An illustration of wo men dueling with swords under Spanish moss hung oak trees.

Medical Identity and Ethnicity in 19th-Century New Orleans

Dr. Amy Wiese Forbes spoke today at the National Library of Medicine on “Medical Identity and Ethnicity in Nineteenth-Century New Orleans.” Dr. Forbes is Associate Professor of History and Director of European Studies at Millsaps College. Circulating Now interviewed her about her work.

Circulating Now: Tell us a little about yourself. Where are you from? What do you do? What is your typical workday like?

Amy Weis Forbes in a library.

Amy Forbes: I was born and raised in Louisiana.  We lived in Baton Rouge, but had family and friends in New Orleans, and I developed an early interest in the city’s history.  Growing up, I read about the things I saw:  French immigration and influence, the famous above-ground cemeteries, and, of course, the popular stories of Voudun practioners.  In college, courses in French history made institutions like European carnival seem deceptively familiar, and challenged me to set them in cultural context.  When I went to graduate school, I dove into what was then new work in French cultural history on public shaming through charivari (threatening ‘rough music’ serenades), creating citizens through revolutionary symbolism, grappling with disputed identity, and expressing class resentments through cat massacres.  I was drawn to histories of disenfranchised people expressing themselves in what might be called unofficial ways, particularly through satire.  The rhetoric of mockery carried so much power in nineteenth century France.  My dissertation (PhD Rutgers, 1999), book, and other published work have focused on French satire’s role in teaching the political skills needed by republican citizens and fostering the Republic of 1848.

I teach at Millsaps College in Jackson, MS.  Teaching at a liberal arts college, much of my day goes to course preparation, class time, and meeting with students.  I also direct the European Studies program, which involves a good bit of advising and administrative work for students studying abroad.  At professional conferences, when people see my Mississippi institutional affiliation on a name tag, they often say, “You must be on the job market.”  Not at all.  Teaching students skills of critical analysis is its own reward, and I enjoy the proximity to research repositories in New Orleans and across Louisiana.  I am currently collaborating with faculty at the University of Mississippi Medical Center, the Center for Bioethics and Medical Humanities, and the University’s medical archives on several projects. I just finished an article on sickle cell anemia and am working currently with medical faculty on studies of the state’s only clinic for people with HIV/AIDS, and of African-American patient care at the Mississippi State Tuberculosis Sanatorium.  I spend a lot of time driving to small Mississippi towns to record oral histories from the sanatorium’s former patients and staff.

CN: Would you tell us about the work you presented in your lecture, “Medical Identity and Ethnicity in Nineteenth-Century New Orleans?

AF: I am presenting preliminary work on two portions of a book-length cultural history of medicine in New Orleans.  The book will examine the arguments and debates through which medical knowledge was created in New Orleans, along with the many paths by which those arguments influenced, and were influenced by, medical arguments in France and Saint-Domingue. It focuses on how that medical “knowledge” was transformed by and transformed local culture, how it circulated in the three geographical areas, and ultimately how medicine and the medical community played a role in forming American national identity in the region. 

The first part of the presentation looks at the creation of the French medical corps in the city as it developed around debates over yellow fever epidemics that struck New Orleans in the 1860s.  Close readings of tracts at the center of one of the biggest of these disputes reveal how French trained doctors who debated “medical” matters through rhetorical sparring as men of letters, but who involved the public in their debates, vied for position in the face of looming Anglo/American influence.  Connections with France were maintained and lauded.  French-trained doctors viewed their American-trained colleagues as both intellectual and cultural inferiors, and French and Anglo doctors fought for status.  As a measure of the connections between medicine and the cultural milieu of the city, the medical disagreements between French and Anglo doctors were not confined to professional circles but were taken well beyond them to play out before the public in speeches, lay publications, and frequent duels.

A postcard showing men dueling with swords under Spanish moss hung oak trees.
“Old Dueling Grounds in City Park showing De Lissue le Bouisque Duel in 1841”, undated postcard
Courtesy the Rudolph Matas Library of Health Sciences Archives at Tulane University

As doctors argued over diseases, healing, and medical institutions, they wrote into their disputes meta-narratives about medical knowledge—what it was, who should determine that, and how.  The very form their dispute took, of quoting each other’s documents as evidence and responding to the quotations with ridicule as often as with counter evidence, shows medical proof and credibility evolving into a tangled combination of wit, rhetoric, observed evidence, and its manipulation.  From their debate emerged calls for a medical epistemology based on facts that were evaluated not by the public, but by trained professionals.

In all of this, French doctors wrote about the benefits offered by the “French race” to medicine, culture, and politics in New Orleans, Louisiana, and the United States, which forms the second and more preliminary portion of the presentation.  French influence made many Americans skeptical of Louisiana’s national loyalty.  Historians have argued that Louisiana proved itself to American leadership in the War of 1812, others argue it was the Civil War that forged American identity in the state.  I am interested in the way French-trained doctors continued to argue for French influence in both racial and political terms through the end of the nineteenth century, seeking to leave a French impress on American republican identity.  The main question in this portion is what French doctors meant by “race.”

