Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation

TWO: Sickness Rages Fearfully among Them: A Wartime Medical Crisis and Its Implications

44 •chapter two Sickness Rages Fearfully among Them A Wartime Medical Crisis and Its Implications “Shelter, clothing, fuel, physicians bills and expenses of burials have been a very heavy tax on us, for so large a class, so destitute of every thing.” Thus did O. H. Browning, a former U.S. senator from Illinois, assess the situation of the African American people he encountered during the Civil War. His words acknowledge the numbers of needy African Americans during this time. However, the same phrase masks the enormous diversity of situation and circumstance among the Civil War–era African Americans living far from the plantations and farms where they had spent their lives. Some were soldiers in active duty or seeking opportunities to enlist or contract with the Union army. Others, labeled “contraband” because they were no longer considered the property of their Confederate masters, had fled plantations and labored or looked for work in contraband camps.1 Some lived with families; some had left families behind on plantations or in the camps. Many contributed valuable labor to the Union side; others , too old, too young, or too infirm, were in need of care. As their circumstances varied, so did the cultural and political meanings that their illness and wounds took on. This chapter explores how white northerners perceived the medical needs of “contraband” ex-­ slaves— ​ the thousands of African Americans who had escaped their plantations or whose owners had fled during the Civil War. These northerners supported the Union, and many were abolitionists committed to helping African Americans develop into productive citizens. When they tried to organize appropriate medical treatment for ex-­slaves, they brought with them a host of ideas about African Americans’ bodies and potential. The antebellum southern medical establishment had claimed that blacks were medically and physiologically distinct, that they needed as caretakers white superiors or owners who combined a firm hand and understanding of African physiology with benevolent intention. At the same time, abolitionists had dwelled on the cruel physical damage that slavery wrought on black people’s bodies. When white reform- A Wartime Medical Crisis • 45 ers and Union army officers encountered large numbers of ill, wounded, and destitute African Americans, these different narratives tangled together as they tried both to cure these patients and to imagine their role in the nation once they were healthy and free. Uncertain about how African Americans would respond to emancipation, they fretted openly that free medical care might lead to a permanently dependent African American populace— ​ a vision informed as much by cultural imagination as it was by real evidence. They hoped that any medical care that they provided would offer immediate humanitarian relief to suffering ex-­slaves but also make their bodies fit for wage labor and begin to instill the Christian habits of order and cleanliness that would ensure health in the future. Antebellum notions about “African” bodies, both slave and free, shaped their perception of ex-­ slaves’ illness. Most often northerners’ responses were messy and contradictory. Notions of duty and charity, empathy and racial superiority, were all at work as they began the new work of treating African American patients. With the exception of Union army soldiers, some of whose letters appear in the next chapter, the African Americans who had recently left their masters’ farms and plantations did not often leave written accounts of their views and experiences with medical care. Most were illiterate, and life in contraband camps and settlements near Union lines left little opportunity for record keeping. Many African Americans found that they had to stay on the move, fleeing Confederate forces, searching for missing relatives, and trying to keep families intact. Moreover, without clear legal rights, they often had no one to whom they could formally appeal for help when sick or injured. However, reformers working with contrabands sometimes included African Americans’ words directly in diaries or letters, and these utterances can be revealing, even when the writer saw the African American only as a source of amusement. Dramatic differences between the northern reformers’ understandings, customs, and assumptions and those of their patients only recently released from slavery emerged, often resulting in the patients’ resistance to hospital routines. These early conflicts foreshadow some of the anxieties of African Americans about care in hospitals in later decades. Similarly, army officers’ and northern reformers’ preconceptions about African Americans had long-­ lasting consequences, contributing to the limitations that characterized African Americans’ access to health care and medical training in years to come. White...