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Enslaved African Americans were more vulnerable than whites to

respiratory infections, thanks to poorly constructed slave shacks that admitted

winter cold and summer heat. Slaves’ immune systems were unfamiliar



Harriet A.Washington 



Medical Apartheid: The Dark History of Medical Experimentation

on Black Americans from Colonial Times to the Present by Harriet A. Washington

Reviewed by Kam Williams


The experimental exploitation of African-Americans is not an issue of the last decade or even the past few decades. Dangerous, involuntary, and non-therapeutic experimentation of African-Americans has been practiced widely and documented extensively at least since the 18th Century... The problem is growing… No other group as deeply mistrusts the American medical system.

These subjects were given experimental vaccines known to have unacceptably high lethality, were enrolled in experiments without their consent or knowledge, were subjected to surreptitious surgical and medical procedures while unconscious, injected with toxic substances, deliberately monitored rather than treated for deadly ailments, excluded from lifesaving treatments, or secretly farmed for sera or tissues that were used to perfect technologies such as infectious disease tests. Excerpted from the Introduction

In taking the Hippocratic oath, every new doctor pledges “Never to do deliberate harm to anyone for anyone else’s interest.” However, Hippocrates, the father of modern medicine, must be spinning in his grave, given the rampant ethical violations of his sacred doctrine being routinely perpetrated by physicians in the United States.

Most people only think of the infamous Tuskegee study of subjects with untreated syphilis when it comes to the exploitation of blacks as guinea pigs. But such experimentation by medical researchers neither began nor ended with that shocking case.

In recent years, on a couple of occasions, I have been skeptical about physicians I felt were doling out different brands of medicine based on their patients’ skin color. Frustrated because I had neither the time nor the wherewithal to pursue my hunches, I couldn’t confront anyone or go public based only on anecdotal evidence.

For this reason, I am so grateful that Harriet A. Washington has written Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. For this groundbreaking book confirms my suspicions by addressing the disparate methodologies currently being employed with patients presenting the specific symptoms I had been concerned with.

Ms. Washington, a Harvard and Tuskegee-trained scholar in ethics and journalism, conducted exhaustive research in order to be able to shed light on the country’s racism in the name of scientific research. Among the brutalities uncovered here by the author is proof that “black women have been systematically sterilized without their consent, and that “the brains of African-American children as young as six” have secretly been “surgically excised.”

She illustrates how this disregard for the well-being of blacks began during the days of slavery when Africans en route to the Americas were “thrown overboard if signs of disease were found” by the ship’s surgeon. By the conclusion of this compelling opus, she makes it abundantly clear that just as America has a two-tiered criminal justice system, it has totally different quality healthcare systems when it comes to blacks and white citizens.

So, when you encounter an African-American who harbors a deep distrust of doctors, that might not be paranoia but simply a sensible survival instinct still intact.Kam Williams


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Other Reviews

From the era of slavery to the present day, the first full history of black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment.

Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections.

Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.

The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.

—Publisher, Random House

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Washington’s book is a rallying call for change within the medical and African American communities. While doctors must understand their black patients’ fears of exploitation, African Americans, Washington writes, “cannot afford passivity.” Increased participation in ethically designed medical studies would not only be a boon to African Americans suffering from serious diseases but would also lead to better preventive care in general. As she concludes, “Physicians, patients, and ethicists must…understand that acknowledging abuse and encouraging African Americans to participate in medical research are compatible goals.”

Amaya Rivera, Mother Jones

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Given the history presented in Medical Apartheid, it is no surprise that some African Americans continue to regard the medical system with apprehension, despite more stringent safeguards enacted by the federal government in the 1970s. Washington attributes this outlook, which she calls iatrophobia, to the seeds of distrust sown in black communities by the Tuskegee scandal and a history of lesser-known mistreatment.

Washington, a visiting fellow at Chicago's DePaul University, intends that Medical Apartheid serve a socially therapeutic—if not cathartic—function. Laying bare these atrocities, her logic goes, will foster healing and frank but necessary conversation. Clearing the air may encourage a better informed African American public to participate in clinical trials.. . . . Precisely because Washington's account of racially stratified medical exploitation is so gripping, it may be difficult for the public to muster enthusiasm to enter clinical trials, no matter their cultural background. And with the experimental research burden shifting from Americans of African descent to Africa itself (which Washington calls a "continent of subjects"), Asia, and Latin America, where some cavalier researchers are seeking more plentiful and pliant subjects, readers may be more convinced than ever of the durability of the medical color line. ?

