Dying in Paradise : Colonial South Carolina

Dying in Paradise

South Carolina was the wealthiest colony in British North America at the time of the Revolution. It was also the unhealthiest. It was long notorious for its deadly fevers, notably malaria and yellow fever, both transmitted by mosquitoes. 

Dysentery was another major hazard, transmitted by amoebas or bacteria in water. The “bloody flux” subjected many to enormous suffering and in many cases, an early grave. Smallpox and other periodical contagions added to the grisly toll.

Wealth and unhealth were intimately connected. Both arose largely from the cultivation of rice with enslaved Africans, the majority of South Carolina’s population from 1708 until the early 20^th century. [Image: Africans hoeing in the rice fields]

 It is widely known that whites suffered terribly from disease in the lowcountry plantation areas. In Christ Church Parish [now Mount Pleasant] in the early 18th century, the parish register records that 86% of baptized children died before age 20. 

Between 1750 and 1779, planter Henry Ravenel and his wife had 16 children. Eight died before age 5. Only six survived past 21. Of their seven daughters, none lived to be 20. Elias Ball and Mary Delamere, who married in 1721, had six children. All died before age 20. Many other families fared the same or worse. The death rate for whites in early 18^th century Charleston was roughly twice that of the average parish in England or New England at the time. 

Less well known is that Africans also died in large numbers from these diseases and many others. This is due to the staying power of pro-slavery arguments of the 19th century, which claimed that Africans were virtually immune to the “tropical” fevers that killed so many whites. A benevolent God had “designed” African constitutions for this work. 

Gov. John Drayton summed up this argument in 1802: “these situations are particularly unhealthy, and unsuitable to the constitutions of white persons … that of a Negro is perfectly adapted to its cultivation.” In 1850, the Lutheran minister and naturalist John Bachman claimed that Africans were perfectly designed for laboring in the lowcountry environment. [Images: John Drayton and John Bachman] 

In stark contrast, some 18th century observers commented on the heavy mortality of the enslaved. An example is Alexander Garden, a Charleston physician and naturalist for whom the gardenia is named.  Garden served for several years as port physician in the 1750s. In this capacity he inspected arriving ships for signs of contagious diseases. This included slave ships. 

Garden was shocked by what he found. Many of them had lost as much as one-third to three-fourths of their "cargoes" during the voyage from West Africa. The ships on arrival were "so filthy and foul it is a wonder any escape with life.” (Image: JMW Turner, Slave Ship, showing sick slaves being thrown overboard, alive, based on the infamous Zong Case 1783)

Many Africans also died on the slave ships in harbor waiting to be sold. Their bodies were often thrown overboard into the Cooper River to save the cost of burial. In 1769, the royal governor published the following proclamation in the South Carolina Gazette:

"A large number of dead Negroes have been thrown into the river … the noisome smell arising from their putrefaction may become dangerous to the health of the inhabitants." The governor offered a reward to be paid on the conviction of those responsible  in hopes of ending this "inhuman and unchristian practice." [Image: Charleston harbor, c. 1770] 

It did not end. In 1807, the last year that the slave trade was legal, traders brought almost 16,000 Africans to Charleston in the last four months of the year alone. The local economy could not absorb so much "labor" in such a short time. Hundreds died of disease on the filthy ships while waiting to be sold.

In April 1807, The Courier reported on an inquest on the body of an African woman found floating in the harbor. The jury concluded that she died as a result of "a visitation of God," shifting responsibility to the Almighty. They "supposed her to belong to some of the slave ships in this harbour, and thrown into the river, to save expence of burial."

This was hardly an isolated incident. The newspaper's editor noted that such "burials" had become so common that something ought to be done to stop it. His great concern was the unpleasant thought that Charleston's citizens [whites] might eat fish from the harbor that had "fattened on the carcasses of dead Negroes."

Alexander Garden also treated many sick and injured Africans, of whom he wrote: "Masters often pay dear for their barbarity, by the loss of many valuable Negroes, and how can it well be otherwise -- the poor wretches are obliged to labor so hard ... and often overheat themselves, then exposing themselves to the bad air ... The result was pneumonia and other respiratory disorders, "which soon rid them of cruel masters, or more cruel overseers, and end their wretched being."

Further Reading: Peter McCandless, Slavery, Disease, and Suffering in the Southern Lowcountry (Cambridge and New York: Cambridge University Press, 2011, PB, 2014) Winner of the SHEAR Prize for Best Book on the early American Republic, 2012.

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Pandemics may be Inevitable: Ignorance is Not

"Migration of man and his maladies is the chief cause of epidemics." Alfred W. Crosby, The Columbian Exchange, 2003

(Image: Romanticized depiction of the arrival of Columbus in the New World)

Alfred Crosby's words were written in connection with the European discovery of the New World. In the wake of the discovery, Europeans began to migrate to the Americas, first a trickle, then a flood, then a tsunami. The same is true for Africans, although they did not come by choice. 

