On the eve of the Revolution, the Carolina lowcountry was the wealthiest and unhealthiest region in British North America. Slavery, Disease, and Suffering in the Southern Lowcountry argues that the two were intimately connected: both resulted largely from the dominance of rice cultivation on plantations using imported African slave labor. This development began in the coastal lands near Charleston, South Carolina, around the end of the seventeenth century. Rice plantations spread north to the Cape Fear region of North Carolina and south to Georgia and northeast Florida in the late colonial period. The book examines perceptions and realities of the lowcountry disease environment; how the lowcountry became notorious for its 'tropical' fevers, notably malaria and yellow fever; how people combated, avoided or perversely denied the suffering they caused; and how diseases and human responses to them influenced not only the lowcountry and the South, but the United States, even helping to secure American independence.

Co-winner of the 2012 SHEAR Book Prize

'A compelling and meticulously researched account … McCandless has made exceptional use of a wide variety of primary materials, including letters, personal papers, diaries, official documents, parish records, pamphlets, and newspapers, to reconstruct the impact of tropical diseases in the lowcountry … This is a valuable and provocative study and will appeal to those interested in southern history as well as the history of medicine.'

Shauna Devine Source: Journal of the History of Medicine and Allied Sciences

'… until now, few authors have been able to intertwine the economic, medical, and environmental threads so successfully. One recent exception who managed to set the bar high is William Dusinberre, author of … Them Dark Days: Slavery in the American Rice Swamps … McCandless has cleared that same bar with apparent ease. We can only hope that their impressive works inspire more such compelling interdisciplinary studies, for the Lowcountry and beyond.'

Peter H. Wood Source: Southern Spaces

'McCandless nicely balances attention to rural plantations and their urban entrepôt, demonstrating how the spector of yellow fever and other afflictions strained and recast Charlestonians' lifestyles, customs, and commercial aspirations.'

Michael D. Thompson Source: The South Carolina Historical Magazine