Report on the Diseases and Physical Peculiarities of the Negro Race

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Report on the Diseases and Physical Peculiarities of the Negro Race

by Samuel A. Cartwright, M.D., Chairman of the Committee appointed by the Medical Association of Louisiana to report on the above subject

(Read at the Annual Meeting of the Association, March 12th, 1851.)

Gentlemen:—On the part of the Committee, consisting of Doctors Copes, Williamson, Browning and myself, to investigate the diseases and physical peculiarities of our negro population, we beg leave to report—

That, although the African race constitutes nearly a moiety of our southern population, it has not been made the subject of much scientific investigation, and is almost entirely unnoticed in medical books and schools. It is only very lately, that it has, in large masses, dwelt in juxta position with science and mental progress. On the Niger and in the wilds of Africa, it has existed for thousands of years, excluded from the observation of the scientific world. It is only since the revival of learning, that the people of that race have been introduced on this continent. They are located in those parts of it, not prolific in books and medical authors. No medical school was ever established near them until a few years ago; hence, their diseases sad physical peculiarities are almost unknown to the learned. The little knowledge that Southern physicians have acquired concerning them, has not been derived from books or medical lectures, but from facts learned from their own observation in the field of experience, or picked up here and there from others.

Before going into the peculiarities of their diseases, it is necessary to glance at the anatomical and physiological differences between the negro and the white man; otherwise their diseases cannot be understood. It is commonly taken for granted, that the color of the skin constitutes the main and essential difference between the black and the white race; but there are other differences more deep, durable and indelible, in their anatomy and physiology, than that of mere color. In the albino the skin is white, yet the organization is that of the negro. Besides, it is not only in the skin, that a difference of color exists between the negro and white man, but in the membranes, the muscles, the tendons and in all the fluids and secretions. Even the negro's brain and nerves, the chyle and all the humors, are tinctured with a shade of the pervading darkness. His bile is of a deeper color and his blood is blacker than the white man's. There is the same difference in the flesh of the white and black man, in regard to color, that exists between the flesh of the rabbit and the hare. His bones are whiter and harder than those of the white race, owing to their containing more phosphate of lime and less gelatine. His head is hung on the atlas differently from the white man; the face is thrown more upwards and the neck is shorter and less oblique; the spine more inwards, and the pelvis more obliquely outwards; the thigh-bones larger and flattened from before backwards; the bones more bent; the legs curved outwards or bowed; the feet flat; the gastrocnemii muscles smaller; the heel so long, as to make the ankle appear as if planted in the middle of the foot; the gait, hopper-hipped, or what the French call l'allure déhanchée, not unlike that of a person carrying a burden. The projecting mouth, the retreating forehead, the broad, flat nose, thick lips and wooly hair, are peculiarities that strike every beholder. According to Sœmmerring and other anatomists, who have dissected the negro, his brain is a ninth or tenth less than in other races of men, his facial angle smaller, and all the nerves going from the brain, as also the ganglionic system of nerves, are larger in proportion than in the white man. The nerves distributed to the muscles are an exception, being smaller than in the white race. Sœmmerring remarks, that the negro's brain has in a great measure run into nerves. One of the most striking differences is found in the much greater size of the foramen magnum in the negro than the white man. The foramen, or orifice between the brain and the spinal marrow, is not only larger, but the medulla oblongata, and particularly the nerves supplying the abdominal and pelvic viscera. Although the nose is flat, the turbinated bones are more developed, and the pituitary membrane, lining the internal cavities of the nose, more extensive than in the white man, and causing the sense of smell to be more acute. The negro's hearing is better, his sight is stronger, and he seldom needs spectacles.

The field of vision is not so large in the negro's eye as in the white man's. He bears the rays of the sun better, because he is provided with an anatomical peculiarity in the inner canthus, contracting the field of vision, and excluding the sun's rays,—something like the membrana nictitans, formed by a preternatural development of the plica lunaris, like that which is observed in apes. His imitative powers are very great, and he can agitate every part of the body at the same time, or what he calls dancing all over. From the diffusion of the brain, as it were, into the various organs of the body, in the shape of nerves to minister to the senses, everything, from the necessity of such a conformation, partakes of sensuality, at the expense of intellectuality. Thus, music is a mere sensual pleasure with the negro. There is nothing in his music addressing the understanding; it has melody, but no harmony; his songs are mere sounds, without sense or meaning pleasing the ear, without conveying a single idea to the mind; his ear is gratified by sound, as his stomach is by food. The great development of the nervous system, and the profuse distribution of nervous matter to the stomach, liver and genital organs, would make the Ethiopian race entirely unmanageable, if it were not that this excessive nervous development is associated with a deficiency of red blood in the pulmonary and arterial systems, from a defective atmospherization or arterialization of the blood in the lungs—constituting the best type of what is called the lymphatic temperament, in which lymph, phlegm, mucus, and other humors, predominate over the red blood. It is this defective hematosis, or atmospherization of the blood, conjoined with a deficiency of cerebral matter in the cranium, and an excess of nervous matter distributed to the organs of sensation and assimilation, that is the true cause of that debasement of mind, which has rendered the people of Africa unable to take care of themselves. It is the true cause of their indolence and apathy, and why they have chosen, through countless ages, idleness, misery and barbarism, to industry and frugality,—why social industry, or associated labor, so essential to all progress in civilisation and improvement, has never made any progress among them, or the arts and sciences taken root on any portion of African soil inhabited by them; as is proved by the fact that no letters, or even hieroglyphics—no buildings, roads or improvements, or monuments of any kind, are any where found, to indicate that they have ever been awakened from their apathy and sleepy indolence, to physical or mental exertion. To the same physiological causes, deeply rooted in the organization, we must look for an explanation of the strange facts, why none of the languages of the native tribes of Africa, as proved by ethnographical researches, have risen above common names, standing for things and actions, to abstract terms or generalizations;—why no form of government on abstract principles, with divisions of power into separate departments, has ever been instituted by them;—why they have always preferred, as more congenial to their nature, a government combining the legislative, judicial and executive powers in the same individual, in the person of a petty king, a chieftain or master;—why, in America, if let alone, they always prefer the same kind of government, which we call slavery, but which is actually an improvement on the government of their forefathers, as it gives them more tranquility and sensual enjoyment, expands the mind and improves the morals, by amusing them from that natural indolence so fatal to mental and moral progress. Even if they did not prefer slavery, tranquility and sensual enjoyment, to liberty, yet their organization of mind is such, that if they had their liberty, they have not the industry, the moral virtue, the courage and vigilance to maintain it, but would relapse into barbarism, or into slavery, as they have done in Hayti. The reason of this is founded in unalterable physiological laws. Under the compulsive power of the white man, they are made to labor or exercise, which makes the lungs perform the duty of vitalizing the blood more perfectly than is done when they are left free to indulge in idleness. It is the red, vital blood, sent to the brain, that liberates their mind when under the white man's control; and it is the want of a sufficiency of red, vital blood, that chains their mind to ignorance and barbarism, when in freedom.

