What is the topic of the chapter/article? What are the major themes?

What is the authors main

point or argument? What type of evidence is used? What are the strengths and limitations of the
work? What is most interesting? What questions do you still have after reading the material?

Summary Dying to Be Free: The Unexpected Medical Crises of War and Emancipation

Topic
o Illness, disease, extremely poor living conditions, or even the lack of proper living
conditions, contributing to high death rates in emancipated slaves during and after
the civil war
Major theme
o Unintended consequences of emancipation
o Emancipation slaves facing illness
o Armies and battlefield conditions
o Doctors and lack of preparation
Evidence
o Historical accounts of individuals who witnessed events in that period
Teachers, physicians, emancipated slaves, soldiers
Correspondence from that era
Works from other historians of the era
Military generals and officers
Union Army made deals with escaped slaves and their families
o Able bodied men to enlist in the Union Army in exchange for food and shelter for his
family
Unintended consequence of the Emancipation Proclamation
o Proclamation did not apply in border states, e.g Kentucky
o Institution of slavery still intact in these states
Former/escaped slaves predicament amidst the chaos of the civil war and the Emancipation
Proclamation
o Told through the story of the Millers Joseph, Isabella the parents, Joseph Jr, Maria,
Calvin and Youngest son, their 4 children
o Youngest son died after Brigadier General Pry broke the deal the Army struck with
the slaves
o With no food and shelter, slave families were left to fend for themselves
o Joseph Millers family died within a span of 3 weeks after losing Army
accommodation, he followed shortly after
o Environment slaves found themselves in made them vulnerable to illness
o Compounded by nebulous political status being in a border state and beholden to
the Army
No longer slaves but unable to be independently mobile and make their own
choices
They were refugees as opposed to families supported by the military
o Emancipation turned out to be a continuous process of displacement, deprivation,
and ultimately death
Sickness and disease threatened lives of approximately 500,000 freed slaves, and the 3.5
million more after the civil war ended
Both Confederacy and Union had anticipated a quick war
 o Unprepared when it became protracted causing:
Massive dislocation
Widespread poverty
Prolonged starvation
Outbreaks of sickness and disease
Emancipation and the resulting war was considered in terms of economic, legal, political and
social consequences
o Not the human consequences and immediate realities of emancipation
o Where would slaves live?
o How would they find food and water?
o How would they access medical care?
o How would their massive displacement contribute to the compounding of all these
problems?
Emancipated slaves banded together after they were freed, which contributed to the spread
of disease and outbreak of epidemics
o Quarantine strategies they developed, namely constructing sick houses could not
be used as they found themselves forced to live in overcrowded environments
Collapse of plantation economy and breakdown of the community they had while being
bonded created broader social transformations that left them further defenceless against
sickness
o Led to the breakdown of their kin networks
o Loss of support systems that sustained them during slavery
o Family and kin became most likely to provide nursing care
o Families no longer had the same economic relationships with their employers as
before, most were reduced to depending on receiving Union Army rations
o Some families chose to stay on plantations even though they their relationship with
plantation owners had fundamentally changed
Freedwomen were in a particularly difficult situation
o They could not leave Confederate territory and move up North, risking capture and a
return to slavery should they be try
o They had no access to food and lack of tools to hunt or gather,
o Should they choose to follow the Union Army, being constantly on the move mean
they could not grow their own, however meagre, crops
Emancipation did not mean the Unionists viewed freed slaves as equals
o Racism contributed to poor treatment of freed slaves
Mass movement of large groups of people (both armies) contributed to the carrying of
disease and pathogens into locales that were not previously exposed
o In addition, the waste they left behind, from supplies, animal and human excrement
contributed to the spread of disease
Sickness and disease spreading from the introduction of new pathogens, together with
wartime conditions, and the epidemics ravaging the communities of freed slaves required
centralized, concerted efforts to combat
o Lack of a federalized structure and institution meant that outbreaks were impossible
to contain by local and military doctors
o Post war, doctors had collected enough data to develop national outbreak protocols,
but precious little could be done during the war
 The federal government did not consider the health of former slaves when thinking about
the war
o It was always through the perspectives of political and economic gain, military
strategy, recruitment and morale
o They were not prepared to fight illness as a constant enemy
o Lacked the resources, money and infrastructure to respond to the medical crises
that erupted throughout the war
o Union camp officers feared that military campaigns would fail because of their
soldiers failing health
Personnel and staffing also played a part in the eruption and failure to control these crises
o Army medical department was staffed based on seniority, not experience
o They were not prepared for war, and had no idea how to prepare medically for war
This led to disastrous results at the Battle of Bull Run
o Many wounded soldiers could not be saved, many were left on the battlefield
o Lack of infrastructure like hospitals or field treatment facilities meant mortality rates
even among those who were saved were very high
o Led to plummeting morale and desertions
U.S Sanitary Commission was formed as a result
o Inspected conditions of Union camps, helped attend to the wounded
Pollution of water sources further contributed to outbreaks of disease and death
o Dead bodies were left to decompose in rivers and lakes
o Lack of fresh water exacerbated already poor conditions
Doctors in that era did not have the requisite experience in preventing spread of sickness
and disease
o No experience in treating multitudes of patients in a day
o No experience in dealing with mass outbreaks of pneumonia and intestinal viruses
o No experience working under wartime conditions, with most physicians having come
from working in small private practices
Lack of established medical doctrine in that era
o Conflicting views on how disease spread and treatment methods
o Medical profession was divided in its approach on how medicine should be practiced
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