[Dr. Elizabeth Fee:] History ofmedicine seminar,

one of the specialevents that we're

putting on to mark African-AmericanHistory Month.

I'm very pleased to be able tointroduce Margaret Humphreys.

She is the Josiah CharlesTrent professor

in the history of medicineat Duke University

and she is also a professorof medicine at Duke.

She received herPhD from Harvard

and she is the author ofYellow Fever and The South.

And, Malaria: PovertyRace, and Public Health

in the United States.

Books that explorethe tropical disease

environment ofthe American South

and its role in the Nationalpublic health effort.

Now in the spring of2008, Dr. Humphreys

published her latest book,Intensely Human, The Health

Of The Black Soldier InThe American Civil War.

And this is her topic for today.

She teaches history of medicine,public health, and biology

at Duke University,where she also

edits the Journal ofthe History of Medicine.

Her current researchproject concerns

the impact of the CivilWar on American medicine.

Now just beforeshe starts, I want

to mention that the nexthistory of medicine seminar

will be on WednesdayMarch, 23.

Here in the Lister Hill Auditorium.

And it's a program forWomen's History Month.

Professor Valerie Hartouni ofthe University of California,

San Diego, will speak onReproductive Technologies

and the Post HumanFuture, are we there yet.

So now please help me towelcome, Dr. Humphreys.

[Applause]

[Dr. Margaret Humphreys:] Thank you.

Thank you, Liz.

And to Steven Greenberg whohelped organize my visit

and to whoever else may havebeen involved in planning it.

It's a pleasure to be here.

I particularly ampleased to be here

because the NationalLibrary of Medicine

has supported my research,both with grants as well

as their wonderfulcollections on the historical,

the historical collections here.

And so it's niceto give back some.

And it's also very nice to betalking during Black History

Month and talking inconjunction with the exhibit--

I've got my mic, I hope it's on.

The exhibit which you seea brief version of out

in the lobby here andthere's a Fuller version

over in thehistorical collection.

So I urge you to visit that.

That exhibition is about Blackhealth workers in the Civil

War, my talk is about the Healthof Black soldiers in the Civil

War and they cross.

But they're obviously comingat it in different ways,

whether blacks who workedas healers versus blacks

who were actually soldiers.

So, I'm talking today fromthe book as Liz mentioned.

And some people will askme where it's available.

I'm sure Amazon has it and alsoJohns Hopkins University Press

will be glad to sell you a copy.

I'm almost certain it'sstill in print with them.

And if it's not, tell themto put it out in paperback.

Anyway, so let's see now.

You got all thistechnology here.

Now I imagine that most ofyou, if you know anything

about the Black soldiersin the Civil War,

if you haven't made aspecial study of it.

Know this movie, which ofcourse, starring Matthew

Broderick, Denzel Washington,and Morgan Freeman.

called Glory, which wasabout the 54th Massachusetts

regiment and its experiencesduring the Civil War.

This movie brought thestory of the Black soldiers

to people who hadnever known there were

black troops in the Civil War.

In fact, 1/10 of uniontroops were African-American

and they were key in helpingthe union win the war.

[Movie poster]

So it's good the movieexists but it also

gives a very different imageof the kind of experiences

black troops had on average.

And I'm going to talksome about how I see that.

[Narratives about Black Soldiers slide]

To understand thekinds of things

I'm going to talk about today.

One is to point out that thehistorians of the Civil War

tend to start in 1861 goto 1865, and ignore

the rest of the 19th century.

But you can't reallyrewrite history that way.

And one of the things thathappens with the Civil War is

all sorts of discussions frombefore the war-- continue to get

transformed, get changedby the events of the war.

And so you cantrace at least three

or four narrativesabout African-Americans

through the war experience andthe black soldier experience

and some of those narrativeshave to do with health issues.

Now, the Glory narrative, ifyou will is a heroic narrative.

It's about black men fightingfor their own freedom,

it's about blackmen gaining respect

from their fellow white troops,who first denigrate them.

It's about selfliberation and black men

liberating blackslaves in the South.

And that focus on the Civil War.

You could mix in theEmancipation Proclamation,

the great stepsforward the war brings.

And that's one line whichis a very glorious line.

There's a secondnarrative though about

medical differences,Africans versus whites

that begins before the warand discussions of how slaves

or black bodies aredifferent, carries

through the war withanalysis of what

happens to the blacktroops as they come

under the view of thewhite doctors in the North

and how that warturns out for them

in terms of health and disease.

And then finally,there's something

that I label theAnxiety narrative.

It's hard to put a label on it.

[...]

One needs to be careful to see--

to think that all the peoplein the union were very pro

slaves and abolitionists,which is not true.

They were often just as racistas their Southern fellow

Americans.

And they were also quiteworried that all those slaves

were, if we liberate theslaves what's going to happen.

Are they going to move North arethey going to become citizens,

are they going to overrunus, can they really

take care of themselves.

The Southerners were sayingyou can't make citizens out

of these fourmillion black slaves

because they can'tfeed themselves.

They don't know how totake care of themselves

when they're sick etcetera, et cetera.

So there's an Anxiety narrative

about if we do thisbig change, what's

going to happen next.

All these narrativesget interwoven

during the war in talkingabout the black soldiers.

Now some of thequestions about how

blacks weredifferent than whites

that Northern elites, the kindapeople who write things down

had include, as Isaid, can he become

an independent citizenwho supports himself

and his family.

Since most slaves ofcourse didn't do this

because they weren'tallowed to do it.

Will he maintain his health,will he behave lawfully,

and vote responsibly?

Is he physically differentthan the white man,

in biologically important ways?

More prone to diseases,more or less intelligent?

Well, they knew that, theywere sure they knew that.

More able to work incertain environments?

If you make him a soldier, willhe fight or will he run away?

Some people even askare black men human

or are they a differentspecies somehow,

halfway between animaland real humans of course,

defined as white people.

What about mulattoesare they even fertile?

And this question wassincerely ask in the 1850s.

Should blacks be thoughtof as property like cows

or as people?

[Abraham Lincoln photograph]

Now just to make itclear that it wasn't only

horribly rabid racistto ask these questions,

Lincoln said in hisLincoln Douglas debates.

There is a physical differencebetween the white and black

races, which I believewill forever forbid the two

races living together onterms of social and political

equality.

So these questions, theseassumptions are pervasive even

among those you might thinkof is the most well-meaning

in Northern society.

So the American Civil Warbrings new answers and new data

to all of these questions.

OK.

Now a very brief calendar ofevents in 1862 and 1863 as it

relates to my topic.

Ignoring small otherevents like say the Battle

of Shiloh and so forth.

So in 1862, refugee slavesforced the first discussion

of Emancipation as uniontroops increasingly

invade pockets ofthe South and slaves

rushed to the union camps.

Union soldiers andunion leaders have

to do something about them.

Had to decide what theirpolicy is going to be.

And this makes itclear that if the union

does win, what are they goingto do with all these slaves,

or brings that question up.

You see the evolution ofcontraband policy, which

I'll talk about in a second.