The excess of organic nervous matter, and the deficiency of cerebral—the predominance of the humors over the red blood, from defective atmospherization of the blood in the lungs, impart to the negro a nature not unlike that of a new-born infant of the white race. In children, the nervous system predominates; and the temperament is lymphatic. The liver, and the rest of the glandular system, is out of proportion to the sanguineous and respiratory systems, the white fluids predominating over the red; the lungs consume less oxygen, and the liver separates more carbon, than in the adult age. This constitution, so well marked in infancy, is the type of the Ethiopian constitution, of all ages and sexes. It is well known, that in infancy, full and free respiration of pure fresh air in repose, so far from beings required, is hurtful and prejudicial. Half smothered by its mother's bosom, or the cold external air carefully excluded by a warm room or external covering over the face, the infant reposes—re-breathing its own breath, warmed to the same temperature as that of its body, and loaded with carbonic acid and aqueous vapor. The natural effect of this kind of respiration is, imperfect atmospherization of the blood in the lungs, and a hebetude of intellect, from the defective vitalization of the blood distributed to the brain. But it has heretofore escaped the attention of the scientific world, that the defective atmospherization of the blood, known to occur during sleep in infancy, and to be the most congenial to their constitutions, is the identical kind of respiration most congenial to the negro constitution, of all ages and sexes, when in repose. This is proved by the fact of the universal practice among them of covering their head and faces, during sleep, with a blanket, or any kind of covering that they can get hold of. If they have only a part of a blanket, they will cover their faces when about to go to sleep. If they have no covering, they will throw their hands or arms across the mouth and nose, and turn on their faces, as if with an instinctive design to obstruct the entrance of the free external air into the lungs during sleep. As in the case with infants, the air that negroes breathe, with their faces thus smothered with blankets or other covering, is not so much the external air as their own breath, warmed to the same temperature as that of their bodies, by confinement and reïnspiration. This instinctive and universal method of breathing, during sleep, proves the similarity of organization and physiological laws existing between negroes and infants, as far as the important function of respiration is concerned. Both are alike in re-breathing their own breath, and in requiring it to be warmed to their own temperature, by confinement which would be insupportable to the white race after passing the age of infancy. The inevitable effect of breathing a heated air, loaded with carbonic acid and aqueous vapor, is defective hematosis and hebetude of intellect.

Negroes, moreover, resemble children in the activity of the liver and in their strong assimilating powers, and in the predominance of the other systems over the sanguineous; hence they ate difficitit to bleed, owing to the smallness of their veins. On cording the arm of the stoutest negro, the veins will be found scarcely as large as a white boy's of ten years of age. They are liable to all the convulsive diseases, cramps, spasms, colics, etc., that children are so subject to.

Although their skin is very thick, it is as sensitive, when they are in perfect health, as that of children, and like them they fear the rod. They resemble children in another very important particular; they are very easily governed by love combined with fear, and are ungovernable, vicious and rude under any form of government whatever, not resting on love and fear as a basis. Like children, it is not necessary that they be kept under the fear of the lash; it is sufficient that they be kept under the fear of offending those who have authority over them. Like children, they are constrained by unalterable physiological laws, to love those in authority over them, who minister to their wants and immediate necessities, and are not cruel or unmerciful. The defective hematosis, in both cases, and the want of courage and energy of mind as a consequence thereof, produces in both an instinctive feeling of dependence on others, to direct them and to take care of them. Hence, from a law of his nature, the negro can no more help loving a kind master, than the child can help loving her who gives it suck.

Like children, they require government in every thing; food, clothing, exercise, sleep—all require to be prescribed by rule, or they will run into excesses. Like children, they are apt to over-eat themselves or to confine their diet too much to one favorite article, unless restrained from doing so. They often gorge themselves with fat meat, as children do with sugar.

One of the greatest mysteries to those unacquainted with the negro character, is the facility with which an hundred, even two or three hundred, able-bodied and vigorous negroes are kept in subjection by one white man, who sleeps in perfect security among them, generally, in warm weather, with doors and windows open, with all his people, called slaves, at large around him. But a still greater mystery is the undoubted fact of the love they bear to their masters, similar in all respects to the love that children bear to their parents, which nothing but severity or cruelty in either case can alienate. The physiological laws, on which this instinctive and most mysterious love is founded in the one case, are applicable to the other. Like children, when well-behaved and disposed to do their duty, it is not the arbitrary authority over them that they dread, but the petty tyranny and imposition of one another. The overseer among than, like the school-master among children, has only to be impartial, and to preserve order by strict justice to all, to gain their good will and affections, and to be viewed, not as an object of terror, but as a friend and protector to quiet their fears of one another.

There is a difference between infant negroes and infant white children; the former are born with heads like gourds, the fontinelles being nearly closed and the sutures between the various bones of the head united,—not open and permitting of overlapping, as in white children. There is no necessity for the overlapping of the bones of the head in infant negroes, as they are smaller, and the pelvis of their mothers larger than in the white race. All negroes are not equally black—the blacker, the healthier and stronger; any deviation from the black color, in the pure race, is a mark of feebleness or ill health. When heated from exercise, the negro's skin is covered with an oily exudation that gives a dark color to white linen, and has a very strong odor. The odor is strongest in the most robust; children and the aged have very little of it.

