A Disability History of the United States

by Kim E. Nielsen

  Indeed, significant evidence exists to suggest that unorthodox behaviors were simply part of everyday life. Unless violent, those considered insane were accepted in society. In Brampton, Massachusetts, residents went about their daily business despite the disruptive behavior of one Jack Downs. Downs regularly enjoyed plucking wigs off the heads of church worshippers with a string and a fishhook, and was well known for throwing rotten apples at the minister during the sermon. Bill Buck, of Hopkinton, lived in the town’s almshouse but was not confined there. Townsfolk apparently endured and even enjoyed the insulting speeches he gave residents, as well as the local cornfields, while he roamed the community.11

  Hopkinton’s almshouse was not the only such institution in the rapidly developing Colonies. Almshouses, which began to be in regular use by the end of the colonial period, met many community needs and were a general dumping ground for all those unable to support themselves financially. They also served as correctional institutions. Connecticut’s first such institution, for example, established in 1727, was intended to house “all rogues, vagabonds and idle persons going about in town or country begging, or persons . . . feigning themselves to have knowledge in physiognomy, palmistry, or pretending that they can tell fortunes, or discover where lost or stolen goods may be found, common pipers, fidlers, runaways . . . common drunkards, common night-walkers, pilferers, wanton and lascivious persons . . . common railers or brawlers . . . as also persons under distraction and unfit to go at large, whose friends do not take care for their safe confinement.”12 A perception of the need for care or confinement, rather than diagnosis (for one could be a “fidler,” a vagabond, or “persons under distraction”), drove this early development of institutionalization.

  Similar institutions developed in Rhode Island in 1725, in New York in 1736, and in Pennsylvania in 1752. The Pennsylvania Hospital was intended for “the Reception and Relief of Lunaticks: and other distemper’d and sick Poor within this Province.” The New York “Poor-House, Work-House, and House of Correction” similarly welcomed a broad spectrum of people. Virginia opened the doors of the first asylum exclusively for those with mental and cognitive disabilities—“ideots, lunatics, and other persons of unsound minds”—in 1773. The institution sought to “care . . . [for] those whose cases have not become quite desperate . . . [and restrain] others who may be dangerous to society.”13

  Those with cognitive or mental disabilities may have been confined only if considered necessary, but confinement was not pleasant—either at home or in an institution. Sometimes confinement was horrific. Patrick Henry’s wife died locked in her cellar. All individuals who entered Connecticut’s institution were automatically whipped on the back “not exceeding ten lashes.” Those institutionalized as insane in the Pennsylvania Hospital were confined in the institution’s cellar and chained by the waist or ankle to the wall. Many wore a “madd-shirt”: “a close-fitting cylindrical garment of ticking, canvas, or other strong material without sleeves, which, drawn over the head, reached below the knees, and left the patient an impotent bundle or wrath, deprived of effective motion.”14

  Though horrid in contemporary terms, such conditions are evidence of early efforts to provide curative treatment. The decades surrounding the American Revolution were a period of transition for those with mental and cognitive disabilities, in which some were referred to experts outside of the family and some were not. The little that physicians had to offer generally included bleeding, purging, and blistering, but turning to physicians implied that those involved considered “cure” to be possible. For James Otis Jr., cure involved a simple firming up of self-control—at least according to his father. Increasingly, however, finding a solution (which assumed an identified problem) meant seeking the assistance of individuals outside the family. Those considered available to provide assistance variably were midwives, ministers, and educators, but increasingly physicians.

  This was one more manifestation of the American Enlightenment’s turn to education and reason, science, and the belief in human capacity (or at least the capacity of some people). The Revolution and the new nation itself would come to be founded on the radical argument of the Enlightenment that citizens, however limited in breadth the category might be, had rights and were capable of reasoned decision making and could be trusted with the vote. As the US Constitution, adopted in 1787, stated, “all men are created equal . . . [and] endowed by their Creator with certain unalienable rights.” Given such human potential, and trust in human reason, the new scientific method of thinking held tremendous sway. Advances and attempted advances in medicine and technology presumed that order could be found, solutions achieved, and increased enlightenment would result.

  When Cotton Mather (the very same Puritan minister who had considered his stuttering a sign of sin) encouraged smallpox inoculations, and those inoculations resulted in far fewer deaths, many saw it as one more example of an enlightened society’s ability to conquer nature. Few recognized or knew that Mather had learned of the beneficial consequences of inoculation from an African-born slave. If science and reason, however, could advance technology, bring forth new political imaginings, and find medical solutions to perceived physical problems, perhaps it could be relied upon for others as well.

