Manuel Barcia’s work on the illegal slave trade deserves praise for its fresh focus on health and medicine in the nineteenth-century Atlantic world. The title of the book refers to yellow fever, which gets surprisingly little attention in the study. Instead, the book breaks new ground by looking at how slave traders and anti-slave trade patrols sought to combat various diseases on the sea, and how those efforts were extended to reception centres on land. Geographically, the book’s focus lies on West Africa (especially Sierra Leone), Cuba and Brazil, but it also forays extensively to Angola, Mozambique, and Saint Helena. Therefore, it is truly an Atlantic history, the writing of which has required archival work in thirty locations and in several languages, including English, French, Portuguese and Spanish. As such, it is a marvellous achievement.

The book is thematically arranged into an introduction, five chapters and closing remarks. For historians of medicine, chapter one on prophylaxis and prevention presents valuable insights on medical geography and environmentalist thinking in the Atlantic slave-trading zones. It shows the importance of miasma theories for many practitioners in the nineteenth-century Atlantic, and demonstrates the role of bills of health and quarantines as hygienic measures. Chapter two focuses on disease and medical practice as used by slave traders in factories and barracoons, as well as by personnel aboard slave ships. The following chapter then discusses the fight against disease waged by western navies and shows that the medicines used by anti-slave trade patrols were often those confiscated from seized slave ships. In practice, slave vessels also served occasionally as quarantine ships when they were taken to Sierra Leone, Brazil, Cuba, Saint Helena or Angola to face the Mixed Commission or Vice-Admiralty courts.

Chapter four discusses the anti-slave trade reception centres and their attempts to organise health care by constructing hospitals to take care of the sick. It also presents preliminary data on mortality (without engaging with Philip Curtin’s pathbreaking studies on the subject), noting that the topic would deserve a detailed study in its own right. The fifth chapter presents Barcia’s findings on cooperation and knowledge exchange between Europeans and Africans on the African coast, but also beyond it in Brazil and Cuba, engaging with the studies of James Sweet and Pablo Gómez on healing in the Black Atlantic. According to Barcia, the late eighteenth and early nineteenth-century medical practice presented a turning point in the Western incorporation of African medical knowledge and non-western healers, “whose firsthand experiences dealing with diseases and illnesses was finally starting to be appreciated” (emphasis added). While the work can be commended for shining a light on these nineteenth-century material exchanges, it is somewhat problematic, however, to allude to them as a new phenomenon.

Indeed, what I found most troubling with the book’s conclusions are its claims about “a transformation of medical cultures” in the nineteenth-century Atlantic world. According to Barcia, “the illegal character of the slave trade shaped responses to disease” and ushered in “new medical cultures”. However, as Heinrich Loth demonstrated already in the 1980s, and as Benjamin Breen, Carolyn Roberts and others have more recently shown, cross-cultural medical interaction in Atlantic Africa (and Mozambique) was not uncommon in earlier centuries.¹ What Barcia’s work in fact implies are significant continuities in local medical practices in West, West Central and East Africa. Europeans had been participating in these medical exchanges already for three centuries prior to the legal abolition of the Atlantic slave trade. To be fair, it should be noted that knowledge of African medicinal plants was not popularised in early modern Europe to the same extent as Asian and American medicines. Therefore, when nineteenth-century European physicians and surgeons moved to Africa, they had no choice but to learn local medical practices anew without relying on knowledge they could have acquired from travel accounts or medical treatises.

This otherwise fine book is further weakened by its minimal consideration of Africanist historiography on health and medicine. For example, John Rankin’s important study along with Jonathan Roberts’s survey of British and European medicine in Western Africa are both ignored by Barcia.² In his discussion of different types of African healers documented in nineteenth-century sources, the author could also have consulted anthropological studies in order to draw comparisons beyond the nineteenth century and to point out how institutions of healing have evolved in the long run. Barcia’s tight chronological focus on the first half of the nineteenth century, however, now leaves ample room for further studies of health and medicine in the Atlantic world in the longue durée.

The book is richly illustrated with over twenty images. Unfortunately, most of them are used for illustration purposes only, and are hardly discussed by Barcia as visual primary sources, which could be another subject for a further study. The publisher could also have done a much better job with the map images at the beginning of the book. Most geographical locations discussed in the book are omitted from the map, yet they are most likely unfamiliar to many readers.

Despite these drawbacks, this is an important book, to be highly recommended to readers who are trying to imagine and engage with the nineteenth-century world of health and medicine beyond Europe and North America. Barcia has managed to draw attention to locations and historical actors that have mostly escaped previous notice. As such, it raises important novel questions and should serve as an inspiration for several further studies.