Racializing Lung Function

(Book cover<a href= via University of Minnesota Press)” width=”308″ height=”461″ />(Book cover via University of Minnesota Press)Do you support courageous reporting and commentary? Click here to make a tax-deductible donation to Truthout and keep independent media strong.

Lundy Braun’s Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics traces the peculiar history of how 19th century research on lung capacity laid the foundation for a “scientific” framing of racial difference in lung – and other – capacities.

Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics, by Lundy Braun, University of Minnesota Press, 304 pages, $24.95.

Lundy Braun’s Breathing Race into the Machine opens with a story about a group of African-American men who became ill with asbestosis, mesothelioma and lung cancer after years of work in Baltimore’s steel and shipyard industries. A 1999 lawsuit against Owens Corning, their former employer, challenged the company’s denial of disability benefits and charged that Corning had been wrong to rely on distinct medical standards to assess the lung functioning of black and white workers.

Braun notes that Owens Corning’s decision to deny the workers’ claims was not simply an act of corporate racism but was grounded in a centuries-old theory about physical differences. That theory, she writes, created a hierarchy of “normal” – with white men at the top and everyone else below. Indeed, at the time of the workers’ lawsuit, Braun explains that “race-specific criteria for impairment were consistent with the guidelines of the American Thoracic Society, one of the most authoritative associations in pulmonary medicine. Had the company’s motion been successful, black workers would have had to demonstrate lower lung function and worse clinical symptoms than white workers before receiving compensation for asbestos-related disease.”Race correction could not be applied in this lawsuit after the judge’s oral ruling in 1999. However, race correction is still common throughout the world in most medical practices. It is programmed into the spirometers.

Throughout Breathing Race into the Machine, Braun analyzes how difference has been twisted to suggest black physical inferiority and promote practices that privilege white skin. That said, the book is dense and overly laden with acronyms, scientific terms and the names of the many researchers who have been involved in monitoring lung function and creating medical machinery. Still, the big picture – how pre-existing ideas about race, gender and class can influence scientific inquiry – makes the text a valuable contribution to medical anthropology and race studies. Furthermore, the book provides readers with an enhanced understanding of social history.

Braun writes that the ranking of lung capacity by race goes back to the mid-19th century. Dr. John Hutchinson (1811-1861), credited with developing the spirometer in the 1840s, saw the instrument as an invaluable tool to measure breathing, then called “vital capacity.” While his interest was in detecting tuberculosis, this was not for treatment purposes; Hutchinson worked for life insurance companies that were eager to minimize payouts.

The spirometer also was used to justify slavery. “By the mid-nineteenth century,” Braun writes, “the use of science to support white supremacy was becoming more systematic.” Southern physician Samuel Cartwright [1793-1863] is a case in point. Cartwright contended that “the expansibility of the lungs is considered less in the Black than the white race of similar size, age and habit.” This, he argued, was proof of physical pathology, which is why he felt African-Americans needed the constant protection of slave masters and overseers.

Studies of Union soldiers of African descent complemented Cartwright’s conclusion, because the brutal conditions on plantations meant that enslaved men typically bore the scars of overwork, poor nutrition, crowded homes and a lifetime of inadequate medical care. Not surprisingly, this made them more susceptible to pneumonia, respiratory illnesses, typhoid fever, yellow fever and tuberculosis than their white peers.

Braun reports that this unequal playing field was given short shrift. Even more troubling, at the end of the Civil War, numerous medical experts predicted that blacks would soon die out as a race because their lung capacity was so limited. This “natural” weakness gave lawmakers a convenient rationale for doing nothing to ameliorate poverty and oppression. After all, if African-Americans were going to die anyway, why bother trying to improve their lives?

Black leaders, of course, took issue with this, blaming the appalling conditions in which most lived – and not a dysfunctional respiratory system – for high mortality rates from consumption and other illnesses. But the barons of industrial capitalism were not swayed and paid little attention to the critique. Instead, as the idea of human perfectibility took hold, the field of eugenics bloomed.

In addition, “in the last quarter of the 19th century, under pressure of the explosive growth of urban centers, the beginning of African American migration from the South, and massive immigration of ‘the darker races’ from southern and eastern Europe, a crisis of Anglo Saxon manhood emerged,” Braun writes. As people debated immigration policy, imperialism and the definition of “white,” she notes that anthropometry – the measurement of the size and proportion of the human body – gave doctors and other professionals a concrete way to intellectualize their prejudice.

British eugenicist Francis Galton (1822-1911), for one, used the spirometer to study nearly 10,000 men and women in the late 1800s and used his findings to contend that men were superior to women. What’s more, he held up white manhood as the exemplar – a model that influenced Adolf Hitler several decades later. “Galton confirmed what he had long believed,” Braun writes. “Superior physique and intellect were tightly correlated. Breathing capacity was a key marker of this group’s superiority.”

Galton further used his findings to separate people into two groups: savages and the civilized. These categories aligned nicely with prevailing ideas about conquest and allowed Galton to justify England’s ongoing colonial wars in Africa, Asia and the West Indies. “Stamped with the imprimatur of science, nineteenth century research on lung capacity in physical education and anthropometry laid the foundation for the scientific framing of racial difference in lung capacity into the twentieth century,” Braun adds.

This was especially evident in the way mill and mine workers were treated. US scientists who ignored the impact of discriminatory Jim Crow policies and assumed comparability between the races were able to “prove” that blacks were less hearty and more prone to hookworm, malnutrition and lung ailments. Yes, it sounds ridiculous today. But at the time, Braun writes, “it made cultural sense.” In fact, when researchers subsequently crafted a “correction factor” for lung function in people assumed to be black, few people bristled or questioned why the model of normal was white and male.

The upshot is that normal for blacks has been set at 13 percent below that of whites, a standard that has had a profound material impact on who is considered disabled.

Braun highlights the experience of South African gold miners to illustrate this. Starting in 1916, she reports, black workers were called “Native labourers” rather than miners. Miners were exclusively white. The difference was more than semantic: Labourers who became ill were able to collect a small, one-time, lump-sum payment, while white miners were awarded a monthly stipend. Until black trade unions were formed in the 1970s, Braun notes, “Black workers were largely excluded from the controversies over disease definitions, staging and disability to which the spirometer contributed.” The assumption that science – in this case using the spirometer as a diagnostic tool – is objective, she adds, helped reinforce ideas about “innate” biological differences, as well as racial rankings in political life.

This conclusion underscores the central point of Breathing Race into the Machine, a point that rings true in many areas of scientific research and has throughout history: “Social conditions influence scientists and how they interpret their findings.”