Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation by Gretchen Long (review)

In what the ways did newly freed slaves navigate the treacherous path between slavery, freedom and citizenship to obtain healthcare and access to the medical profession? Gretchen Long’s insightful new book, Doctoring Freedom, explores this question and contributes to our understanding of the development of American medical history. In that process, Long argues for a linkage between access to bodily health and roles inaugurated by Emancipation, including those of soldier, physician, and citizen. Primarily organized chronologically, her book examines three distinct time periods: the antebellum period, the Civil War, and post-Emancipation. Each chapter offers extensive documentation and draws on a broad range of texts, from medical journals and planters’ diaries to WPA narratives, fundraising appeals, fiction, and poetry. Equally important, her thematic organization repeatedly calls attention to the intense commitment of the newly freed to define their roles as citizens despite a system that continuously misrepresented their capacity for independence. Over the course of the immediate post-Emancipation period, African Americans as both patients and healers used letters, petitions, minutes of meetings, diaries, and so forth, to articulate a place in the emerging healthcare system of the late nineteenth century.

Long situates her argument in the antebellum period by focusing on the texts of slaveholders and abolitionists who engaged in a war of words about the black body; for the former, healthy slaves helped owners capitalize on an economic investment, while for abolitionists the brutalized slave body testified to the horrors of bondage. Both pictured the slave as passive, as these images of dependency lingered in the white imagination long after emancipation. Both drew on the new language of science as well as pseudoscience to buttress their positions. As Long argues, however, slaves were not without agency; they also assigned their own meanings to illness and health, as some argued for traditional magic and herbal remedies, while others aligned themselves with the beginnings of “modern scientific medicine.” African American physicians, such as James McCune Smith, who attended medical school in Glasgow, Scotland, used statistical data to compare black- and white-child mortality, and asserted elsewhere that “the colored race is best suited by nature to endure the climate of New York” (33).

Chapters two and three focus our attention on the Civil War years, tracing the physical and emotional journey of African Americans as they fled their increasingly precarious positions in the South, unsure of how to enact their freedom. The dual antebellum systems, those of masters and those of slave communities, were disrupted by the war, and until the passage of the Militia Act in July 1862, blacks found in army camps were considered contraband—stolen goods with no positive role. With few African American accounts to draw upon, Long renders letters of white physicians and soldiers who find proof of their deepest fears about African Americans as passive dependents. The tone of these missives changes as African Americans assume their role as soldiers; some of the earliest letters are petitions to the government concerning the need for medical care for themselves and their families. Soon a new image—the proud, confident soldier—emerges to counter that of contraband. From the letters housed in the Freedmen and Southern Society Project archives at the University of Maryland, Long traces the claim that manhood comes not with emancipation, but rather with the role of soldier. For these men, government-funded medical care was not a mark of dependency but was instead a claim for honor and mutual respect. While as slaves men were denied the rights of fatherhood and the role of provider, they now as free men demanded protection for their families. The wounded African American body is no longer a sign of abject slavery, but is instead the mark of a fitness for freedom.

Long’s last three chapters address the postbellum period, in which newly freed African American communities faced a white society not willing to...