I have thus hastily and imperfectly noticed some of the more striking anatomical and physiological peculiarities of the negro race. The question may be asked, Does he belong to the same race as the white man? Is he a son of Adam? Does his peculiar physical conformation stand in opposition to the Bible, or does it prove its truth? These are important questions, both in a medical, historical and theological point of view. They can better be answered by a comparison of the facts derived from anatomy, physiology, history and theology, to see if they sustain one another. We learn from the Book of Genesis, that Noah had three sons, Shem, Ham and Japheth, and that Canaan, the son of Ham, was doomed to be servant of servants unto his brethren. From history, we learn, that the descendants of Canaan settled in Africa, and are the present Ethiopians, or black race of men; that Shem occupied Asia, and Japheth the north of Europe. In the 9th chapter and 27th verse of Genesis, one of the most authentic books of the Bible, is this remarkable prophecy: 'God shall enlarge Japheth, and he shall dwell in the tents of Shem; and Canaan shall be his servant.' Japheth has been greatly enlarged by the discovery of a new world, the continent of America. He found in it the Indians, whom natural history declares to be of Asiatic origin, in other words, the descendants of Shem: he drove out Shem, and occupied his tents: and now the remaining part of the prophecy is in the process of fulfilment, from the facts every where before us, of Canaan having become his servant. The question arises, Is the Canaanite, or Ethiopian, qualified for the trying duties of servitude, and unfitted for the enjoyment of freedom? If he be, there is both wisdom, mercy and justice in the decree dooming him to be servant of servants, as the decree is in conformity to his nature. Anatomy and physiology have been interrogated, and the response is, that the Ethiopian, or Canaanite, is unfitted, from his organization and the physiological laws predicated on that organization, for the responsible duties of a free man, but, like the child, is only fitted for a state of dependence and subordination. When history is interrogated, the response is, that the only government under which the negro has made any improvement in mind, morals, religion, and the only government under which he has led a happy, quiet and contented life, is that under which he is subjected to the arbitrary power of Japheth, in obedience to the Divine decree. When the original Hebrew of the Bible is interrogated, we find, in the significant meaning of the original name of the negro, the identical fact set forth, which the knife of the anatomist at the dissecting table has made appear; as if the revelations of anatomy, physiology and history, were a mere rewriting of what Moses wrote. In the Hebrew word 'Canaan,' the original name of the Ethiopian, the word slave by nature, or language to the same effect, is written by the inspired penman. Hence there is no conflict between the revelations of the science of medicine, history, and the inductions drawn from the Baconian philosophy, and the authority of the Bible; one supports the other.

As an illustration, it is known that all the Hebrew names are derived from verbs, and are significant. The Hebrew verb Canah, from which the original name of the negro is derived, literally means to submit himself—to bend the knee. Gesenius, the best Hebrew scholar of modern times, renders both the Kal, Hiphil and Niphal form of the verb from which Canaan, the original name of the negro is derived, in the following Latin: Genu flexit—he bends the knee; in genua procidet—he falls on his knees; depressus est animus—his mind is depressed; submisse se gessit—he deports himself submissively; fractus est—he is crouched or broken; or in other words, slave by nature, the same thing which anatomy, physiology, history, and the inductions drawn from philosophical observations, prove him to be.

A knowledge of the great primary truth, that the negro is a slave by nature, and can never be happy, industrious, moral or religious, in any other condition than the one he was intended to fill, is of great importance to the theologian, the statesman, and to all those who are at heart seeking to promote his temporal and future welfare. This great truth, if better known and understood, would go far to prevent the East India Company and British government from indulging in any expectation of seeing their immense possessions in Asia enhanced in value, by the overthrow of slave labor in America, through the instrumentality of northern fanaticism; or of seeing the Union divided into two or more fragments, hostile to each other; or of gaining any advantages, that civil commotion on this side of the Atlantic would give to the tottering monarchies of Europe. With the subject under this aspect, the science of Medicine has nothing to do, further than to uncover its light, to show truth from error.

Without a knowledge of the physical differences between the Ethiopian and the Caucasian, the Queen of England's medical advisers would not be much better qualified to prescribe for a negro, than her parliament to legislate for him, or her subjects to dictate to us what position he should occupy in our republican Union of Sovereign States.

The Diseases of Negroes—Pulmonary Congestions, Pneumonia, etc.

One of The most formidable complaints among negroes, and which is more fatal than any other, is congestian of the lungs, or what European writers would call false pleurisy, or peri-pneumonia notha. It is often called cold plague, typhus pneumonia, bilious pleurisy, etc., according to its particular type, and the circumstances attending it; sometimes the head complains more than any other part, and it then bears the misnomer, 'head pleurisy.' It occurs, mostly, in winter and spring, but is met with at every season of the year, when cold nights succeed to warm days. It is more common among those who sleep in open houses, without sufficient fires to keep them warm and comfortable. It is seldom observed among negroes who inhabit log cabins, with cemented or clay floors, or warm houses made of brick, or any material to exclude the cold wind and air. The frame houses, with open weather-boarding and loose floors, admitting air both at the sides and from below, are buildings formed in ignorance of the peculiar physiological laws of the negro's organization, and are the fruitful sources of many of his most dangerous diseases.

Want of sufficient fires and warm blankets, is also another cause of thoracic complaints. The negroes lungs, except when the body is warmed by exercise, are very sensitive to the impressions of cold air. When not working or taking exercise, they always crowd around a fire, even in comparatively warm weather, and seem to take a positive pleasure in breathing heated air and warm smoke. In cold weather, instead of sleeping with their feet to the fire, as all other kinds of people do, whether civilized or savage, they turn their head to the fire—evidently for the satisfaction of inhaling warm air, as congenial to their lungs, in repose, as it is to infants. In bed, when disposing themselves for sleep, the young and old, male and female, instinctively cover their heads and faces, as if to insure the inhalation of warm, impure air, loaded with carbonic add and aqueous vapor. The natural effect of this practice is imperfect atmospherization of the blood—one of the heaviest chains that binds the negro to slavery. In treating, therefore, their pulmonary affections, the important fact should be taken into consideration, that cold air is inimical to the lungs of healthy negroes, when the body is in repose, and not heated by exercise, and consequently more prejudicial in the diseases of those organs. A small, steady fire, a close room, and plenty of thick blanket covering, aided with hot stimulating teas, are very essential means in the treatment of the pulmonary congestions to which their lungs are so prone. An accurate diagnosis, whether the complaint be a mere congestion, pleuritis or pneumonia, is not of much practical importance in the first instance, because, whether it be one or the other, warm air is equally essential, and warm stimulating teas, to determine to the surface. It is proper, first to warm the body by external means and stimulating drinks, after which, an emetic, followed by a purgative of a mild kind, will be beneficial. When there is pain in taking a full inspiration, a moderate blood-letting from the arm, followed by half grain or grain doses of tartar emetic, repeated at intervals of an hour or two, and combined with a little anodyne, to prevent its running off by the bowels, will be found a very effectual remedy in subduing inflammation and promoting expectoration. In the typhoid forms of pneumonia, the quinine, in efficient doses, combined with camphor, aromatics and calomel, is generally the best practice. Bleeding is not admissible in this form of pneumonia, otherwise they bear blood-letting in chest complaints much better than any others. But even in these, they will not bear repeated blood-letting, as the white race do.