  The most popular home medical manuals of the period also offered suggestions for the treatment of mental and cognitive disabilities. John Wesley’s 1747 Primitive Physic suggested treating “lunacy” with a daily ounce of vinegar or applying a boiled blend of ivy, oil, and white wine to one’s shaved head every other day for three weeks. “Raging madness” could be treated by applying cold water to the head or eating only apples for a month. (Baldness would be treated by rubbing first an onion and then honey on the afflicted area twice a day.)15

  The general lack of discussion and institutional acknowledgment of physical disabilities suggests that they simply were not noteworthy among communities of European colonists in the period before the Revolution. Indeed, it suggests that such bodily variations were relatively routine and expected—and accommodations were made, or simply didn’t have to be made, to integrate individuals into community labor patterns. And some people simply died. Smallpox and other epidemics routinely ran through colonial towns and villages, resulting in increased deafness, blindness, and skin disfigurements. Undoubtedly, axes occasionally caused one to lose either finger or limb, trees toppled in the wrong direction, children were burned in fires, and guns misfired.

  First and foremost, families cared for individuals in the late colonial period—and could do so relatively easily in their own homes: those considered insane, for example, might need only a daily dose of vinegar. Communities of European colonists moved to provide organized care only when and if individuals came to be considered overly disruptive, and when and if families could or did not provide care.

  INDIGENOUS NATIONS AND COMMUNAL RESPONSE

  The desire and ability to provide consistent familial or community care generally depended on some level of stability, resources, and security. European colonization in North America left few indigenous nations with the ability to provide care on a meaningful and significant scale.

  Nearly half the Cherokee nation of Oklahoma died when smallpox hit in 1738, as did half the Catawbas of the southeastern coastal region in 1759. When British explorer and navigator George Vancouver first reached Puget Sound in 1792, he met members of the southern Coast Salish nation who already had been scarred and lost vision due to smallpox. In the race among European nations to best one another in gaining greater colonial control of North America, the disease had beaten the Europeans to the continent’s northwest coast.16

  People of the Kiowa nation in what are now Texas, Oklahoma, and New Mexico tell a story in which a Kiowa man encounters Smallpox, riding a horse through the plain.

  The man asks, “Where do you come from and what do you do and why are you here?” Smallpox answers, “I am one with the white men—they are my people as the Kiowas are yours. Sometimes I tr
avel ahead of them and sometimes behind. But I am always their companion and you will find me in their camps and their houses.” “What can you do?” the Kiowa asks. “I bring death,” Smallpox replies. “My breath causes children to wither like young plants in spring snow. I bring destruction. No matter how beautiful a woman is, once she has looked at me she becomes as ugly as death. And to men I will not bring death alone, but the destruction of their children and the blighting of their wives. The strongest of warriors will go down before me. No people who have looked on me will ever be the same.”17

  It’s likely that indigenous nations that highly valorized the warrior were more rigid in their bodily ideals, and thus less accepting of disability, than groups primarily agricultural or nomadic. The ever-increasing number of European settlers, and their ever-expanding geographical reach, also intensified large- and small-scale military conflicts between indigenous nations and the colonists. In those cases, and in those regions, the ability to battle became far more important for both Native and European men. A successful warrior generally required physical strength, agility, and keen eyesight, hearing, and analytical skills; and while some women excelled at war, most tribes masculinized the ideal. Some individuals simply could not live up to, or it was assumed they could not live up to, the physical and mental demands of the warrior ideal because of their bodies. In nations such as the Aztec and the Iroquois, ideals of leadership thus were more likely to exclude people whose bodies did not meet the high standard set for the community’s most esteemed positions. Such exclusion would have resulted in stigma—sometimes harsh, sometimes mild—being attached to those impairments.

  “REFUSE” SLAVES AND THE SLAVE TRADE

  At the same time indigenous peoples were dying in large numbers and being pushed from the regions of European settlement, Europeans were bringing Africans to North America by force. The first Africans arrived in North America in 1619, nineteen in number and bearing the legal status of indentured servants—not slaves. By the 1640s, however, European colonists had built slavery into the legal frameworks of colonies both north and south, and Africans landed in the New World as chattel. In 1700, twenty thousand enslaved Africans lived in North America, and by 1790 there were almost seven hundred thousand; by 1860 there were nearly four million. The transportation of slaves into the United States was abolished as of January 1808, but slavery continued legally in some parts of the United States until the Union prevailed in the Civil War in 1865.

  The racist ideology of slavery held that Africans brought to North America were by definition disabled. Slaveholders and apologists for slavery used Africans’ supposed inherent mental and physical inferiority, their supposed abnormal and abhorrent bodies, to legitimize slavery. Indeed, slaveholders argued that the bodies and minds of those they enslaved were disabled to such an extent that slavery was a beneficial kindness owed to those in need of care. Disability permeated the ideology, experience, and practices of slavery in multiple and profound ways.

  Estimated US Slave Population, 1619–1860

  Year Estimated US slave population

  1619 19

  1700 20,000

  1790 697,897

  1800 893,041

  1810 1,191,364

  1820 1,538,038

  1830 2,009,050

  1840 2,487,455

  1850 3,204,313

  1860 3,953,760

  Source: US Census Bureau

  European slave traders built on an already existing slave trade and market within Africa. While important differences existed between the internal and transatlantic African slave trades, the two became intertwined. (Within Africa, for example, slavery did not pass from parent to child. Children born of an enslaved mother were born free.) Slave traders were in the business to make money. This meant that they sought to enslave people with bodies and minds considered fit for work, people who could command a good price.

