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~Aja Lans, PhD, MHL Educational Resources Fellow, 2021

Medicine During Slavery | Creating Racial Differences | The Eugenics Movement | Experimentation on Black Bodies

The goal of this resource set is to introduce viewers to the roots of anti-Black racism in medicine that have perpetuated health disparities whereby Black individuals disproportionally suffer from a variety of medical concerns and a lack of adequate healthcare resources. Many diseases, including but not limited to tuberculosis, syphilis, and sickle cell anemia, have a long history of being associated with specific racial types. Poor health among Black people has repeatedly been presented as simply a fact of life, caused by assumed intellectual and biological inferiority. However, we must address the roots of such assumptions, assumptions that were created, disseminated, and reinforced by racist scientific research and medical practice.

“Race” is a fraught word that has been interpreted and weaponized in many different contexts. Races as discrete biological categories do not exist, but as social constructs have major ramifications. Therefore, it is important to keep in mind that “race becomes biology” through a vicious cycle in which racial discrimination harms community and individual health, and these negative health outcomes are then used to reinforce the notion that race is indeed biological. 

These resource sets are based on four broad themes that are meant to build upon and complement one another, so there is overlap between topics. While readers can begin anywhere in the sets, the first three are loosely arranged chronologically: (1) Medicine During Slavery, (2) Creating Racial Differences, and (3) The Eugenics Movement. The fourth set, Experimentation on Black Bodies, covers all time periods and intersects with the previous sets.

This topic of course turns up no shortage of offensive and unsettling material. The term “negro” is very commonly used as are other outdated notions of race. There are also materials with offensive and outdated discussions of sexuality, gender, disability, and socioeconomic status. It is necessary to search the texts using various keywords and phrases to locate the relevant content. Terms to search for include but are not limited to the categorizations “negro,” “black,” “slave,” and “servant.” Searching for specific medical conditions, tools, or procedures also proves effective. 

Medicine During Slavery

The first set begins with sources that are intended to orient the viewer to the treatment of enslaved Africans and their descendants, largely focusing on but not limited to slavery in the present-day United States. By starting with this set, the viewer should be able to trace certain assumptions about race and health and see how they are both maintained and transformed over time to fit different circumstances.

Take for instance the work of Dr. Samuel Cartwright, who created an illness called drapetomania, or the disease causing slaves to run away. Cartwright considered this a curable disease of the mind which could be prevented by encouraging order and good discipline. While some diseases were considered to be unique to the condition of enslavement, after emancipation other illnesses would be attributed to freedom.

This is a diagram depicting Dr. John Hutchinson’s spirometer, a tool designed to measure lung capacity. Dr. Samuel Cartwright is believed to be the first individual to use the spirometer to measure differences in lung capacity between Black and white people. This led to the notion that Black people naturally have lower lung capacity than white people, and modern spirometers still automatically “correct” for racial differences. See Lundy Braun’s Breathing Race into the Machine (Minneapolis: University of Minnesota Press, 2014).

Creating Racial Differences

As we turn to the next set focusing on post-emancipation science, medicine, anthropology, and “The Negro Health Problem,” readers will see many arguments that slavery was indeed better for the mental and physical health of Black people. There is also an increased focus on quantifying differences between races in order to better categorize people and build a hierarchy of humans. Racialized science was used to contribute to ideologies about human difference and rationalize the inferior treatment of Black people based on their supposed lack of intelligence, morals, and animal-like physical features. These sorts of studies flourished throughout the 19th and early 20^th centuries, with an emphasis placed on studies of skin color, hair length and texture, and anthropometry, especially of the head. Scientists claimed neutrality while their research fueled discriminatory public policy against Black, indigenous, and immigrant communities.