Bilious and Adynamic Fevers—Remittents and Intermittents

The next class of complaints to which they are mostly liable, are bilious and adynamic fevers—remittents and intermittents. Evacuating the stomach and bowels by a mild emetico-cathartic, combined with a weak anodyne carminative, to prevent its excessive action, is generally the best medicine to begin with; for, whatever be the type of the fever, as negroes are hearty eaters, it will be an advantage, in the after treatment of the case, to have the primæ viæ cleared of their load of undigested food, and the superabundant mucosities poured out into the alimentary canal of a people so phleghmatic, when attacked with a fever suspending digestion, and interrupting absorption.

For this purpose, a combination of ipecacuanha, rhubarb and cream of tartar, each half a drachm, and a tea-spoonful of paregoric, in ginger or pepper tea, is a very safe and effectual medicine. It will vomit, if there be bile or much mucosity, and will afterwards act on the bowels, promote secretion of urine, and determine to the surface; after which, a dose or two of quinine will generally effect a cure. Calomel is used too indiscriminately in the treatment of their diseases; nevertheless, in obstinate cases, it is not to be dispensed with. Negroes are very liable to become comatose, particularly after watery operations, or in torpid states of the liver. Such cases are best treated by a combination of calomel, camphor, capsicum, quinine and laudanum, and a blister to the back of the neck. Cold water to the head is dangerous. Nearly all their complaints bear stimulating, aromatic substances much better than similar affections among white people, and will not tolerate evacuations so well. The pure anti-phlogistic treatment by evacuations, cold air, starvation and gum water, so effectual in the inflammatory complaints of the hematose white man, will soon sink them into hopeless collapse. Even under the use of anti-phlogistics in their inflammatory complaints, pepper or ginger tea, or some stimulant, is necessary to support the vital actions, which would soon fail under such insipid drinks as gum water. The reason of this is, that the fluids and all the secretions are more acrid than those of the white man. In the latter, the lungs consume more oxygen; the blood is redder and more stimulating, and all the fluids more bland and sweet: whereas, in the negro, the deficient hematosis renders the blood less stimulating, and requires acrid and piquant substances addressed to the digestive system, to supply the stimulus that would otherwise be derived from the air in the lungs. Although they are so liable to congestive and bilious fevers—remittents and intermittents they are not liable to the dreaded el vomito, or yellow fever. At least, they have it so lightly, that I have never seen a negro die with black vomit, although I have witnessed a number of yellow fever epidemics. This is a strong proof against the identity of yellow fever, and the other fevers just named.

Scrofula, etc.

Like children, negroes are very liable to colics, cramps, convulsions, worms, glandular and nervous affections, sores, biles, warts, and other diseases of the skin. Scrofula is very common among them. Rickets, diseases of the spine and hip joint, and white swellings, are not uncommon. They are also subject to the goitre. All very fat negroes, except women who have passed the prime of life, are unhealthy and scrofulous. The great remedy for the whole tribe of their scrofulous affections, without which all other remedies do very little good, is sunshine. The solar rays is one of the most efficient therapeutic agents in the treatment of many other affections to which they are liable. A good, wholesome, mixed diet, warm clothing, warm, dry lodgings, and inunction of the skin, with oleaginous substances, and occasional tepid baths of salt and water, are also very necessary remedies. The limits of this report will not permit me to go into details of familiar treatment, as the use of iodine, and the usual remedies.

Frambæsia, Pian, or Yaws

The Frambæsia, Pian, or Yaws, is a disease thought to be peculiar to negroes. I have seen it in its worst forms, in the West Indies. I have occasionally met with it in its modified form, in the States of Mississippi and Louisiana, where it is commonly mistaken for syphilis. It is a contagious disease, communicable by contact among those who greatly neglect cleanliness. Children are liable to it, as well as adults. It is supposed to be communicable, in a modified form, to the white rice, among whom it resembles pseudo-syphilis, or some diseease of the nose, throat or larynx. Further observations are wanting in regard to it. It is said to be very prevalent in Tamaulipas, in Mexico. Attacking the nose and throat, in the first instance, very similar to secondary syphilitic affections, without ever having appeared on the genital organs at all, except in the shape of a slight herpes preputialis. According to my experience, no other remedies have been found to make the least impression upon it but the deuto-chloride of mercury, combined with guaiacum and dulcamara. Our planters do not go to the North or to Europe to learn the art of making sugar, cotton, rice, and tobacco, but they send their sons there to study medicine in the hospitals, where nearly all the diseases they see arise from causes unknown on our plantations—want of food, fire, and the common necessaries of life. Very good physicians they might be, if they staid there; but, on returning home, they have to study Medicine over again, in the school of experience, before they can practice with success, particularly among negroes. It would be very strange, that among the whole multitude of medical schools in the United States, there is not one that has made any special provision for instruction in regard to three millions of people in the Southern States, and representing half the value of Southern property, differently organized in mind and body from any other people, and having diseases requiring peculiar treatment,—if it were not for the well-known fact of the predominance of a most erroneous hypothesis among statesmen, divines, and other classes of people nearly everywhere, 'That there are no radical or physical differences in mankind, other than those produced by external circumstances, and that the treatment applicable to the white man would be just as good, under similar external circumstances, for the negro.' This false hypothesis is at the root of the doctrine that the liberty and political institutions so beneficial to the white man, would be equally beneficial to the negro—that there is no internal or physical difference between the two races. The every-day experience of the Southern people, where the two races dwell together, prove this hypothesis to be unfounded; whereas its fallacy is not so apparent to the people of the North and of Europe, where only one race of mankind is found in numbers sufficient to make comparisons between the two. Hence they have not the data to arrive at the truth, and nothing to correct the erroneous views that a false dogma has given them in regard to negro slavery. But it is most strange that our institutions for medical learning, South, should be doing nothing, with such ample materials around them, to overturn an hypothesis, founded in gross ignorance of the anatomy and physiology of the African race—an hypothesis threatening to cause a disruption of our federal government, and that could be disproved and put down forever at the dissecting table; as it also could be by contrasting the phenomena, drawn from daily observations taken among three millions of negroes, in health and disease, with the phenomena already drawn from observations of the white race; and thereby proving the difference of organization in mind and body between the two races. Stranger still, that our Southern schools in Medicine should be content to linger behind those of the North, without even hope of rivaling them in the numbers of their students, when a provision for including, in their course of instruction, the three millions of people in our midst, not cared for by any school, would, in time, put them far a-head, by attracting the current of students South, who have heretofore been attracted to the North. Some provision in our schools especially devoted to the anatomy and physiology of our negroes,—to the treatment of their diseases,—to the best means to prevent sickness among them,—to improve their condition, and at the same time to make them more valuable to their owners, and governed with more ease and safety,—would be sending Science into a new and wide field of usefulness, to reap immense benefits for the millions of both races inhabiting the South.

