Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction by Jim Downs, and: Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation by Gretchen Long (review)

Although January 1, 2013, marked the official sesquicentennial celebration of freedom, freedom itself, as Jim Downs rightly argues in Sick from Freedom, came unevenly and contingently, arriving at different places at different times and releasing more than jubilation. Emancipation had a dark side, for with freedom came unexpected dire consequences, namely the unleashing of an unprecedented medical crisis. Less concerned with the massive resulting deaths, Gretchen Long’s Doctoring Freedom uses medicine as “a lens through which to understand larger issues of racial hierarchy, freedom, and African American political life,” arguing that African Americans viewed emancipation as an opportunity to claim ownership over their bodies as a means of securing freedom and citizenship (7). Taken together, Sick from Freedom and Doctoring Freedom offer different layers of the same tragic story, expand the long-neglected historiography on emancipated slaves and medical care, and provide new ways to understand emancipation.

Long and Downs agree that one of the reasons for the medical crisis resulted inadvertently from the dismantling of the antebellum medical system. Under slavery, planters, white doctors, and, most importantly, slave healers took responsibility for African American health care. Some slaves, argues Long, relied heavily on healers and actively resisted white medicine as a means by which to reject white power and exert control over their bodies. With the outbreak of the Civil War, slaves extended that rejection and control by removing their bodies from the plantation and fleeing to Union lines, which unexpectedly unleashed a wartime medical crisis. Ill-prepared for the unimaginable numbers of white wounded, the Union scrambled to deal with the care of black soldiers and contrabands. Black soldiers, as Long points out, advocated for medical care for themselves and their families on the basis of citizenship granted by virtue of military service. With the complete destruction of slavery and its accompanying paternalism, whites withdrew their medical power from the black population on the basis of citizenship, namely their lack thereof. Healers, like many newly freed people, tested the limits of their freedom through mobility, and in doing so moved away from the regional herbs and vegetables critical to antebellum healing. Emancipation therefore ushered in, as Downs rightly argues, “the largest biological war of the nineteenth century,” revealing that with freedom came unexpected consequences (41).

For Downs, those consequences came in the form of unimaginable waves of devastating epidemics. Viewing emancipation “in terms of the labor power that former bonds people could offer,” the federal government sought to create a healthy independent work force and tasked the Freedmen’s Bureau with African American health care (41). The federal government worked at cross purposes with the Freed-men’s Bureau, funding a mélange of medical care that ranged from complete neglect to the creation of an efficient hospital on the grounds of Arlington, Robert E. Lee’s former plantation. The federal government failed to give clear instructions and provide basic supplies, like caskets and cemetery space, to these institutions. When cholera, yellow fever, and especially small pox epidemics devastated the black population, the federal government, generally, and the Freedmen’s Bureau, specifically, proved stunningly inept on all levels in dealing with freedpeople’s health care, resulting in massive death. Focused on African American health care as a way to ensure a healthy work force—thus limiting their pathetic efforts to able-bodied men and tossing aside women, children, the orphaned, the elderly, the insane, and the dependent—the federal government, and by extension the Freedman’s Bureau created yet more death and devastation. Some whites interpreted these deaths as evidence of...