Book: Sick from Freedom

3 May

Sick from Freedom; African-American Illness and Suffering during the Civil War and Reconstruction
Jim Downs

bookshotApr 2012
ISBN13: 9780199758722
ISBN10: 0199758727
Hardback, 280 pages


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 freedpeople. 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.


  • 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.


“James Downs’ Sick from Freedom is 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. Against an archival record of statistics–of so many bodies sick or dying and denied access to local and state hospitals and asylums–Downs gives us the story of a people, of individual men, women and children ‘dying to be free.'” — Thavolia Glymph, Duke University

“In Sick from Freedom, 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

“Sick from Freedom by Jim Downs 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

About the Author

Jim Downs is Assistant 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.



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