And even a congressionalcommittee or commission

that looked at thewhole question of how

the freedmen, the beginning ofthe discussion of how freedmen

if they are broughtinto being liberated

slaves, how theyare to transform

into American citizens.

That explore questions like,do black people get married?

They just didn't know.

So what's a contraband.

In 1862, General Benjamin Butlerwas at Fort Monroe in Virginia

and they were startingto deal with slaves

who had come into the Unioncamps or into the Union sphere,

and he was asked, whatdo we do with them?

And Butler wasfrom Massachusetts,

he wasn't a fullfledged abolitionist,

but he was at least sympatheticto the cause and he said,

these men are contraband of war.

Meaning and it's notparticularly complimentary

thing to say, black menthat come into our camps

are just like if we capturedtheir mules or their horses

or their wagons or theircorn, it's contraband of war

and they're ours now.

Now realize the Fugitive Slavelaw was still on the books.

And you're supposed tosend captured slaves back,

but Butler says, no the slavesare important to the war effort

just like horses, mules,they're contraband,

and not going to be sent back.

This had a lot of resonanceamong Northern abolitionists

and anti-slavery folks.

One of the things Idid in the Civil War

is make envelopeswith old cartoons

in the corner andstationery and so forth

and so you see this cartoon.

"Come back here youblack rascal."

"Can't come back nohow massathis child's contraband."

So you see him go andnenna and inana over here

at Fortress Monroe.

Now that's 1862 as I said,this is from a very limited

perspective.

On the 1st ofJanuary 1863, Lincoln

issued his EmancipationProclamation,

freeing all the states.

To bring all the slavesin the states that

are under rebellion,namely the states

he doesn't haveany control over.

But never mind, it's atleast a major statement

that those slaves are free.

That left by the way.

Union states with slavesand slavery intact.

So there's still slaveryin Kentucky, in Maryland,

in Missouri, and Arkansas.

So he only freed themin states in rebellion.

That spring is whenthere for example,

draft riots in New York City.

The Irish are rebelling.

The poor are tiredof being called upon

to die when so manyhave already died.

And the union is starting tofeel the pressure of where

are we going to getenough troops to continue

this war, which was becomingincreasingly unpopular.

And Lincoln finally agreedto start drafting, not

drafting but enlistingblack men in large numbers.

A lot of people were doubtful,this was a good idea,

but that summer.

You see the battlesof Battery Wagner,

where the "Glory" guys die.

Milliken's Bend in Port Hudsonon the lower Mississippi-- people

start to say, yeah,they can't fight.

Yes, this is a reasonable plan.

So by the end of1863, more and more

Northerners would come to agreethat the black man properly

led, made a good soldier.

This had been in questionnow, it had been shown.

And many acceptedthe transition mantra

that you see overand over again.

We'll take slaves, willturn them into soldiers,

and they'll come outready to be citizens.

So slave to soldier to citizen.

And this comes in an era whenpeople are still talking about

whether black menare animals or not.

So this rather rudecartoon from Harper's

Weekly in January 1863.

So you have the blackgentleman there on the left.

“Ugh! Get out. I ain’t one ob you no more. I’se a Man, I is!“

There's a lot oftalk about what's

it going to take to makeAfrican-American males into men

into citizens.

[...]

So, Frederick Douglass of course,one of the great abolitionist

thinkers and writers, putsome of this into words

and then Ken Burns hadMorgan Freeman say it:

“Once let the black man get upon his person the brass letters, U.S.--

[Music, The Battle Hymn of the Republic]

Let him get aneagle on his buttons

and a musket on his shoulder,bullets in his pockets.

There's no poweron Earth which can deny

that he has earnedthe right to citizenship

in the United States."

[Music ends]

I played this clip in Charlestonand before I started I said

is it legal to playthe Battle Hymn

of the republic in Charleston.

It got a laugh there too.

OK.

So this is the 24th regimentUS Colored Troops flag

and it says, you seethis the sentiment.

I don't know if youcan see it the way this

is projected, but says upthere let soldiers in war

be citizens in peace.

So some officersanyway took this

on as an important functionof their leadership

that they not only trainedthem to be soldiers

but they brought inteachers to teach them

to read in this sort of thing.

But other peoplesaid, they're really

good at being trained tobe soldiers because they're

like children, they like tomatch, and they like music,

and they've got rhythm,and all this sort of stuff,

and they're accustomedto obedience.

I just wanted tothrow this and not

everybody saw this gloriouspath to citizenship.

So now this is supposedto be about the health

of the Black soldier andwe're finally getting there.

The question that comes upis having already decided

whether the blackman has the willpower

and the mental abilityto be a good soldier,

is he physically strong enough.

Now you might think thatif you were comparing

men who could work 10 hoursin the sun of Mississippi

picking cotton to some whiteguy sitting on the veranda,

that there'd be noquestion about who's

physically stronger.

But of course, any sortof narrative that ranks

the races in themid 19th century

has to make whitepeople the strongest

and to talk aboutinherent weakness

of the African-Americans.

So they're down the list.

So there's these broad questionsabout biological differences.

And one of the ways thedebate changes during the war

is that black men die in verylarge numbers from disease.

In the contraband camps,these camps that form up

around the Union troops,they're refugee camps,

they're not runby the Union Army,

they're toleratedby the Union Army.

The mortality ratein the year tended

to be as high as 25%,men and women.

These black soldiersdied at higher rates

than white soldiers of disease.

So some notice wastaken and these results

had to be interpreted.

The probably worstregiment that we

have data for and onehistorian has very carefully

gone through every person whois enrolled in that regiment,

not me did this.

Found that the regimentenrolled just over 1,700 men

and 772 of them died of disease.

Horrific.

In this regiment saw nobattle, so you can't blame it

on battle or battle conditions.

So they didn't knowwhat this meant.

Did it mean that blackmen were physically weaker

than white men?

Were slavery's defendersright and the black man

would not thrive in freedom.

So some data, whichis lousy data.

Just to say that straight out.

And I could do a whole talk onwhy the data for Black Civil

War soldiers is so terrible,partly because they didn't care

as much about writing it down.

And we could go on and on.

But still it givesyou a ballpark figure

of what the differenceswere and people,

even if they disagreed aboutthe actual numbers talk

about the distinctions.

So about the deaths fromdisease per 1,000 men about one

in seven of theirofficial category

was US Colored Troops,USCT, about one

in seven died of diseaseduring the war and about 1

in 62 died in battle.

That's because they didn't putthe black men in battle as much

and that's a separate issue.

White volunteers 1 in 17died of disease and 1 in 29

died in battle.

So for some reason,the difference

in mortality from diseasewas markedly higher

in the Black troops.

Another way to look at it isto compare disease mortality

to battle mortality it was 8 to1 for Black troops and 2 to 1

for white troops.

So-- why?

Now you can ask why in termsof a modern perspective

or asked why in termsof what they said.

So let's start witha modern perspective.

The first thing to sayis the Massachusetts 54th

was not typical of USColored Troops that's

the Glory regiment.

Matthew Broderick,was a really nice guy

and most of the leadersof the black troops

were not really nice guys.

