Eric V. Snow

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Slave midwives were valuable to their owners, not just to their sisters in bondage. Kemble noted that the "midwife of the [rice-island] estate--[was] rather an important personage both to master and slave, [for] as to her unassisted skill and science the ushering of all the young negroes into their existence of bondage is intrusted." Births attended by midwives enabled masters to reduce both medical expenses and the number of doctor's visits. The slave women benefited from having someone of their own race and sex serving them during such an intimate passage of life. Slave midwives helped rebut any contentions that black women could not assist or serve competently in some crucial position in the slave community's life. Zack Bloxham of Florida recalled his mother was a field hand, adding an evident exaggeration: "She was a midwife, too, an' treated right special on 'count of it. Dey didn' need no doctor wid Mammy dar!" Despite her very ordinary main position on the plantation, Bloxham's mother role as midwife greatly raised how much respect others, both black and white evidently, gave her. "Aunt" Florida of Georgia said her grandmother, the "sworn midwife" of the plantation, attended on both blacks and whites in her locality of "Hurricane an' Briefiel'." By helping women of both races, she again shows that whites under slavery often accepted "race mixing," but only under a social system that theoretically ensured the whites' almost complete control over most blacks. Illustrating the importance midwives potentially had, overseer John Garner blamed the death of a newborn baby slave on Matilda telling him only at the last minute she was going to have a child, which kept him from getting a midwife soon enough: "I cold not get the old woman there in time, her lying up at the same time." Of course, the "help" some midwives gave to women in labor could clearly be harmful. One "ignorant old negress" that Kemble encountered would, in cases of greatly long and difficult labor, "tie a cloth tight round the throats of the agonized women, and by drawing it till she almost suffocated them she produced violent and spasmodic struggles, which she assured me she thought materially assisted the progress of the labor."132 Despite this caveat, slave midwives were usually vital members of the plantation community who received respect from black and white alike.
Medical Care for English Agricultural Workers
English farmworkers had one major advantage over the slaves in medical care, but also one major disadvantage. On the one hand, they were potentially free to go or not go to any doctor, and to accept or reject any treatment offered. However, financial limitations made a mockery of this freedom, since their poverty normally forced to rely on parish-provided medical help. On the other, the employing farmers often cared little about the fates of their (often overly plentiful) employees, since their self-interest was less directly tied to the health of their laborers than for planters owning slaves. People tend to care more for what they OWN than for what they do NOT own, although the self-interest of slaveowners only unreliably restrained their conduct, as Kemble observed (see p. 82). Quite literally, the agricultural workers were more on their own, for good or for ill. Paternalism, whether that of slaveowners or landed gentry, necessarily involves the subordinate class giving up some degree of freedom in exchange for greater security. The slaves clearly were further along the continuum that traded freedom for security than the farmworkers. Consequently, the slaves probably had more guaranteed medical care but definitely less freedom than the farmworkers. The slaves received (white) medical care whether they wanted it or not, while the agricultural workers got the freedom to fend for themselves, unless the parish paid for a doctor to attend on them when sick. If the parish did, excepting for private acts of charity, no individual farmer or landowner provided it.

In Petworth Union, Sussex, standard practice was to pay for the medical care of paupers under both the New and Old Poor Laws.133 The union hired two doctors to attend the poor, both in the workhouse and without, at, respectively, ninety and one hundred pounds a year each.134 Although the New Poor Law of 1834 prohibited outdoor relief to the able-bodied non-elderly, and used the workhouse as a "test" of destitution (i.e., desperation) to discourage applications for relief, it still allowed medical aid to paupers not in the poorhouse. Initially, this union argued with William Hawley, an Assistant Poor Law Commissioner, over whether the husband as head of the family and as a pauper was the only one legally entitled to medical relief, or whether his wife and children also were covered. The tradition of the union (including before Petworth parish became part of a union in 1835) had been to relieve medically the poor even when they failed to legally meet the definition of being a pauper. The clerk to the local board of guardians even asserted that although this was his union's standard practice, he believed it was not for other unions. The doctor, Mr. Hall, aided anyone poor who asked him for help, although strictly legally by contract he only had to help when requisitioned by the relieving officer or workhouse master.135 In times of medical emergency, however, Hawley said the doctor should attend to a poor patient immediately, deeming as unnecessary the drawing up of a formal order for relief if the relieving officer was not nearby. A letter by Edwin Chadwick, the Secretary of the Poor Law Commission in London, dated August 22, 1836, declared that relieving the whole family was to be standard practice in England.136 The Petworth union's board of guardians evidently operated by a more compassionate ethos than the New Poor Law required or even permitted. First, at least one of their doctors by tradition aided any poor person asking for help, not just those strictly meeting the legal definition of "pauper." Second, even before receiving Chadwick's letter, they had opted for the broader legal interpretation of helping the whole family, not just the father. Petworth Union's fairly liberal administration guaranteed the laborers a reasonable amount of medical care, but more restrictive unions elsewhere would have covered only those legally declared to be paupers, which normally meant only the able-bodied in the workhouse, and the non-able-bodied (including the elderly) without.

