Medicine & Power: Authority and British Caribbean Medical Practitioners, 1750-1823 by Aonghus Garrison Submitted in partial fulfilment of the requirements for the degree of Master of Arts at Dalhousie University Halifax, Nova Scotia April 2019 © Copyright by Aonghus Garrison, 2019 For my Mother ii Table of Contents Abstract…………………………………………………………………………………………...iv Acknowledgments………………………………………………………………………............…v Chapter 1. Introduction………..……………………………………………………………….….1 Chapter 2. Ameliorative Literature and the Racialization of Disease…………………………...23 Chapter 3. The Plantation Healthcare Network of Thomas Thistlewood……………………..…52 Chapter 4. “Acted his Obia”: the Authority and Power of Medico-Spiritual Practices….............97 Chapter 5. Conclusion…………………………………………………………………………..129 Bibliography……………………………………………………………………………………135 iii Abstract In the late eighteenth-century on British Caribbean Plantations, there were dynamic groups of medical practitioners operating within the same physical space. The plantation healthcare system was made up of white doctors and the enslaved people who were trained in European style medicine. Enslaved people had access to alternative medical authorities in the form of Afro-Caribbean medico-spiritual practices that operated outside of plantation healthcare system implemented by planters. After the 1770s, pan-Caribbean ameliorative literature was designed to alleviate the living and working conditions of enslaved people in an attempt to foster the health and natural reproduction of the enslaved workforce during an era of rapidly escalating slave prices. A close reading of the ameliorative literature reveals the dehumanization of enslaved black people through the racialization of disease in the British Caribbean. Disease became racialized based on white assumptions of black inferiority, and planters’ and doctors’ perceptions of racial diseases were given intellectual support through humoural thinking. Ideas about healthcare among planters and doctors – revealed here through study of the diaries of Jamaican planter and overseer Thomas Thistlewood -- rested on the assumption that increased control of healthcare and surveillance of the sick enslaved populations would result in a healthier workforce. Healthcare infrastructure such as slave hospitals, appropriately called hothouses, were designed to contain and treat the sick. Within this controlling and dehumanizing structure, skilled enslaved medical practitioners could gain social capital that provided them with improved social and material living conditions. As an alternative medical authority among the enslaved on plantations, Obeah and Myal people practiced their Afro-Caribbean medico-spiritual arts. After Tacky’s Rebellion in 1760, Obeah and Myal practice was made illegal but it was still in demand by the enslaved people who sought their physical and spiritual healing. British planters imposed intellectual and physical dehumanization upon enslaved people through the racialization of disease and the imposition of plantation healthcare infrastructure, but the medical healing arts that enslaved people practiced, European or Afro-Caribbean, provided them an opportunity to survive slavery. iv Acknowledgments First and foremost I want to thank my mother, Karren Fader, without whom my education, post-secondary or otherwise would not have been possible. Her love, time, and energy allowed me to become the student and person I am today. Thanks to my family who were there through it all, sister, grandmother, and father. To Mat Barkley and Joel Scott, friends who provided me with the support and levity needed through the trying times of academia. Thank you to my partner, Sophia Allen-Rice, the only person who could completely understand the process and trial of producing a history MA at Dalhousie University. On the academic side of support, a sincere and deepest thank you to my supervisor and friend Justin Roberts. Having taken one of Justin’s courses 8 years ago, he set me on the path to which I owe my academic journey. Justin’s support and guidance provided me the opportunity to be successful in my undergraduate thesis. Encouraging me to do graduate work, Justin ushered me into the master’s history program at Dalhousie. His advice and direction has been integral to the final product of my research. A special thanks to Phil Zachernuk for agreeing to be my second reader and Jerry Bannister, who was the second reader on my undergraduate thesis and the third reader for my graduate thesis. Thank you to Gordon McOuat for facilitating my directed reading. Many thanks to Val and Tina, their consistent help and organization kept me on track and in the know throughout this entire process. To Patricia, the head librarian at the University of King’s