After the American Civil War, the process of emancipation overwhelmed almshouses and state hospitals. Some 500,000 Black people self-emancipated during the war, and 3.5 million were freed when the war ended. Former slaves existed in a liminal state, without a clear political status. They were also defenseless against infectious diseases. The increase in mortality among newly freed Blacks was used to argue for their biological inferiority and that they were better suited for enslavement. Despite advances in germ theory and disease causation, physicians continued to discriminate against Black patients. Social and moral status was still assumed to play a role in black patients’ illness.

The Eugenics Movement

Such ideas about racialized types directly contributed to the field of eugenics, or the study of race improvement by better breeding. British scientist Francis Galton (1822-1911) coined the term eugenics after reading his cousin Charles Darwin’s On the Origin of Species (1859). Eugenicists believed that people were born with certain qualities including character and intellect, and that traits including alcoholism, feeblemindedness, prostitution, criminality, and immorality were genetically controlled pathological conditions. Many eugenicists, including Galton, argued that selective breeding would resolve human suffering. During the Progressive Era, many Americans would come to consider the movement to be a scientific breakthrough. Therefore, certain individuals should be selected to reproduce and improve the (white) race. The eugenics movement became popular in the United States as a way to bolster legislation that oppressed people of color, immigrants, and the disabled.

The eugenics movement in the United States was spearheaded by Charles Davenport (1866-1944). In 1904 Davenport became the director of the Station for Experimental Evolution at Cold Spring Harbor, Long Island, where he would eventually establish the Eugenics Record Office. Here, Davenport and colleagues trained students to be field workers who were then sent to various institutions, including prisons and asylums, to collect anthropometric measurements of inmmates. 

Eugenics researchers also gathered biased information from poverty-stricken urban areas to argue that African Americans were of inferior intellect and had weaker immune systems than whites. Eugenics based arguments were also used to forcibly sterilize women who were institutionalized in various prisons, asylums, and hospitals against their will, and the procedures were deemed legal. Such practices continued until the 1940s and were only discredited after the Holocaust, although many eugenic philosophies remain. 

Experimentation on Black Bodies

The theme of human experimentation runs throughout this entire set and so covers many time periods. The objectification of Black people began with chattel slavery. The traditional role of the enslaved as objects for study carried on after emancipation, making black bodies into objects suitable for medical demonstrations, dissections, and risky surgeries and experiments. To put it simply, “The atmosphere created by racial inferiority theories and stereotypes, 246 years of black chattel slavery, along with biased educational processes, almost inevitably led to medical and scientific abuse, unethical experimentation, and overutilization of African-Americans as subjects for teaching and training purposes.”

Here, let us consider the legacy of J. Marion Sims, the “Father of Modern Gynecology.” Sims pioneered tools and surgical treatments for women’s reproductive health by conducting research and experiments on enslaved Black women without the use of anesthesia. His early surgeries carried out on enslaved women such as Lucy were not successful and caused months of agony and illness. He supposedly perfected fistula surgeries after 30 operations on 17-year-old Anarcha. It wasn’t until this success that he began the operation on white women with the use of anesthesia.

Works Cited

Baker, Lee D. From Savage to Negro: Anthropology and the Construction of Race, 1896-1954. Berkeley: University of California Press, 1998.

Byrd, Michael W. and Linda A. Clayton. “Race, Medicine, and Health Care in the United States: A Historical Survey.” Journal of the National Medical Association 93, no. 3 (March 2001): 11S-34S.

Downs, Jim. Sick From Freedom: African-American Illness and Suffering during the Civil War and Reconstruction. New York: Oxford University Press, 2012.

Cooper Owens, Deirdre. Medical Bondage: Race, Gender, and the Origins of American Gynecology. Athens: University of Georgia Press, 2017.

Gould, Stephen Jay. The Mismeasure of Man. New York: W.W. Norton, 1996, 1981.

Gravlee, Clarence C. “How Race Becomes Biology: Embodiment of Social Inequality.” American Journal of Physical Anthropology 139, no. 1 (2009): 47-57.

Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Anchor Books, 2006.