—Alondra Nelson, Washington Post

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Harriet A. Washington

Medical Apartheid: The Dark History of Medical Experimentation

on Black Americans from Colonial Times to the Present

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Chapter 1

SOUTHERN DISCOMFORT: Medical Exploitation on the Plantation

The South was a particularly unhealthy region and was home to 90 percent of American blacks, the majority of whom were enslaved until 1865. The first blacks arrived in the colonies in 1619, and by 1700 there were only about 20,000 blacks. But as the slave trade flourished, 20,000 more blacks arrived each year. Although 30 percent of transported slaves died in the nightmare of the Middle Passage, there were 550,000 chattel slaves in the United States by 1776, when blacks constituted 20 percent of the U.S. population. By 1807, slave importation was legally prohibited throughout the country, and by 1860, the nation’s four million enslaved blacks had a value equivalent to four billion dollars today. In some states, the black population completely comprised slaves: Alabama, for example, forbade the presence of free blacks.

The South was the nadir of the American medical experience, visited by a deadly triple confluence—the pathogens of North America, Europe, and Africa. This unholy trinity yielded a bewildering array of unfamiliar infectious diseases, such as hookworm, types of malaria, and yellow fever, incubated by a subtropical climate that was hospitable year–round to pathogens that could not thrive in the colder North. Even familiar European illnesses flared anew in strangely virulent forms, abetted by the hot, marshy climate, poor sanitation, and a public–health vacuum. Although the South harbored a highly visible affluent class, the region’s relative poverty led to a dearth of medical care and a host of unrecognized nutritional–deficiency diseases. So did enslavement.

A dramatically misunderstood set of disease etiologies led to the adoption of heroic remedies calculated to kill or cure. Through the eighteenth century, Western medicine was not only misinformed but dangerously so. Caustic medicines of the period often contained metabolic poisons such as arsenic, or calomel, (3) a compound of mercury and chlorine that was used as a purgative. Many other remedies contained highly toxic substances such as mercury and addictive Schedule II narcotics, including the opiates laudanum, (4) opium, and morphine, as well as cocaine derivatives. These medicines addicted, sickened, or killed outright; they also could trigger chemical pneumonitis, or progressive lung injury, if inhaled during a bout of iatrogenic, or physician–triggered, vomiting. No studies seem to have been done on this point, but such lung injuries may have helped to account for slaves’ higher death rate from respiratory disease.

Induced vomiting was an everyday event because the common denominator of medical techniques in this period was the violent release of bodily fluids. Copious bleeding, blistering, and the induction of violent diarrhea were standard therapies. Harsh laxatives or “draughts” such as calomel or jalap (5) produced copious diarrhea, which leached nutrients, water, and electrolytes from the body. They also invited painful bedsores, which were open to infection unchallenged by antibiotics. These crude therapies were not only unpleasant but debilitating to ill persons and even to the strong and healthy. Arsenic, for example, produced not only the intended vomiting and diarrhea but also a wide range of other problems, including fainting, heart disease, disorders of the nervous system, gangrene, and cancers (6). Mercury’s very serious effects included injury to the nervous system, profound mental deficits, hair and tooth loss, kidney and heart disease, lung injury, and respiratory distress. Mercury crossed the placental barrier and concentrated in breast milk, contributing to the high black infant–death and birth–defect rates (7).

Such ministrations were often fatal. The 1799 death of George Washington, hastened by a copious bloodletting the debilitated former president could ill afford, is perhaps the best–known example of a patient finished off by the misguided heroics of eighteenth–century medicine. However, whites of the slave–owning class enjoyed better initial health, better nutrition, and less exposure to environmental pathogens and parasites than did enslaved blacks. Slave owners did not suffer from overwork and exposure, so they were better able than slaves to withstand the rigors of bloodletting. Sensing this, many physicians and scientists discouraged bloodletting for slaves. Thomas Jefferson, statesman and amateur physician–scientist, wrote unequivocally, “Never bleed a negro.” (8) But in their everyday practices, physicians didn’t listen.

Dr. Lunsford Yandell wrote, “On March 16, 1833 I was called before sunrise to visit a Negro woman. I took from her twelve ounces of blood…I waited about fifteen minutes when she had a severe convulsion.” (9) Such techniques as cupping (the use of heated glass jars to create a partial vacuum that drew blood upward to the skin’s surface or through an incision in the skin) and trephination (the therapeutic drilling of holes in the skull) were risky for pampered, well–nourished adults living in relatively healthy environments. But they were fatal attentions for sickly, undernourished, and exhausted slaves and for their children, who were at even higher risk of succumbing to anemia or dehydration.

