Anti-Black Racism in Medicine

~Aja Lans, PhD, MHL Educational Resources Fellow, 2021

Medicine During SlaveryCreating Racial Differences | The Eugenics Movement | Experimentation on Black Bodies

The goal of this resource set is to introduce viewers to the roots of anti-Black racism in medicine that have perpetuated health disparities whereby Black individuals disproportionally suffer from a variety of medical concerns and a lack of adequate healthcare resources. Many diseases, including but not limited to tuberculosis, syphilis, and sickle cell anemia, have a long history of being associated with specific racial types. Poor health among Black people has repeatedly been presented as simply a fact of life, caused by assumed intellectual and biological inferiority. However, we must address the roots of such assumptions, assumptions that were created, disseminated, and reinforced by racist scientific research and medical practice.

“Race” is a fraught word that has been interpreted and weaponized in many different contexts. Races as discrete biological categories do not exist, but as social constructs have major ramifications. Therefore, it is important to keep in mind that “race becomes biology” through a vicious cycle in which racial discrimination harms community and individual health, and these negative health outcomes are then used to reinforce the notion that race is indeed biological. 

These resource sets are based on four broad themes that are meant to build upon and complement one another, so there is overlap between topics. While readers can begin anywhere in the sets, the first three are loosely arranged chronologically: (1) Medicine During Slavery, (2) Creating Racial Differences, and (3) The Eugenics Movement. The fourth set, Experimentation on Black Bodies, covers all time periods and intersects with the previous sets.

This topic of course turns up no shortage of offensive and unsettling material. The term “negro” is very commonly used as are other outdated notions of race. There are also materials with offensive and outdated discussions of sexuality, gender, disability, and socioeconomic status. It is necessary to search the texts using various keywords and phrases to locate the relevant content. Terms to search for include but are not limited to the categorizations “negro,” “black,” “slave,” and “servant.” Searching for specific medical conditions, tools, or procedures also proves effective. 

Medicine During Slavery

The first set begins with sources that are intended to orient the viewer to the treatment of enslaved Africans and their descendants, largely focusing on but not limited to slavery in the present-day United States. By starting with this set, the viewer should be able to trace certain assumptions about race and health and see how they are both maintained and transformed over time to fit different circumstances.

Take for instance the work of Dr. Samuel Cartwright, who created an illness called drapetomania, or the disease causing slaves to run away. Cartwright considered this a curable disease of the mind which could be prevented by encouraging order and good discipline. While some diseases were considered to be unique to the condition of enslavement, after emancipation other illnesses would be attributed to freedom.

This is a diagram depicting Dr. John Hutchinson’s spirometer, a tool designed to measure lung capacity. Dr. Samuel Cartwright is believed to be the first individual to use the spirometer to measure differences in lung capacity between Black and white people. This led to the notion that Black people naturally have lower lung capacity than white people, and modern spirometers still automatically “correct” for racial differences. See Lundy Braun’s Breathing Race into the Machine (Minneapolis: University of Minnesota Press, 2014).

Creating Racial Differences

As we turn to the next set focusing on post-emancipation science, medicine, anthropology, and “The Negro Health Problem,” readers will see many arguments that slavery was indeed better for the mental and physical health of Black people. There is also an increased focus on quantifying differences between races in order to better categorize people and build a hierarchy of humans. Racialized science was used to contribute to ideologies about human difference and rationalize the inferior treatment of Black people based on their supposed lack of intelligence, morals, and animal-like physical features. These sorts of studies flourished throughout the 19th and early 20th centuries, with an emphasis placed on studies of skin color, hair length and texture, and anthropometry, especially of the head. Scientists claimed neutrality while their research fueled discriminatory public policy against Black, indigenous, and immigrant communities.

Black and white photograph of a side view of a partial human skull (lower jaw missing); from "The Negro in the New World," Harry H Johnston, 1910
From The Negro in the New World, Harry H Johnston, 1910

After the American Civil War, the process of emancipation overwhelmed almshouses and state hospitals. Some 500,000 Black people self-emancipated during the war, and 3.5 million were freed when the war ended. Former slaves existed in a liminal state, without a clear political status. They were also defenseless against infectious diseases. The increase in mortality among newly freed Blacks was used to argue for their biological inferiority and that they were better suited for enslavement. Despite advances in germ theory and disease causation, physicians continued to discriminate against Black patients. Social and moral status was still assumed to play a role in black patients’ illness.