Extrapolating from Petworth to all of England is an obviously hazardous act. More restrictive policies operated elsewhere. Thomas Sockett, the rector for Petworth parish, described a case involving a man named Holden, living in Tillington, Midhurst parish. After asking for relief, he found that the union withheld medical aid. Free medical aid was first denied because only male heads of households were to receive it, not wives or children. Later, he heard that renting a house worth eight pounds a year cost him all free medical help. Although he did pay that much rent nominally, this denial ignored that half of the house was sublet to another man for three pounds eighteen shillings per year. He ultimately got no relief, except perhaps two weeks later. Showing that English medical practice's backwardness rivaled the antebellum South's, the laborer tried to help his wife like the physician had done before. After getting some leeches, he applied them as the doctor had, who "had blistered her head and put on leeches."137 When medical help was this primitive and errant, the conflict between intentions and results is obvious. Assuming medical treatment was routinely this bad, the skinflint board of guardians governing Midhurst, by denying free medical "aid," helped the poor more than the relatively compassionate Petworth board!
Establishing medical clubs were another way to help laborers and others who were poor pay for medical care. Similar to the clothing club described above (p. 54), and friendly societies in general, they guaranteed benefits when the member was sick in return for paying some small amount weekly or monthly. As Thompson notes: "Small tradesmen, artisans, labourers--all sought to insure themselves against sickness, unemployment, or funeral expenses through memberships of 'box clubs' or friendly societies." According to Huggett, a typical laborer as a member might pay one shilling a month in return for potential benefits of one shilling a day for six weeks and six pence a day for another six weeks when sick and unable to work. Why were these clubs so scarce among laborers compared to the artisans, at least before c. 1815? Since class consciousness or political activism developed more slowly among the laborers than the skilled tradesmen (see below pp. ), the former naturally lagged behind the latter in organizational activities. Clearly, compared to the skilled, the unskilled were less likely to be politically concerned and more likely to possess fatalistic attitudes towards accepting conditions as they were, as Mayhew experienced in London. But consider a more immediate, practical issue: If a laborer and his family are just barely above subsistence, spending an extra shilling or two a month may be an impossible burden to bear. As Rector Sockett commented: "I think it quite a mockery to propose a medical club to a man that has not shoes to his feet." Furthermore, the local parish authorities might set their face against a club because it would make the laborers too independent. Arch remembered his local parish's parson refused to preach a sermon to help a club raise funds, although it still was organized anyway. Since rural areas contained fewer people to control and a likely even more concentrated elite possessing the great powers the central government had delegated it and a possible near monopsony over the local labor market, the rural elite has relatively more power to exert against any attempts at organization by the laborers compared to their urban counterparts. Additional problems could come from within: Members, usually having only grade school educations at best, could commit fraud or mismanagement. The former ultimately destroyed the benefit society that shepherd Caleb Bawcombe had been a member of (c. 1885) for three decades. He sued its secretary for refusing to pay him because of narrow, legalistic reasons for the six weeks he had been laid up. Helped by others, he won, but the judge ordered the club to be dissolved and its money to be distributed to its members since its secretary was exposed as a cheater.138 Although friendly societies were hardly a panacea because of the laborers' tight finances, they still represented a level of freedom in open collective action that American slaves could only dream about.
The laborer's right to reject a medical treatment seems unimportant, but it demonstrates the difference between a free man and a bondsman. At times it mattered, despite its theoretical nature. Arch had a running battle against the local authorities who wished to vaccinate his children over his objections. Four times He went to court, represented by just himself. Four times he won and stopped them, something which no slave could boast of. Admittedly, his reasons for opposition were dubious. He disliked the mass vaccinations at school, saying he was not going to have his "children treated as if they were cattle." He told the bench that his children were healthy. He said no hereditary diseases can be traced back for many generations in his family. He feared that their blood could be tainted by the "filthy matter . . . too often used for vaccination purposes." His reasoning was specious: The eighteenth-century's crude inoculations were still a mighty contributor to the overall death rate's decline, even before the introduction of Jenner's improved process of smallpox vaccination (1796).139 Nevertheless, this situation shows the farmworkers and slaves occupied sharply different legal categories, despite being as mistreated as a class by enclosure and the multitude of petty tyrannies committed by the local gentry, large farmers, and parsons. Slaves simply could not testify in courts of law against whites at all. But if the laborers were well-informed legally (which, admittedly, they usually were not), they could wrest favorable decisions from even hostile magistrates, as Arch did. The laborers did not always have to accept what the local authorities provided for them, in medical matters or other areas of life, although the costs of insubordination could be high, while the slaves had less choice concerning what they received from their masters and mistresses, against whom disobedience usually brought much harsher, swifter punishments.
