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Doctors or monsters?

Slavery drove the development of tropical medicine

“We have arrived at the greatest scourge that I have seen of these inhabitants of this part of Minas, an ailment that certainly fools all the beginners in this climate, both surgeons and doctors, because, doing what they studied and the authors taught, they see no effect from their diligence, if they see some in one, do not see any in a hundred.  I speak from experience and feeling very sad for that principle, seeing that this disease was very common and that so many slaves died and so much gold was lost in so few days”, noted, in Luís Gomes Ferreira in his Erário Mineral [Mineral Treasure], annotations made by him about diseases experienced or observed in Minas Gerais in the 18th century. Ferreira was one of the many surgeons or “practical doctors” who were at work in Brazil and whose education had been acquired in the daily toil with the sick. Unlike the doctors, in far lesser numbers and more respected for their European academic education, practical doctors like Ferreira dealt with the day to day of colonial ailments, “experimenting” and often “being mistaken”. When this happened, they would be “very sad”. After all, a slave dead was gold lost.

Accordingly, surgeons were widely employed in Brazil, using much of the traditional knowledge of the medicine from different communities (blacks, “bandeirante” bands of adventurers etc.), blending it with the knowledge of Western medicine. “From the exoticism of the diseases present in the crossings and conquests, from the need for improvising therapies and remedies, from the scarceness of physicians in the new lands and from the vast experimentalism of the surgeons, there came as a result guides to medical practice valued in the kingdom and in the colony, as was the Erário Mineral“, explains Maria Cristina Cortez Wissenbach, who, in her doctoral thesis, Medical matter, slavery and traffic in Brazil, supported by FAPESP, analyzed the so-called manuals of practical medicine. These, if at first they were used for the treatment of slaves, who acted as “guinea pigs”, were used later to treat the rest of the population. Unusually, Brazilian medicine is in debt to this not very altruistic concern in keeping the slaves alive for work.

Worse still: these surgeons contributed equally to the optimization of slave trafficking, choosing the best individuals and taking care of the many who fell sick on the journey from Africa to Brazil. “A good part of tropical medicine was born on board the slave ships”, says Cristina. Hardly a noble origin. But necessary in a world driven by slavery. After all, in a 60-day crossing, it was common for over half of the 500 to 800 blacks  heaped up in the holds to die of smallpox, and, even with the supervision of the surgeons, mortality on the ships would be in the region of 10% to 20%. “But by taking care of one of the most important stages in the trading of slaves, the surgeons became acute observers of physical qualities and defects, of the evidences of age, of the symptoms of diseases or predispositions to ailments, that the merchants would often try to hide”, the historian says. It is, though, worth pointing out that this concern with getting to know the diseases of the blacks was aimed more at the market than at the human side. Each loss meant a reduction in the profit. On land as at sea.

“It was cheaper to exploit the slave to the utmost and to replace him when he was ill”, the historian explains. The surgeons would use the knowledge acquired in their practice, as active participants in the slave trade, to add value to the so-called rejected “pieces”. “I also observed in that country that there were men of little resources who would employ themselves in buying the remainder of the slaves, for which the commissioner had no purchaser (…), taking them home, medicating them, and giving them their upkeep and the necessary clothing, and bringing about a change in them; with the despised slave convalescing, within a short time, they would resell him as a healthy, robust and strong one, for a very good price: and they would continue with this traffic, devoting themselves to a new kind of industry”, reported Luís Antônio de Oliveira Mendes, in a text written to the Royal Academy of Sciences, in Lisbon, at the end of the 18th century.

These expedients gave the surgeons the chance to raise their earnings, since they were often the only means of alleviating the pain of the sick, given the scarcity of doctors educated in Europe. “Once established, these practical doctors would transform themselves into lords of sugar mills, well-heeled traders or peddlers, or owners of mines, and the exercise of the functions connected with heath often appears in a circumstantial way, possibly as an imposition of a needy society that had a demand for their services”, the researcher clarifies. To help their enrichment even more, there was the difficult access to medicines in the colony, which led Brazil to absorb with ease the practitioners of health, since they met the demands and assimilated the local knowledge. Little by little, the oriental and European products of traditional medicine were replaced by others from the local pharmacopoeia.  A common characteristic is the little distinction that there was between scientific and popular knowledge, a mosaic of teachings from Iberian, indigenous, African, Brazilian backland and Jesuit popular medicine.

Although, the researcher explains, it is impossible to dimension the proportion there was between doctors and surgeons between the 17th and 18th centuries, some reports indicate that there were only three surgeons for the 30,000 persons who inhabited Recife at the beginning of the 1700’s, or no more than two doctors and seven surgeons in Belém, at the end of the same century now, for a population of 11,000. On the farms, though, the writings of the surgeons had a place set aside for them on the bookshelves, as was the case of the treatise by José Antonio Mendes, of 1770, Very necessary government of Minas for those who live six, eight, ten or more leagues from teachers, or later, now in the 19th century, the Dictionary of popular medicine  and of the accessory sciences for the use of families, containing the description of the causes, symptoms and treatment of ailments; the prescriptions for each ailment (1842), by Pedro Luís Chernoviz. From the pity of these practical doctors, arose, as the fruit of experimentation in the heat of the moment, the guides for the new generation of men of health. Despite their more than pragmatic origins, these publications ended up transforming themselves into the basis for tropical medicine, and their observations, enriched with the transit of surgeons through Angola, Costa da Mina, Caribbean and Brazil, made possible an immense circulation of knowledge, prescriptions and therapies.

Suffice it to recall that, when reporting that scurvy was the fruit of a lack of vitamin C, the manuals taught the captains of slave ships to stock them with greens and the juices of citrus fruits to prevent the disease. But not just them: the colonial world was able to expand in its maritime frontiers, benefited by this knowledge. Knowledge that, in a short time, was enriched by other similar experiences, carried out in other parts of the globe. In the comparison between the various works analyzed in her thesis, the researcher observed inflections in the medical knowledge that, if until the first half of the 18th century was limited to the Portuguese and Luso-Brazilian experiences, from the last few decades of that century came to absorb as well the knowledge about the diseases from the other colonial areas. The vicious circle, with time and the end of slavery, was transformed into a virtuous one, saving lives, never mind the color of the skin. Medicine was overcoming the pragmatism of the profits.

The project
Medical matter, slavery and traffic in Brazil (1683-1850) (nº 99/03869-9); Modality Postdoctoral Scholarship; Supervision Silvia Lara – History Department/USP; Investment R$ 65,160.00 (FAPESP)