Further Resources

https://www.aaihs.org/syllabus-a-history-of-anti-black-racism-in-medicine/

https://www.pbs.org/video/regional-voices-what-race-and-what-it-not-dr-agustin-fuentes/

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~Rachael Gillibrand, MHL Jaipreet Virdi Fellow for Disability Studies, 2021

In 2020, a survey produced by MRA Simmons showed that approximately 41 million people living in the USA (out of an approximate 332 million surveyed) wore dentures – making up 12% of the total population. However, tooth-loss and decay resulting in the need for dentures isn’t a modern problem. Due to the expense of treatment and lower overall standards of dental hygiene, the number of people who suffered from lost or decaying teeth used to be much higher than it is today. As early as c. 300 BCE, Aristotle noted that ‘figs, which are soft and sweet, destroy the teeth’ because they, ‘owing to their stickiness, penetrate into the gums, and, because they are soft, insinuate themselves into the thirty spaces between the teeth’ (Ross, Works of Aristotle, Vol. VII, Problemata, Book XXII). 

Despite the ubiquity of tooth-decay and tooth-loss throughout time, these conditions probably wouldn’t be considered to be ‘disabling’ by modern society. As many people are fortunate enough to have access to preventative measures like toothpaste and brushes, as well dental care when things go wrong, severe and untreated chronic dental problems are something few experience. However, in a time before easy access to paracetamol and affordable dental care, persistent dental problems resulted in a number of physical and social dis/abilities. For example, the loss of a large number of teeth can lead to difficulties chewing and eating, social ostracisation and, as Dubois de Chémant suggested in his Dissertation on Artificial Teeth (1797), could also result in speech impediments in which ‘words and syllables are indistinctly pronounced, and slurred, or run in to one another’. 

This primary source set will subsequently consider the ways in which dentures were used as a disability technology in the past. It will consider the construction, use, and care of dentures as well as some of the more ‘popular’ attitudes towards dental care.

Animal, Vegetable, Mineral?

ANIMAL, VEGETABLE, MINERAL? CONSTRUCTING ARTIFICIAL TEETH

Today, dentures tend to be constructed from a combination of acrylic and metal due to the affordable, lightweight, and malleable nature of those materials. However, it was not until the 1930s that neo-hecolite, a kind of acrylic resin, was first used in dentistry (we can see an example of this in the 1931-32 Bulletin of the North Carolina Dental Society, in which a conference programme lists a clinic to be delivered by J. W. Whitehead titled ‘Hecolite Dentures – Advantages and Disadvantages’, p. 39). So what were people using to construct dentures before this point?

Gold

Gold

False teeth, or dentures, have ancient origins. Some of the earliest surviving examples were produced by the Etruscans (people who lived in Etruria – a historical region of central Italy) c. 700 BCE. These dentures were made by riveting either human or animal teeth into an oval shaped golden band, which would be held in place by the individual’s surviving teeth. Gold was also used to create dentures in the medieval Islamic world; however, rather than using bands and rivets, thinner golden wires were inserted through holes drilled in the dentures (again, made from human or animal teeth) before being wrapped around the surviving teeth to hold the denture in place. This method was outlined in detail by Albucasis c. 1100 CE, and was later adopted by surgeons such as Guy de Chauliac in the medieval West. Since this point, gold has continued to be a popular choice of material in dentistry, and is still used for fillings and crowns today! 