Workhouse infirmaries imposed a regime of regimentation, but likely presented decidedly more orderly and clean conditions than most infirmaries in the South that were intended for slaves. Showing its high level of control over the inmates, Petworth Union's workhouse for the elderly at Kirdford, Sussex denied them the freedom to walk anywhere without permission except for the garden/backyard area outside it.140 Jeffries described one place where an elderly agricultural worker stayed that lacked the freedom and sentimental value of his own cottage, but which provided better food and care: "In the infirmary the real benefit of the workhouse reached him. The food, the little luxuries, the attention were far superior to anything he could possibly have had at home. But still it was not home."141 Certainly the cleanliness of this particular workhouse beat hands down the disorderly squalor and filth that Kemble encountered in an infirmary on a plantation whose general treatment of the slaves was better than the neighboring masters' average standards. Although workhouse inmates were not treated much as individuals, their conditions surely beat the dirt floor of some "infirmary" as a place to regain health compared to staying at home.
Whose Medical Care Was Better?
Since the late eighteenth to mid-nineteenth-century's health care was undeniably crude and primitive, the medical care slaves or agricultural workers received from their superiors remains for us today more a test of intentions than results. The fewer slaves or farmworkers that doctors bled, blistered, or gave useless patent medicines to, the better off they were. The stingy board of guardians or master who refused to pay for doctors may have helped their charges more than the seemingly compassionate authorities who paid the fees of physicians producing more pain and death than cure and life. Based on the sources above, parishes and unions providing doctors for the paupers in their midst may have been given more regular care than a majority of slaves received, if for no other reason than England's higher population densities helped doctors serve more people in a given day by reducing the amount of travel between patients. But those English workers not declared official paupers at the time they fell ill likely received less help since they would either have to pay for medical expenses out of pocket or lean on the doctor's sense of altruism. Those fortunate enough to live in a parish or union that provided medical help to basically all laborers, not just the legal paupers, were probably better off than a majority of slaves. As for the bondsmen, the masters and mistresses owning them may have had more immediate self-interest in helping them when sick, just as a farmer who owns a cow calls a veterinarian when it has a disease. But self-interest only unreliably "guaranteed" slaves received medical help, since self-interest could also dictate its denial or cutting corners on its provision, such as slaveowners or overseers trying to administer medicines or treatments on their own and avoiding the calling in of doctors until the last minute. Slaves in areas where doctors were reasonably accessible may have on average received more professional medical attention than those English farmworkers on their own because they were not declared paupers legally.
Reflecting their different cultures and legal statuses, the slaves and farmworkers had different ways to get their own medical aid. The slave conjurors, being warlocks or witches as well as healers, became someone in their own community with a source of authority independent of the white establishment's. Besides the problems caused by the "magical" side of their healing arts, the conjurors' treatments probably helped no less and hurt no more their brothers and sisters in bondage than the white physicians did. The slave midwives did more good on average for their community by helping fellow slave women through the travail of birth, but they lacked the same level of power if they were not conjurors also. As shown by their limited freedom to organize medical benefit clubs, the English agricultural workers were able to engage in collective action to help meet their medical needs. But their tight family budgets were roadblocks against the sparing of a shilling or two a month, which discouraged many from joining or organizing these groups. Those engaged in collective action also took on the risk that one or more persons involved may let the whole group down by failing to do their jobs effectively, such as by committing fraud or causing bankruptcy. How these subordinate groups independently got medical care varied because of the agricultural workers' greater freedom legally allowed them to organize collectively, while the slave community, drawing on their African cultural heritage, turned to the conjurer's treatments and his perceived magical powers.
The Overall Standard of Living: Were the Slaves or Farmworkers Better Off?
Without reliable, broad-based quantitative statistics, it is difficult to decisively prove which group of two was better off materially or the same group in different generations. Conditions that vary regionally merely add further complications, such as the differences between the Border States and Deep South for the slaves, or northern and southern England for the farmworkers. Diversity within the subordinate group cannot be dismissed, which could be caused by individual ability, the character of the specific master(s) a slave or farmworker has, and family relationships. Finally, the material standard of living only partially covers the quality of life. When making broad group generalizations, such as comparing all Southern slaves to all English agricultural workers to determine whose standard of living was higher, dogmatism should be avoided and these caveats remembered. But although this realm allows one literary source to be pitted against another, some generalizations are still possible.