They were not driven byabolitionist tendencies,

they were not driven by adesire to elevate and reform

their troops, they weredriven by the desire

to get an officer'spay and they were

willing to put up withthe fact that they were

leading Black troops to get it.

We know this from a lot ofletters home and whatnot.

In general werenot led by officers

that would have beenofficers of white troops.

They were goodenough black troops,

but they weren't goodenough for white troops.

The Mass-54th was tiedto a particular state.

The governor wasinvolved, the governor

was interested in their outcome.

Most of US Colored Troopswere just federal troops.

They didn't have a state tobe tied to and with any kind

of local support.

And the Mass-54th had peoplewho could read and write.

That little guy in the moviewith the little glasses

and whatnot, he could write.

Most troops would have beenilliterate and unable to speak

for themselves andadvocate for themselves.

The 140,000 more or lessof the black troops,

they were maybe 186,000in all-- were ex slaves.

And some of them wereactually bought off

the plantations of Kentucky,in Maryland, in Missouri,

and Arkansas.

Now of course this is theslave belt, the black belt.

And you can imaginethat or you probably

know that most of theCivil War, Mississippi,

except for thecoastal on the river

Alabama, Georgia, untilSherman's March, and much

of South Carolina wereout of union hands.

But the union has a lotof contact on the coast

here, Northern Virginia,they control Kentucky,

they get West Tennessee, andMiddle Tennessee fairly early,

they control Missouriand Arkansas,

and parts of West Texas.

So they are enrolling exslaves who belong to rebels,

so therefore they'reofficially free

or they buy slaves fromloyal Kentucky slave owners.

Some of them resisted.

It's hard for me to get in themind of a Kentucky slave owner

in 1864, who's fighting sellinghis slave to the Union army,

like he doesn't get thepicture of where this is going.

But still it's not our image ofglory of a recruiting officer,

actually buyingmale slaves, which

is what he did for the army.

So why does this matter?

Well, this is just somepictures of who these guys were.

I think also the kindof lost and scared look

of some of them.

This picture and thenext one was commonly

shown to go from slave tofree man or slave to citizen.

They put to thesepictures side by side,

but it gives you someconcept of from where

they came to where they went.

Most of these ex-slaveswere illiterate.

It was illegal toteach slaves to read.

In most Southernstates they couldn't

advocate for themselves, theycouldn't write to somebody

and complain.

They arrived incamp malnourished,

diseased, poorly clothed.

They should have been exempted,but recruiting officers

didn't care thatthey had aspects

that would have kept them outif they'd been white troops

and they had no advocacy group.

They were treated assecond class soldiers.

We think of the Civil Warsoldiers as glorious person

that everybody rah-rah along,but by the middle of the war

they needed cannon fodderand these guys were it in it.

They were semi slavesin the Union Army.

They received much lower pay.

They couldn'tbecause of that pay

buy extra food to supplementthe rations the army gave them.

They receive poor qualityrations, poor quality tents,

shabby clothing, poor qualityfirearms that didn't work,

and their officers didn'tdo much to defend them.

Now I've heard people say,but yes the Union troops--

the regular troops also hadpoor tents and blah blah.

But we know that becausethey wrote letters home

and they complained andthe governor got mad

and he called the generaland something happened.

Black troops couldn't pullthat kind of influence.

So, this was also manifestedin the medical care

of the black soldiers.

There weren't enough doctors,there wasn't enough medicine,

their hospitals wereterrible, and they didn't

get the rest they needed.

OK.

So one of the problems wasjust finding enough doctors.

It's 1863.

All the doctors who wantto be in the Union Army

are already in it.

Maybe there's afew new ones who've

come through medicalschool, but most

of the guys who would havebeen in medical school

are in the army.

They've dropped outof medical school.

They're doing something else.

The doctors supplyis very scarce.

So one general who was involvedin recruiting black troops

said maybe we couldturn hospital stewards

into surgeons, because afterall these are black troops,

they don't have to be--

they don't have to have thefirst class M.D. quality

medical care.

Hospital stewards were tosome extent pharmacists, often

they were trained onthe spot by doctors.

They had some medicalknowledge, but not often they

had more than themedicine knowledge but not

the surgical knowledge.

And Lorenzo Thomascountered this idea.

He said, we shouldn't do this.

But we know from thefact that he fought it

that other commandersallowed hospital stewards

to become the medicalofficers for black regiments.

And we have another letterfrom Nathaniel Banks

who was involvedin the supervision

of the department that includesLouisiana, Southern Missouri.

Who pointed outthat, well, maybe you

might think thathospital stewards are

fine for black troops, but blacktroops it's not like they're

just all isolated andnot near white troops.

So what do you do if you haveBlack troops and white troops

in battle and here's awhite guy who's injured

and the only doctor availableis this poorly trained steward,

this isn't going to work.

So the officersremember, they have

white officers, saidwe need real doctors,

because we're like valuablepeople we're white men.

And so, again theyhad this debate.

Banks actually tried toget new medical graduates.

And he hired someguys who were students

and we know that one blacksoldier at least in Texas

didn't think muchof these students.

The doctors visits themabout three times a week

and they do more harm than good.

They poison the soldiers.

They are called doctorsbut they are not.

They're only studentswho knows nothing

about issuing medicines.

I think patients arestill complaining

about medical students,but these particularly

seem to have even ablack soldier could

tell they didn't know anything.

So one solution to thisproblem is why don't we

get black doctors forblack patients they'll take

good care of them and so forth.

Well, first of all, thereweren't very many of them.

But we know thata few guys tried

to get commissions in theUnion Army as black men

to get commissionsas black doctors.

The most famous of themis Alexander Augusta,

who surfaces duringthe Civil War,

trying to do this becomesafter the war an advocate.

One of the people who helpsstart Howard medical school

and the NationalMedical Association.

Throughout his careerhe is an advocate

for civil rights for blacks ingeneral and for black doctors.

So in January 1863, in lieu ofthe Emancipation Proclamation

has just come outhe writes Lincoln,

"I beg leave to apply toyou for an Appointment

as surgeon to some ofthe coloured regiments...

where I can be ofuse to my race."

So Lincoln gets the rightpeople to examine him,

he gets appointed as a major andsurgeon of the 7th US Colored

Infantry in April 1863.

Major is a fullfledged surgeon, he's

also a commissioned officer.

The assistantsurgeons were white.

"This is wrong, it's grave,it's unjust and humiliating."

said the white surgeons,because suddenly you

have white men beingcommanded by a black man.

This cannot stand.

"This thing of amalgamationor miscegenation in the

appointment of officersI do not believe in."

Wrote this surgeon who wouldhave been under Augusta writing

to John Sherman of Ohio,William Tecumseh's brother.

Sherman was a Senator from Ohio.Big uproar and hoop-dee-doo

and white doctors sayingwe cannot serve under black

doctors.

So the surgeon generalsends Augusta to Baltimore

to serve as a recruitingdoctor to examine recruits

so he doesn't haveanybody underneath him,

but he does leave the war witha brevet rank of Lieutenant

Colonel which makes him thehighest ranking black officer

in the American Civil War and hegoes on to these other events.

