Survival
Macon County ranked third in Negro mortality in a list of 67 rural Alabama counties, according to the 1929 mortality census. There were 406 deaths and these gave a rate of 18.4. This rate was exactly the same as that for the white population in this county. There is, however, something unexplained about the figures. Just one year before the Negro mortality was 22.1 and in 1925 it was 22.2 and second highest in the state. The ratio between white and Negro deaths has remained approximately the same, and the mortality of the white population of this county has exceeded that of Negroes in the majority of counties of the state. This may indeed be a reflection of the hard life of the northern section of the county where most of the white residents live (in the shadow of their own past).
Charles Johnson was president of Fisk University and a well-known sociologist. This study was funded by the Rosenwald Fund to provide a sociological analysis of the African American community in Macon County.
Originally published in Shadow of the Plantation (Chicago: University of Chicago Press, 1934), 186–207. Reprinted by permission of the University of Chicago Press.
One of the unexplained circumstances in the number of Negro deaths for 1929 may possibly be connected with the discrepancy between the numbers of Negroes dying as reported by the federal census, on the one hand, and the county health officer, on the other. The records of the latter show 60 white and 154 Negro death certificates while the census shows 87 whites and 406 Negroes, residents and nonresidents. This would presumably include deaths at the Negro Veterans Hospital located in the county near Tuskegee. During the same year 119 white and 574 Negro babies were added to the population. The white population, thus, it seems, had 98 per cent more birth survivals than deaths and the Negroes about 3.6 per cent more. The extent to which the lower Negro rates of survival are related to inadequate birth registration is not evident in the figures alone, nor does the county health officer know what proportion of the total was registered. There is some evidence that the number of Negro births registered is less than the actual number of births. In our 612 families, which might be taken as an average, there were 69 children under one year of age. These were 2.7 of the total population. If this rate may be assumed for the entire population, it would be expected that 600 of the children born during a given twelve months’ period would be alive. Such an estimate, however, would not take into account those who were born and died during the first few months of the year. If these were included it would point to a somewhat greater discrepancy. Since the fecundity rate is known to be high, a situation exists which emphasizes the high infant mortality rate as well as the rate for stillbirths and nonviable abortions.
In order of numerical importance the chief causes of death, as listed by the county health officer, were violence, heart disease, stillbirths, tuberculosis, influenza, nephritis, cancer, pellagra, and malaria. The distribution is unusual. Little confidence can be placed in the figures available on this mortality. In the first place, diseases are not adequately diagnosed because of the uncertain relation of doctors to sick persons, the rather general ignorance of disease, the reliance upon folk diagnosis and cures, and the exceedingly high rate of venereal infection in the population. The relative inaccessibility of many of the families leaves them very largely to the informal agencies of the community for handling both sickness and death. When violence is responsible for death it becomes a matter of both health and crime registration, and the state steps in with considerably more determination and insists on greater accuracy in the record.
The only index to sickness among the families studied was the non-technical one of persons being treated for malaria, pellagra, and syphilis, the latter under a special demonstration instituted as an experiment by the Rosenwald Fund. The county health service provided some mass treatment for persons with malaria. In 100 of the 612 families, or 16.3 per cent, all members of the family had been treated for malaria; in 194, or 31.6 per cent of the families, one or both of the parents had been treated; and in 50 more families, or about 5 per cent of them, some of the children and one or both parents had been treated. Twenty-eight of the families, or 4 per cent, reported that some of the children had been treated. In 212 families, or 43.6 per cent, there was no record of treatment for malaria. This does not measure the extent of malarial infection. Pellagra is similarly a common malady as indicated by the scaly, cracking skins, but there was no medical appraisal of the extent, since this would have required professional examination. Forty-one families were receiving, or had received, some treatment for pellagra. With respect to syphilis, however, the opportunity for determining the extent was unparalleled for studies of this type.
The Julius Rosenwald Fund, in co-operation with the United States Public Health Service, had undertaken a study of the prevalence of syphilis among Negroes in selected areas of the South. The health officers of six southern states were brought in co-operation with the Fund, through the Public Health Service and demonstrations were set up in six areas. The purpose of the demonstration was to provide a basis for determining the practicability and effectiveness of measures for the mass control of syphilis. Macon County was selected as one of these areas because of the proximity of Tuskegee Institute, the John A. Andrews Hospital, and the United States War Veterans Hospital, and because the administrative controls of the county and state, particularly in the health and welfare divisions, were cooperative. A thorough campaign was made to include as large a number of families as possible within a limited section of the country, in examinations which included Wassermann tests. All ages of both sexes were examined, and as many treated as would accept. The results of the medical examinations provide perhaps one of the most complete samples of a total population anywhere available. In this county 3,684 Wassermanns were taken, of which 1,474, or 35 per cent, were positive. This rate, incidentally, was the highest of the six demonstrations. A county in Georgia stood next with 26 per cent, on the basis of 5,775 tests; a county in Mississippi was next in order with 20 per cent on 9,753 tests; a county in North Carolina ranked fourth with only 12 per cent positives on a basis of 10,196 examinations. The average for the 30,000 serological examinations was 20 per cent positives.
