an offer to purchasefrom
slaveownersany chronicallydiseased slaves they might wish to
''dispose of." He would pay "The highest cash price" for fifty
blacks"affected with scrofulaor king'sevil, confirmedhypochondriasm, apoplexy, diseasesof the liver, kidneys, spleen, stomach
and intestines, bladder and its appendages,diarrhea,dysentery,
&C."43
It was obvious from the wordingof the advertisementthat
Dr. Stillmanplannedto test newly formulatedremedieson these
fifty chronicallyill blacksfor the benefitof medicalscience,as well,
no doubt, as for personalgain.
In a few instancesactualdiscussionsof the kindsof exDeriments
42 Weymouth T. Jordan, Ante-Bellum Alabama: Town and Country (Tallahassee, Fla.,
1957), 34-35.
43 Charleston Mercury, October 12, 1838, reprinted in Weld, Slavery as It Is, 171.
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THE JOURNAL
OF SOUTHERN
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to whichslavesweresubjectedareavailable,both fromthe point of
view of the patientsand the physicians.Therelived in Clinton, seat
of Jones County, Georgia, during the 1820s and early 1830s, a
who was attemptingto discoverthe best remedies
physician-planter
for heat stroke. This man, Dr. Thomas Hamilton, borrowedthe
slave Fed from a grateful patient in order to test some of his
medicationson a humansubject. He had a hole dug in the ground
which he then had heatedwith fire to a high temperature.Fed sat
nakedon a stool on a platformplacedwithinthis ovenlikepit with
only his head above ground level. To retain the heat Hamilton
fastenedwet blanketsover the hole. Fed took a differentmedicine
eachof the five or six timeshe enteredthe pit overa periodof two or
three weeks, so that Hamiltoncould determinewhich preparation
best enabledthe slaveto withstandhigh temperatures.Fed fainted
each time from the heat and from exhaustion(he had put in a full
day'sworkbeforeeachexperiment).Accordingto Fed'saccountof
the proceedingsthe doctor found cayennepepperto be the most
effectivepreparation.Experimentationdid not end here, however.
Fed claimed, in a book written in London some years after his
escape from slavery,that Hamilton came to his master's farm to
perform other experimentson him for nine months, after which
time "I hadbecomeso weak,that I wasno longerableto workin the
fields.""Dr. Hamiltonbledthe slaveeveryotherday for threeweeks
and repeatedlyblisteredhim "to ascertainhow deep my black skin
went." Hamiltonneverpublisheda descriptionof his experiments,
so Fed's accountof these eventscannotbe verifieddirectly.Extant
recordsplaceboth menin the sameneighborhood,one as slave,the
other as physician,at the sametime. Otheraspectsof Fed's narrative also bear up under historicalscrutiny."
Hamilton's crude experiments did little to advance medical
knowledge.The samecannot be said for Dr. JamesMarionSims's
use of slave women to develop a cure for vesico-vaginalfistula.
Vesico-vaginalfistula is a breakin the wall separatingthe bladder
from the vagina, which allows urine to pass involuntarilyto the
outside from the vagina rather than from the urethra. Women
suffering from this defect, usually the result of trauma during
childbirth,areincontinentof urineand continuallyuncomfortable.
The constantflow of urineproducesfetid odors, irritatedskin, and
" Louis A. Chamerovzow, ed., Slave Life in Georgia: A Narrative of the Life, Sufferings,
and Escape of John Brown, a Fugitive Slave, Now in England (London, 1855), 45-48, cited
in F. Nash Boney, "Doctor Thomas Hamilton: Two Views of a Gentleman of the Old
South," Phylon, XXVIII (Fall 1967), 288-92 (quotation on page 291).
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MEDICAL
EXPERIMENTA
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345
frequentinfectionsof the reproductiveorgans.Sims,a SouthCarolinian practicingin Montgomery,Alabama, duringthe 1840sand
early 1850s, became interestedin this condition when three cases
among black servantscame to his attentionwithin a few months,
and a chanceoccurrencegave him the idea of how to cureit. While
treatinga whitepatientfor a traumaticallymalpositioneduterusby
placingthe woman on her knees and elbows, he suddenlyrealized
that by puttingvesico-vaginalfistulapatientsin that sameposition
he would be able to visualizethe fistulaand perhapseven repairit.