Both Europeans and Africans unknowingly brought their microbes along, unleashing an explosion of diseases in the New World. All suffered, but the indigenous inhabitants suffered most -- indeed catastrophically. It was like being attacked by several deadly pandemics at once. War and enslavement worsened things.

Native Americans were extremely vulnerable to Old World diseases. Having been isolated from the rest of the world for thousands of years, they had no experience with or immunity to a host of Old World infections. 

Smallpox, measles, influenza, pneumonia, and many other diseases killed Native Americans in huge numbers. The microbial invasion wiped out, or nearly wiped out, many Native American cultures. It was perhaps the worst demographic disaster in world history. 

The Europeans and Africans, in contrast, grew in numbers. Unlike Native Americans, they had experience and some levels of immunity to the diseases they carried from their own regions, many of which had been around for centuries or even millennia. They suffered, too, just not as much. The only major disease that the New World gave to the Old is, possibly, syphilis. The disease exchange was heavily one-sided.

Africans were vulnerable to some European diseases, especially respiratory disorders such as pneumonia and tuberculosis. Europeans were vulnerable to some African diseases, especially tropical fevers such as falciparum malaria and yellow fever. Bad as these could be, they did not prevent population growth among the new arrivals.

As Western peoples moved around the globe during the orgy of imperialism in the 19th century, the same epidemiological patterns were repeated. Remote island peoples, for example in the South Pacific, faced an onslaught of western diseases. Westerners in some regions faced disease tsunamis of their own when they moved into Sub-Sharan Africa and parts of South Asia. 

There are many other examples of disease that spread through human migration. In the 14th century, the Second Plague Pandemic  (Black Death) migrated along trade routes such as the Silk Road and pilgrimages routes. Swift Mongol horsemen also played a role in spreading plague as they conquered much of Eurasia.  

The Cholera Pandemics of the 19th century followed a similar pattern. Originating in British India, cholera crept along trade routes and reached Western Europe and the Americas by the early 1830s, sparking panic. 

The Third Plague Pandemic, which began in China in the late 19th century, spread around the world aided by steamships and railroads. It reached San Francisco and Sydney, Australia by 1900. It was especially deadly in India, killing about ten million. (Image: Plague in Sydney, Australia, 1900: rat killing)

The mass movement of millions of soldiers in World War I famously spread the Great Influenza of 1918-20. American troops aboard crowded ships brought the influenza to Europe, where it mutated. Then they brought the more virulent mutation back to the Americas. (Image: Pandemic Incubator: US troopship returning from Europe, 1918)

That is history, ancient history for many of us. Today the world is battling against another virulent disease that has spread in part through the temporary migration we call tourism. Commercial airliners can spread microbes around the globe faster rate than even steamships and railways. 

Unprecedented numbers of people are constantly on the move, fleeing from violence, oppression, and poverty. Human migration into hitherto sparsely populated regions like rain forests and increased contact with wild animals have helped to create new deadly viruses like Ebola, SARS and now Covid-19. Unlike the first two, coronavirus is highly contagious and becoming ever more so as new strains like Delta and Omicron evolve. 

One of the main means of controlling Covid, or at least slowing its spread, is to restrict human migration, a difficult and sometimes inhumane thing to do. Countries can close their borders to prevent both in migration and out migration. Many have, but often too late. 

The perceived economic cost led most countries to avoid such restrictions for too long. Governments have mastered the art of closing the barn door after the horses have left. Economies are crashing anyway. 

"No one could have predicted this" is a common but largely false claim. Epidemiologists and public health experts have been predicting something like this for decades. WHO has been warning for decades that "disease X" will come from nowhere and we must be prepared for it. Even the film industry warned us, if often in an overly sensationalized form. Contagion (2011) was the best of these.

Those who made the predictions had science on their side, and history as well. But who pays attention to science and history nowadays?

The present combination of overpopulation, mass migration, tourism, and destruction of natural habitats makes the coming of more more "disease X's" and pandemics almost inevitable. The changes necessary to reduce their likelihood may be beyond the capabilities of the global systems we  have created, with their emphasis on maximizing GDP at all cost to the planet. 

Pandemics may be inevitable. Humans have the ability to minimize their damage if we learn the lessons that history and science can teach us. Ignorance is not inevitable, but overcoming it is a huge task. It will be especially difficult as long as sections of the media, especially social media, give free reign to the spread of false information and bizarre conspiracy theories.

