Through archival records, contemporary anecdotes, and scientific literature, Thomas Helling, MD, explores the intricacies of health and healthcare for an agrarian population that, by virtue of its location, was inordinately vulnerable to sicknesses and epidemics. With the influx of enslaved Africans, a new set of healthcare issues were introduced. Given the region's peculiar climate, ethnic makeup, and customs, southern doctors adopted an attitude of distinctiveness themselves. As a result, southern medical progress became increasingly isolated from northern colleagues. The destructiveness of the Civil War finally provided the impetus for true integration with northern practices in the rapidly changing science of medicine and surgery. Yet, with the regeneration of a medical elitism in postbellum years, southern doctors clung to nostalgic notions of southern culture and southern medical distinctiveness. In this compelling volume, Helling explains how the predominant mindset of southern particularity guided regional interpretation of illness, therapeutic decisions, and medical education, foreboding a healthcare system embedded, still, with institutional racism.