Enslaved African Americans were more vulnerable than whites to respiratory infections, thanks to poorly constructed slave shacks that admitted winter cold and summer heat. Slaves’ immune systems were unfamiliar with, or naïve to, microbes that caused various pneumonias and tuberculosis. Parasitic infections and abysmal nutrition also undermined blacks’ immunological rigor. Before antibiotics and sterile technique, surgery was an often-fatal affair. Unaware of the connection between bacteria and infection, surgeons operated in their street clothes and with dirty hands in filthy environments, such as the shacks that served as “slave hospitals.” Even minor incisions or injuries could proceed to life threatening infections with frightening rapidity.

Southern medicine of the eighteenth and early nineteenth centuries was harsh, ineffective, and experimental by nature. Physicians’ memoirs, medical journals, and planters’ records all reveal that enslaved black Americans bore the worst abuses of these crudely empirical practices, which countenanced a hazardous degree of ad hoc experimentation in medications, dosages, and even spontaneous surgical experiments in the daily practice among slaves.

Physicians were active participants in the exploitation of African American bodies. The records reveal that slaves were both medically neglected and abused because they were powerless and legally invisible; the courts were almost completely uninterested in the safety and health rights of the enslaved (10). The practice of hiring slaves out further endangered enslaved workers by removing much of an employer’s incentive to keep the slave healthy and safe. Some humane plantation owners were careful to choose less risky work venues, but a great danger of slave death or disability was inherent in some forms of mining, tobacco production, rice farming, and most plantation work. In these settings, the slave’s possible death became part of his owner’s commercial calculations. Ominously for blacks, the owners, not the enslaved workers, determined safety and rationed medical care, deciding when and what type of care was to be given. Because professional attention was expensive, most owners dosed their own slaves as long as they could before calling in physicians, who usually saw slaves only in extremis, as a last resort.

In clinical notes, medical journals, and memoirs, physicians consistently decried the planters’ tendency to rely upon the cheaper ministrations of overseers, slaves, and mistresses in order to save expense. Physicians’ records also expressed disgust at the conditions in which enslaved workers were kept. Historian Richard Shryock observed in 1936: “Of all critics, the Southern physician was perhaps in the best position to report on the physical and moral treatment of the slaves. When he stated, as he sometimes did, that Negroes were overworked and underfed, he can hardly be suspected of antislavery bias since he was the friend of the planter who employed him. As a matter of fact, he usually approved of the institution.” (11) Planters’ own records and slave narratives corroborate physicians’ complaints that planters provided professional medical care only when they deemed it necessary to save the slave’s life—often too late.

Owners also restricted access to medical care by routinely accusing sick blacks of malingering. Slave narratives and planters’ records reveal that an owner faced with a sick slave was likely to believe the illness was feigned. In her excellent and nuanced history, Working Cures: Healing Health and Power on Southern Slave Plantations, Sharla Fett describes how, in 1859, slave owner William Massie resentfully recorded that his eighty–year–old slave “Patty” had just died “of I know not what disease…She has been saying she was sick for near a year and always pretended to be sick.” No doctor was ever summoned to investigate, and not even Patty’s death seems to have exonerated her from charges of malingering (12). The enfeebled Patty was no longer valuable in the fields or as a “breeder,” so the nature of her sickness was inconsequential.

Source: Random House

Harriet A. Washington has been a fellow in ethics at the Harvard Medical School, a fellow at the Harvard School of Public Health, and a senior research scholar at the National Center for Bioethics at Tuskegee University. As a journalist and editor, she has worked for USA Today and several other publications, been a Knight Fellow at Stanford University and has written for such academic forums as the Harvard Public Health Review and The New England Journal of Medicine. She is the recipient of several prestigious awards for her work. Washington lives in New York City. Law DePaul

posted 8 February 2007

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The Immortal Life of Henrietta Lacks

By Rebecca Skloot


Faith, Cancer, Death, Racism, Science, and Ethics

A Research Sampling by Rudolph Lewis

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Anarcha's Story

By Alexandria C. Lynch, MS III

Quickly, he forces her to spread her legs so that he can exam her damaged

vagina. She is unable to say anything as he pokes and prods in her most

private areas. She lies there in that backyard hospital and waits while

he completes his initial examination.

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Endgame AIDS in Black America

HIV Continues Its Grim Toll on Blacks in the U.S.—‘Endgame: AIDS in Black America’ on PBS—9 July 2012—Today in America, 152 people will become infected with H.I.V.,” a speaker is telling a World AIDS Day gathering as the program opens. “Half of them will be black. Today in America, two-thirds of the new H.I.V. cases among women will be black. Today in America, 70 percent of the new H.I.V. cases among youth will be black.”