The Eugenics Movement

Such ideas about racialized types directly contributed to the field of eugenics, or the study of race improvement by better breeding. British scientist Francis Galton (1822-1911) coined the term eugenics after reading his cousin Charles Darwin’s On the Origin of Species (1859). Eugenicists believed that people were born with certain qualities including character and intellect, and that traits including alcoholism, feeblemindedness, prostitution, criminality, and immorality were genetically controlled pathological conditions. Many eugenicists, including Galton, argued that selective breeding would resolve human suffering. During the Progressive Era, many Americans would come to consider the movement to be a scientific breakthrough. Therefore, certain individuals should be selected to reproduce and improve the (white) race. The eugenics movement became popular in the United States as a way to bolster legislation that oppressed people of color, immigrants, and the disabled.

The eugenics movement in the United States was spearheaded by Charles Davenport (1866-1944). In 1904 Davenport became the director of the Station for Experimental Evolution at Cold Spring Harbor, Long Island, where he would eventually establish the Eugenics Record Office. Here, Davenport and colleagues trained students to be field workers who were then sent to various institutions, including prisons and asylums, to collect anthropometric measurements of inmmates. 

Family tree diagram purporting to show the inheritance of family traits. From Charles Davenport, "Heredity in Relation to Eugenics," 1912
From Heredity in Relation to Eugenics, Charles Davenport, 1912

Eugenics researchers also gathered biased information from poverty-stricken urban areas to argue that African Americans were of inferior intellect and had weaker immune systems than whites. Eugenics based arguments were also used to forcibly sterilize women who were institutionalized in various prisons, asylums, and hospitals against their will, and the procedures were deemed legal. Such practices continued until the 1940s and were only discredited after the Holocaust, although many eugenic philosophies remain. 

Experimentation on Black Bodies

The theme of human experimentation runs throughout this entire set and so covers many time periods. The objectification of Black people began with chattel slavery. The traditional role of the enslaved as objects for study carried on after emancipation, making black bodies into objects suitable for medical demonstrations, dissections, and risky surgeries and experiments. To put it simply, “The atmosphere created by racial inferiority theories and stereotypes, 246 years of black chattel slavery, along with biased educational processes, almost inevitably led to medical and scientific abuse, unethical experimentation, and overutilization of African-Americans as subjects for teaching and training purposes.”

Here, let us consider the legacy of J. Marion Sims, the “Father of Modern Gynecology.” Sims pioneered tools and surgical treatments for women’s reproductive health by conducting research and experiments on enslaved Black women without the use of anesthesia. His early surgeries carried out on enslaved women such as Lucy were not successful and caused months of agony and illness. He supposedly perfected fistula surgeries after 30 operations on 17-year-old Anarcha. It wasn’t until this success that he began the operation on white women with the use of anesthesia.

Works Cited

Baker, Lee D. From Savage to Negro: Anthropology and the Construction of Race, 1896-1954. Berkeley: University of California Press, 1998.

Byrd, Michael W. and Linda A. Clayton. “Race, Medicine, and Health Care in the United States: A Historical Survey.” Journal of the National Medical Association 93, no. 3 (March 2001): 11S-34S.

Downs, Jim. Sick From Freedom: African-American Illness and Suffering during the Civil War and Reconstruction. New York: Oxford University Press, 2012.

Cooper Owens, Deirdre. Medical Bondage: Race, Gender, and the Origins of American Gynecology. Athens: University of Georgia Press, 2017.

Gould, Stephen Jay. The Mismeasure of Man. New York: W.W. Norton, 1996, 1981.

Gravlee, Clarence C. “How Race Becomes Biology: Embodiment of Social Inequality.” American Journal of Physical Anthropology 139, no. 1 (2009): 47-57.

Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Anchor Books, 2006.

Further Resources

https://www.aaihs.org/syllabus-a-history-of-anti-black-racism-in-medicine/

https://www.pbs.org/video/regional-voices-what-race-and-what-it-not-dr-agustin-fuentes/

AuthorPublication TitlePublisherPublication Year
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