“Experiment and Good Sense Must Direct You”: Managing Health and Sickness in the British Plantation Enlightenment, 1756-1815

Between the start of the Seven Years’ War in 1756 and the end of Napoleonic Wars in 1815 enslaved patients, plantation managerial staff, healing adepts, and military and urban practitioners in the Greater Caribbean (a region that encompassed the plantation societies of the Carolina Lowcountry and the Anglophone West Indies) exchanged medical know-how, therapeutic information, and patient narratives. In so doing they not only made what were previously ephemeral and elusive knowledges of illness and its cure in the Greater Caribbean more enduring, they transformed plantations in the region into vibrant yet coercive spaces of medical knowledge-making. This dissertation spotlights the role of military practitioners, urban physicians, plantation managerial staff, and enslaved healers and patients in generating new ideas about illness. Over the course of six decades, these groups forced a paradigm shift in ideas about illness from a classical humoral-model to the modern disease framework. Grappling with tropical fevers during the Seven Years’ War, regimental practitioners created intellectual scaffolding for thinking about fevers and disease in the tropics writ large. Their conclusions obtained both for the military rank and file and for plantation slaves, and also fundamentally transformed how healers throughout the region understood illness. Urban practitioners subsequently gathered observations from plantation managers and enslaved healers to recast illnesses common among plantation populations, such as locked-jaw, yaws, and dirt-eating, as distinctive disease entities. The immediate consequences of this intellectual work were regional: it expanded the interpretive chasm between European-trained “country practitioners” and their enslaved patients and increased conflicts over the interpretation over what had caused an enslaved person’s illness and what was needed to restore her to health. During the era of abolition, however, anti-slavery reformers in metropolitan Britain used the new explanations of plantation diseases to agitate for the reform of British Caribbean slavery. Diseases are not transparent reflections of the natural world; they are instead the product of local conflicts and epistemological struggles to differentiate an ailment from others like it, to determine how it came to be and what should be done to treat it, and to assign interpretive power to specific occupational or political groups to make these determinations. Taking as its point of departure the insight that diseases are preeminently cultural objects, each chapter in this dissertation excavates the development of disease categories that historical actors linked to enslaved plantation populations. It examines how urban practitioners carved out distinctive diseases from the welter of symptoms and signs that healing adepts, managerial staff, and enslaved patients conveyed. The intersection of the local political economy of slavery with enslaved patients’ resistance, this dissertation shows, profoundly shaped the development of different categories of disease in the Greater Caribbean during the period