Wood

Wood

Some of the earliest evidence for the use of wooden dentures comes from Japan in the sixteenth century. One surviving example, made of wood from the Japanese box tree, was said to have been worn by a priestess of the Ganjyoji Temple (Kii Province) named Nakaoka Tei. These kinds of wooden teeth continued to be produced in Japan until the late nineteenth century. They were generally carved by expert craftsmen such as Negoro Sokyu (an artist and artificial tooth-maker based in mid-eighteenth-century Osaka), and could be finished with ivory crowns or lacquer. However, finding hardwoods strong and non-porous enough to be used for the construction of dentures was difficult, and wooden teeth did not have a lot of popularity outside Japan. “But what about George Washington?!” I hear you ask. Well, unfortunately, the pervasive myth that Washington wore wooden denture is just that – a myth. Whilst Washington certainly possessed and wore multiple sets of false teeth, they were constructed from metal, ivory, and porcelain – which brings us onto our next section… 

Ivory

Ivory

Perhaps the most popular material in the construction of early dentures was ivory – more specifically, hippopotamus ivory. Hippopotamus ivory was denser and more hardwearing than elephant or walrus ivory, and would therefore have been more suitable for use as dentures (such as those listed in the Switzerland entry of the Great Exhibition catalogue). However, ivory was still an organic material and had a tendency to stain, smell, and ultimately rot. It was also quite difficult and dangerous to acquire hippopotamus tusks, so these kinds of ivory dentures would have been rare and expensive to purchase. 

Human teeth, on the other hand, were much easier to come by. ‘Waterloo Teeth’ for example, were named for the soldiers who had died at the Battle of Waterloo and who had subsequently had their teeth pulled and sold by battlefield scavengers. The removal and sale of dead soldiers’ teeth also took place throughout the Crimean War and in the aftermath of the Battles of Bull Run and Gettysberg. A much more sinister example of this can be seen in George Washington’s financial records. In 1784, Lund Washington (George Washington’s cousin and steward of the Mount Vernon plantation) recorded ‘cash pd on acct of Genrl. Washington [to] Negroes for 9 teeth, on acct of the French Dentis [sic] Doctr Lemay’ – thereby demonstrating Washington’s ‘purchase’ of teeth from enslaved peoples for the purposes of dentistry. For more on the subject of race and equity in health and healthcare, please see the work of our Educational Resources Fellow, Aja Lans. 

Porcelain

Porcelain 

Towards the end of the eighteenth century, dentists began experimenting with porcelain as a material for the construction of dentures. The first porcelain dentures were made by the French dentist Alexis Duchateau, who had grown tired of wearing hippopotamus ivory teeth and wanted to create something more durable. However, Duchateau had a problem – whenever he fired the porcelain (to set the material in shape) the teeth he had constructed would shrink! As such, he teamed up with Nicolas Dubois de Chémant, to solve the problem of shrinkage. Dubois de Chémant subsequently secured a British patent for the construction of porcelain teeth, and went on to write his Dissertation on Artificial Teeth in General, which sought to expose ‘the defects and injurious consequences of all teeth made of animal substances’. 

However, although porcelain dentures were thought to be an improvement on earlier ivory models, they were still very expensive and had a tendency to chip – meaning that they had to be repaired or replaced relatively frequently. In the 1820s, Claudius Ash (a goldsmith and jeweller) began to manufacture porcelain dentures mounted on gold plates, which improved their durability (if not their price!) Claudius Ash went on to found the company ‘Ash & Sons’, which became Britain’s leading supplier in dental appliances.

Vulcanite

Vulcanite 

From the mid-nineteenth century, dentures began to be constructed from Vulcanite – a material discovered by Charles Goodyear in 1843 (you can find Goodyear’s original patent for Vulcanite here). Vulcanite was a hard, but flexible, rubber that could be produced relatively cheaply. For the first time, this meant that dentures could be made available to people with lower incomes. However, the introduction of Vulcanite was not entirely smooth sailing. Due to the growing popularity of Vulcanite, the Goodyear Dental Vulcanite Company demanded that dentists had to obtain licences to use their material. Many dentists opposed this licence and the Goodyear Dental Vulcanite Company pursued litigation against any unlicensed practitioners. Fortunately, Charles Goodyear’s patent only lasted for twenty-five years and, in 1881, Vulcanite could be used and produced without a license. 

Keep Your Teeth Clean!