No physicianpriorto this had developeda consistentlysuccessful
surgicaltreatmentfor the conditionowingto difficultiesin visualizing the defect, repairingthe passagethroughthe bladderwall, and
preventinginfection duringthe procedure.
Once Sims had conceivedof a way to operate on patientswith
vesico-vaginalfistula he set about putting his ideas into practice
with the cooperationof his slave subjects. He never disguisedthe
fact that what he was doing was entirelyexperimental.The three
blackwomenwho servedas the first patients,Anarcha,Lucy, and
Betsey,desperatelywishedrelief from theirsufferings.So, too, did
severalother patients,all slaves, who submittedto Sims'sattempts
at a cure over the next four years, 1845 to 1849. Each woman
underwentup to thirty operationsin quest of relief. When local
physicianslost interestand ceased assistingSims with the procedure, the persistentdoctor trainedthe slave patientsto assist him.
Finally,in May 1849,Simssucceededin overcomingall the complicationsthat had beenplaguinghis procedurefor four years.Oneby
one, the black women were cured and sent home.
It is significantthat all the subjectsin Sims's experimentswere
black. Whenhe decidedto pursuehis idea of curingvesico-vaginal
fistula he "ransackedthe country for [Negro] cases" and found
enough to warrantenlarginghis eight-bed slave infirmary.Sims
agreedwith each slaveownerto pay all costs of maintenanceexcept
taxesandclothingand "to performno experimentor operation ...
to endanger their [slaves'] lives .
. . ."
It was not until after his
success with the slave women became known that white women
venturedto submitto the operations.Interestingly,Simsdiscovered
that Caucasianpatientsoften failedto persevereas well as Negroes
during the painful and uncomfortableprocedure.Typical of the
problemwas the patientabout whom Simsremarkedin his medical
notes: "The painwasso terrificthatMrs.H. couldnot standit and I
was foiled completely." Perhapsit was Sims's recognitionof this
differencebetweenslaveandwhitepatientsthat promptedhim, in a
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346
THE JOURNAL
OF SOUTHERN
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speechseveralyearsafterhis successes,to praiseso highlythe black
women upon whom he experimented.
To the indomitablecourageof theselong-sufferingwomen, morethan to
any one other singlecircumstanceis the worldindebtedfor the resultsof
these perseveringefforts. Had they faltered, then would woman have
continuedto suffer from the dreadfulinjuriesproducedby protracted
parturition,andthenshouldthe broaddomainof surgerynot have known
one of the most usefulimprovementsthat shall foreverhereaftergraceits
annals.45
Sims's relianceon black patientsfor experimentalpurposeswas
continued by Nathan Bozeman, his successor in Montgomery.
BozemanpurchasedSims'spracticewhen the lattermoved to New
York and continued to operate the slave infirmary. In 1855 he
perfecteda new type of suture for relievingvesico-vaginalfistula
with the cooperationof seven new slave patients."
Otherexamplescan be offered of the white southernphysician's
bias towardthe use of black subjectsin medicalexperimentation.
Dr. EphraimMcDowellof Danville, Kentucky,reveredin American medical history as the first to perform successfullyan ovariotomy (removal of an ovary), operated initially upon a white
woman,Mrs. JaneTodd Crawford,in 1809.Littleknownis the fact
that McDowell's subsequentfour ovariotomies,duringwhich he
improvedhis technique, were all performedon black women
again,this in Kentucky,a statewith a relativelysmallblackpopulation.47CrawfordWilliamLongof Jefferson,Georgia,is often cited
as the first to operate on an anesthetizedpatient. In March and
againin June 1842he removedtumorsfrom the neck of JamesM.
