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Medical Apartheid: The Dark History of Medical

Experimentation on Black Americans from
Colonial Times to the Present

Article in Social History of Medicine · October 2007

DOI: 10.1093/shm/hkm086

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Marius Turda
Oxford Brookes University
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620 Book Reviews

support networks to care for the disabled. Unfortunately, this oral testimony, which comes
at the end of the book, reads as a supplement to the main document-based narrative. Con-
sequently, the authors inadvertently accord the oral evidence the same diminished status it
usually commands in courts and public debate.
One of the major questions posed in Miners’ Lung is how such a tragedy could have
occurred. The current epidemic of silicosis among South African gold miners is easily
explained by apartheid, but in Britain there were powerful trade unions, a critical
press, a nationalised industry after 1947 and even at times Labour governments.
McIvor and Johnston cite plenty of evidence that the mines were so hazardous
because management and owners wanted more production. For example, the gradual
mechanisation of the mines after 1920 increased output. It also increased dust levels

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and with the dust came more lung disease. They also argue that the masculinity charac-
teristic of mining communities rendered miners complicit in the hazardous work con-
ditions. However, it is not clear whether the authors believe that contributed in a
structural sense to the dangers of mining.
Jock McCulloch
RMIT University
doi: 10.1093/shm/hkm085
Advance Access published 12 November 2007

Harriet A. Washington, Medical Apartheid: The Dark History of Medical Exper-

imentation on Black Americans from Colonial Times to the Present, New York:
Doubleday, 2006. Pp. 502. $27.95. ISBN 978-0-385-50993-0.

This revealing and informative study traces the convoluted history of medical experimen-
tation on Black Americans in the USA since the middle of the eighteenth century. In an
engaging narrative, Harriet A. Washington forcefully argues that diverse forms of racial
discrimination have shaped both the relationship between white physicians and black
patients and the attitude of the latter towards modern medicine in general. The book
is divided into three parts: the first engages with the cultural memory of medical exper-
imentation; the second examines recent cases of medical abuse and research; while the
last addresses the complex relationship between racism and medicine. While some topics
are familiar, like the notorious ‘Tuskegee Syphilis Study’ (1932– 72), in which African
Americans suffering from the disease were prevented from receiving the necessary medi-
cation by the US Public Health Service so that the evolution of the disease could be
observed, other episodes are less well-known to the general public.
In the first part of the book, Washington describes, for instance, the purchase of slaves
for purposes of clinical experimentation, the use of black bodies for anatomical dissection
and the display of black subjects as curiosities at fairs, museums and zoos. The work of Dr
James Marion Sims, considered the father of American gynaecology due to his successful
techniques to treat vesicovaginal fistulae (passageways that sometimes develop between
the bladder and the vagina as a result of prolonged labour) is also carefully scrutinised.
Washington appropriately describes how Sims conducted successive medical experiments
on a group of slave women without administering ether or other tranquillisers. To be sure,
it is difficult to document mistreatment, both physical and psychological. In the case of
medical abuses against African Americans, however, such difficulties are complemented
by a long tradition of racially infused practices of social selection and class protectionism.
 Book Reviews 621

Washington then discusses recent cases of medical research involving African

Americans, from prisoners exposed to forms of radiation, blood transfusions and drug-
testing, to children selected for research studies that sought to establish a link
between genetics and violence. Among many relevant examples offered in the second
part, the case of sickle cell anaemia is particularly illustrative. Before 1950, sickle cell
anaemia was defined by most physicians as a Mendelian dominant disorder specific to
African Americans. Washington reveals how this view of the disease fed into (and was
supported by) prevalent social concerns about racial miscegenation. Paralleling develop-
ments in racial thought, convictions based on the uniformity of human nature gave way
to others based on the hereditary inferiority of certain peoples.
Because the African Americans have always been categorized as ‘inferior’, it was rela-

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tively unproblematic to cast them as ‘dispensable’ and ‘exploitable’. As a result, humani-
tarian views were cast aside in favour of racial stereotypes that not only left white
physicians comfortable with experimenting on black patients but also encouraged
them to regard that process as a positive virtue. To substantiate her claims, Washington
draws on a vast range of archival material, journal articles, legal documents, medical
reports and interviews with victims of experimentation. Aptly, this longue-durée
account of human suffering and racial manipulation is presented in its historical
context, as Washington also deftly discusses general episodes in the political and cultural
history of the African Americans during the twentieth century.
Further proof of the importance of the topic is provided by the discussion of race and
medicine attempted in the third part. The intrinsic relationship between aetiology of
certain diseases and racial specificities, Washington insists, resurfaces in as diverse situ-
ations as when scientists diagnose tuberculosis, catalogue the spread of AIDS or evaluate
the impact of bioterrorism. Significant parts of existing medical praxis, we are therefore
told, are still generated and legitimised by the discourse of race. Consequently, certain
medical conditions continue to be linguistically and morally ‘constructed’ as diseases
specific to an ethnic group. Washington’s final set of considerations is equally polemical
as she disentangles the inner workings of racial beliefs as manifested in the attempted
dissemination of new biotechnological methods to cure infectious diseases, develop
new drugs and genetically determine the future of next generations.
This book is fascinating and compelling. Some readers might find Washington’s auctorial
attachment to her topic of research too passionate but there is no denying that her
empathy stems from both human compassion and scholarly principles. The book’s analysis
challenges the reader to question established paradigms in the history of medicine. To this
end, Washington has written a volume of interest not only to those engaged in the history
of human experiments but also for those interested in medical ethics and morality.
Marius Turda
Oxford Brookes University
doi: 10.1093/shm/hkm086
Advance Access published 13 November 2007

Karol K. Weaver, Medical Revolutionaries: The Enslaved Healers of Eighteenth-

Century Saint Domingue, Urbana and Chicago: University of Illinois Press,
2006. Pp. 168. $50. ISBN 0-252-03085-0.

This slim volume explores the medical establishment of France and San Domingue,
enslaved healers who inhabited the colony, and the coming of the Haitian Revolution.

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