In writing this book I have investigated facets of slave life that affected their health and well-being, such as culture shock, diet, work loads, punishment, housing, clothing, sanitation, and occupational hazards. I have looked at the demographic experience of the slaves, their birthrates, death rates, sex ratios, longevity, and, above all, their failure to increase their population by natural means. I have looked at the principal diseases of the slaves, contemporary and modern theories of disease causation or etiology, and methods of treatment and their efficacy. I have looked at problems of natality and infant and child care. I have investigated the state of medical science and art in Europe and Africa; the education of doctors, midwives, nurses, and pothecaries; the nature of plantation medical practice; and the quality of health care. Because of its size and economic and political importance, Jamaica has been given central attention in this study; however, other British Sugar Colonies have been investigated to the extent that demographic and medical records permit.

My approach to slave medicine and demography has been influenced by the environmental and ecology movements of recent decades. Ecology is a term used in the biological sciences to describe a total system of interrelated populations of different species; it is the study of the relationship of plants and animals to their environment, of the relationship of plants and animals to one another, and of the influence of humans on the ecosystem.