From there the program, directed by Renata Simone, embarks on a history lesson, tracing how AIDS was almost immediately typecast as a disease of gay white men, even though some of the earliest cases were in black men. That led to an indifference among blacks at the start of the epidemic, and soon along came the drug nightmare of the 1990s, with sex being traded for a fix, rampant needle sharing and resistance to needle-exchange programs that sought to do something about the problem. Endemic poverty in black America of course exacerbated everything about the AIDS crisis.

Black leaders acknowledge that they failed to take the kind of vocal role in the early years that they had been known for in civil rights battles and other struggles. “I didn’t do what I could have done and should have done,” Julian Bond, the civil rights activist and a former chairman of the N.A.A.C.P., says bluntly.—nytimes

*   *   *   *   *'s 25 Best Selling Books



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*   *   *   *   *

The New New Deal

The Hidden Story of Change in the Obama Era

By Michael Grunwald

Time senior correspondent Michael Grunwald tells the secret history of the stimulus bill, the purest distillation of Change We Can Believe In, a microcosm of Obama’s policy successes and political failures. Though it is reviled by the right and rejected by the left, it really is a new New Deal, larger than FDR’s and just as transformative. It prevented an imminent depression, while jump-starting Obama’s long-term agenda. The stimulus is pouring $90 billion into clean energy, reinventing the way America is powered and fueled; it includes unprecedented investments in renewables, efficiency, electric cars, a smarter grid, cleaner coal, and more. It’s carrying health care into the digital era. Its Race to the Top initiative may be the boldest education reform in U.S. history. It produced the biggest middle-class tax cuts in a generation, a broadband initiative reminiscent of rural electrification, and an overhaul of the New Deal’s unemployment insurance system. It’s revamping the way government addresses homelessness, fixes infrastructure, and spends money.

Grunwald reveals how Republicans have obscured these achievements through obstruction and distortion. The stimulus launched a genuine national comeback. It also saved millions of jobs, while creating legacies that could rival the Hoover Dam: the world’s largest wind farm, a new U.S. battery industry, a new high-speed rail network, the world’s highest-speed Internet network.  Its main legacy, like the New Deal’s, will be change.

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Allah, Liberty, and Love

The Courage to Reconcile Faith and Freedom

By Irshad Manji

In Allah, Liberty and Love, Irshad Manji paves a path for Muslims and non-Muslims to transcend the fears that stop so many of us from living with honest-to-God integrity: the fear of offending others in a multicultural world as well as the fear of questioning our own communities. Since publishing her international bestseller, The Trouble with Islam Today, Manji has moved from anger to aspiration. She shows how any of us can reconcile faith with freedom and thus discover the Allah of liberty and love—the universal God that loves us enough to give us choices and the capacity to make them. Among the most visible Muslim reformers of our era, Manji draws on her experience in the trenches to share stories that are deeply poignant, frequently funny and always revealing about these morally confused times. What prevents young Muslims, even in the West, from expressing their need for religious reinterpretation? What scares non-Muslims about openly supporting liberal voices within Islam?

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What Orwell Didn't Know

Propaganda and the New Face of American Politics

By Andras Szanto

Propaganda. Manipulation. Spin. Control. It has ever been thus—or has it? On the eve of the 60th anniversary of George Orwell's classic essay on propaganda (Politics and the English Language), writers have been invited to explore what Orwell didn't—or couldn't—know. Their responses, framed in pithy, focused essays, range far and wide: from the effect of television and computing, to the vast expansion of knowledge about how our brains respond to symbolic messages, to the merger of journalism and entertainment, to lessons learned during and after a half-century of totalitarianism. Together, they paint a portrait of a political culture in which propaganda and mind control are alive and well (albeit in forms and places that would have surprised Orwell). The pieces in this anthology sound alarm bells about the manipulation and misinformation in today's politics, and offer guideposts for a journalism attuned to Orwellian tendencies in the 21st century.

*   *   *   *   *

Medical Apartheid: The Dark History of Medical Experimentation

on Black Americans from Colonial Times to the Present

By Harriet A. Washington


Medical Apartheid is the first and only comprehensive history of medical experimentation on African Americans. Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. . . . The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit.—Random House / Kam Williams review

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The White Masters of the World

From The World and Africa, 1965

By W. E. B. Du Bois

W. E. B. Du Bois’ Arraignment and Indictment of White Civilization (Fletcher)

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Ancient African Nations

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The Death of Emmett Till by Bob Dylan  The Lonesome Death of Hattie Carroll  Only a Pawn in Their Game

Rev. Jesse Lee Peterson Thanks America for Slavery / George Jackson  / Hurricane Carter

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The Haitian Declaration of Independence 1804  / January 1, 1804 -- The Founding of Haiti 

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