CN: In researching this subject, were you drawn to any particular individual’s story?

A formal vignette portrait of a man with a ribbon tie.
Jean-Charles Faget, ca 1850
NLM #101414752

AF: I was very much intrigued by Jean-Charles Faget, son of a French-educated doctor from Saint-Domingue and himself French educated, who argued desperately that New Orleans’ wealthy creole families and the black slaves and servants who worked in their homes were immune to yellow fever.  I found him enigmatic.  He was certainly a man of science; he discovered the inverse relationship between rising fever and dropping pulse rate that today remains the tell-tale sign of yellow fever.  This was a crucial discovery for New Orleans and throughout the Caribbean where regular yellow fever epidemics killed thousands.  And he was part of the community of New Orleans physicians who trained in Paris and exchanged copies of their medical theses with warm dedications to each other, suggesting the close nature of the French-trained community in the city.  He didn’t seem merely opportunistic, a mercenary trying to support his practice by telling wealthy patients what they wanted to hear.  Yet he held his ground in the face of obvious and overwhelming evidence against it, breaking with nearly all of his colleagues on the question of creole acclimatization to yellow fever and debating the issue fiercely with colleague Charles Délery.  Faget’s theories were opposed by his peers, first in New Orleans’ medical journals, then in public venues where they were openly ridiculed.  I struggle to understand his motivation, but am fascinated by the process of medical argumentation and the knowledge that emerged from his primarily “rhetorical” contests.

CN: You’ve worked in several fields of history, what sparked your interest in this medical history subject?

AF: My work in medical history evolved from my early interests in rhetoric, French immigration to New Orleans, the public health issues and environmental factors that necessitated burial crypts, attempts to heal at a time when doctors couldn’t really do much, and the play of race and ethnicity in determining who could claim to have certain types of knowledge.  My professional work has focused on how people find means to communicate despite various obstacles, and how rhetorical strategies relate to political, social, and cultural factors.  These issues unfolded in New Orleans medical history in fascinating ways.

Hurricane Katrina brought these interests together professionally.  After the storm struck in August, 2005, many of my students’ family members came to live with them in their dorms.  (Jackson is the first sizeable city north of New Orleans on Interstate 55, the main evacuation route going north.) Millsaps typically draws students from New Orleans, but that year displaced students from Tulane (which closed completely for the fall semester before reopening in stages) attended Millsaps, as well.  Listening to their stories, I was struck by the centrality of medical issues in the aftermath of the disaster.  As an intake responder for the Red Cross, I heard refugees who had lost everything claim medical needs as their chief concern—heart medication, dialysis, insulin, anti-seizure drugs, eye glasses, asthma medicine, epi-pens, broken bones, concussions, pre-natal care, not to mention routine viruses and infections that were going untreated.

An aerial view of a flooded neighborhood.
Views of inundated areas in New Orleans following breaking of the levees surrounding the city as the result of Hurricane Katrina, September 11, 2005
Photographer: Lieut. Commander Mark Moran, NOAA Corps, NMAO/AOC

In such compelling circumstances, one could think of little else.  I began reading about earlier medical disasters in the city and became interested in the politics of medical care during the nineteenth century.  The demise of Charity Hospital shocked many people, including myself, professionally and personally.  I recall driving past it months after the hurricane, after power had been restored across New Orleans, and seeing lights inside, still on from the day people fled.  Medical sociologists and anthropologists began scholarly investigations immediately, but it was harder for medical historians.  The biggest repository of medical history in the city, the Rudolph Matas Library of Health Science, had flooded.  The death of a library staff member, standing water, and pervasive mold left the facility closed for some time. Other libraries and archives closed or lost materials.  The NLM’s History of Medicine collections became invaluable to the study of New Orleans medical history.  Much of my early reading, and what eventually would become my research, was done through NLM collections.

CN: As an Associate Professor, what kind of primary sources do you enjoy working with and sharing with your students?

AF: I look for documents that help students learn historical empathy.  In my courses, I am asking them to engage in great acts of imagination across time and culture, so I try to give them documents that help them learn that practice.  Letters home from medical students that offer some commonality or documents describing cures for familiar diseases that differ from modern-day therapies are good for this.  Typically, students bring a sense of justice (as they define it) to the classroom.  Documents that spark outrage—reports of government sponsored testing on minorities, for example—force students to think about the complexities of medical understanding.  Their desire to empathize with the exploited populations, the medical professionals, the beneficiaries of therapeutic understanding, and the defenders of civil rights and medical ethics, brings medical history to life.

Dr. Amy Wiese Forbes’s presentation was part of our ongoing history of medicine lecture series, which promotes awareness and use of NLM and other historical collections for research, education, and public service in biomedicine, the social sciences, and the humanities.

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