So if you go tothe exhibit, you'll

see this picture of JohnVan Surly DeGrasse, which

I stole from their website.

He's the only othercommissioned surgeon.

After all this whoopty do theystopped commissioning surgeons.

I must say DeGrasselooks very light to me.

If you looked at this pictureyou wouldn't necessarily

say he's an African-American.

And this highlightsthe fact that many

of the African-American doctorswe know about from the war

would not have been seenas black in their time,

but would have beencalled mulatto.

And perhaps got theireducation and so forth

because their whitefather was able to fund

some of their education,but that's just supposition.

At least eight men werehired as contract surgeons

meaning you avoid thecommissions during the war.

And one of theconfusions is that you

have contrabandhospitals such as one

here in DC, which tookcare of the black freedmen

as well as the blacksoldiers so you

get this mix of essentiallya quasi VA with a Freedmen's

Bureau Hospital.

And they're the black doctorswere seen as more acceptable.

There were never enough doctorsfor the Black regiments.

And that US Colored Infantrythat lost 700 and 1,700,

it'll give you anidea of why when you

look at their doctor career.

The regiment was gathered inSt. Louis in the winter of 1863,

'64.

Now a regiment issupposed to have

one surgeon, fourfledged surgeon, and two

assistant surgeons.

So surgeon 1, one yearout of medical school

appointed for surgeon January1864, developed a hernia,

he was gone by the summer.

Surgeon 2, joinedin April 1864, he

was dead one monthlater of diarrhea.

Surgeon 3 joined in August 1864,to which point you might say,

but wait a minute, they don'thave a doctor at all in July,

Yeah, well that's true.

Joined in August1864, he got sick

and he left inNovember on disability.

And then there's a guywho joins in August 1864

and lasted for a year.

So while this regiment isdying in such large numbers

of disease, theydon't have doctors.

So what?

Given mid 19th century medicalcare weren't they better off

without doctors.

And I beg to differ.

All right.

So this is the time ofso-called heroic medicine.

When doctors treatedfevers with bloodletting,

they used a lot ofmedicines we now know

as toxic such as Calomel,it's a mercury compound.

And so you might argueyou'd be better off

without a doctor giving youthese things than with one.

But there were certainthings that doctors

did in the Civil War thatdid make a difference

and made a positive difference.

They organized afield evacuation

and getting the sickoff the battlefield

so you don't die of dehydration,two days after the battle

because you can'twalk and nobody

is getting you any water, orgetting you out of there.

There were effective medicalinterventions, quarantine

being one of the major ones.

Chloroform was very helpful ifyou happen to be having surgery

and they did havechloroform and ether,

and opium which could help youwith diarrhea and with pain

or other opium compounds.

The most importanteffective interventions

was available in the hospital.

Food, warmth, hydration, rest.

And somebody tosay that man needs

food, warmth, hydration, rest.

He should not be living in thattent lying on a wet blanket,

we should get himin the hospital.

These may seemobvious, but it wasn't

until somebodyorganized, he created,

it created a clean hospital,and took care of guys.

Surgery this is a grim19th century surgery kits.

Save lives when a leg hadbeen shattered or whatnot.

And the wound ofcourse it took some too

because there was noantisepsis, but many,

many men survived theamputations in the war

and it saved their lives.

Further medical officers or whocontrolled furloughs and rest.

And a Furlough was beingallowed to go home for 30 days

or 90 days or whatnot and getover whatever is wrong with you

or just to say oflike modern day you

need a note from your doctorto get off work for three days.

The medical officers controlledthat to that if you're sick

and not diggingditches or whatnot

you're better off than if you'remade to do that kind of work

while you're ill.

So the Colored Troopsin general were

worked more in slave like ways.

And so the doctors sayingstop that was important.

The white doctors wereoften insensitive and cruel

to the black soldiers.

We have a lot ofinformation about that.

They shared southernassumptions that the black man

was lazy and proneto malingering

and had decreased empathy.

And so they were less likelyto advocate for improvement

for the guys.

So what medicalofficers they had

weren't necessarilygood ones and they

didn't serve these functions.

Now finally and we could talka lot about this epidemiology

was against them too.

All those guys whohad been slaves

had lived largely inisolated rural settings,

they never had the childhooddiseases measles, mumps,

rubella, and in thattime period smallpox.

And so when they weregathered together,

they tended to get them all,one after the other.

They also were susceptibleto things like pneumococcus

from crowding in barrackswhich they might not

have seen at all.

That exposure mattered.

And the union deliberatelyput the black troops in areas

with malariabecause they thought

they would do better therethan whites or at least

were more expendablethan whites.

So I want to talk about justa few examples of places

when things went really bador badly for black troops

and that we have someinformation about them.

The first is Bentonbarracks in St. Louis.

We know about this because ofa man named Ira Russell, who

wrote reports and sent themto the United States Sanitary

Commission, whosepapers have been saved.

And so we know aboutwhat he had to say.

This was a gatheringpoint for black recruits

from Missouri,Kentucky, and Tennessee.

We know theirhousing was terrible.

It was the middle ofwinter, they were not warm,

they got rainedon, and so forth.

And many of theseregimens as I gathered

didn't have doctors yet andthere were rampant outbreaks

of meningitis,pneumonia, smallpox,

measles with veryhigh mortality.

Amidst all these, Russellwas having trouble

getting them hospital bedsbecause the army was sure

that they had to strictlysegregate the black guys

from everybody else.

And so the black guysare waiting for beds

while there's lotsof white beds and he

couldn't get them released.

And one of the thingsRussell did is do a lot of,

he did a lot of autopsieswhich we'll talk about a bit

later, trying tounderstand why they were

dying in such high numbers.

In Port Hudson, Louisianathe aftermath of one

of their famousbattles the troops

are garrisonedmeaning they are put

there to guard now theMississippi River in this spot.

There was a highly malariousarea, the southern part

of the Mississippi River.

They thought the black troopswere better there, because they

wouldn't get as much malaria.

Some didn't even thinkthey needed quarantine

if they got sick.

They were camped in an areawith a very high water table.

They actually werecamped in an area where

men had been buriedfrom prior battles

and they weresinking their wells

through these burying groundsand dysentery was rampant.

Because the highwater table meant

the Privy and the watersupply are connected.

And they weren't allowedto do local foraging,

the Union Army wasworried about incidents

between the blacktroops and the locals,

so they didn't let them ingo out and find more food.

They didn't have enoughfood and they got scurvy.

In Texas, an islandcalled Brazos Santiago,

which is just Southof South Padre

Island, which of course is ahighly valuable beachfront now.

In the summer of 1865, when youmight think this was all over,

there's a huge outbreak ofscurvy among black troops.

Where they didn'thave enough water,

their officers werecompletely inept

and their doctors were busyimporting things like--

importing things fromMexico and selling them

to the local inhabitantsusing the money they had

rather than buyingthings for the men.

So you have men in thehospital for scurvy

who are being fed coffee andhardtack which is crackers.

And they didn't care.