Negro Consumption

Negro consumption is a disease almost unknown to medical men of the Northern States and Europe. A few Southern physicians have acquired some valuable information concerning it, from personal experience and observation; but this knowledge is scattered in fragments about, and has never been condensed in a form to make it of much practical utility. It is hoped that Dr. Fenner's Southern Reports will collect the experience of our physicians, and make that experience more available than it has heretofore been; some physicians, looking upon negro consumption through Northern books, suppose it to be a variety of phthisis pulmonalis—but it has no form or resemblance to the phthisis of the white race, except in the emaciation, or when it is complicated with the relics of pneumonia, or a badly-cured pleurisy. Others regard it as a dyspepsia, or some disease of the liver or stomach; the French call it mal d'estomac. But dyspepsia is not a disease of the negro; it is, par excellence, a disease of the Anglo-Saxon race; I have never seen a well-marked case of dyspepsia among the blacks. It is a disease that selects its victims from the most intellectual of mankind, passing by the ignorant and unreflecting.

The popular opinion is, that negro consumption is caused by dirt-eating. The eating of dirt is not the cause, but only one of the effects—a mere symptom, which may or may not attend it. As in pica, there is often a depraved appetite for substances not nutritious, as earth, chalk, lime, etc.; but oftener, as in malacia, a depraved appetite, for nutritious substances to a greater degree, than for non-nutritious. In negro consumption, the patients are generally hearty eaters of all kinds of food; but there are exceptions.

The disease may be detected, at a very early stage of its existence, by the pale, whitish color of the mucous membrane lining the gums and the inside of the mouth, lips and cheeks: so white are the mucous surfaces, that some overseers call it the paper-gum disease. It can be detected, however, in its incipient state, by making the patient ascend a flight of stairs; the pulse will be accelerated from eighty or ninety beats, to an hundred and thirty or forty. All kinds of active exercise will greatly accelerate the pulse, that of walking up hill or up stairs more than any other. The skin is ashy, pale and dry; the veins of the head are distended, and show more than in health; occasionally during the day, there is some heat of the skin, and febrile excitement; the blood is poor, pale and thin, in the advanced stages, containing very few red globules; but the pathognomonic symptoms of the complaint are the acceleration of the pulse on exercise, and the whiteness of the lining membrane of the cheeks, lips and gums; the lining membrane of the eye-lids is also pale and whitish. It is of importance to know the pathegnomic signs in its early stages, not only in regard to its treatment, but to detect impositions, as negroes afflicted with the complaint are often for sale; the acceleration of the pulse on exercise incapacitates them for labor, as they quickly give out and have to leave their work. This induces their owners to sell them, although they may not know the causes of their inability to labor. Many of the negroes brought south for sale are in the incipient stage of the disease; they are found to be inefficient laborers, and are sold in consequence thereof.

In order to be able to prevent or cure any malady, it is necessary to know its cause, and its seat. The seat of negro consumption is not in the lungs, stomach, liver or any organ of the body, but in the mind, and its cause is generally mismanagement or bad government on the part of the master, and superstition on the part of the negro. The patients themselves believe that they are poisoned; they are right, but it is not the body, but the mind that is poisoned. Negroes are very jealous and suspicious; hence, if they are slighted or imposed on in any way, or over-tasked, or do not get what they call their rights, they are apt to fall into a morbid state of mind, with sulkiness and dissatisfaction very plainly depicted in their countenances. It is bad government to let them remain in this sulky, dissatisfied mood, without inquiring into its causes, and removing them otherwise, its long continuance leads to the disease under consideration. They fancy, that their fellow-servants are against them, that their master or overseer cared nothing for them, or is prejudiced against them, and that some enemy on the plantation or in the neighborhood has tricked them, that is, laid poison for them to walk over, or given it to them in their food or drinks. On almost every large plantation, there are one or more negroes, who are ambitious of being considered in the character of conjurers—in order to gain influence, and to make the others fear and obey them. The influence that these pretended conjurers exercise over their fellow servants, would not be credited by persons unacquainted with the superstitious mind of the negro. Nearly all, particularly those who have passed the age of puberty, are at times kept in constant dread and terror by the conjurers. These impostors, like all other impostors, take advantage of circumstances to swell their importance, and to inculcate a belief in their miraculous powers to bring good or evil upon those they like or dislike. It may be thought that the old superstitition about conjuration has passed away with the old stock of native Africans; but it is too deeply radicated in the negro intellect to pass away: intelligent negroes believe in it, who are ashamed to acknowledge it. The effect of such a superstition—a firm belief that he is poisoned or conjured—upon the patient's mind, already in a morbid state, and his health affected from hard usage, over-tasking or exposure, want of wholesome food, good clothing, warm comfortable lodging, and the distressing idea, that he is an object of hatred or dislike, both to his master and fellow servants, and has no one to befriend him, tends directly to generate that erythism of mind, which is the essential cause of negro consumption. This erythism of mind, like the erythism of the gravid uterus in delicate females, often causes a depraved appetite for earth, chalk, lime, and such indigestible substances. The digestive passages, in both cases, become coated with acescent mucosities, or clogged with saburricious matters. Natural instinct leads such patients to absorbents, to correct the state of the stomach.

