Rachel D. Maree, M.P.H.
2012 M.D. Candidate, Medical University of South Carolina
The history of race and medicine is a deep and complex trail of deception, misperception, social struggles and exploitation. In particular, the history of Blacks and the institution of medicine provide several examples of how scientists and health professionals used medicine and science to promote theories concerning the inferiority of blacks. From pluralist theories of different origins for different races, to the development of diseases specific to one race, racial biology has formed a deep seated question of whether there are true anatomical and physiological differences among mankind. From the early 18th to mid-19th century, several theories were employed to support the belief that blacks were an inferior race. Decades later, the works of two black, male scholars added to the growing thoughts concerning racial health and hierarchy. The association between the theories proposed under black, male scholarship can be linked to efforts to eliminate the use of racial and physiological differences to promote discriminatory practices.
In 1735, Carl von Linneaus (1707-1778) released “Systema Naturae,” a book of nomenclature creating biological classifications. In the book, Linneaus also classified various races of people, and at one point argued that Black-Africans were inferior to other races. In 1786, Thomas Jefferson, who studied Linneaus’ work, wrote “Notes on the State of Virginia.” Having adopted Linneaus’ thoughts on the inferiority of Black- and Native-Americans, Jefferson used these ideals to promote the institution of slavery. Jefferson’s work used both physiological and anatomical characteristics of Blacks as evidence to support his belief of inferiority. Jefferson further commented on the mental capacity of Blacks, saying:
Comparing them by their faculties of memory, reason, and imagination, it appears to me, that in memory they are equal to whites; in reason much inferior, as I think one could scarcely be found capable of tracing and comprehending the investigations of Euclid; and that in imagination they are dull, tasteless, and anomalous.
Jefferson further classified blacks as inferior to Native-Americans, whom he said had “prove[n] their reason and sentiment strong, their imagination glowing and elevated.” These examples show various ways that Jefferson justified theories of the inferiority of blacks.
Jefferson also alluded to another theory of the racial superiority of whites and inferiority of blacks: “The improvement of the blacks in body and mind, in the first instance of their mixture with the whites, has been observed by every one, and proves that their inferiority is not the effect merely of their condition of life.” Here Jefferson reinforced the superiority of whites by claiming that any mixture of white blood with that of Negro blood would produce someone who was more capable, both mentally and physically, than someone with little or no mixture of white blood, for example, someone who was pure Negro.
Theories of Black inferiority, such as the one posed by Linneaus and supported by the observations of Jefferson were steps in the progression leading to the development of diseases particular to the black race. Physician Samuel A. Cartwright (1793-1862) classified diseases particular to blacks. According to Cartwright, Drapetomania is a disease “that induces the Negro to run away from service” and “is as much a disease of the mind as any other species of mental alienation, and much more curable, as a general rule.” Despite what seems to be Cartwright’s characterization of a medical ailment or disease, the methods he recommended for curing Drapetomania were most likely used to promote oppressive institutions in society: “…whipping them out of it, as a preventive measure against absconding or other bad conduct…punished until they fall into that submissive state…”
In addition to Cartwright’s classification of new diseases, Samuel George Morton (1799-1851), an honored professor at the University of Pennsylvania Medical School, collected and measured over 1000 human skulls to assess differences in cranial measurements based on race. Morton asserted that there were innate differences in the various races, specifically between whites and Negroes and Caucasoid and “Mongols” that could not be explained by environmental factors. He used the measurements he obtained from the skulls to publish works supporting the superiority of Whites.
Josiah Clarke Nott (1804-1873), a student of Morton’s, took Morton’s findings in the differences between white and Negro cranial measurements, which were subsequently disproven by a different evaluation of his results, and promoted the theory of pluralism as further justification for slavery. Pluralists such as Louis Agassiz (1807-1873), espoused the thoughts that different races had separate origins. Despite the fact that Agassiz’s intentions were not to support ideologies of slavery, his works were used to promote the idea of the physical and mental inferiority of blacks.
Nott also published a book, “Indigenous Races of The Earth,” in 1857, which has a chapter concerning “The Cranial Characteristics of The Races Of Men.” In his writing, Nott and other scholars such as J. Aitken Meigs, alluded to the necessity for comparing cranial structures of men with those of apes to properly distinguish between the races of men. Meigs supported the theory that there were different classes of men, and those men who were in lower classes were more closely related to monkeys and other primates. Typical of the time, Meigs and Nott both found “a comparison between the cranium of a negro and that of a gorilla [to be] admirably drawn.” This limited study shows that there were several theories concerning the biological and anatomical differences between blacks and other races. Most of these theories promoted the inferiority of blacks as compared to whites, and were used to promote lower societal standing of blacks throughout history.