KEEP YOUR TEETH CLEAN! THE USE AND MANAGEMENT OF ARTIFICIAL TEETH

In 1851, John Tomes (surgeon dentist to Middlesex Hospital, England) published a lecture titled Instructions in the Use and Management of Artificial Teeth. In this lecture, Tomes states that, if you don’t take care of your false teeth, they will ‘sooner become offensive’. ‘The wearer’ he says, ‘often seems singularly unconscious of the offensive odor which arises from neglected teeth, – not so, however, the bystander; he is almost poisoned by the offensive breath of his neighbour’. To save these poor bystanders, Tomes offers three main pieces of advice: 

Brush

Brush the teeth once or twice a day and rub with a soft dry towel

First of all, Tomes advised that dentures be brushed twice a day and rubbed dry with a soft towel. Although written in 1851, this kind of advice is not so far removed from medieval treatises on dental hygiene. Gabriele Zerbi’s Gerontocomia, for example, was published in 1489 and suggested that ‘the teeth can be cleaned with a linen cloth dipped in rose water or wine (not sweet) and rubbed with a powder that restores their powers’. (Zerbi, Gerontocomia, trans. L. R. Lind, p. 258). Similarly, the twelfth-century De ornatu mulierum [On Women’s Cosmetics] suggested that women should wash their teeth with wine after meals before cleaning them with an abrasive powder and drying them with a linen cloth. This kind of abrasive tooth-cleaning powder remained popular well into the nineteenth and twentieth centuries. Multiple types of tooth powders, pastes, perfumes, soaps and tablets can be found in Peter MacEwan’s Pharmaceutical Formulas of 1908. However the use of these treatments was often condemned by dentists. For example, in his New System of Treating and Fixing Artificial Teeth, Frederick Eskell claimed that ‘all acids, gritty powders, are injudicious and prejudicial to the teeth’. Tomes tries to strike the middle ground in this debate, suggesting that dentures can be cleaned with ‘a little precipitated chalk’ when necessary.

Remove

Take the teeth out of your mouth

Secondly, Tomes explains the importance of removing dentures from the mouth. He states that the mouth and gums cannot remain healthy if they are continuously covered, and graphically claims that, if continually worn, the base of the dentures will become ‘coated with a highly offensive white cheese-like matter’. To avoid this, he argues that dentures should be taken out for at least eight hours a day (ideally overnight) and properly cleaned. In this sense, Tomes’s work builds upon the advice of the Royal College of Physicians of Edinburgh who, in their Practical Treatise on the Most Frequent Diseases of the Mouth and Teeth (1823), state that the ability to remove dentures from the mouth, gives users the ‘additional advantage of having it in their power to keep them clean’ – so no excuses!

Storage

When not in the mouth, keep the teeth in a ‘well-stoppered’ glass jar

Finally, Tomes advised that, when not in the mouth, dentures should be kept in a ‘well-stoppered glass jar’ filled with two-thirds of spirits of wine, and one-third of water. Whilst wine might not seem like a natural choice of cleaner to a modern reader, both red and white wines have antibacterial properties. Subsequently, a mixture of wine spirits and water would have helped to disinfect and clean a set of dentures.

However, liquid suspension was not the only way to store dentures. In 1871, Claudius Ash & Sons produced a range of cases in which people could keep their dentures. These boxes were available in square, half-oval, and oval designs, and could be constructed in different materials, including leather, metal, wood, and cardboard. For people with a larger budget, these cases could also be made to include a glass display tray and a locking system with a key. 

Denture Danger!