In the depraved appetite caused by pregnancy, or in young women afflicted with leuchorrhœa, true art improves upon instinct, or the natural medication of the patients themselves, by substituting magnesia, cathartics, bitters and tonics. But for the same morbid appetite in negro consumption, the natural medication, resorted to by the instinctive wants of the patient, is mistaken for the cause of the disease. It is not only earth or clay that the patients have an appetite for, but, like chlorotic girls, they desire vinegar, pepper, salt, and stimulants. Their skins are dry, proving want of cutaneous exhalation; very little aqueous vapor is thrown off from the lungs, owing to their inability to take exercise. Consequently, defluxions occur on the mucous coat of the digestive passages, from want of action of the skin and lungs; the mucosity, lining the intestinal canal, interrupts the absorption of chyle—the blood becomes impoverished, and the body wastes away from interstitial absorption and want of nutriment.

As far as medication is concerned, I have found a combination of tartar emetic half grain, capsicum five grains, a tea-spoonful of charcoal, a table-spoonful of tincture of gum guaiacum, three times a-day, a good remedy; also, rubbing the whole surface of the body over with some oily substance. But these, as various other remedies, as purgatives, tonics, etc., should be assisted by removing the original cause of the dissatisfaction or trouble of mind, and by using every means to make the patient comfortable, satisfied and happy.

Drapetomania, or the Disease Causing Slaves to Run Away

Drapetomania is from δραπέτης, a runaway slave, μανια, mad or crazy. It is unknown to our medical authorities, although its diagnostic symptom, the absconding from service, is well known to our planters and overseers, as it was to the ancient Greeks, who expressed by the single word δραπέτης the fact of the absconding, and the relation that the fugitive held to the person he fled from. I have added to the word meaning runaway slave, another Greek term, to express the disease of the mind causing him to abscond. In noticing a disease not heretofore classed among the long list of maladies that man is subject to, it was necessary to have a new term to express it. The cause, in the most of cases, that induces the negro to run away from service, is as much a disease of the mind as any other species of mental alienation, and much more curable, as a general rule. With the advantages of proper medical advice, strictly followed, this troublesome practice that many negroes have of running away, can be almost entirely prevented, although the slaves be located on the borders of a free State, within a stone's throw of the abolitionists. I was born in Virginia, east of the Blue Ridge, where negroes are numerous, and studied medicine some years in Maryland, a slave State, separated from Pennsylvania, a free State, by Mason & Dixon's line—a mere air line, without wall or guard. I long ago observed that some persons, considered as very good, and others as very bad masters, often lost their negroes by their absconding from service; while the slaves of another class of persons, remarkable for order and good discipline, but not praised or blamed as either good or bad masters, never ran away, although no guard or forcible means were used to prevent them. The same management which prevented them from walking over a mere nominal, unguarded line, will prevent them from running away anywhere. To ascertain the true method of governing negroes, so as to cure and prevent the disease under consideration, we must go back to the Pentateuch, and learn the true meaning of the untranslated term that represents the negro race. In the name there given to that race, is locked up the true art of governing negroes in such a manner that they cannot run away. The correct translation of that term declares the Creator's will in regard to the negro; it declares him to be the submissive knee-bender. In the anatomical conformation of his knees, we see 'genu fexit' written in the physical structure of his knees, being more flexed or bent, than any other kind of man. If the white man attempts to oppose the Deity's will, by trying to make the negro anything else than 'the submissive kneesbender', (which the Almighty declared he should be) by trying to raise him to a level with himself, or by putting himself on an equality with the negro; or if he abuses the power which God has given him over his fellow man, by being cruel to him or punishing him in anger, or by neglecting to protect him from the wanton abuses of his fellow-servants and all others, or by denying him the usual comforts and necessaries of life, the negro will run away: but if he keeps him in the position that we learn from the Scriptures he was intended to occupy, that is, the position of submission, and if his master or overseer be kind and gracious in his bearing towards him, without condescension, and at the same time ministers to his physical wants and protects him from abuses, the negro is spell-bound, and cannot runaway. 'He shall serve Japheth; he shall be his servant of servants;'—on the conditions above mentioned—conditions that are clearly implied, though not directly expressed. According to my experience, the 'genu flexit'—the awe and reverence, must be exacted from them, or they will despise their masters, become rude and ungovernable and run away. On Mason and Dixon's line, two classes of persons were apt to lose their negroes; those who made themselves too familiar with them, treating them as equals, and making little or no distinction in regard to color; and, on the other hand, those who treated them cruelly, denied them the common necessaries of life, neglected to protect them against the abuses of others, or frightened them by a blustering manner of approach, when about to punish them for misdemeanors. Before negroes run away, unless they are frightened or panic-struck, they become sulky and dissatisfied. The cause of this sulkiness and dissatisfaction should be inquired into and removed, or they are apt to run away or fall into the negro consumption. When sulky and dissatisfied without cause, the experience of those on the line and elsewhere was decidedly in favor of whipping them out of it, as a preventive measure against absconding or other bad conduct. It was called whipping the devil out of them.

If treated kindly, well fed and clothed, with fuel enough to keep a small fire burning all night, separated into families, each family having its own house—not permitted to run about at night, or to visit their neighbors, or to receive visits, or to use intoxicating liquors, and not overworked or exposed too much to the weather, they are very easily governed—more so than any other people in the world. When all this is done, if any one or more of them, at any time, are inclined to raise their heads to a level with their master or overseer, humanity and their own good require that they should be punished until they fall into that submissive state which it was intended for them to occupy in all after time, when their progenitor received the name of Canaan, or 'submissive knee-bender.' They have only to be kept in that state, and treated like children, with care, kindness, attention and humanity, to prevent and cure them from running away.

Dysæsthesia Æthiopis, or Hebetude of Mind and Obstuse Sensibility of Body—A Disease Peculiar to Negroes—Callled by Overseers, 'Rascality'

Dysæsthesia Æthiopis is a disease peculiar to negroes, affecting both mind and body, in a manner as well expressed by dysæsthesia, the name I have given it, as could be by a single term. There is both mind and sensibility, but both seem to be difficult to reach by impressions from without. There is partial insensibility of the skin, and so great a hebetude of the intellectual faculties as to be like a person half asleep, that is with difficulty aroused and kept awake. It differs from every other species of mental disease, as it is accompanied with physical signs or lesions of the body, discoverable to the medical observer, which are always present and sufficient to account for the symptoms. It is much more prevalent among free negroes living in clusters by themselves, than among slaves on our plantations, and attacks only such slaves as live like free negroes in regard to diet, drinks, exercise, etc. It is not my purpose to treat of the complaint as it prevails among free negroes, nearly all of whom are more or less afflicted with it, that have not got some white person to direct and to take care of them. To narrate its symptoms and effects among them would be to write a history of the ruins and dilapidation of Hayti and every spot of earth they have ever had uncontrolled possession over for any length of time. I propose only to describe its symptoms among slaves.