People some like2/3 of the troops

were sick with scurvyand their officers

knew exactly how to treatscurvy and they weren't

making any effort to do it.

So you see in these casesepidemiology, the crowding,

uncaring officers.

Bad assumptions about theblack troops and their health

all can come together tocreate high mortality.

It was widelyrecognized at the time

that the black troops weredying like flies, if you will.

And it called for aninvestigation, study,

and explanations.

This built on this Northernfascination with the black body

that somehow it'sgoing to be different.

They sufferpneumonia differently

or malaria differently,what can we find out.

And one of the thingsthey do is autopsies

were very big inthat time period.

Did I see Michael [?]Sepulchers, there is.

One [?] autopsies just came.

It was one of themajor forms of research

in the mid 19thcentury and they looked

for what's the difference,black and white in these bodies.

There studying inthis in every way

they can know they haveall these black bodies

at their command.

Now this is a page from theCentury Commission papers

Ira Russell's autopsyresults from St. Louis

and the BentonBarracks and all these.

Every line hereis a guy who died

and I realize youcan't read that

but that's a fullspan of the page.

And this is the sort ofinformation he gathered.

So here's the guy'sname, his rank,

and they're all private ispretty much, he's regiment.

And the company number.

And this fascinates me.

This is what color the guyis and almost none of them

are black.

They're 1/8 white,1/4 white, 3/16 white.

I have this sense of themwith Sherwin-Williams strips,

saying know what color isthe skin, how white is he,

because they're fascinatedby the question of mulattoes.

And many of theslaves in the West,

in this area in Missouri,Kentucky, Northern Arkansas

were mixed race blacks.

The Joel Williamsonhas written about this

that a lot of the mixed raceslaves were sold in that area

to get them away fromthe wives in Virginia.

Who were mad about theexistence of these people.

Just an example.

This is the brain is one of thecategories you see it flipped.

And so you get aeffusion into the ventricle

or in the arachnoidcondition wait.

So they described it they way--there wasn't a whole lot else

they could do.

They didn't do muchmicroscopic in this.

And so spleen, intestines,stomach, left lung, right lung,

and heart.

About the only thingRussell was able to conclude

after looking at some 500 slavesor 500 black men who died.

One thing you can seeis when tuberculosis

comes into his system.

He sees his firstTB case in February

after documenting forexample, a whole bunch

of cerebral spinalmeningitis cases

and pneumonia cases in January.

So you get a pieceof information

that know these peopledidn't have TB until they

got exposed to soldiers.

The second kind of researchthey did to send out surveys.

The US Sanitary Commissionlove to send out

surveys about things.

And one of thethings they surveyed

is what is your experiencewith black guys.

And so they ask doctors,why are they weak?

What diseases arethey susceptible to?

What sort of therapies do theyget and are they different

and how they respondto those therapies?

And do you see whatthey call as mulattoes

is having these thingsdifferently than pure blacks

or pure whites.

So they gather allthat information,

which was as you mightimagine fairly conclusive.

And then finallyBenjamin Gould, who's

known for doing thesemeasurements of white soldiers.

Did measured all sorts ofthings about the bodies

of soldiers blackand white, how tall

they are, how longtheir arms were,

where their fingers touched,what their lung capacity was,

how strong they were, hetried to measure endurance

and to compare black and white.

About the only thing conclusivethat comes out of his study

is that black lungcapacity didn't seem

to be as greatas that of whites.

So they did all the study, theytalked about it, they surveyed

and what conclusionsdid they come to.

Well, this guy theProvost Marshal General,

who's one of theleaders of the war

said having lookedat the statistics.

Well, "The Negro in the conditionin which the war found him"

like it's not our fault, hewas a slave before the war.

"Was less able thanthe whites to"

"endure the exposures andannoyances of military service."

I love the thought of militaryservice having annoyances.

"It is merely suggested that itis moral rather than physical"

"that the great susceptibilityof the colored man to disease"

"rose from lack of heart,hope, and mental activity."

And that a lot ofpeople think that.

Well, actually if youlook at Fry's own data,

they didn't think that at all.

But Fry wants it to bethat the black men just

didn't have the mental strengthand this trait of endurance,

which is sort of amental characteristic

that of course whiteguys have and he doesn't

see the black guys as having.

Roberts Bartholow who wasa leading Midwest physician

said, "The negro soldieris unquestionably less

enduring than the whiteless active vigilant

and enterprising, moregiven to malingering."

Most of these are mental traits.

Enduring, active vigilantenterprising, lying.

But Ira Russell thefellow in St. Louis who

did those autopsiesand did try to advocate

for the black troops said it'sbecause they were treated bad.

"It is often said even by surgeonsin charge of colored regiments

said it is of no use todoctor a sick negro that he

will die do what you may.

I am satisfied that no greatermistake can be committed.

When I hear a surgeonmaking such a statement,

I regard it as evidenceof culpable indifference

and neglect."

"Among no class ofpatients have I

seen better resultsfrom treatment

than among colored soldierswith proper care and study

has been given to their disease."

So, Russell is oneof the lone voices

to say, it's becausethey've been mistreated

and you treat them well, theydo just as well as anybody else.

Now the only use I've seenof Russell's autopsy data

published use and Russelldoesn't publish anything

about this whichis disappointing.

[?] data, Sanford Huntwho publishes his paper

to the anthropologicalreview in 1869,

another union soldier saysthat from Ira Russell's data

that the black brain issmaller than white by 5 ounces.

And he also has blacks aremore susceptible to pneumonia,

they are equallysusceptible to malaria.

And overall there's notmuch result from this.

Old assumptions are tenacious.

One is he was surprisedto not find much TB

because Northern doctors whohad seen black men in the North

saw a lot of TB, but when youlook at black men who have not

lived in the citiesof the North there

was very little tuberculosis.

These all feeds into a later19th century discussion

about black mental powers beingdeficient, the black brain not

being as strong as whites,that supposedly grows out

of these attitudesfrom the Civil War.

So these are notbenign conclusions.

You see discussionsof late 19th century

that the black race is justgoing to dwindle and disappear

because they are unable totake care of themselves.

They die of diseasemore than whites,

they lack the mentalpowers, et cetera.

And it continues thisdiscussion about the Civil War

and draws all theseconclusions incorrectly

from what happened there.

So instead of seeingthe disease mortality

of black soldiersin the Civil War

as an indictment of theirtreatment by the Union Army,

most contemporaryobservers concluded

the black man was intrinsicallyweaker than the white.

This argumentpresaged assumptions

about racial degenerationthat would follow later

in the century.

But there was onedissent which is

what gives my paper itstitle in my book its title.

These two officerswere in the scenes

of South Carolina amongthe earliest places

where black troopswere recruited,

they're bothMassachusetts people

of abolitionist tendencies.

And they got the UScentury commission

survey about how blacksare different from whites.

And "General Saxton,examining with some

impatience a longlist of questions

from some philanthropiccommission at the North

respecting the traits andhabits of the freedmen.

bade some staff-officeranswer them all in two words,

"Intensely human."

We all admitted that was astriking and comprehensive

description.