In Macon County the large number of positive Wassermanns for children pointed to heridito-syphilis. The large number of positive reactions in men and women of advanced ages presented a problem for the medical men, since it is usually expected that the disease would have manifested itself in the advanced ages in other and more violent results.
The highest positive rates for men were found in the age group twenty-five to twenty-nine, with 32 per cent of their cases, and the women in the age group twenty to twenty-four, with 34 per cent of the cases.
Most of these families were not burdened by defectives so far as it was possible to ascertain. In 588 families, or 96 per cent of the total, there were no defectives. There was a blind child in 2 of the families. Two families had what appeared to be an imbecile, and 5 families had a person subject to “spells.” A crippled person was found in 13 families, while 1 family had a ten-year-old child that had been crippled and an imbecile because of infantile paralysis since he was two or three years old.
The number of stillbirths and miscarriages in these families also served as an index to the health of the people in these communities. In the 612 families there were 490 known stillbirths. Less than half of the wives were responsible for the 490 stillbirths and miscarriages. There were 368 families in which none was reported.
To understand the somewhat unusual incidence of certain diseases and causes of death it is necessary to go back again to the life of the families.
There is a tradition of violence which seems to mark personal relations to a high degree. Although strictly speaking not a matter of health, reference to the setting in which these violent deaths take place is important as a phase of the social life as well as the mortality. They include accidents of various sorts as well as homicides. The violence of life was an inescapable fact in a large number of families of the county. In another connection reference has been made to the violence attending jealousy in sex relations, but violence is not confined to love affairs. The large amount resulting in death in this group of 612 families may be considered simply another index to its cultural status. A woman who was asked about sleeping with her windows open replied that “people do’s so much killin’ round here, I’se scared to leave ’em open.” Another, referring to their recreation, explained why they stopped attending the dances: “Dere’s so much cutting and killing going on.” One notes either casualness or fatalism in recounting deaths in the family by violence.
My little grandchild what dead got a grain of corn down her throat, I think. She was shelling corn when she started coughing and she look jest like she had whooping cough, and never did get well. My other boy got kilt. He was jest stabbed to death. Oh, they sent the boy what done it to the reformatory.
Playing with Weapons
My brother wuz killed accidentally by his wife. He had gone to see ’bout my oldest sister who had gone crazy. He took my brother-in-law’s automatic pistol back to Birmingham with him ’cause he was ’fraid my sister would get holt to it and hurt somebody. He had promised to teach his wife to shoot it, so one mornin’ he was learnin’ her. He took all the cartridges out and give it to her to shoot but he had left one in. He didn’t know one wuz in the barrel. She took the pistol and ’cose she wuz scared to shoot it, and she throw her head on the side and her hand out and shot it and it hit my brother right in the head.
Juvenile Murders
My brother got killed out there by the creek. He was coming home from a ball game one evening and two boys grabbed him. I spose they got to fussing and the boys got mad and kilt him. We found him dead over there. They caught the boys. . . . One was a little boy ’bout twelve. They sent him to the ’formatory. The other one they sent to the mines for seven years.
Absent Sons
My boy got killed in Birmingham. They say he got shot—I don’ know.
A White Gentleman Shot Him
My boy dead now. A white gentleman shot him. He went to his house to see his sister working there, and the gentleman told him to stay ’way. ’Twas his fault, I reckon. The man said, “Stay ’way.”
A Baseball Bat
Our preacher’s brother just got killed. He was at a ball game and a boy was batting and instead of hitting the ball he turned the bat loose and it went and struck him. The boy batting musta had something in him [corn whiskey].
All of this suggests the rough-handed closeness of a frontier community before adequate control of personal relations have been developed. There is the significant difference that social control in this community is related only vaguely to law. The courts are outside of the scheme of life; adjustment of relations in the past has been very largely the province of the white planter. Such unanimity of sentiment on law as exists is a common disposition to remain as far as possible out of contact with the courts whether as plaintiff or accused. Where these traditional forms of control over all phases of Negro social life by the white proprietor are weakening, as is apparent in the younger generation, or where there are no protectors available, the adjustment of disputes becomes a matter of the individuals involved. Instead of providing security as the arbitrator of personal differences, the courts are an institution to be feared, a medium through which justice is to be secured only by recourse to some individual white protector. Thus, differences tend to be settled on a personal and face-to-face basis. This sentiment helps further to account for the prevalence of weapons of defense.