Venable.Two of Long's next threeexperimentswith etherwereon
Negropatients:the amputationof a slaveboy's toe in July 1842and
45 J. Marion Sims, The Story of My Life (New York, 1884), 226-46 (first and second
quotations on p. 236); Seale Harris, Woman's Surgeon: The Life Story of J. Marion Sims
(New York, 1950), 82-93,99-103, 108-10 (third quotation on p. 109); J. Marion Sims, Silver
Sutures in Surgery ... (New York, 1858), 55 (fourth quotation); Sims to Dr. H. V. Wooten,
January 23, 1850, Hardy Vickers Wooten Papers (Manuscripts Division, Alabama Department of Archives and History, Montgomery, Ala.).
46 Bozeman, "Remarks on Vesico-Vaginal Fistule, with an Account of a New Mode of
Suture, and Seven Successful Operations," Louisville Review, I (May 1856), 75-101. For
information on a Virginia physician's earlier attempts to cure vesico-vaginal fistula using
white and black patients see Savitt, Medicine and Slavery, 297-98.
41 Samuel D. Gross, "Report of the Committee on Surgery," Kentucky State Medical
Association, Transactions, II (October 1852),104-106; Cobb, "Surgery and the Negro
Physician," 148.
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347
of a bondsman'sfingerin January1845.48John M. B. Harden, a
physicianin LibertyCounty, Georgia,removedand measuredthe
circumferencesof certain blood vessels from the bodies of one
Negro man and three hogs during the 1830s "to determinethe
relative areas of the Trunks and Branchesof arteries." Harden
publishedhis findings,whichhe consideredof significanceto anatomical and physiologicalknowledge,in a regionalmedicaljournal.49
A finalexampleof the usefulnessof blacksto physiciansin a slave
society was the performanceof Caesareanoperationson pregnant
women. Attempts at deliveringchildren abdominallywhen they
could not pass throughthe mother'scontractedor occludedpelvis
had been generallyunsuccessfulthroughout history. Doctors in
antebellumAmericacontinuedto performthis procedureand occasionallymet with success.The racialstatistics,derivedfrom compilations of the PhiladelphiaphysicianDr. Robert P. Harrisin the
1870s and early 1880s, are revealing:of fifteen northernwomen
whose race was reported,thirteenwere white, one black, and one
Mexican(California);in the South, twenty-nineof thirty-sixcases
wereblack.30This trendcontinuedthroughoutthe nineteenthcentury: as of the year 1881 fifty-one of sixty Caesareanprocedures
performedin northernstateshad been on whites,whileonly twelve
of fifty-nine in southern states had been on whites. Doctors in
Louisianaperformedthe most procedures(twenty)of those in any
state, nineteenof which were done on blacks."'
It is to be expectedin a slave society that the subjugatedwill be
exploited. Such was the case in the AmericanSouth whereblacks
acted not only as servantsand laborersbut also as medicalspecimens. Some medicalscientistslivingin that societytook advantage
of the slaves'helplessnessto utilizethemin demonstrations,autopsies, dissections, and experiments,situationsdistastefulto whites
[8 Minutesof Annual Meeting,April 14, 18531,MedicalAssociationof the State of
Georgia, Transactions,IV (April 1853),7.
49 Harden, "Some Experiments
to Determinethe RelativeAreas of the Trunks and
Branchesof Arteries," SouthernMedical and SurgicalJournal, N.S., II (June 1846),
330-33. The authorwishesto thankProfessorLesterStephensof the HistoryDepartment,
Universityof Georgia,for bringingthis articleto his attention.
50 Robert P. Harris, "The Operationof Gastro-Hysterotomy
(true CaesarianSecAmericanJournalof theMedicalSciences,N.S., LXXV(April1878),336-39.
tion) ...,"
For more detail on Caesareansectioncases in Virginiasee Savitt,Medicineand Slavery,
118-19.
51 RobertP. Harris,"SpecialStatisticsof the CesarianOperationin the United States,
Showingthe Successesand Failuresin Each State," AmericanJournalof Obstetrics,XIV
(April 1881),347.
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OF SOUTHERN
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andrejectedby them. Somewhites,usuallythe poor andthe friendless, found themselvesin the samepositionas blacks. But giventhe
racial attitudes of that time and place, blacks were particularly
vulnerableto abuse or mishandlingat the hands of researchers,
medicalteachers, or students.
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