So thanks to the NationalLibrary Medicine.

ACLS, National HumanitiesCenter, the Trent Family,

and Duke University.

So I'll be glad toanswer your question.

[Applause]

[Dr. Elizabeth Fee:] Don't go away.

[Dr. Margaret Humphreys:] I'm not.

[Dr. Elizabeth Fee:] We have time forquestions, comments.

You which should havea mike in front of you.

If you press the littlebutton, the red light comes on

and then everybody shouldbe able to hear you.

Yes.

[Audience:] Hi.

That was fascinating.

Thank you.

Was Hikinson a friendof Emily Dickinson

and was he part of theQuaker group up in Amherst,

I seem to remember that.

[Dr. Margaret Humphreys:] I think so.

I'd say about 85%, yes.

Somebody could probablyGoogle and by the time

I'm done talking.

But that sounds familiar.

I read his memoirs quite afew years ago and he certainly

of that ilk and I'mpretty sure you're

right that he ispart of that group.

[Audience:] Because I come atit from totally not being

a historian, but I justwrote a book called--

it's somethingabout Hummingbird's.

And there's a group ofpoets, Emily Dickinson

and a group in Amherst who wereall abolitionists and worked

together and use the symbolof hummingbirds for freedom.

[Dr. Margaret Humphreys:]That's interesting.

[Audience:] A summerof hummingbirds.

[Dr. Margaret Humphreys:]Summer of hummingbirds.

OK.

Thanks.

[Silence]

Others?

Yes.

[Jill:] I think I've asked youthis question once before,

but I'm going to ask you again.

[Dr. Margaret Humphreys:] Hi.

[Jill:]  Hi.

Do you think that the healthand care of black soldiers

might have beendifferent if there

were more black physiciansthat were surgeons

tending to those troops inthe field, or in the hospitals

also?

[...]

[Dr. Margaret Humphreys:] I can'thelp but think so.

Ira Russell in St. Louis hadheard this claim that you can't,

just can't treat a black guy.

He gets sick, he turns hisface to the wall and he dies.

They don't have the willto live blah, blah, blah.

And what Russell hadwho was sympathetic

to the black soldier.

He had one ward of a doctorwho provided what he saw

as good care, attentive care.

He doesn't go into detailhe just characterizes it

as the doctors paying attention.

And another ward where theguys were dying more than

in the first ward.

And the second ward, the highmortality ward the doctor

said, well you justcan't treat black guys

or my black guys aresicker than the other one

or it's not my fault.So Russell switched them

and found that the mortalityswitched with them,

that it did make a difference.

It seems to me the mostimportant things are not

actually things that doctors, perse have that much to do with.

But it's keeping thepatient clean, fed,

hydrated, dealing with pain,changing the dressings,

that sort of thing.

And if you just think aboutif you attended people

in the hospital whoare not very able

and the person bringingin the tray just

slops it down on thetable, near the door

where the person in thebed can't even reach it.

And it sits therefor three hours

and then the tray is takenaway, versus a situation where

a family member puts thetray after the person

and does one spoonful at a time.

That sort of thingmakes a difference.

I don't think thatin the Civil War

the specific qualificationsprobably mattered

that much for thedoctors, so much

is attentiveness and caring.

So if the black doctors weremore attentive in caring,

then yes, I think it wouldhave made a difference.

You want to follow up on that.

I can't prove it,it's a counterfeit.

[Jill:] I can't prove it either.

I think the black surgeons someof them cared more than others

just like anybody.

And I think there's someevidence that some of them

were accused ofneglecting their patients

and others clearly gavetheir patients good care.

But I would think that mostof the surgeons that I know of

went in becausethey wanted to be

part of the fightfor freedom and they

wanted to serve their race.

So they were going in there witha different intent that maybe

some of the surgeons thatwere looking for promotions

or advancement or something.

[Dr. Margaret Humphreys:] Right.

I agree.

There's a fair numberof surgeons white

mostly, because most of themare white who were drunks

and who took advantageof the access

to narcotics andall the rest of it.

You have to factor that in.

I do think it's likelythat the common,

particularly those who go inwith the sense of a cause would

have worked harderthan those who didn't.

[...]

Yes.

[Audience:] Dr. Margaret, is thereany data or historical writing

about the medical care thatfreed black communities perhaps

in the North, how their healthwas in the same time period

to compare the warexperience-- to civilians?

[Dr. Margaret Humphreys:]I understand.

There were partsof the major cities

of the NorthPhiladelphia, Boston, New

York that were black, freeblacks, obviously there

in the northern communities.

These people wouldhave been, of course

more prone to be impoverished.

And lack access to health carebecause of the impoverishment

and to live in verycrowded conditions.

The Robert Bartholow whowrote the recruiting manual

for white troops inthe North, the doctor--

I'm sorry, the doctor doing theexams at recruiting stations

said about, once they starteddoing black soldiers he

added a sectionon black soldiers

and said that it was very commonfor them to have tuberculosis.

Now we know that particularlyfrom Benton Barracks

that the ex-slavesdidn't have much TB.

But the blacks livingin northern towns

probably did, becausetuberculosis was extremely

common in northern urban areas.

In that era and we knowfrom Samuel Roberts' work.

After the Civil War that TBfor example, in Baltimore

was a huge problem.

So what diseases, whatparticularly were the problems.

I suspect tuberculosis was amajor problem in those areas.

We know that forjust about everybody

the diseases of poor watersupply in urban areas

were, the fecal oral spreaddiseases were very common,

half the kids bornin Chicago in 1980

die before they'refive years old.

And I'm standing up herewith some trepidation

because Liz knows moreabout Northern public health

than I do.

So it might be hard toseparate out black health

from poor urban health.

[Audience:] What Iwas hearing you,

you were talkingabout economics.

You were talkingabout impoverishment,

so health has alwaysbeen a problem for people

who can't afford medical care.

[Dr. Margaret Humphreys:] Right.

And people who can't afford tolive in a decent part of town.

And all the things thatgo with that better food.

[Audience:] Even into today.

[Dr. Margaret Humphreys:] Absolutely.

But I don't havea sense that there

was enough of a force, enoughof a recognition of "black health"

problems before the war in theNorth to create any knowledge.

Liz, can you think of any.

I can't think of anydiscussion of that.

That most of the discussions ofblack health-- antebellum

were about slaves orabout southern cities.

And I don't have asense in the North.

That the North theconversation starts more

toward 1880s, the 1890s.

[Dr. Elizabeth Fee:] We have a questionthere at the end of the road.

[Audience:] Yes.

Did these men also makecomments about black women

who served in the CivilWar as nurses and cooks?

[Dr. Margaret Humphreys:] OK.

A couple of pointsto make about that.

First of all, blackfemale mortality

during the warparticularly contraband,

camps for womenwho were associated

with the black troops who weretheir spouses and so forth,

was very high.

Perhaps even higher thanthe black male mortality.

My colleague, [?]at Duke University

has tried to capture some ofthat horrific mortality, which

is not very well documented.

So that's one side of it.

And the exhibit doesthis better probably

than I'm going to beable to do here now.