One of the most frequently asserted evidences of respectability is that “we ain’t been in no trouble yet.” It is sufficiently difficult to avoid, in the community setting, to make avoidance a virtue.
Woofter reports an interesting situation among St. Helena Negroes, who live relatively isolated but very largely under their own social controls. There is similar attitude toward the “law,” which they refer to as “the unjust law,” in contradistinction to their own extra-legal machinery centered largely in the church. The local magistrates, recognizing this, encourage settlements through their own agencies. Cases of violence are thus very often avoided. A consequence is that there is very little crime and extremely few civil suits. Out of a population of about five thousand there were only about thirty-five cases annually brought before the local magistrate and most of these were cases of nonresidents.
Except on the basis of a general health examination it would be impossible to estimate the extent of sickness from various diseases. Complaints are generalized into merely “feelin’ kinda poorly” or “I ain’t no good,” and generalized complaints call for the generalized measures of patent medicines, or home herb remedies. “Black Draught,” “666,” salts, and castor oil make up a large part of the treatment of disease. Other standard remedies are “White Wonder Salve,” calomel, and quinine.
Unless there is some folk pattern of treatment, death may result from sickness which in all probability could be avoided or intelligently treated. As one illiterate mother stated: “I had one child to die when it was just three days old, but I ain’t never knowed what the trouble was. It just cried an’ cried for three days and nights and then died.”
Children die in great numbers and mothers accept their death with a dull and uninquiring fatalism. Some of the expressions back of the infant mortality rates are thus most casual and uninformed: The mother of eleven children sighed when she recalled “I don’ had lots of chillun to die. I don’t know what ailed them.” Another, referring to her stillbirths, said, “I birthed eleven chillun. I got two living, six was born dead, and three lived a little while. That boy that died when he was three days old bled to death at the navel.”
All that another mother knew about her infant’s death was that “he just keep on spitting up blood and then died.” “The granny” explained that “strainers” [meaning constipation] killed one infant, and eating too much dirt while carrying twins killed both of them for another of her patients. Then came this accident, which left a heavy memory for the mother:
I was washing and my little baby asked for some water. I said, “Wait, honey; mammy busy,” and I plumb forgot him till he scream. He done drunk my lye. He die so pitiful and hard I wisht I’da stop and give him a drink.
By some good fortune there are those who survive serious attacks without the aid of physicians. A man and his wife, aged fifty-three and forty-six respectively, live alone and pay $65 for rent of their farm. One daughter of the husband died of tuberculosis. The husband said:
Don’t ask me if we’ve been sick; that’s all we bees. Last year I paid nigh over one hundred dollars for my sickness alone, and then my old lady there she’s all time sick. Got so once we thought we was losing her for fair. All one side was paralyzed. She didn’t speak for twenty-four hours. All the church folks come. Some give money, some give food, and she just lay there and hold ’em. Didn’t know who gie’d ’em. She don’t know yet. Well, I got busy. God and myself worked, rubbed, and twisted her till she finally come ’round. I tell you I believe in the Lord. He just didn’t mean for me to lose her. . . . I has all kinds of trouble with my stomach. That’s why I’m sick.
The following is an account of one woman’s “miseries” as she described them. She had been sick for three years.
I was in the field plowing one day and I felt something jerkin’ my head around. Then I tried to spit and I couldn’t. I said to my sister, “Can yo spit?” And she did, but I couldn’t. I been sick and not able to work for three years. I has miseries in my stomach.
Indigestion (“indijestus”) is a frequent complaint among the families, and this is a description of it:
My boy’s out there is sick. He got indijestus. It jest takes him that way every time he gets a little cold in him. He’ll start coughing and it hurts him all in there [lungs and chest], and you kin hear him trying to git his breath and he just has that indijestus with it every time.
My girl is sick too. The boy ain’t sick as the girl. He only gits that way when he takes cold, but she dat way all the time.
This mother had thirteen children, and most of them had had trouble with “indijestus.” The family gave evidence of being wracked with tuberculosis without the least suspicion of the lethal character of the ailment. Each successive death was an accidentally ill effect of “indijestus.” Other descriptions of ailments suggest serious maladies, but in the absence of both diagnosing physicians or adequate treatment of these disorders they usually take this fatal issue, and perhaps affect others through contagion.
My husband he got sores all over him and I ain’t got but one sore.
This child takes fits after his daddy. He ain’ long stopped having them.
All my chillen is fond of having fevers.
They tell me its “two bumps” [tuberculosis]; anyhow he keep a terrible misery in his throat so he can’t swallow water.
Two of my chillen die with “yellow thrash.” I gived them thread salve made from yellow berries but they die right on.
