Scholars in recent years have been exploring medicine and health in the Civil War era from different perspectives. Books and articles [End Page 463] published in 2012 have focused on topics ranging from how and why many African Americans did not live long enough to celebrate the jubilee of freedom to how doctors thought about illness, gender, and race. Gretchen Long shows that much more can be said on the topic. Doctoring Freedom is not so much about African American suffering through war and its aftermath or the response of institutions and professionals to the health crisis brought about by war as it is about the struggle by African Americans for health security (their own, as well as for families and communities). Long introduces readers to a large cast of characters who approach the struggle in different ways and with different results. Because of Long's multifaceted approach to understanding what happened, this is a must-read for historians of the Civil War era, the history of medicine, African American history, and the history of the South, no matter how many other books the reader may have already tackled.
The genius of Long's approach is her ability to employ a wide variety of sources (i.e., medical and agricultural journals, private journals and correspondence, oral histories of former slaves, and military and government records) to understand the goals and experiences of diverse people who addressed the problem of securing the health of African Americans. Black southern doctors coexist in this story with the men and women who joined northern self-help groups. African American soldiers make their appearance, as well as contrabands (slaves who entered Union-held territory), white military men, government officials, white doctors, hospital administrators, nurses, licensing agents, slaveholders and former slaveholders, even poets, lyricists, and musicians. The various constituencies overlapped. For example, many African American soldiers had once been contrabands or had family members identified as such. Long demonstrates that each social group accepted the idea that the nation needed to address the issue of health during the war and later during the transition to freedom, but they did not all agree on what should be done. In addition, the social, cultural, political, and economic climate put constraints on what was possible. Still, groups with names such as [End Page 464] the Colored Ladies' Freedman's Aid Society did what they could as best they could, even managing at times to build hospitals when no government agency would take responsibility.
The book demonstrates that notions of race were never far from decisions about who received medical care, where hospitals should be built, and who could be licensed to practice medicine. In a particularly evocative chapter (chapter five) on regulating private medical practice, Long shows how three black doctors with very different types of knowledge and practices (a folk healer, an apprenticed-trained doctor, and a university-educated physician) experienced different career trajectories that were all shaped by racist thinking on the part of others. None gave up the struggle for autonomy, and each achieved at least some degree of success.
Doctoring Freedom addresses health care from the time of slavery through the late nineteenth century, which allows the author to explain the changes that occurred as slavery collapsed (and with it the notion that slaveholders should care privately for the labor force) through the devastation of war, reconstruction, and the emergence of Jim Crow laws. The lengthy period allows Long to draw conclusions about continuity as well as change. Throughout, enslaved and freed people associated the acquisition of health care for themselves and their families with freedom and citizenship, and they never wavered in their quest to attain it.
Marie Jenkins Schwartz, PhD, professor of history at the University of Rhode Island, Kingston, is the author of numerous books and articles on the history of slavery, including Birthing a Slave: Motherhood and Medicine in the Antebellum South (2006). She is currently writing a book about...