For the southern English agricultural workers (who composed a solid majority of their group) and typical rural slaves, there was likely little to choose between the quality and quantity of clothing or housing. Perhaps the slaves of the Deep South of smaller planters and farmers had worse clothes, but its hotter climate ensured they had less need for them than the English did, which partially justified their owners' complacency. Apparently most in both groups probably owned only one or two changes of clothes, excluding the nicer clothes some slave servants had, or the "Sunday best" saved for church. Both often lived in one-room houses with dirt floors and non-glazed windows, having perhaps a loft for the children to sleep in. The slaves might have been better off since wood was plentiful in the New World, making construction and repairs cost less than in most of England. The English had to use other materials which nonskilled people had more trouble building with than the logs thrown together for many a frontier cabin. As for medical care, the average slave may have had better access to a physician's care than the average English farm laborer who was not legally a pauper, assuming the South's lower population densities did not sharply reduce the number of house calls made per day, and that smaller planters and farmers paid for medical help as much as large planters. Turning to diet, the slaves had much more meat and probably more food overall, but the southern English agricultural workers ate white wheat bread that was clearly less coarse than the crude corn bread many slaves ate. Ironically, the free southern rural laborers of England approached bare subsistence closer than the African-American bondsmen, thanks to enclosure, rapid population growth in a long-settled realm, and the belt-tightening of the New Poor Law (1834). Northern English agricultural workers, who composed perhaps one-third or one-fourth of all English farmworkers, were usually significantly better off than the slaves.142 Their higher wages (and superior access to allotments or other land) kept meat solidly in their diets, allowing them to pay for more clothing and better cottages. Similarly but less dramatically, the Border States' slaves enjoyed better treatment and conditions than the Deep South's. Hazarding a broad-brushed judgment, it appears the farmworker's material standard of living was no higher than slaves on average, who often were marginally better off than the southern agricultural workers considered alone, at least in diet.
Trickle-Down Economics with a Vengeance: How the Slaves Benefited
How could a slave labor force arguably have a marginally higher standard of living than (much of) a free one? Several unusual factors produced this result. First, even American slaves benefited some from living in a part of the world where population density was low and natural resources were abundant, especially wood and land. True, the white slaveholders expropriated most of the benefits that the slaves would have had if they had been free. This is "trickle-down economics" with a vengeance! In the South, wood for homes, heating, and cooking was nearly a free good. Masters knew slaves put to work growing corn and raising hogs in addition to the cash crop could cover most of their living expenses, leaving largely to themselves the surplus generated by the cash crop. The prudent, risk-averse planter or slaveowner made his or her slaves pursue subsistence as a collective by raising corn and hogs. Benefiting from cheap land, this strategy made many slaveowners rich, since the cash crop's receipts greatly exceeded the direct cash expenses, at least in good years. By contrast, since land was relatively scarce and expensive in England, the landlords and gentry passionately clung to it; even most farmers had little or none, let alone the farmworkers. As the industrial revolution began, England's growing population ensured competition for land ownership would intensify. Southern England's general deforestation guaranteed fuel for cooking and heating would be expensive. Hiking fuel's costs still more, its scarcity often required it to be transported considerable distances. Furthermore, the landlords and farmers used access to land as a social control/labor discipline device. They often hesitated to lease even tiny parcels of land as allotments to the agricultural workers. By making their labor force totally dependent on wages and forcing it into the labor market to survive, they wanted to keep them from pursuing a subsistence strategy in order to control its actions better. By contrast, under their masters' direction and control, the slaves normally had to pursue subsistence, but their lack of freedom ensured they wouldn't become too independent of their owners. By owning the slaves and their produce, and keeping firm control of the distribution of food (under the gang system), the slaveholders grasped the throats of the slaves firmly even as they raised most of the food they ate. But in England, since neither the labor force nor the product of its labor was owned by the rural elite, controlling the laborers was intrinsically more difficult. The landlords and their tenants alienated the labor force from the means of production (the land through enclosures), creating a more easily controlled, wage-dependent rural proletariat since farmworkers were denied the ability to eke out a living from the local commons all or part of the year. The American slaveowner almost whimsically granted his slaves small patches of land to grow vegetables thanks to the abundance of land on the frontier, but those trying to persuade English landlords and farmers to provide allotments to farmworkers often resembled dentists trying to pull teeth from balky patients. In short, since southern England had a higher population density and lower resource base than the American South, this difference helped to ensure farmworkers likely had a lower standard of living than the slaves, particularly for food and fuel.

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