CHAPTER 1 SOUTHERN DISCOMFORT Medical Exploitation on the Plantation Celia's child, about four months old, died last Saturday the 12th. This is two negroes and three horses I have lost this year. DAVID GAVIN, 1855 Frederick Gardiner, a peripatetic Mormon physician, left among his travel memoirs an impression of the nineteenthcentury slave markets of Washington, D.C.: There are a great number of Negroes, nearly all of whom are Slaves. And on different Streets are large halls occupied as Marts or stores, for the sale or purchase of Slaves. . . While I have been looking at one of these places on Gravier Street, Two Gentlemen have arrived, one of whom I have Seen in the Saloon, he is a young Planter and come to purchase a girl to take care of his children, or whatever duties he may think proper to impose upon her. The other person is a Doctor whom he has brought with him for the purpose of examining her. They pass along the front of the row in company with the agent or Salesman. As they move forward One is called upon to stand up, then another while a passive examination is made. Then finally he discovers a bright mulatto, who appears about 16 years of age and is quite good looking. She is ushered into a private room where she is stripped to a nude condition and a careful examination is made of all parts of the body by the Dr. and is pronounced by him to be sound. The money is then paid and she is transferred to her new owner...I have heard that the Masters beat and scourge them most cruelly. But I have not seen anything of the kind, nor do I believe that it occurs very often. For the southern people as a class are Noble minded kind hearted people, as can be found in any country...And moreover it would be against their own interests, to brutally treat their Slaves. As no planter desired to have sick negroes on his hands. According to my judgment so far as my experience extends, I believe that the Negroes as a class, are far more humanely treated and taken care of, Than are the laboring classes of European countries (1). Enslavement could not have existed and certainly could not have persisted without medical science. However, physicians were also dependent upon slavery, both for economic security and for the enslaved "clinical material" that fed the American medical research and medical training that bolstered physicians' professional advancement. Gardiner's vignette suggests the integral role of medicine in enslavement and repeats a key beliefthat slave owners and physicians shared an interest in preserving the slave's health, "as no planter desired to have sick negroes on his hands." But although medicine was essential to enslavement, the apparent solicitude for the health of slaves was not all it seemed. Rather, the medical interests of the slave were often diametrically opposed to the interests of his owner and of American physicians. From the first, antagonism reigned between African Americans and their physicians. Between the seventeenthcentury advent of African settlers to North America and the end of the nineteenth century, the slave and the physician shared an unrecognizably primitive medical world. The "germ theory" that revealed the microbial nature of much disease and led to the first grand waves of disease cures was still well in the future: The existence of pathogens (2) such as bacteria, viruses, and fungi was unsuspected. Almost no effective treatments existed for prevalent diseases until the eighteenth century. Until the late 1830s, the lack of effective anesthesia made the few common surgical procedures horribly painful and all others impossible. Between the seventeenth and nineteenth centuries, medicine in the United States reflected a narrowly limited understanding of diseaseWashington, Harriet A. is the author of 'Medical Apartheid', published 2008 under ISBN 9780767915472 and ISBN 076791547X.