Working Cures: Healing, Health, and Power on Southern Slave Plantations.

By Sharla M. Fett. Gender and American Culture. (Chapel Hill and London: University of North Carolina Press, c. 2002. Pp. [xiv], 290. Paper, $18.95, ISBN 0-8078-5378-X; cloth, $39.95, ISBN 0-8078-2709-6.)

Since the 1970s, scholars such as Kenneth F. Kiple and Todd L. Savitt have uncovered the demographic and biological trends that structured life on slave plantations. In contrast to the "biomedical" approach of these pathbreaking authors, Sharla M. Fett concentrates on the cultural dimensions of slave health (p. 10). Her book does not include a single table or chart dealing with slave fertility or mortality. Instead, Fett approaches slave health and medicine as a cultural pathway by which diverse "African philosophies and therapies" were mixed with the "indigenous botanical knowledge" of Native Americans and the influences of "European popular and elite doctoring" (p. 2). Presenting slave ideas about health as vibrant dimensions of the African American culture of resistance to slavery, she seeks to explicate the ideological context in which masters and slaves pursued vastly different medical agendas. Throughout her admirably researched and beautifully argued study, Fett traces the complications that flowed from "the fact that fluid cross-cultural exchanges in medicine took place within a slave society characterized by a sharply defined social order" (p. 3).

In the first half of the book Fett delineates the tensions between white and black visions of health. Slaveholders conceptualized slave health using the narrow concept of "soundness" (chap. 1). Eager to protect and to enlarge their investment in human property, white southerners "defined slave health as the capacity to labor, reproduce, obey, and submit" (p. 20). Planters perversely characterized their pursuit of slave soundness in humanitarian terms, even as the white medical establishment dehumanized slaves by tailoring treatments to maximize white financial gains. African Americans, on the other hand, understood health as a "relational" concept (p. 36). Health, sickness, and healing were rooted in the African American "pharmocosm"--the axiom that the world was "imbued with sacred meaning" and lacked "distinctions between secular and religious spheres." The "spiritual power" that permeated the African American world endowed black healers with the ability to both cure and harm (p. 39).

Fett resists the temptation to draw a sharp distinction between white and black cultures of health. Instead, she explores how spirituality and African influences crept into white ideas about sickness and takes stock of planters' willingness to capitalize on "reputed cures from African American practitioners" (p. 67). Fett likewise sees diversity and conflict among the slaves themselves, whose relational understanding of health frequently reflected the lack of harmonious relations in the slave community. Sick slaves, for example, sometimes attributed their health problems to conjurations by enslaved rivals.

Still, plantation health did take place in an arena in which masters and slaves struggled for power, and the second half of Working Cures explores the theme of black subversion and resistance. In a marvelous chapter on gender, Fett simultaneously reveals the skilled nature of black women's tasks as healers and the indignities they endured through "[c]lose involvement with [the] bodily waste" of their black and white patients (p. 120). By the antebellum era, when white women were increasingly charged with moral authority as caretakers, racist orthodoxy increasingly denied respect and agency to slave women. As it turned out, white distrust of black healers and black medical knowledge was not entirely misplaced. Whereas white medical authorities often employed medical treatment as punishment, black healers sometimes used their conjuring skills to foster insubordination and insurrection. Most common, perhaps, was the slave strategy of feigning illness to avoid labor.

Notwithstanding the countless slave victims of white medical practices (such as the slave woman forced to undergo thirty experimental obstetrical surgeries without anesthesia [pp. 151-52]), African American responses to plantation health emphasized the self-reliance of the slave community. Fett's work provides a theoretical framework for future scholarship on the ideological interplay between masters and slaves regarding health care. Working Cures does not, however, offer clear conclusions about how these ideologies shifted over time and place. Although Fett considers evidence ranging from the Lowcountry to the Chesapeake, she tends to lump these subregions together into a largely static portrait of antebellum health practices. Her brief discussion of how practices changed over the antebellum period raises the possibility that her already nuanced argument could be further refined by future scholarship.

JEFFREY ROBERT YOUNG 

Georgia Southern University