Weaver reconstructs a medical world in eighteenth-century Saint Domingue staffed largely by enslaved practitioners: herbalists, kaperlatas, hospitalières, infirmières, and accoucheuses. Out of Western, African, and Caribbean remedies they assembled a form of medicine particular to the island, and they treated both enslaved patients and the colony's white residents.

Trust ran along predictable lines. Enslaved people preferred the methods of the popular healers, herbalists and kaperlatas above all, whose care felt familiar to them. Poorer whites who could not pay for orthodox medicine, or wanted no part of it, consulted kaperlatas as well.

Others found the arrangement profitable. Plantation managers put the medical labor of enslaved women to work in ways that enriched the planters employing them and enriched the managers themselves. Licensed practitioners, for their part, drew on what enslaved herbalists knew about remedies, and in dealing with enslaved midwives sought to pull them further under the supervision of European medical men.