Indigenous Americans — The Journal’s Historical “Indian Problem” [The New England Journal of Medicine]

Indigenous Americans — The Journal’s Historical “Indian Problem”

By David S. Jones, M.D., Ph.D., Moustafa Abdalla, M.D., D.Phil., and Joseph P. Gone, Ph.D.
January 4, 2024
 
By the time the Journal was launched in 1812, Boston had witnessed two centuries of destructive confrontations between Europeans and Indigenous Americans. Although some Indigenous communities persisted in New England, most conspicuously in whaling, few Indigenous people would have been visible on Boston’s streets. But away from the Atlantic coast, North America remained an Indigenous continent.1,2 Over the ensuing years, the Journal published thousands of articles that mentioned Indigenous people, but far fewer that focused on them.
 
The Journal, like American society more broadly, had an “Indian problem.” Racism against Indigenous Americans and settler-colonial strategies shaped centuries of dispossession, war, subjugation, and impoverishment; these attitudes persist today.3 The Journal’s authors theorized about the merits of savagery and civilization, decried Indigenous medicines, speculated about susceptibility to epidemics, or prophesized Indigenous extinction. The disdain was often gratuitous. An 1895 article about syphilis slandered Indigenous women who had been sent to assimilationist industrial schools: “A prevalent opinion, especially among philanthropists, is that the Indian s— is a model of chastity. God spare the model! Even some of the girls who have been to the schools on the Atlantic coast are common property for white men. What their habits with the bucks are is not known, but many white devils contract venereal diseases from the ‘blankets.’”4 A 1913 essay by Ernest Codman about appendicitis included a striking caption: “There is no good Indian but a dead Indian and there is no safe appendix but a completely obliterated one.”5 This adage, a relic of frontier wars, endured for decades.6 Equally striking are the erasures: decades could pass without the Journal seriously engaging with problems of Indigenous health.
 
Although it’s simple enough to mine the Journal’s archive for slanderous commentaries, the challenge is to strike a balance among documenting what authors said, conveying empathy and outrage, and suggesting productive interpretation. The Journal’s historical commentaries about Indigenous Americans reveal more about authors’ and editors’ values and priorities than about Indigenous communities themselves. Such racist discourse reflected, perpetuated, and legitimated settler-colonists’ faith in the righteousness of their mission. It’s essential that readers understand these dynamics if they are to recognize and repudiate similar processes at work today.
 
There is no simple way to characterize the Journal’s representations of Indigenous Americans. Searches for “Indigenous,” “Native American,” or “Indian” yield thousands of articles, many of which are not actually about Indigenous Americans. It’s also important to search for terms that, regrettably, were once in common use, such as “savage.” To generate an overview, we collected a subset of articles that focused on Indigenous Americans and used it to train a machine-learning classifier that identified 212 relevant articles. The rate of publication steadily increased, from 0 to 2 articles per year in the mid-19th century to 0 to 12 articles per year by the late 20th century. We divided those articles into 25-year groups and generated a word cloud for each period, which revealed major themes and associations (see figure). The analyses that follow are drawn from articles we identified using many strategies.
 
Curiosity and Respect in a Time of Appropriation
 
Even as Europeans pushed west across America, commandeering lands and displacing Indigenous communities, they remained curious about what they could learn. They hoped, for instance, to learn local remedies from Native populations.7 In 1817, the Journal published six articles about the medicinal powers of the Saratoga springs, recommended by Indigenous communities.8 An 1831 account praised garden sage, “one of the most celebrated Indian remedies” for cancer and ulcers.9 Such praise was often qualified: physicians argued that though Native healers had great powers of observation, they had no understanding of disease or therapeutic mechanism.10
 
Settlers did respect aspects of Indigenous life. Many accounts in the early 19th century contrasted the hardiness and fortitude of “savage life” with “the evils of civilized life.”11 Indigenous Americans were capable of feats that would kill White people: “the savage, in northern climates, is said to plunge with impunity, at every season of the year, into the coldest stream, yet the health, if not the life of an individual, reared amid the luxuries and refinements of civilized society, would be endangered, were he to attempt a similar course.”12 Such accounts cast civilized life in stark relief. An Illinois physician warned in 1839 about its perils: “The rude Indian of the forest breathes the balmy air of his native abode, partakes of his simple repast, and rarely lays the sickened head to rest. Not so with the man whom education and refinement have placed in the high circles of life.” When “artful man” interferes with nature, “he suffers the penalty of sickness.”
 
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