From the careless movements of the individuals affected with the complaint, they are apt to do much mischief, which appears as if intentional, but is mostly owing to the stupidness of mind and insensibility of the nerves induced by the disease. Thus, they break, waste and destroy everything they handle,—abuse horses and cattle,—tear, burn or rend their own clothing, and paying no attention to the rights of property, they steal other's to replace what they have destroyed. They wander about at night, and keep in a half-nodding sleep during the day. They slight their work,—cut up corn, cane, cotton or tobacco when hoeing it, as if for pure mischief. They raise disturbances with their overseers and fellow servants without cause or motive, and seem to be insensible to pain when subjected to punishment. The fact of the existence of such a complaint, making man like an automaton or senseless machine, having the above or similar symptoms, can be clearly established by the most direct and positive testimony. That it should have escaped the attention of the medical profession, can only be accounted for because its attention has not been sufficiently directed to the maladies of the negro race. Otherwise, a complaint of so common occurrence on badly-governed plantations, and so universal among free negroes, or those who are not governed at all,—a disease radicated in physical lesions and having its peculiar and well-marked symptoms, and its curative indications, would not have escaped the notice of the profession. The northern physicians and people have noticed the symptoms, but not the disease from which they spring. They ignorantly attribute the symptoms to the debasing influence of slavery on the mind, without considering that those who have never been in slavery, or their fathers before them, are the most afflicted, and the latest from the slave-holding South the least. The disease is she natural offspring of negro liberty—the liberty to be idle, to wallow in filth, and to indulge in improper food and drinks.

In treating of the anatomy and physiology of the negro, I showed that his respiratory system was under the same physiological laws as that of an infant child of the white race; that a warm atmosphere, loaded with carbonic acid and aqueous vapor, was the most congenial to his lungs during sleep, as it is to the infant; that, to insure the respiration of such an atmosphere, he invariably, as if moved by instinct, shrouds his head and face in a blanket or some other covering, when disposing himself to sleep; that if sleeping by the fire in cold weather, he turns his head to it, instead of his feet, evidently to inhale warm air; that when not in active exercise, he always hovers over a fire in comparatively warm weather, as if he took a positive pleasure in inhaling hot air and smoke when his body is quiescent. The natural effect of this practice, it was shown, caused imperfect atmospherization or vitalization of the blood in the lungs, as occurs in infancy, and a hebetude or torpor of intellect—from blood not sufficiently vitalized being distributed to the brain; also, a slothfulness, torpor and disinclination to exercise, from the same cause—the want of blood sufficiently areated or vitalized in the circulating system. When left to himself, the negro indulges in his natural disposition to idleness and sloth, and does not take exercise enough to expand his lungs and to vitalize his blood, but dozes out a miserable existence in the midst of filth and uncleanliness, being too indolent and having too little energy of mind to provide for himself proper food and comfortable lodging and clothing. The consequence is, that the blood becomes so highly carbonized and deprived of oxygen, that it not only becomes unfit to stimulate the brain to energy, but unfit to stimulate the nerves of sensation distributed to the body. A torpor and insensibility pervades the system; the sentient nerves distributed to the skin lose their feeling to so great a degree, that be often burns his skin by the fire he hovers over, without knowing it, and frequently has large holes in his clothes, and the shoes on his feet burnt to a crisp, without having been conscious of when it was done. This is the disease called dysæsthesia—a Greek term expressing the dull or obtuse sensation that always attends the complaint. When aroused from his sloth by the stimulus of hunger, he takes anything he can lay his hands on, and tramples on the rights, as well as on the property of others, with perfect indifference as to consequences. When driven to labor by the compulsive power of the white man, he performs the task assigned him in a headlong, careless manner, treading down with his feet, or cutting with his hoe the plants he is put to cultivate—breaking the tools he works with, and spoiling everything he touches that can be injured by careless handling. Hence the overseers call it 'rascality,' supposing that the mischief is intentionally done. But there is no premeditated mischief in the case,—the mind is too torpid to meditate mischief, or even to be aroused by the angry passions to deeds of daring. Dysæsthesia, or hebetude of sensation of both mind and body, prevails to so great an extent, that when the unfortunate individual is subjected to punishment, he neither feels pain of any consequence, or shows any unusual resentment, more than by a stupid sulkiness. In some cases, anæsthesiæ would be a more suitable name for it, as there appears to be an almost total loss of feeling. The term 'rascality,' given to this disease by overseers, is founded on an erroneous hypothesis and leads to an incorrect empirical treatment, which seldom or ever cures it.

The complaint is easily curable, if treated on sound physiological principles. The skin is dry, thick and harsh to the touch, and the liver inactive. The liver, skin and kidneys should be stimulated to activity, and be made assist in decarbonising the blood. The best means to stimulate the skin is, first, to have the patient well washed with warm water and soap; then, to anoint it all over with oil, and to slap the oil in with a broad leather strap; then to put the patient to some hard kind of work in the open air and sunshine, that will compel him to expand his lungs, as chopping wood, splitting rails or sawing with the cross-cut or whip saw. Any kind of labor will do that will cause full and free respiration in its performance, as lifting or carrying heavy weight or brisk walking, the object being to expand the lungs by full and deep inspirations and expirations, thereby to vitalize the impure circulating blood by introducing oxygen and expelling carbon. This treatment should not be continued too long at a time, because where the circulating fluids are so impure as in this complaint, patients cannot stand protracted exercise without resting frequently and drinking freely of cold water or some cooling beverage, as lemonade, or alternated with pepper tea sweetened with molasses. In bad cases, the blood has always the appearance of blood in scurvy, and commonly there is a scorbutic affection to be seen on the gums. After resting until the palpitation of the heart caused by the exercise is allayed, the patient should eat some good wholesome food, well seasoned with spices and mixed with vegetables, as turnip or mustard salad, with vinegar. After a moderate meal, he should resume his work again, resting at intervals, and taking refreshments and supporting the perspiration by partaking freely of liquids. At night he should be lodged in a warm room with a small fire in it, and should have a clean bed, with sufficient blanket covering, and be washed clean before going to bed in the morning, oiled, slapped and put to work as before. Such treatment will, in a short time, effect a cure in all cases which are not complicated with chronic visceral derangements. The effect of this or a like course of treatment is often like enchantment. No sooner does the blood feel the vivifying influences derived from its full and perfect atmospherization by exercise in the open air and in the sun, than the negro seems to be awakened to a new existence, and to look grateful and thankful to the white man whose compulsory power, by making him inhale vital air, has restored his sensation and dispelled the mist that clouded his intellect. His intelligence restored and his sensations awakened, he is no longer the bipedum nequissimus, or arrant rascal, he was supposed to be, but a good negro that can hoe or plow, and handle things with as much care as his other fellow-servants.

