Sick from Freedom: African-American Illness and Suffering During the Civil War and Reconstruction

ISBN : 9780199758722

Jim Downs
280 Pages
162 x 237 mm
Pub date
May 2012
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  • Reveals that the moment of emancipation triggered widespread illness and death among African Americans.
  • 2012 marks the 150th anniversary of the unofficial liberation of the slaves during the Civil War and 2013 the anniversary of the Emancipation Proclamation.
  • The first in-depth study of the Medical Division of the Freedmen's Bureau, the first system of national medical care created by the federal government.
  • Connects the federal government's response to emancipation to the displacement of Native Americans on reservations.

Bondspeople who fled from slavery during and after the Civil War did not expect that their flight toward freedom would lead to sickness, disease, suffering, and death. But the war produced the largest biological crisis of the nineteenth century, and as historian Jim Downs reveals in this groundbreaking volume, it had deadly consequences for hundreds of thousands of freed people.
In Sick from Freedom, Downs recovers the untold story of one of the bitterest ironies in American history--that the emancipation of the slaves, seen as one of the great turning points in U.S. history, had devastating consequences for innumerable freed people. Drawing on massive new research into the records of the Medical Division of the Freedmen's Bureau-a nascent national health system that cared for more than one million freed slaves-he shows how the collapse of the plantation economy released a plague of lethal diseases. With emancipation, African Americans seized the chance to move, migrating as never before. But in their journey to freedom, they also encountered yellow fever, smallpox, cholera, dysentery, malnutrition, and exposure. To address this crisis, the Medical Division hired more than 120 physicians, establishing some forty underfinanced and understaffed hospitals scattered throughout the South, largely in response to medical emergencies. Downs shows that the goal of the Medical Division was to promote a healthy workforce, an aim which often excluded a wide range of freedpeople, including women, the elderly, the physically disabled, and children. Downs concludes by tracing how the Reconstruction policy was then implemented in the American West, where it was disastrously applied to Native Americans.
The widespread medical calamity sparked by emancipation is an overlooked episode of the Civil War and its aftermath, poignantly revealed in Sick from Freedom.



1. Dying to be Free: The Unexpected Medical Crises of War and Emancipation
2. The Anatomy of Emancipation: The Creation of a Healthy Labor Force
3. Freedmen's Hospitals: The Medical Division of the Freedmen's Bureau
4. Reconstructing an Epidemic: Smallpox among Former Slaves, 1862-1868
5. The Healing Power of Labor: Dependent, Disabled, Orphaned, Elderly, and Female Freed Slaves in the Postwar South
6. Narrating Illness: Freedpeople's Health Claims at Reconstruction's End


About the author: 

Jim Downs is Associate Professor of History and American Studies at Connecticut College. He is the editor of Taking Back the Academy: History of Activism, History as Activism and Why We Write: The Politics and Practice of Writing for Social Change.

"Downs' book places the Civil War in another perspective that helps the reader think critically beyond the Emancipation Proclamation...I would highly recommend this book."--Joshua V. Chanin, The Midwest Book Review

"One comes away from this book with no doubt that the path out of slavery was a minefield of death and disease that needs its proper acknowledgement in histories of reconstruction."--Journal of the History of Medicine

"An important challenge to our understanding of an event that scholars and laypeople alike have preferred to see as an uplifting story of newly liberated people vigorously claiming their long-denied rights."--The New York Times

"A major turning point in how we understand the African-American past, the nation's past, and their intertwining."--Journal of Interdisciplinary History

"Based on extensive research, particularly in the Freedman's Bureau's Medical Division records, the book details the enormity of the public health crisis that afflicted freed people during and after the Civil War...This is revisionist history at its finest, and it deserves a wide audience. Highly recommended."--CHOICE

"Jim Downs' exceptional research has resulted in a major study...Highly recommended."--Civil War News

"Sick from Freedom is a welcome addition to the literature on the history of the Civil War and Reconstruction, medicine, and public health...[T]hought-provoking."--Journal of American History

"Sick from Freedom is beautifully written...The author dedicates this work to 'all those who were emancipated but never made it to freedom' (p. v). He honors their memories in this excellent and haunting book."--Arkansas Historical Quarterly

"As Jim Downs makes clear in this carefully documented work, the Union leadership, domestic and military, was wholly unprepared to deal with the breakdown of the system of slavery that followed the Union army with every foray into southern soil...One comes away from this book with no doubt that the path out of slavery was a minefield of death and disease that needs its proper acknowledgment in histories of reconstruction."--Journal of the History of Medicine and Allied Sciences

"A signal contribution to the vastly understudied question of freedpeople's health and a formidable challenge to the dominant analytical framework that has heretofore framed our understanding both of the transition from slavery to freedom in the American South and the meaning of death and dying in the era of the Civil War. It, quite simply, remaps a field."--Thavolia Glymph, Duke University
"A fresh and ambitious account of the Civil War era that not only interrogates the transition from slavery to freedom in new and unsettling ways but also invites us to rethink the geographical dimensions of Reconstruction."--Steven Hahn, University of Pennsylvania
"Charts new, darker, and profoundly revealing paths into the history of the American emancipation in the Civil War. In a work of medical, social, labor, and military history all at once, Downs shows that achieving freedom for American slaves was a signal triumph, but only through a horrible passage of disease, suffering and death. A 'new' history of emancipation is emerging, and Downs is one of its most talented and innovative craftsmen."--David W. Blight, author of American Oracle: The Civil War in the Civil Rights Era

"Jim Downs paints a startling and little known portrait of African American emancipation in which struggles for health and survival must be factored alongside the political and economic history of the period."--Sharla Fett, Occidental College
"Traces a shrouded chapter of American history: the mass death and medical devastation that visited African Americans in the immediate wake of legal emancipation. Downs compellingly reveals how the confluence of racial slander, government indifference, and medical malign neglect proved widely fatal, and in doing so he paints a detailed and disheartening portrait of man's inhumanity to man."--Harriet Washington, author of Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

"An important contribution to understanding the process of emancipation and the suffering so many freedpeople endured."--North Carolina Historical Review

"Downs insists that understanding the scale of the medical crisis for African Americans during the war is critical to the idea of what freedom felt and looked like for those who were trying to experience it...This book reminds us that this grim portrait must be a part of any discussion of the years that messily separate African American slavery from freedom."--Bulletin of the History of Medicine

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