I been sick a year going on two months. I ain’t nobody, honey. See all these here sores on my legs [pointing to open sores as large as one’s hand], water runs out of my legs there like that all the time. I can’t lay down. I have to set up all the time. I can’t lay down. If I lay down this here water you see running out will overflow my heart. I ain’t nobody to be depended on. Liable to be dead tomorrow. I jest set here all day and fan flies. All this begin when I was four years old; now I’m at changing life. Sometimes I’m so hot look like I’m gonna run out of my skin, but in the evenings I get jest as cold as ice.
My wife here she out of her mind; jest come and go you know. She been sick so long.
My boy there [aged eleven] he had tumors—you know, a risin’ come out on his head. In three weeks them doctors got sixty dollars but they saved him. For myself you see I ain’t got no teeth. I tooks a dose of calomoy and ’fore I know it my teeth all start dropping out. I has the ear run, too, but that ain’t so bad. Now my wife she died ’cause she had some tumors in her stomach. Them folks at the hospital [in Montgomery] just killed her. How I knows ’cause one of them nurses is my friend and she tole me herself they jest feeled around and couldn’t find the tumor so they jest out and out and cut the wrong vescicule.
I been sick about four years. I have shortness of breath and fulness of the chest.
I got plenty chillen dead. One eleven months old died with fever; one the thrase run over him and one girl sixteen died in 1915. She got wet the wrong time. Doctor claim she had pellagacy. She said she could hear something inside her head, and she break out with great big old red bumps. Then they went in an’ where they left was just as black. She didn’t live no time. She was sick four weeks to the day she died.
I been so sick with my back and running bladder.
My daughter died with the fever. I don’t know ’zackly what kind of fever it was. Dr. ———say it was swamp fever, but Dr. ———say it was malaria. My son die with heart trouble. That what Dr. ———say, but Dr. ———say it was bad blood. Dr. ———’s father was my husband’s father’s master. That’s wha’ he gets the same name.
That child there has spells since she was a little baby. Jest one right after another from eight to four o’clock every day for two years. I dosed her with calomel and I sent to Montgomery and got some worm powder and got nineteen worms from her in one day. But she can’t learn nothing in school now. She jest sets with her mouth open and her tongue doubled back most of the time.
The heavy fall of death prompts to reliance upon both herbs and something akin to magic, in the attempt to bring about cures. The little granddaughter of one of the older women became ill.
I done all I could. Then one of them nurses in Tuskegee says to me I weren’t doing the right thing by the child. Honey, I sho’ was hurted so much ’cause I done everything for the little motherless thing. So I got me a bottle of castoria and fed it to her but hit didn’t help her none. By and by I was told to wash her in dish water, so I done that every night for a long time. Then when I fear’d it warn’t no use, my dead friend she come to me in a dream. She and me was dear friends together. She stood right there at the bed like real and she washed up a big sheet till hit was pure white. She ain’t never spoke till she got done. Then she hung it up and spoke for the first time. She said, “Dat child ain’t gonna die; she gwine live and grow up from there restrenkened.” I got some more castoria and worked on the baby and here she am—well and healthy. It sho’ was a miraculous sent from God.
Whooping cough is treated by tying a leather string around the child’s neck. A necklace of cork and moles’ feet is used to make teething easy. “White Wonder Salve” softens up old injuries; “Thread Salve” cures “yellow thrash.” A woman said: “Papa died with pneumonia. He wouldn’t use nothing but rubbing medicine, and wouldn’t never call no doctor.” Another woman, with enormous sores of long standing on her arm and breast, was trying to nurse her baby. “Dese boils hurt so bad,” she complained. “Dey’s sore from de kernel. I been so sick I could hardly stand up.” She put sulphur and vaseline on these sores. There was, however, a sense of the possibility of contagion. She talked of weaning the baby “so de boils won’t turn on it.” Still another woman kept a string around the children’s necks to keep off disease. Pomegranate hull tea and broom-straw root tea are used for “back weakness.” Peach-tree leaves and elephant tongue are good for fever. The woman who gave this formula said “doctor ain’t no good when it comes to fevers.” Boiled fireweed and lard make an excellent salve for burns. Sheep-nanny tea, kerosene, and sugar may be used for whooping cough, or red onions alone. If swollen feet are sweated first in pine top and mullen, then in cedar water, they will give no more trouble. Pepper and salt will cure spasms.
Rural calls are expensive and time consuming to make, whether the physicians take into account the ability of patients to pay or not. During the past year 258 of the 612 Negro families used the professional services of physicians, 322 did not use them, and in 32 cases the information could not be secured.
The expenditures for health as nearly as they could be estimated were as shown in Table 1.
