This introductory chapter surveys the sources of our knowledge of population in the West Indies; die physical, social, and disease environments of the region; and interactions with other disease environments. Accordingly, we investigate the rise of the South Atlantic System with special reference to the spread of infectious disease through the movement of people and their microorganisms, the expansion of slave-grown sugar and other agricultural staples, the killer diseases of malaria and yellow fever, and the findings of the Army Medical Board's Report. Later sections of the chapter focus on medical writings that sought to advance rational conceptual schemes of disease causation, prevention, control, or eradication. Major emphasis is placed on the nature and incidence of slave diseases and injuries.