While this is in no way a comprehensive review of the history of racial theory, it provides a background for the theory and thought concerning the onset of racial health disparities. The implications of race theory should be contextualized within the establishment of racial hierarchies during the times in which they were written. Nevertheless, these theories likely served as the precedent for the establishment of the health and health care of blacks. The social and economic ramifications that stemmed from the unequal treatment created a cyclic effect on the overall health of blacks. Research has repeatedly proven that increases in income, education, and quality of life are likely to show improved health status. By stifling the success and self-sufficiency of blacks within society, these theorists also inhibited them from achieving optimal health outcomes.
As such, the history of racial theory should not be left without at least mentioning the contributions of William Edward Burghardt (W.E.B.) DuBois’ “Health and Physique of the Negro American” (1906) and Julian Herman Lewis’ “The Biology of the Negro” (1942), both of which used alternative views to address the health and disease of blacks. Neither author specifically stated that their work was an effort to refute the then popular theories of racial and biological superiority. However, literary pieces used sociology and science to support the disparities between Negro and Caucasian physical and mental health, and provided reasoning as to why there may have been differences seen between the two races. What makes these two works even more important and interesting is that both authors were African-American males making not only commentary, but providing statistical and scientific evidence on a topic previously dominated by White, male scholarship.
DuBois’ writing, while claiming to be merely a report of Negro-American problems with health, encompassed issues of mixed ancestry and mental capacity; the historical construct of race; the anatomical and physiological differences between blacks and whites; and vital, morbidity, and mortality statistics. In covering this range of topics, DuBois, at times, provided counterarguments for previously held notions of Negro inferiority due to racial traits.
Likewise, Lewis claimed that his text, “The Biology of the Negro,” had no distinct thesis and was merely a comprehensive overview of racial pathology. Lewis made it known throughout the volume that disease prevalence was “no less a racial characteristic than is head form or skin color.” Lewis used much more scientific evidence such as blood type and chemical composition characteristics as evidence against biological differences or similarities. Furthermore, Lewis devoted a substantial amount of his text to the discussion of disease and the differences seen among African-Negroes, American-Negroes, and Caucasian, and suggested that environmental and social factors accounted for many of the differences seen between races. Lewis also attempted to provide valid and reliable reasoning or explanations for racial differences as well as a comprehensive review of the research of his time.
DuBois’ attempt at making others aware of the problems of the Negro may well have been part of the onset of a significant amount of attention being paid to black health. In some aspects of “The Health and Physique of the Negro American,” DuBois provided an introduction to what would later be termed health disparities research through his comparisons of Whites and Negroes or Colored. Both DuBois and Lewis were well ahead of their time in publishing these texts, as the wave of epidemiological health disparities research would not come for many decades later.
Despite DuBois and Lewis’ efforts to eliminate thoughts and theories concerning Negro inferiority, some of today’s scholars still feel that physiological or anatomical differences exist between races. One piece of evidence for this is the recent promotion of BiDil, a prescription drug targeted specifically towards African-Americans with heart failure, cardiovascular disease, and diabetes. This is further proof that there must be some thought that medication will function differently in African-Americans than it would in people of other races and is an indication that the theories of anatomical and physiological differences among races have not totally been eradicated. What remains to be seen, however, is whether or not these supposed differences will be used to achieve better health outcomes or if they are merely continuations of thought used in efforts to create division and promote anatomical and racial hierarchies.
Cartwright ,S.A. (1851). Report on the Diseases and Physical Peculiarities of the Negro Race. New Orleans Medical and Surgical Journal, 691-715.
DuBois, W.E.B. (1906). Proceedings of the Eleventh Conference for the Study of the Negro Problems: The Health and Physique of the Negro American. Atlanta, GA: Atlanta University.
Gould, S.J. (1978). Morton’s Ranking of Races by Cranial Capacity. Science, 200 (4341). 503-509.
Jefferson, T. (1786). Notes on the State of Virginia (excerpt). Retrieved from the University of Virginia Database.
Lewis, J.H. (1942). The Biology of the Negro. Chicago, IL: University of Chicago Press.
Lurie, E. (1954). Louis Agassiz and the Races of Man. Isis, 45 (3), 227-242.
National Medical Association. (2002). Racism in Medicine and Health Parity for African Americans: ‘The Slave Health Deficit’. Washington, D.C.: National Colloquium on African American Health.
Nott, J.C. and Gliddon, G.R. (1857). Indigenous Races of The Earth. Philadelphia, PA: J.B. Lippincott & Co.
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