The fee for an office consultation is $2.50 and $3.00. Fees for rural calls appear to vary according to distance and accessibility, sometimes amounting to $12. A curious practice of using proxies in the diagnosis of disease is noted in the following case:
I fell mighty low sick. I don’t know exactly what the trouble. Think the doctor says it was an abscess on my bladder and it busted. The doctor didn’t come to see me ’cause he was busy wid a label case, but he sent Mr. ———over to see me and he took down my complaint and written up my case. No, Mr. ———ain’t no doctor but he writes up my case and takes it back to Dr. ———and he sent me some medicine.
All of the physicians serving the Negroes of this part of the country are white, save one who lives in the town of Greenwood. Some of the physicians are also landowners. One doctor, in particular, seems to be greatly liked and admired by the Negroes. He extends them credit, does not exact exorbitant fees, and is sympathetic with their complaints. A few of the plantation-owners will send doctors to their good workers when they are ill, or guarantee the payment of their bills. This is sufficient security since the doctor’s bill can be taken out of the crop. For the most part, however, the doctors insist upon some security for the debt before calling. Ownership of a cow, or mule, or other property will suffice, and these are taken in if the bills are not paid within a reasonable time. Some of the objection to doctors was based upon their insistence upon prompt payment in cash.
TABLE 1. Health Expenditures
None |
248 |
Amount unknown |
115 |
Under $5 |
112 |
$5–$9 |
45 |
$10–14 |
33 |
$15–19 |
17 |
$20–24 |
13 |
$25–29 |
5 |
$30–34 |
1 |
$35–39 |
0 |
$40–44 |
5 |
$45–49 |
1 |
$50 and over |
17 |
Total |
612 |
They just gets all our money when we is sick. A poor nigger has a hard time. You phones them and they say, “Is you got the money?” If you ain’t, you need not ’spect them. You gotta have that money right on the table or you just lies here and dies.
Adjustments are made around the necessity for doctors. One woman, in speaking of her husband, said:
When I get sick, he don’t take me to no doctor. He’ll buy medicine and bring it to me. He’ll go to the doctor hisself, but he won’t take me. Last time I was sick I had stomach trouble and he kept getting me medicine and I got worse, so he got a midwife and she said my womb had fallen. She fixed it up and I got all right. He had been giving me “666” and castor oil.
As serious as any other factor, however, in the attitude toward and frequently fatal result of disease is the air of resignation toward sickness when it comes. It explains to some extent the frequent lack of faith in doctors and the diffidence about certain public health measures.
Old man B—— took dropsy. His legs bust open and his feet bust open. He had money enough to buy fifty-cent socks, but he ruint so many they had to put tencent socks on him. They take him to springs but it didn’t do no good. When God get hold of you, you can go to any kind of springs but it won’t help you none.
An old man and his wife, both devoutly religious, sat waiting for death. Said the husband:
The Marster [God] give me notice about six months ago for me to wind up my portion of this world’s goods and to go in secret prayer. I was in the room and he come in too and just look like I could shake hands with him. I don’t feel sick but I’m painful.
Said the wife:
The Lord come to me about three or four weeks ago. I was in bed and I look up and saw him just like I’m seeing you, and he was in a book. I got up and put on my burial clothes and he was waiting for me. I called my son to come in there and look at him but couldn’t nobody see him but me. I kept waiting all day dressed for I thought he done come to take me. I’m prepared to die when he do come to get me. I ain’t dead yet and I thought good God done come after me long time ago.
The rôle of the midwife and her method can be best understood in the account of one of the best-known “grannies” of the county:
How Training Was Acquired
These old people ’round here learned me how to deliver babies. Long before I ever thought ’bout it we was at Mr. ———’s sister’s house and she got confined and they sent for the granny and she didn’t come. I didn’t know and mammy didn’t know what to do. So I measured the baby’s navel and cut it off and I cut it off too much and that baby died, but the doctor didn’t do nothing about it but he said that old granny ought to be stopped for not coming to see about her and I couldn’t help it ’cause I was doing the best I could. Then after that, when I was living down on the hill a girl got confined and her brothers got on the horses and started for the granny and ’fore she could get there the baby begin to come on and I told her I wan’t gonna let it drap, to let it come on that I wan’t gonna let it hit the floor. I put the girl to bed good as I could, and I didn’t put a cloth to her but I seed after the baby.
Treatment of the Mother
You know you don’t put a cloth to a woman till after three days; it is best to let it drain for that long. It will kill her if you bound her up before that time. I don’t like to have a crowd around when I am bringing a baby; somebody might go out and say one thing and some will go out and say another. Some of them will go out and talk about how the woman carried on and I just don’t like to have them around. You turn the baby on the right side so as to give the blood chance to go all through his body. Then you turn the mother on her right side and let her lay on her right side for ’bout a hour.
A Knife To Cut the Pain
I usually put a sharp knife under the pillow; they say that cuts the pain, but I don’t know whether it do or not. Some people say they can tell how many children you gonna have by the number of rings on the cord, but I don’t believe that’s so ’cause the old granny told me I was gonna have ’bout ten chillen and I ain’t never had but one. After that I said I was done with that saying.
