Gangrene and Glory: Medical Care during the American Civil War (review)

252CIVIL WAR HISTORY what the new form would entail, but it is difficult to imagine any system of bound labor that would constitute a "revolutionary program" (115). In any case, the ministers made little headway in reforming, much less replacing , slavery before the Civil War or during it. Genovese makes a convincing , well-documented case that, although Southern ministers supported the war for a slaveholding republic, they did not do so uncritically and repeatedly warned Southerners that they had to conform to God's word on the treatment of their slaves if the Confederacy were to benefit from God's support and achieve victory . When defeat came, the clergy interpreted it as God's punishment for failing to christianize slavery. Reform efforts failed, Genovese concludes, because "the political and economic viability ofthe South or, more precisely of its dominant class, required the retention of property in man" (117). Nevertheless, Genovese adds, he and other historians "have . . . been excessively rigid in" their "formulations" of the guilt thesis; in fact white Southerners did have significant reservations about the institution (xiv). In the midst of his subtle analysis of the clergy's thinking on slavery and defeat, Genovese inserts another, less carefully documented and developed, argument . After the war, southerners' acceptance of liberal capitalism and liberal theology, rather than the heritage of slavery or persistent Christian orthodoxy, led to the horrors of both segregation and imperialism. Genovese admits that religious liberals more often opposed segregation and that the orthodox more often defended it, which seems to undermine his case. But Genovese explains that when religious conservatives embraced racism they contradicted "their muchtrumpeted adherence to the Word" and resorted to other intellectual arguments to justify their actions (94). He even claims that religion played little role in the continued defense of the South's racial system in the 1950s. Perhaps Genovese will further develop and defend his explanation of the role religion played in segregation in another book; the strength of A Consuming Fire lies in its analysis of the white South's response to defeat and its success in rendering more complex the southern white clergy's attitudes toward slavery and the Confederacy. Gaines M. Foster Louisiana State University Gangrene and Glory: Medical Care during the American Civil War. By Frank R. Freemon. (Madison, N.J.: Fairleigh Dickinson University Press, 1998. Pp. 256. $52.50.) With the exception of the title, which does not do justice to the book's contents, and an unconnected prologue, this is a highly readable and well-researched history of medical care during the Civil War. Freemon provides a wonderfully good narrative, accompanied with anecdotes, analyses, tables, and photographs. BOOK REVIEWS253 Together, they offer excellent insight into the Union and Confederate medical organizations, their challenges, heroics, trials, and tribulations. Freemon, who is both a medical doctor and a professional historian, avoids the temptation ofviewing past medical debacles from the perspective ofcurrent medical science. Only in his concluding chapter does he explain the relationship of mid-nineteenth century medical practices and disease nosology with current thinking. This allows the reader to view events from the point ofview of someone living at that time. He deftly builds on the works ofGeorge W Adams, Doctors in Blue: The Medical History ofthe UnionArmy in the Civil War (1952); Horace H. Cunningham, Doctors in Gray: The Confederate Medical Service (1958); Mary C. Gillett, The Army Medical Department, 1818-1865 (1987); Stewart M. Brooks, Civil War Medicine (1966); Paul E. Steiner, Disease in the Civil War: Natural Biological Warfare in 1861-1865 (1968); Louis Duncan, Medical Department ofthe United States Army in the Civil War (1910); and a broad array of primary and secondary sources. The author is particularly strong in his analysis of the materia medica, especially the use of calomel and quinine, the problems attendant to wound infections and amputations, an insider's view of battlefield medicine, and the introduction of women nurses as health providers. He treats equally well the strategic functions of hospital ship usage; the reforms brought about by Surgeon General William Hammond and by Jonathan Letterman affecting the evacuation of wounded during and after battles; the impact of epidemics (smallpox, mumps, measles, chickenpox, diphtheria, typhoid fever, typhus, malaria...