DENTURE DANGER! THE PROBLEM OF SWALLOWING DENTURES

For all the good that dentures could do, they could also be a serious hazard to a person’s health if they were swallowed! In 1854, S. D. Gross published A Practical Treatise on Foreign Bodies in the Air-Passages. In this work, Gross claimed that the subject of swallowed objects had not received ‘any adequate share of attention’ from the medical profession and set out to remedy this. In this book, Gross discusses the case of a man who died thirteen years after accidentally inhaling four porcelain teeth during a coughing fit. During the man’s autopsy, the artificial teeth were found ‘in the right thoracic cavity, [when] sponging out the blood, and replacing the lung. They were covered with a brownish crust, and furnished with silver rivets, by which they had been adapted to the upper jaw’. It was decided that the man had died from pleurisy triggered by the presence of the teeth in his lung. In the same year, Dr. James Phillips of Nashville also found himself treating a patient who had swallowed a partial denture consisting of four teeth. Fortunately for this patient, ‘two days and eighteen hours from the date of the accident, he passed the plate per anum, with but little pain’.

However, with the rise of Vulcanite as an inexpensive material for the construction of dentures, and the subsequent accessibility of dentures to the masses, more medical professionals found themselves dealing with swallowed teeth. A comprehensive example of this can be seen in a Royal College of Surgeons of England tract concerning ‘cases where artificial teeth have been swallowed, or have become impacted in the pharynx’. This tract describes eight cases where artificial teeth had been swallowed and ‘passed’; eight cases where swallowed teeth had been removed with forceps; three cases where surgery was needed to remove dentures from the throat or stomach; and just one case in which inhaled dentures had resulted in death.

Bibliography

Please find a list of the sources referenced in this set below.

• Albucasis, De Chirugia (Oxford: Clarendon Printers, 1778)
• Anon, ‘Dental Preparations’, in Pharmaceutical Formulas, ed. by Peter MacEwan (London: The Chemist and Druggist, 1908), pp. 113-175
• Ash, Claudius, & Sons, A Catalogue of Artificial Teeth, Dental Materials, Instruments, Tools, Furniture, &c. (London: C. Ash and Sons, 1871)
• de Chauliac, Guy, Chirurgia Magna (Lyon: In off[icium] Q. Philip Tinghi, 1585)
• Cigrand, B. J., The Rise, Fall and Revival of Dental Prosthesis (Chicago: Severinghaus & Beilfuss, 1892)
• Clapp, George Wood, Russell Wilford Tench, Professional Denture Service (New York: The Dentists’ Supply Company, 1918)
• Dubois de Chemant, M. [sic.], A Dissertation on Artificial Teeth in General (London: J. Barker, 1797)
• Dubois de Chemant, Nicholas, Specification of Nicholas Dubois de Chemant: Artificial Teeth (London: Great Seal Patent Office, 1856)
• Eskell, Frederick A., A New System of Treating and Fixing Artificial Teeth (Manchester: Printed for the Author, 1862)
• Gerbaux, J. C., A Practical Treatise on the Most Frequent Diseases of the Mouth and Teeth (London: J. Anderson, 1823)
• Goodyear, Charles, Specification of Charles Goodyear: Plates for Artificial Teeth (London: Great Seal Patent Office, 1855)
• Gross, S. D., A Practical Treatise on Foreign Bodies in the Air-Passages (Philadelphia: Blanchard and Lea, 1854)
• North Carolina Dental Society, ‘Program’, The Bulletin of the North Carolina Dental Society, 15:2 (1931), 39-41 (p. 39)
• Phillips, James, ‘A Plate of Artificial Teeth Swallowed and Subsequently Discharged per Anum’, The New Orleans Medical and Surgical Journal, 12 (1856), 543-544
• Royal Commission, Great Exhibition of the Works of Industry of all Nations, 1851. Official Descriptive and Illustrated Catalogue, Vol. III: Foreign States (London: Spicer Brothers, 1851)
• Tomes, John, Instructions in the Use and Management of Artificial Teeth (London: John W. Parker, 1851)
• Weiss, Felix, ‘A Summary of Cases where Artificial Teeth have been Swallowed, or have Become Impacted in the Pharynx’, Tracts of the Royal College of Surgeons, 2 (1819), 3-42
• White, Samuel S., ‘Vulcanite Litigation’, Dental Cosmos, Supplement (1873), 1-3