Mighty few of the chillen glad to see you come, for they ’fraid they will have to give you a little bread. Now when I lived in Birmingham all the little chillen used to see me coming and holler, “Yon come my mammy,” and they all say, “Don’t you stay down there and suffer for nothing to eat.”
Cutting the Cord with Scissors
I always cut the cord with scissors and when I get through I just slip them under the pillow. They tells us you ought to get hold of what you charge before you hit a lick of work. These folks don’t want to pay you for nothing. I heard that Mrs. F—— was telling all the women to use G——. G—— is a right nice seamstress and I reckon she do sewing for Mrs. F—— and Mrs. F—— tell the women to use her, but I reckon the Lord will straighten things out. I loses more than I make trying to get my money.
Causes of Deformity
Plenty women’s chillen is deformed ’cause its the way they do in carrying them and they always trying to lay it on the fever, ’cause fever don’t cause you to be deformed ’cause I try to hold the jints together so close so that they won’t be deformed. I had a brother who was deformed; he was marked by a turtle. My mamma was plowing one day and plowed up a turtle and she stuck a plow in the back of his head. He sets his feet out like a turtle and walks and slides them back like one. I got one of his shoes in here now and it don’t look like it was ever straight. I was a plow hand when my first child was born and I plowed up to the time and it didn’t hurt it none; its just all right if you don’t let the plow kick you. That woman over yonder plows all the time and it don’t hurt her, and that other woman said she went over to her mama’s and picked a bag of peas and carried them home and that’s what caused her to have him deformed.
Dirt-Dauber Tea for Labor Pains
Some folks say if you pick the dirt out of dirt-dauber holes and make tea out of it, it will cut the pains, but I don’t know whether that will do any good or not. I sometimes give them a little weak camphor to force the pains and that is mighty weak too. Sometimes when folks eat dirt and when the baby comes its a whole lot of dirt on his back where they have been eating too much. I don’t believe in using so many of these old things ’cause I believe some of them is pizen.
White-Flannel Weed for “Whites”
There is a weed grows out there called “white flannel” that is mighty good for whites [leucorrhea]. A woman asked me once, “Ain’t you a doctor woman?” And I told her yes, and she told me her daughter don’t never have no health and said she can’t hardly get over the floor, and I told her to go get her some white flannel and make her a tea off it; and she wanted to know if a yard would be enough to get and I told her it wasn’t no cloth but a weed. So I went up on the hill and found her some and give it to her. That woman got all right. Her husband had to stop work every week one day and stay home with her and help her scrub, but after she started taking the white-flannel tea she got all right. That white flannel sho’ is good.
How To Reduce Water
Another thing, some women when they has babies they drink so much water that their stomach’s get large and poke way out and get pot-gutted; well, if you fix up some corn bread with a heap of salt in it and put it on the fire and let it burn right black and then split it open and put it in a bucket and let her drink off that, her stomach will come down jest as nice.
Hot Ginger Tea for Retarded Menstruation
Heap of them come to me for female trouble but I tell them to go on to the doctor ’cause I’m ’fraid to fool with so many things. When the flowers is clogged I give them hot ginger tea.
Bad Blood and Corn Bread
When I went to the clinic they said my blood was good, but I told the doctor my blood might be good but there was something the matter with my body ’cause I can’t eat corn bread no more. I used to eat corn bread all the time and I believe I eat too much ’cause one day something come and said to me just like somebody talking, “That corn bread is killing you.” It done that twice and I quit eating it ’cause I didn’t want it to kill me, and I told the doctor about it and told him to give me some medicine for it.
The county has been attempting to give some instruction to the Negro midwives, recognizing that most of the deliveries are made by them. The health officer has corralled sixty-seven of these midwives and has been talking to them about cleanliness and essential though elementary hygiene for mother and child, and about the necessity of records, although most of the midwives are illiterate. From the record of the health officer’s work it appears that each midwife had been talked to once in individual conference.
In the entire 612 families interviewed there was not a single expression which seemed to connect syphilis with the sexual act. The fact of “bad blood” carried little social stigma and was spoken of in about the same manner as one speaks of having a “bad heart” or “bad teeth.” The violent expressions of jealousy, manifested toward women suspected of transferring affections to other men, reflected no relation to transmitted infection. In one instance only was “bad blood” associated with heredity. “I knowed I had bad blood ’cause my mamma had scrofula when I was born.” In but few instances was “bad blood” associated with syphilis as a venereal disease. Where there were obvious physical manifestations of the disease the persons were referred to as being afflicted, but this was generalized. Often no distinction was made between complaints and the symptoms of “bad blood.” Accordingly, treatments for bad blood were expected to cure headaches, indigestion, pellagra, sterility, sores of various sorts, and general run-down condition.
