Book Review: Medicine, Science, & Making Race in Civil War America

Medicine, Science, & Making Race in Civil War America. By Leslie A. Schwalm. Chapel Hill: University of North Carolina Press, 2021. Softcover, 232 pp. $24.95.

Reviewed by Jon Tracey

Dr. Leslie Schwalm, Professor Emeritus of history at the University of Iowa, specializes in slavery, the history of race, and Reconstruction. With her latest book, Medicine, Science, & Making Race in Civil War America, Schwalm turns her attention toward Civil War medicine not to examine conditions in field hospitals but to look at the often-racist ideas that guided the treatment of Black Americans during the war years. In doing so, she also reminds us of the pitfalls of over-glorifying historic figures without carefully considering the context of the world they lived in. Many White Northern anti-slavery men and women who diligently labored to end the “peculiar institution” still firmly believed in the inferiority of Black bodies and minds and thus created records and documents that supported and “proved” those differences.

Schwalm contends that these activists, doctors, and leaders “saw no contradiction in being antislavery and embracing the idea that science and natural law separated humanity into superior and inferior races” (2). Schwalm begins the work with a thoughtful Preface before outlining the history and actions of both the US Army’s medical department and the United States Sanitary Commission (USSC), the war’s premier Federal civilian aid organization. The book’s remaining chapters explore how those two organizations constructed race through written documents and studies, including a heart-wrenching chapter on the treatment of Black bodily remains that profoundly resonated with me due to my prior work researching the Army Medical Museum.

The fact that American medicine made significant advances during the Civil War is beyond dispute. However, Schwalm explores how progress in the medical field during this time can also be examined and explained through the lens of race. The war generated an immense amount of medical records. The collection, publication, and study of many of these records in turn led to new ways of thinking about how to treat diseases, heal illnesses, and repair wounds. Books such as the Medical and Surgical History of the War of the Rebellion, are full of these types of documented cases. But, Schwalm reminds readers that these same records produced by the same doctors respected for solving issues like sanitation and wound treatment were also often used to justify white superiority and create medical racism which still has echoing legacies today. To do so, Schwalm consults massive amounts primary sources about Civil War medicine and she takes into valuable consideration the secondary sources by other scholars who have also explored the impact of race on medicine such as: Amy Murrell Taylor’s Embattled Freedom: Journeys through the Civil War’s Refugee Camps (Chapel Hill: University of North Carolina Press, 2018); and especially Jim Downs’, Sick From Freedom: African American Sickness and Suffering during the Civil War and Reconstruction (New York: Oxford University Press, 2012).

Histories of the USSC tend to focus on the gender dynamics at play within the organization. Unfortunately, most USSC women were forced into volunteer roles despite being the primary force behind its operation, while men held the paid positions. Schwalm explains these dynamics but also explores the added dimension of race, which further complicates the organization. The USSC’s efforts often neglected Black soldiers’ needs, while other relief organizations, especially those directed by Black women, did not receive much support from the umbrella of the USSC.

Schwalm’s deep search through archival material to create this well-researched book is clearly evident. However, she admits that much of the book comes from a “one-sided archive,” as the statistics, tables, surveys, medical specimens, and even skull collections that survive today were designed to make the argument that Black bodies were inherently different and inferior, and Black voices from those who endured it may not have survived (xi). Still, she treats these subjects respectfully in the same way she addresses the absolutely racist acts and thoughts of many white abolitionists, with nuance.

Medicine, Science, & Making Race in Civil War America is a valued addition to any library focused on Civil War medicine. It encourages the reader to think about and view the vast amount of medical documentation created during the war through a different lens and thus develop a better understanding of the lasting racial legacies of slavery and freedom in the Civil War era.



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