 

Slavery, Disease, and Suffering

“offers an unparalleled look at the early history of Charleston and the economic region of which it was a part. Focusing on the close relationship between the pursuit of wealth and the risk of death, McCandless forces readers to reassess the economic, demographic, and moral foundations of South Carolina’s past. A riveting, if sobering, work by a masterful historian.”  
Peter Coclanis, University of North Carolina – Chapel Hill, author of Shadow of a Dream

“compassionate, compelling history ... Peter McCandless writes with wisdom and humanity, inspiring us not just to think differently about the past, but also to ask how similar forces are shaping the world today.”  
Elizabeth Fenn, Duke University, author of Pox Americana

“This meticulously researched and smoothly written book provides the first comprehensive history of the Carolina lowcountry’s ferocious disease environment. It navigates masterfully among social, economic, cultural, religious, demographic, military, and medical history, from the 1670s to the Civil War, exploring every aspect of the deadly struggles with malaria, yellow fever, and smallpox.” 
J. R. McNeill, Georgetown University, author of Mosquito Empires

“McCandless does more than provide sound and accessible medical history. He adds an important social and economic twist. The knot that he deftly ties between slavery, disease, and the Lowcountry environment has devastating and lasting implications that stretch far beyond South Carolina. McCandless is quick to absorb and ponder the irony that the continent’s least healthy place swiftly became its wealthiest. Rice, indigo, and then cotton yielded huge profits to a tiny minority of intermarried merchant and planter families, while “most of the population experienced pestilence without prosperity.” Peter Wood, Duke University, author of Black Majority. 

In Slavery, Disease, and Suffering in the Southern Lowcountry, Peter McCandless paints a startling portrait of the troubled and troubling history of disease in the South of the United States from the colonial period to the first half of the nineteenth century....Due to his impressive grasp of a variety of sources, McCandless uncovers the problematic reporting of disease and the convoluted ways that Southern physicians often misdiagnosed illness. This analytical move elevates his book from a mere survey of sickness in the South to a sophisticated evaluation of the representation of disease; Slavery, Disease, and Suffering in the Southern Lowcountry can thus serve as a primer on how to research the history of public health before the microbiological revolution." Jim Downs, Connecticut College, author of Sick from Freedom: African American Illness and Suffering During the Civil War and Reconstruction 

Link: Slavery, Disease, and Suffering

The First Vaccine Eliminated History's Greatest Killer, Smallpox

Perhaps the greatest weapon human beings possess against infectious disease is vaccines. They are also one of the most cost-effective, because they prevent disease and costly hospital and medical procedures. 

This lesson needs to be hammered home repeatedly, because humans have short memories and short attention spans. Vaccines have saved hundreds of millions of lives in our lifetimes alone. 

The vaccines for Covid-19 are now promising to release us from our lockdowns as well. They may be the only hope beyond herd immunity, whic wll cost many millions of lives. 

The terms "vaccine" and "vaccination" derive from the Latin "vacca" for cow. The reason is that the first effective vaccine used pus from a mild skin disease, the so-called cowpox, to immunize people against the deadly smallpox. 

"Cowpox" was in fact horse-pox, which sometimes infected cows. Most people who got it worked with cows or horses.

The cartoon below by James Gillray, c. 1800, shows Edward Jenner, usually given credit for the procedure, vaccinating people, who are turning into cows. Although satire, the cartoon shows the fears the procedure aroused in many people. 

The use of the vaccine derived from observations that people who worked with cows and got "cowpox" never got smallpox. Jenner was not the first to use the procedure. A farmer, Benjamin Jesty, pictured below, had employed it about twenty years before.

Jenner (below) was the first to publicize it and get credit, a knighthood, and a ton of money from Parliament.

Before the use of "vaccine" an immunization using actual smallpox pus from human cases had been in use, in some places for centuries. Inoculation, or variolation, as it was called, was intended to induce a mild case of the disease and lifelong immunity. It was not always mild. It had a mortality rate of about 1% inoculated and it sometimes left ugly scars. Image below compares inoculation and vaccination effects on arms.

The natural disease, however, often killed 20% or more of the infected, which explains the attraction of inoculation, especially during epidemics. Its use had become widespread by the time Jenner popularized vaccination. 

Vaccination was much safer than inoculation, but it was soon discovered that it did not provide lifelong immunity. Once that was understood, periodic re-vaccination became standard in the later 19th century. (Image below shows people being vaccinated in the US in 1870s.)

Public resistance to vaccination remained high in many countries for a long time. But access to it was a bigger problem, often because of cost or lack of health care infrastructure. 

By 1979, a global vaccination campaign headed by WHO had eradicated smallpox, the greatest killer disease known to mankind. Its success had also led to the development of many other "vaccines." The polio vaccine has nearly eliminated that disease. Vaccines have many other diseases on the run. 

The lesson: Get your jab!