The Rosenwald Fund experiment in mass control of syphilis was probably more successful in bringing a large number of persons to have blood tests made than any similar venture. The reasons for this lie in the character and habits of the population. There was a lack of social embarrassment in being examined and treated for syphilis. The directors of the experiment succeeding in giving a medical rather than a social stress to the connotation of “bad blood.”
My blood was drawed twice but they never sent me no invitation about it. I bet my blood ain’t good ’cause I hear everybody say they blood is bad. I think mine ought to be bad too. I just went down there one day and said I wanted shots and they shot me.
The tradition of dependence and obedience to the orders of authority, whether these were mandatory or not, helps to explain the questionless response to the invitation to examination and treatment. In the conduct of the demonstration, however, the greatest kindliness was shown the patients, and the invitations were in no sense supported by force, either direct or implied.
The extent of sickness among the Negro families and the hope of relief without cost were means of drawing and holding them. “Me and my wife went over to the schoolhouse and they drawed our blood and say it was good, but I can’t understand why we are always so painful.” The familiarity of some of the Negro families with the method of giving “shots” by physicians for which comparatively large sums were paid had given them a “set” for the demonstration. Free “shots” were taken as a boon. The fitting of “salves” and red medicine of the old clinic into old habits of getting relief gave confidence. Some of the persons attempted to get the salves for general complaints, even though their blood was reported “good.” “They said my blood was good. You don’t get no treatment if your blood is good, but sometimes I wish it was bad ’cause they gives away a salve up there and I wanted some of it so bad.” The “shots” were indeed expected to cure all complaints.
They drawed my blood twice last year but I never did get no hearing from it. Look like mine ought to be bad ’cause I was bothered with pellagacy sometime ago.
I goes down to the clinic last Wednesday for the doctor to give me a shot but he didn’t give me none. I had a roaring in my head for four or five years.
Good effects observed prompted many to continue treatment and others to seek examination and treatment.
I never knowed women to have babies like they do this year. Them shots is making them have babies. I knowed women who been married a long time and this year they are all poking out. There is K—— W——; she about thirty-odd years old and been all about different places too and she been taking them shots and now she is ’way out yonder. You reckon them shots make you have babies? I sho’ don’t want no more and if they do I rather have bad blood.
Just think of Sister S—— up there. Her husband was as raw as a piece of meat the first of this year, but he done got better since he been taking these shots.
The medicine I took helped me 50 per cent. I had a terrible misery in my throat. I was sorry for the time to come to drink water, it hurt me so bad. I have taken twenty shots and it certainly has helped me.
The cost of doctors has helped attendance at the clinics:
I tell you dem doctors done de people a whole lot of good ’cause heap of people wan’t able to pay a doctor. They have done this country good ’cause heaps of dem was in a bad fix. The doctors done git tight on de people since dese clinics been through here. They won’t come to see you less you got the money or will pay something. See these folks is knocking them. They charge seven, eight, nine, and ten dollars ’cording how far they have to come.
Finally there was the attitude of appreciation for the gesture of helpfulness which the demonstration represented, and a response on that basis. Many of the families are enthusiastic in their praise of the work being done by the clinic. The wife in a family consisting of mother and father and ten children said:
Them shots really hoped me. ’Til last May I ain’t layed down a night the whole night and slept without getting up and staying wake in twenty years. I can lay down and go to sleep with the chickens and never wake up. When I got so I could rest, I got scared. I used to get up and no feel like working, but now I can get up and feel good. . . . This baby [a little girl five years old] has taken twenty and she don’t cry none hardly. That little boy [aged seven] was born sick, and he has taken all his shots and he is so much better. He used to get off and hide and never did run and play like the rest of the children. We would have to hunt for him all the time. I was jest expecting to find him dead any time ’cause he would go ’way off somewhere and hide all the time. Now he runs round jest like the rest of them. [The mother and father and eight of the ten children gave positive Wassermanns.]
The figures for mortality, morbidity, illegitimacy, illiteracy, poverty, insufficiency of food and clothing, are barren records for an understanding of the human struggle behind them. They all come to a focus in the story of Mary Hardy, a very sad and very bewildered woman, whose career follows the pattern of life around her, because she could not understand how or why her children continued to die from some strange, persistent malady. She was not married but had wanted the security of a husband and a family.
The first man I liked real well give me a baby. My grandmother made me lave home, and I went and lived with another woman till the baby came, then grandma let me come back home, but he stole me again one night. I had to wait till my grandmother was sleep, so it was about nine o’clock and I slipped out of the window and he was down in the woods waiting for me. I went with him to his people and I stayed with his sister. I never did stay with him, but my grandmother would not let me come back home after I’d done run away and he kept putting me off. He promised to marry me the next morning. I never would a run off with him if he hadn’t promised to marry me, but kept putting me off and I wanted to go back to grandma, but she told me not to come back there less she tell me so, so I just had to stay. I stayed there with his sister three years and got these other two chillen. His mother kept the oldest boy and raised him.