Contrary to the received opinion, a northern climate is the most favorable to the intellectual development of negroes, those of Missouri, Kentucky, and the colder parts of Virginia and Maryland, having much more mental energy, more bold and ungovernable than in the Southern lowlands; a dense atmosphere causing a better vitalization of their blood.

Although idleness is the most prolific cause of dysæsthesia, yet there are other ways that the blood gets deteriorated. I said before that negroes are like children, requiring government in everything. If not governed in their diet, they are apt to eat too much salt meat and not enough bread and vegetables, which practice generates a scorbutic state of the fluids and leads to the affection under consideration. This form of the complaint always shows itself in the gums, which become spongy and dark, and leave the teeth. Uncleanliness of skin and torpid liver also tend to produce it. A scurvy set of negroes means the same thing, in the South, as a disorderly, worthless set. That the blood, when rendered impure and carbonaceous from any cause, as from idleness, filthy habits, unwholesome food or alcoholic drinks, affects the mind, is not only known to physicians, but was known to the Bard of Avon when he penned the lines—'We are not ourselves when Nature, being oppressed, commands the mind to suffer with the body.'

According to unalterable physiological laws, negroes, as a general rule, to which there are but few exceptions, can only have their intellectual faculties awakened in a sufficient degree to receive moral culture, and to profit by religious or other instruction, when under the compulsatory authority of the white man; because, as a general rule, to which there are but few exceptions, they will not take sufficient exercise, when removed from the white man's authority, to vitalize and decarbonize their blood by the process of full and free respiration, that active exercise of some kind alone can effect. A northern climate remedies, in a considerable degree, their naturally indolent disposition; but the dense atmosphere of Boston or Canada can scarcely produce sufficient hematosis and vigor of mind to induce them to labor. From their natural indolence, unless under the stimulus of compulsion, they doze away their lives with the capacity of their lungs for atmospheric air only half expanded, from the want of exercise to superinduce full and deep respiration. The inevitable effect is, to prevent a sufficient atmospherization or vitalization of the blood, so essential to the expansion and the freedom of action of the intellectual faculties. The black blood distributed to the brain chains the mind to ignorance, superstition and barbarism, and bolts the door against civilization, moral culture and religious truth. The compulsory power of the white man, by making the slothful negro take active exercise, puts into active play the lungs, through whose agency the vitalized blood is sent to the brain, to give liberty to the mind, and to open the door to intellectual improvement. The very exercise, so beneficial to the negro, is expended in cultivating the burning fields in cotton, sugar, rice and tobacco, which, but for his labor, would, from the heat of the climate, go uncultivated, and their products lost to the world. Both parties are benefitted—the negro as well as his master—even more. But there is a third party benefitted—the world at large. The three millions of bales of cotton, made by negro labor, afford a cheap clothing for the civilized world. The laboring classes of all mankind, having less to pay for clothing, have more money to spend in educating their children, and in intellectual, moral and religious progress.

The wisdom, mercy and justice of the decree, that Canaan shall serve Japheth, is proved by the disease we have been considering, because it proves that his physical organization, and the laws of his nature, are in perfect unison with slavery, and in entire discordance with liberty—a discordance so great as to produce the loathsome disease that we have been considering, as one of its inevitable effects,—a disease that locks up the understanding, blunts the sensations and chains the mind to superstition, ignorance and barbarism. Slaves are not subject to this disease, unless they are permitted to live like free negroes, in idleness and filth—to eat improper food, or to indulge in spirituous liquors. It is not their masters' interest that they should do so; as they would not only be unprofitable, but as great a nuisance to the South, as the free negroes were found to be in London, whom the British government, more than half a century ago, colonized in Sierra Leone to get them out of the way. The mad fanaticism that British writers, lecturers and emissaries, and the East India Company, planted in our Northern States, after it was found by well-tried experiments, that free negroes in England, in Canada, in Sierra Leone and elsewhere, were a perfect nuisance, and would not work as free laborers, but would retrograde to barbarism, was not planted there in opposition to British policy. Whatever was the motive of Great Britain in sowing the whirlwind in our Northern States, it is now threatening the disruption of a mighty empire of the happiest, most progressive and Christian people, that ever inhabited the earth—and the only empire on the wide earth that England dreads as rival, either in arts or in arms.

Our Declaration of Independence, which was drawn up at a time when negroes were scarcely considered as human beings, 'That all men are by nature free and equal,' and only intended to apply to white men, is often quoted in support of the false dogma that all mankind possess the same mental, physiological and anatomical organization, and that the liberty, free institutions, and whatever else would be a blessing to one portion, would, under the same external circumstances, be to all, without regard to any original or internal differences, inherent in the organization. Although England preaches this doctrine, she practises in opposition to it every where. Instance, her treatment of the Gypsies in England, the Hindoos in India, the Hottentots at her Cape Colony, and the aboriginal inhabitants of New Holland. The dysæsthesia æthiopis adds another to the many ten thousand evidencies of the fallacy of the dogma that abolitionism is built on; for here, in a country where two races of men dwell together, both born on the same soil, breathing the same air, and surrounded by the same external agents—liberty, which is elevating the one race of people above all other nations, sinks the other into beastly sloth and torpidity; and the slavery, which the one would prefer death rather than endure, improves the other in body, mind and morals; thus proving the dogma false, and establishing the truth that there is a radical, internal, or physical difference between the two races, so great in kind, as to make what is wholesome and beneficial for the white man, as liberty, republican or free institutions, etc., not only unsuitable to the negro race, but actually poisonous to its happiness.

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