Medicine, Science, and Making Race in Civil War America by Leslie A. Schwalm (review)

Reviewed by: Medicine, Science, and Making Race in Civil War America by Leslie A. Schwalm Melanie A. Kiechle (bio) Medicine, Science, and Making Race in Civil War America. By Leslie A. Schwalm. (Chapel Hill: University of North Carolina Press, 2023. Pp. 232. Cloth, 99. 00; paper, 24. 95. ) In considering how the Civil War was a turning point in United States history, George M. Fredrickson directed historians' attention to the organizing efforts of northern intellectuals, through which they claimed authority in and over American society. 1 Leslie A. Schwalm's new book is a valuable expansion upon Fredrickson's thesis, clearly documenting how Civil War organizations including the United States Sanitary Commission, military medicine, and the Army Medical Museum strengthened and deepened racial science. Although racial science was not the primary purpose of these organizations, physicians and scientists who were steeped in End Page 271 a racist society rarely paused to question how racial beliefs structured their efforts during the Civil War. As Schwalm states in the preface, "Racist ideas and actions do not exist without harm" (xii). The book bears this out as it establishes the racism inherent in Civil War medicine and its legacies in today's medical practice. Schwalm's central question in this study is "how and why white Northern scientists and physicians created and used the opportunities presented by the war to more deeply invest in race medicine and race science" (5). This question is the focus of five tightly argued chapters, which span the years of the conflict. The first and shortest chapter, "Militarizing Race, " sets the groundwork for Schwalm's argument in the early days of wartime military and civilian organizing. In both the War Department and the United States Sanitary Commission, Schwalm finds the early establishment of policies and practices "that perpetuated a lasting structure of inequality" (13). Throughout the book, Schwalm's emphasis on organizations and structures means that readers spend scant time with a few individuals but emerge with a clear picture of how military medicine and hospitals reinforced and bolstered the differential treatment of white and Black sufferers. The second chapter closely interrogates the United States Sanitary Commission (USSC), documenting patterns of racial exclusion in the USSC's fund-raising, selection of auxiliaries, and distribution of care and resources. While some of these exclusions dovetailed with existing segregation (such as army policies for camps), others were racially exclusive decisions made by USSC leaders. For example, when the smallpox hospital for freedpeople in New Berne, North Carolina, requested food and clothing—forms of aid that the USSC regularly distributed to soldiers—the USSC refused its support to Black civilians. As Schwalm notes, in failing to address the medical crisis experienced by African Americans, the USSC blinded itself to the full medical reality of a civil war and changes in social order. Readers attuned to the USSC's importance in the establishment of organized public health might take this argument further, considering how wartime prejudices were woven into public health during its creation. One of the USSC's lasting contributions to public health is its careful reports, which expanded upon the efforts of antebellum sanitarians and became the model for the boards of health that were founded in cities and states after the war's conclusion. Schwalm digs into these reports in the third chapter, "Narrating and Enumerating Race, " to explain how the USSC created its authority and prominence through major bureaucratic investigations. The questions on the commission's forms reified race, which carried through into published surveys and statistics that substantiated End Page 272 racist beliefs. None of this was casual or incidental; the men who led the USSC during the war emphasized its fact-finding investigations as one of the organization's key contributions to knowledge. Schwalm's careful reading of the forms that physicians submitted reveals that these individuals, rather than create new knowledge about bodies, frequently asserted preexisting beliefs about racial difference. While white physicians understood and presented themselves as the scientific ideal of disinterested observers offering empirical evidence, their reports conflated observations with long-standing assumptions. The final two chapters of Schwalm's volume focus on the handling of Black bodies. Chapter 4 highlights comparative anatomy. . .