When my third baby was coming, his father jumped up and married another girl. She was in a family way and I wondered why he married her ’cause she was in a family way and he didn’t marry me when I was in a family way too.
This girl was a school teacher and he married her one month before she got down. Then when he started coming back ’round, I told him, “I ain’t going to fool with you no more; you done fooled me enough. I got real mad. I got mad about him, so I told him to stay away ’cause I felt bad about it . . . and I was ’specting to marry him.
He left here and went to Montgomery. Then he sent me money to come to him but I was so hungry that I took the money and bought us something t’eat. I guess I’d a went if we hadn’t been so hungry. After he married, he would give me rice and things for the chillen every time he saw me in town. He just seemed to be in love with the chillen. They say now that he is living with another woman. His wife died when she was getting down the second time. He had left and went to Montgomery to work but they wasn’t separated. It was after she died that he sent for me to come to him.
Now my youngest boy is sickly and got bumps breaking out on his face—you know, fever blisters, but big ones, and when they burst they leave a sore. The sore leaves a black place when it dries up. I took him to the doctor once and he said he charge $2.50. I didn’t have but $2.00, so he said he would charge me that. Then we had to send for him once and I ain’t never paid him for that. He usually charge $12.50 to come out here.
Just when I thought I got my chillen well, my oldest boy die. He just rotted to death. This is how he got sick. He started with a headache. He said his head nearly bust open and Br’er [brother] got some salts and give him and he didn’t complain no more for about two weeks; then he went to school one morning and the next morning they didn’t have no school and he got up and it started with a hurting right here [just inside the elbow bend]. He said it was itching first, then hurting, and he just started running ’round having fits. He just went crazy. We rubbed and greased his arms and we rubbed him good, but he just went crazy and tore up the things in the house. The doctor give him some medicine when we took him to him and he said it was pellagacy but I ain’t seed where it done him a bit of good. He told one man down here that it was the curriest pellagacy he ever seed in his life, and he told somebody up there that he didn’t know what it was; but he told me it was pellagacy. Well, that boy would run away and I’d hear him calling way up on the hill. He just come unjointed. It all just rotted off—all his hands and arms. He bit one of his fingers off and he never was in his right mind after he first went crazy. He would take the bed down and when you ask him what he was doing it for, he’s say he wanted to put it up on a hill. He swold up and just come in two. He died in two weeks.
When I got sick I went to Dr. ——— and he told me I needed shots but that he couldn’t give them to me ’cause I wasn’t able to pay. He asked me if I had any property and I told him no. He said he just couldn’t give ’em to me then. He said, “If you just had a cow to put up against it!”
The experimental health demonstration set up by the Rosenwald Fund in a portion of the county in 1930 has made certain social discoveries vital to other than the venereal problem. The adequate treatment of specific luetic conditions demanded preliminary general physical examinations and these laid bare an extravagant incidence of other disabilities. Some 7,500 blood examinations and 3,200 urine analyses were made on those under treatment, and a total of 2,042 prescriptions dispensed during the first year. Apart from this, however, 3,500 typhoid inoculations were given, and 600 children immunized against diphtheria, and 200 vaccinated against smallpox. This altogether, with the Red Cross distribution of seeds for gardens and yeast to be used in combating pellagra, constituted one of the most intense concentrations upon a reconstructive health campaign of any rural section in the South.
It was evident, however, that that dependent relationship of the Negro tenants to white landowners called for education of the landowner as well as the tenant. And although this has not yet become common in either direction, there are indications that some of the white planters are recognizing time off for health as profitable in the end. One of them commented thus to an official of the demonstration: “The year before this demonstration was put on I paid out over fifteen hundred dollars to doctors for medical service. This year I have had a doctor on the place only twice and those were for new babies. The men work better.”
The startling inbreeding of disease among the Negroes, the violent eruption of nutritional disorders, and the rapid contagion of infectious diseases are intricately bound up with their isolation, their low literacy, and their cultural backwardness. They have little or no knowledge of the diseases responsible for their excessive deaths, and little access to physicians when the seriousness of ailments exceeds their simple folk remedies. With these, however, goes a life-organization which permits neither the full responsibility of the planter for their troubles nor the free development among and for themselves of controls over their most common disabilities. The situation has fostered a striking disorganization.
As in other respects, the most far-reaching changes in habits are proceeding at most rapid pace in the work done with and through the children. This suggests that along with the programs of adult education, social work, and compulsory health regulations, the elementary schools demand foremost attention if these changes are to be given permanence and significance.