There were a lot of places thatblack women served in a health

role during the war.

First of all in the South,slaves or free blacks

were conscriptedinto the hospitals

and did a lot of the work there.

But that's probablynot what you're

particularly interestedin or at least

we could talk about that more.

In the North theblack women were

brought in to nurse in theblack wards of the hospitals

or in the contrabandhospitals, which were often

a mix of black soldiers.

[...]

The freed blacks...

The contraband hospitalsbecome the

Freedmen's Bureauhospitals.

There's this evolution.

Some places we knowthat in St. Louis,

Ira Russell set up a trainingprogram for black nurses,

for his black wards.

Whether that happened elsewhere.

I don't know.

Did you find other?

[Jill:] That didn't really.

Jill has looked atthis more than I have.

[Jill:] Yeah.

As far as trainingI have in most

of the nurses thatI came across,

they were former slaves.

Especially here in Washington,they came to Washington,

they were sick theywent to the hospitals

and then they werehired as nurses.

So a lot of it I think wasjust on the job training.

And whatever skillsthat came with.

[Dr. Margaret Humphreys:] And it'simportant to realize that there

were no formal nurse trainingprograms in the United States

until after the war that,the war is a transition

point in the professionalizationof nursing and the concept

the hospital shouldhave trained nurses.

So the most of the nursingskills that were needed

were the kinds ofskills that a servant

would have whether a slave orpaid wage or a mother, a sister

would have.

It was more a matterof professionalization

in terms of being able toaccept the gore, accept the smell,

do distasteful task, all theseare kind of behavioral training

things.

[...]

And if Jane Schultzwas here, who's

written about womenhealth workers in the war,

she knows more about blackwomen nurses than I do.

So I'll just yield at that.

In the very back.

[Dr. Elizabeth Fee:] Right here andthen the next one.

[Audience:] My question kindof piggybacks on Cynthia's,

but I was thinking alongthe same lines about camp

followers.

We know that there'sdocumentation

of wives going with theirhusbands to war and sisters

or whomever to helpwith the nursing duties.

And I wasn't sure ifthe black soldiers

had something that wasequivalent especially,

since a lot of them I guesswere slaves who were bought

by the union and most probablytheir wives or whomever were

not-- Simultaneously bought.

[Dr. Margaret Humphreys:] Let's see.

A couple of thingsto say about that.

Most of the time I think it'sfair to say that wives did not

hang around theregiments just when they

were in the field or whatnot.

But might well show upat the hospital if--

this is white wives, if theirrelative is in the hospital

to come help with the nursing.

Black women, more than whitetried to stay with their men.

Say, there wereinstances in Kentucky,

where the slaveshad been gathered

into some regiment orsome mustering and spot

and the women followedthem and they're camping

outside the gate with theirchildren it's they're starving.

They have no means of support.

Maybe their slave ownerhas thrown them out

because their husbandhas left or chose to go

when the owner didn't want it.

And the Union Armysaid to they ended up

driving those women away.

They didn't wantto support them,

they couldn't support themthey need to take that regiment

and go someplace else.

And so the womenwere abandoned, which

is one of the reasons whyyou get such high mortality.

Did they end up in St.. Louisto become some of those nurses

that Russell was tryingto train? Probably,

although St. Louis was arefugee center in general.

It was very hard forilliterate slave women

to figure out where theirmen were because they

couldn't write them.

The husband couldn't writethem and say I'm here,

I've gone there.

And so of course, one of thebig things after the war was

getting those people reunited.

But it was harderfor them to know

what hospital their man was inif he didn't know the hospital.

[...]

You need to turnyours off Steve,

I think so shewould turn hers on.

Now try.

Maybe not.

[Audience:] OK.

So I found it interestingthat the Union Army didn't

care about the black soldiersas far as their health

knowing that they neededthem in their army

to fight in the Civil War.

So was there any researchto suggest a decrease

in the mortality rateafter Russell came out

with his findings?

[Dr. Margaret Humphreys:] I'd say no.

Russell tried and he also got--

Russell was fromMassachusetts and there's

a Massachusetts theme hereof decent people trying

to do the right thing.

Russell talked to hisstate sen... the Senator

from Massachusetts, Henry Wilsonabout the situation in St.

Louis and how badly,thought they weren't

being given hospital beds.

And Wilson said on the floor ofthe Senate what was going on,

which got some people riled up.

So he tried andI think you could

argue that the unionshould have treated

the black men better just froma purely practical point of view

because they needed thebodies, but the same argument

has been made about slavery.

Slaveholders should havetreated their possessions better

because it cost so much money,but we know they didn't.

And we know for example howsmall slave children were

and how poorly fedthey were and how

mount the bones we havefrom slave cemeteries,

how malnourished they were.

My general argumentabout this is

that soldiers who can selfadvocate who can write home,

who can get theirstate Senator involved,

can get improvedconditions, but those

who are not tied in any wayreally can become helpless.

And the worst case thiswas in Texas, where

they were completely isolated.

And only because of aSanitary Commission guy,

seeing what's going on, dowe know anything about it.

Much less was therean intervention.

We tend to think of soldiersas this rah, rah great thing

that the countryadmires, perhaps,

but there's also the view ofsoldiers as just hired hands.

The way the British for example,looked upon the Hessians,

that they didn't care about.

They just hired the bodies.

[...]

I think in this case, thefact that they basically

bought slaves toput them in the army

is going to really denigratetheir value in their eyes

in terms of beinghuman beings who

deserve to be treated properly.

[...]

[Stephen Greenberg:] Two things.

First of all as akind of a shameless

plug, Jane Schultz willbe our speaker in May.

[Dr. Margaret Humphreys:] OK.

[Stephen Greenberg:] Rememberyour question.

[Dr. Margaret Humphreys:] Can I justsay to Jane Schultz is then.

Jane Schultz has written a bookabout nursing in the Civil War

and continues to work onmedicine in the Civil War.

She's at Indiana University,Purdue University, Indianapolis

and she's a very good scholar.

So good.

She's coming in.

OK.

[Stephen Greenberg:] As a Civil Warwent on and the Union Army

went from a volunteerforce to a conscript force,

did the help ofthe white soldiers

also decrease since they werenot getting, I'm healthy,

I'm going to volunteer fora good course as opposed

to well what's thebounty if I join now?

[Dr. Margaret Humphreys:]Stephen points out

the first couple ofyears of the war,

the white union soldierswere volunteers.

And I think it's March1863, don't hold me to that.

But I think that's when thedraft law goes into effect.

That men becomesusceptible to the draft.

And they get forcedinto the army.

Now were those men necessarilyof more or less good health?

I'm not sure necessarilythat the conscripts were

of lower health perse, because they might

have several characteristics.

One is that they are somehowless patriotic, or less

willing to serve, or perhapsmore successful financially.

In other words, they're runningtheir dry goods store or whatever

and they don't want to go.

Many of them wouldhave been immigrants,

the Irish immigrants thatare continuing to come in.

And so maybe theywere of course help.