Collage, thank you for patiently taking the time to help me find countless unique books over the last 9 years. To all of those I could not mention specifically, academic or personal, thank you for the role you played whether you know it or not. Cheers! v Chapter 1. Introduction On Thursday, 15 March 1759 Thomas Thistlewood, a rural Jamaican plantation overseer, wrote, “Many Negroes in the hothouse Sick.”1 This seemingly mundane entry reveals that the slave managers were contending with sick and infirm enslaved populations. This was a daily struggle for British Caribbean planters. Thistlewood made regular entries on the state of health of the enslaved people he managed. A sick slave could not work. If slaves could not work production suffered. When production suffered, revenue would be lost. In the second half of the eighteenth century, addressing illness and infirmity among the enslaved was of paramount importance to the economic sustainability of Caribbean plantations. Sugar ruled the Caribbean world, and planters relied on slave labour to cultivate and harvest cane. The tropical environment, labour, and conditions of bondage presented constant challenges to the health of enslaved people. The plantation healthcare system was a dynamic system of care and control that attempted to combat morbidity and mortality among the enslaved population. This thesis addresses the power dynamics within, and outside of, the plantation healthcare system. I argue that masters used western medical ideas and practices to control the treatment of enslaved people and the physical spaces within which they were required to heal. Slave hospitals operated as temporary prisons to control movement and provide care, while ameliorative literature blended humoural theory with racist assumptions that racialized diseases such as dirt eating, yaws, and elephantiasis. White masters used their presumed superior knowledge of health and disease to dehumanize black people’s bodies through the racialization of disease and control 1 The Thomas Thistlewood diary (hereafter TTD), which stretches from 1750 to 1786, is unpublished but the original can be found at the Beinecke Rare Book and Manuscript Library, James Marshall and Marie-Louise Osborn Collection Yale University. Hereafter, I will simply give the date for all citations from the diary. This thesis draws on both the originals and on transcriptions of the originals provided by Dr. Justin Roberts. For this reference, see TTD Thursday 15 March 1759. The full diary has been digitized and is available online at https://beinecke.library.yale.edu/collections/highlights/thomas-thistlewood-papers their movement by implementing slave hospitals. However, within that structure of dehumanization and control, this thesis demonstrates that enslaved people who practiced medicine, of either the European or Afro-Caribbean types, could access varying degrees of social capital and perhaps negotiate better day-to-day material conditions on the plantation. Social capital came in the form of influence and status with their captors and other enslaved people; the improvement of material conditions involved access to resources, such as improved housing conditions, and most importantly, the ability to avoid field work.2 I argue that while masters’ maintained control of their plantations and slave populations most of the time, practicing medicine differentiated the way enslaved people moved through the plantation world and that demarcation, albeit marginal and infrequent, allowed enslaved medical practitioners greater ability to navigate the circumstances of their bondage. The British Caribbean was an agrarian world that needed imported African labour to sustain the empire’s desire for sugar. The British sugar islands’ first large production was in Barbados during the seventeenth century; this economic boon was briefly eclipsed by Antigua, in particular, and the other Leeward Islands as a group in the early 1700’s. By the 1720’s, Jamaica had become the most valuable sugar island in the British Empire.3 At its peak in 1797, Jamaica was producing 66 percent of the sugar in the British Caribbean.4 Jamaica was the largest island in the British Caribbean. Its smaller Lesser Antilles counterparts continued to produce sugar for 2 For more on inequalities in material conditions among plantation slaves, see Justin Roberts. “The ‘Better Sort” and the ‘Poorer Sort’: Wealth Inequality, Family Formation and the Economy of Energy on British Caribbean Sugar Plantations, 1750-1800,” Slavery and Abolition, 35.3 (September, 2014), 458-473. 3 Richard B Sheridan, “The formation of Caribbean society, 1689-1748,” in P. J Marshall, ed., The Oxford History of British Empire: The Eighteenth Century, vol. II (New York: Oxford University Press, 2001),