  In 1701 one slave-trading company wrote directly to the king of Whydah (Ouidah), on the coast of western Africa, characterizing the bodies and minds of those the king’s traders should seek out:

  We . . . do desire your Majestie . . . will be pleased to direct ye Buyers never to buy a Negro to be offered to us to sale above 30 years of Age nor lower than 4 ½ foot high . . . nor none Sickly Deformed nor defective in Body or Limb, for we want Negroes as Chargeable in Carriage as ye best. And ye Diseased and ye Aged have often been ye Distruction of ye whole Adventure, so that we must desire that our Negroes be every way perfect & fit for Service and had much Rather at proportionate prices have a boy & a Girle not under 3 ½ foot high to every 5 Men and 5 Women than have any above 30, sickly & deformed.18

  Age, height, evidence of past disease, or the state of one’s limbs thus protected some individuals from being abducted and sold into slavery but did not protect them from violence.

  What happened to those whose bodies were considered too disabled for enslavement? The historian Hugh Thomas notes that in slaving raids “old men and women, as well as children, were considered valueless and often killed.” This likely included those with physical disabilities that made them ineligible for slavery. On the other hand, Africans with physical abnormalities considered extreme, whose bodies could be exhibited for money, were prized.19

  Once captured or sold into the slave market, the enslaved began the deadly journey to Africa’s western coast. Historians estimate that as many as half of those pressed into slavery suffered the effects of disease, exposure, malnourishment, fatigue, or violence on the overland journey. If they reached the coast alive, they were held in wooden structures; again, with little food, subject to high disease rates, and with already traumatized bodies and minds. More died while awaiting transport.20

  Sailing across the Atlantic in this period was unpleasant even for those who could afford the best of transports, and it could be deadly for anyone. Crewmembers stayed on the ships far longer than slaves did, and made repeated voyages. More than 20 percent of the crewmembers who sailed on English ships from the Bristol and Liverpool trading companies died during their labor.21

  Without exception, enslaved individuals experienced the voyage from Africa to North America, known as the Middle Passage, as horrific. Already traumatized and physically embattled, crowded into a ship’s hold and into the narrow portions between the ship decks, surrounded by strangers who frequently spoke unfamiliar languages, possibly imprisoned with members of enemy tribes and communities, and often tied or in chains, the enslaved endured a journey that could last from fifty-five to eighty days (depending on ports of departure and arrival). Crewmembers raped women and likely sometimes men. Food and water were inadequate.

  In such conditions, disease could spread quickly. One of the most horrendous examples of slave-trade cruelty, and of the consequences of disease and disability, is the story of the French slave ship Le Rodeur. Fifteen days into its 1819 voyage, the first symptoms of the “frightful malady” of “ophthamalia” (or ophthalmia, a highly contagious eye disease that can cause blindness) appeared. Crewmembers initially paid little attention to the “considerable redness of the eyes” among the enslaved, crediting it to the scarcity of water: slaves received eight ounces per day (later reduced to “half of a wine glass”). Cases of the disease and its resulting blindness increased quickly, and were made worse by dysentery. Eventually crewmembers were also afflicted. Ultimately, almost forty Africans failed to regain eyesight, twelve lost sight in one eye, and fourteen “were affected with blemishes more or less considerable.” Twelve of the crewmembers lost their sight, including the ship’s surgeon; and five became blind in one eye, including the captain. Any loss of sight among the enslaved would reduce the trader’s profit. As a later government report stated, “even those blind of one eye would sell for a mere trifle.”22

  The end of the story of Le Rodeur is best told by J. D. Romaigne, a young boy serving on the ship, in the letters he wrote to his mother:

  This morning the Captain called all hands on deck, negroes and all. The shores of
Guad[e]loupe were in sight. I thought he was going to return God thanks publicly for our miraculous escape.

  “Are you quite certain,” said the mate, “that the cargo is insured?”

  “I am,” said the Captain. “Every slave that is lost must be made good by the underwriters. Besides, would you have me turn my ship into a hospital for the support of blind negroes? They have cost us enough already. Do your duty.”

  The mate picked out thirty-nine negroes who were completely blind, and, with the assistance of the rest of the crew, tied a piece of ballast to the legs of each. The miserable wretches were then thrown into the sea.23

  Since the slave trade existed to make money, disability in a slave resulted in a loss of profit. Following the perverse logic of slavery and the prevailing ableist belief that blind people could not labor—and that “even those blind of one eye would sell for a mere trifle”—the crew simply threw overboard those persons who were worth more to them dead than alive. As poet John Greenleaf Whittier wrote in 1834 about the event,