On the other hand, they mayhave been living in the slums

in New York andthus exposed to--

the bad news is they're livingin the slums of New York,

the good news is they've alreadyhad smallpox, and measles,

and mumps, and rubella.

Compared to farm boysfrom Indiana in 1862

who then had all those diseasesthese are the white soldiers

now.

So you get a lot ofinvalided in the first year.

The first nine monthsof soldiers and it

becomes malaria, he maywell be pretty useless.

But then another countervailingthing to all that

is that as the army gets moreand more desperate for men,

the recruitingofficers are pushed

to look less and less closelyat the guys they're examining.

And we know that probablyseveral hundred women

served in the Union Armyin the Civil War as men.

So obviously they didn't geta very thorough physical exam

when they were brought in.

I don't know.

The union, you start to see aseasoning effect in the troops.

And the problem is if youlook at regiment by regiment,

a regiment will shrink and thenthey'll bring in 200 new guys,

but it's stillthe same regiment.

And unless you gocard by card to know

how long person A his serviceis person B, I don't know.

I don't remember seeinga comment on that,

but there may wellbe information.

That's a good question.

Actually, it's nota good question

since I don't know the answer.

So it makes you look bad.

[Dr. Elizabeth Fee: ]Any otherquestion, comments.

[Dr. Margaret Humphreys:] Yes, ma'am.

[Audience:] Yes.

I was curious.

Is there any indication ofwhat Abraham Lincoln thought

about this disparityeither for humane reasons

or because of the detrimentaleffect on the war?

[...]

[Dr. Margaret Humphreys:] I do notremember seeing any comment

from Lincoln about this.

I just have to say that.

There's I don't know how manyvolumes of Lincoln papers

and stuff and haveI looked for it.

No.

Lincoln does notget very involved

in health issues in general,he didn't see the point

of the Sanitary Commission.

He gets involved in the fightsover the surgeon general,

but it's very top level stuff.

It's political stuff notmuch concern or awareness

of the health of soldiers.

[...]

I can't remember him goingto a hospital or something.

He does do that?

OK.

So he does do that.

But I don't know theanswer to that question.

Sorry.

Stephen.

[Stephen Greenberg:] We have diariesof the nurses saying

"Mr. Lincoln came by today."Jill what's the hospital,

he's always walking past.

Armory Square?

[Jill:] I thinkArmory Square.

Also there is someevidence of him going

past on, his way tothe soldiers home

stopping at the contrabandcamp and hospital.

[Stephen Greenberg:] But he's doing itmore as a it bothers him

that these people hadbeen injured in the war.

I don't think he madeany distinction is

to someone who had beenshot or someone who had

quite some sort of camp fever.

If I can draw a distinctionbetween the health

of the soldiers and theinjuries to the soldiers,

he cared very deeplyabout their injuries,

but he may not havecared about their health

as an institutional--

[Dr. Margaret Humphreys:] Why?

[Stephen Greenberg:] That's the fine line.

[Dr. Margaret Humphreys:] I get it.

[Audience:] Just one more quickquestion about mental health.

Was there any attentionpaid to mental health,

either during or afterthe war like for example,

the equivalent ofpost-traumatic stress disorder,

I think it was calleddisordered action of the heart.

Was there a differencebetween the blacks and whites?

[Dr. Margaret Humphreys:] OK.

There has been a fairbit written about that.

One of the SanitaryCommission questions

on their questionnairewas about that.

And one of their assumptionswas that in order to have this,

they call it nostalgia inpart regret for missing home,

if you will.

They said slaves andex-slaves didn't get nostalgic

because what are theygoing to be nostalgic for,

the plantation?

They also though talkedabout mental weakness

and just deciding not to live.

As I said just turning theirhead to the wall and dying.

So they see a lack of mentalpower, but they don't see that.

It seems to me necessarilyas a result of the battle

experience or thewar experiences

just the generic weakness.

There is this irritableheart of soldiers

that there's a fellownamed Jacob DaCosta

who wrote about it.

He studied it in Philadelphia.

And his irritable heart weresymptoms of palpitations,

or heart racing, orwhatever and it's

one of the symptoms of atotally stressed out person.

And Da Costafocused on the heart

but he also saw themental correlates of it.

But I don't think Da Costasaw black soldiers in that.

My guess would bethat if you ask him

he would say that blackmen aren't sensitive enough

to get this.

That you have tohave the higher tone,

reaches of mentalcapacity of the white man

to acquire thisdamage to your nerves.

[...]

There were some cases ofblack men going completely

off the railsmentally, that they

talked about but they sawthat as just insanity rather

than PTSD.

And of course, when you add in--

No.

Never known.

I was going to sayadded syphilis,

but that wouldn't-- tertiarysyphilis wouldn't have been

active during the war,but might be later.

We don't find it much inthe pension records later

that there was any muchdiscussion of syphilis,

but that's a wholeother question.

[Dr. Elizabeth Fee:] We'll take theone last question.

[Audience:] How much was writtenby the blacks themselves

in comparison to the whites?

[Dr. Margaret Humphreys:]Precious little.

I think I have it all.

There are a few lettersfrom black soldiers

to the couple ofblack newspapers.

And sometimes like that thingI quoted about the students who

don't know what they're doing.

That came from oneof those letters.

There's a couple ofliterate black soldiers

who write abouttheir experiences

or have diaries or letters home,but it's frustratingly little.

You can't depend on peoplelike Ira Russell who

are sympathetic, whosometimes quote them,

but we don't have them.

[Audience:] And none of theblack doctors wrote anything?

[Dr. Margaret Humphreys:] WellAugusta wrote a lot

of letters and kinda public things.

Let me ask Jill.

Talk about your sourcesfrom the back there.

She's one of the organizersof the exhibit by the way.

[Jill:] You're correct.

Augusta did writeletters to newspapers

as did some of the soldiers fromthe regiments that could write.

But again there is verylittle personal accounts

from surgeons, blacksurgeons, and even fewer

from black nurses.

Some wrote lettersto family members.

Like John Rapier was this wasan African-American surgeon

and he wrote letters.

And Moran Spingarn hasthe Rapier Thomas records

because other family memberswere political figures.

But it's reallyfew and far between

to find them actuallywriting letters and talking

about their experiences.

The letters that I found thathad been the most helpful

are the ones that arein the Christian Recorder

or other newspapers wheresoldiers and surgeons might

write letters and talkabout their experiences.

[...]

[Dr. Elizabeth Fee:] Those whostill have questions

are welcome tocome down the front

to talk a littlemore to Margaret

or go out and buy their book.

[Laughter]

You get a look more of this.

Really clap for Margaret.

[Dr. Margaret Humphreys:] Thank you.

[Applause]

Thanks.

[...]

[Dr. Margaret Humphreys off mike]

I gave a version of this talkat the College of Physicians

in Philadelphia andthey were black

reenactors lined up against the--

[Dr. Elizabeth Fee:]There were what?

[Dr. Margaret Humphreys:]black reenactors--

lined up against theback wall in uniform.

I better get this right.

[Dr. Elizabeth Fee:] Thank you.

[Dr. Margaret Humphreys:] Anatomy was important, right?

[NLM seal 1836]