[00:02:17] Leslie: Right. I think it's a difficult question, I think, and it's a question that I'm surprised not more historians have paused to really try to answer. Part of the reason it's so difficult is because, on one hand, we have a war that ultimately, gradually ultimately adopted the destruction of slavery as the goal of the war, but on the other hand, it's a nation that invests a great deal of effort and research and institutional support to the idea of racial difference.

We have to then pause and think about what it means to end slavery but to still invest in ideas about racial difference, why that happened, how that happened, who advocated it, and it's made even more complicated by the fact that at the same time that we see this wartime and postwar investment in ideas about race and racial difference, at the very same time, we have white allies in Congress and in state legislators fighting to secure at least some political and civil rights for African Americans. There was a sense after the war that in part because of Black military service, that African Americans having met the obligations of citizenship were now entitled to the rights of citizenship, maybe some of them, but at the same time, many of the same people sustained this commitment to the idea that whites were by nature and by biology superior to African Americans.

Probably for me, the worst thing about thinking about this is to know that ideas about racism in North America are fueled by the desire to justify slavery. From the 17th century on, ideas about race were created and advanced and elaborated on to justify what some humans were doing to other humans. If we end that system of exploitation, why sustain those ideas that had been formed directly to support that horrible institution of slavery? It sounds like a simple question but it ends up being very challenging.

[00:04:59] Host: Right. I want to talk about the title of the book, Medicine, Science, and Making Race in Civil War America. The word "making", it makes me think of the word "fixing", almost as in fixing the numbers to make them work, of kind of creating a science that justifies this already believed notion of superior and inferior.

[00:05:34] Leslie: I'm glad. I'm glad that's what it made you imagine and think of because that was exactly my intention, is to convey the idea of race, the fiction of race, and racial hierarchies had to be made. It had to be created by humans and human thinking and human desires. That's really what the book ends up being about, is why Northern whites in particular were invested in this fiction of race and how they went about ensuring that it would survive the destruction of slavery.

[00:06:17] Host: It's almost like seeing slavery. They see this as an inhumane act, almost as if you would look at a zoo as-- that it's not humane to keep animals in the zoo but they're still seen as less than, that they're still animals. They're still this less than, so let's use our science and this opportunity in the war where there are a lot of numbers and data available to prove what we believe.

[00:06:53] Leslie: To attempt to prove what we believe.

[00:06:55] Host: To attempt to prove. Yes, and skew it to make it that you're creating the science for it at that point.

[00:07:02] Leslie: Exactly. Exactly.

[00:07:06] Host: Let's talk about the US Sanitary Commission, this institution that had a somewhat pious start at the beginning of the war for what it was that they intended to do.

[00:07:22] Host: Right. Yes. The Sanitary Commission, a lot of people have studied the Sanitary Commission. You can't really even think about the Civil War and not look at the Sanitary Commission, number one, because it was the largest voluntary organization that had ever existed up to that point in our nation's history, so it's huge. It did a tremendous amount of good by forming these very local soldiers' aid societies, which then went out into the community and raised cash for the northern war effort and made or solicited goods that would contribute to the comfort of soldiers in the field.

It might mean knitting socks, it might mean making jam, it might mean baking things to send forward, it might mean making bandages to forward to hospitals. It was an incredible organization. It was the only civilian organization that was officially recognized by the federal government, and the monetary value of the work they did was really quite stunning, over $25 million worth of both cash donations and goods that were forwarded to the front. They did an incredible amount of work. It involved a lot of dedicated organizing and activism, so we can't overlook how important that organization was.

It was also important because this was primarily a female organization, and it was a way in which some northern women could be directly involved in the war effort, and in many ways, women experienced this as their first really direct relationship to the federal government. Women, of course, were denied citizenship rights. They couldn't vote, they couldn't serve on juries, et cetera. They couldn't run for elected office, but by contributing in such an important way to the war effort, they create a kind of citizenship for themselves, and they become leaders. Many became community leaders in way they never had. That's all the really great things.

There was some dispute between the women who were doing all the work and the men who assumed they were the best leaders and administrators of the organization, that was a kind of a contested battleground between men and women. All of this is true about the Sanitary Commission, but what few historians have paused to look at is the fact that this was an all-white organization by design and by everyday actions on the ground. African American women organized also, local soldiers' organizations, societies, raised money, rolled bandages, made jams. They did all the same work, but white women would not recognize them as affiliates with the Sanitary Commission. There were three exceptions, and two of them were in Philadelphia, where the Sanitary Commission was particularly strong and where there was an elite Black population. In that instance, I guess white women thought these very, very elite Black women could be admitted as their colleagues in the war effort.

On the whole, when we look at the Sanitary Commission from the perspective of race, we have to recognize that white women and white men use this organization to insist that citizenship was raced. In other words, this avenue towards contributing to the war effort and claiming your role in the war effort would be limited only to whites, that African Americans could not be admitted into this organization or recognized for the similar work they were doing on behalf of the northern war effort.

[00:12:00] Host: Was the organization overall more of an upper class, that you're not finding a lot of working class, or is it people from status that are, “This is my time and I'm going to volunteer?”

[00:12:15] Leslie: I think that's true for the organizers and for the people who rose to leadership positions, that's definitely true, but less middling-class people also participated and did what they could for the war effort.

[00:12:31] Host: You talk about how there was a research arm when the men who did take over saw this war as an opportunity to advance scientific research, but more than that, advance their own placement in the world of science and research by getting authorships and being written about.

[00:12:58] Leslie: Yes, this is another part of the Sanitary Commission that a lot of historians have overlooked, and that's the split between the relief work and the research. The scientific research, the medical research, the anthropological research. The research arm of the Sanitary Commission was run entirely by men, and as you suggest, for men. As it turns out, the war becomes the crucible where medicine and science become more professionalized in the United States because the war offered opportunities to conduct research, to publish about that research, and really to make a name for oneself as a medical or scientific professional. The men of the Sanitary Commission became committed to that kind of work. It was very stunning to me when I come across in the voluminous papers of the men of the Sanitary Commission saying very explicitly, "We are doing this work because it will make us men of mark," that is men who will be recognized as having superior intellect and superior professional grounding.

[00:14:28] Host: Creates more status and opportunities politically, educationally.

[00:14:36] Leslie: That's right.

[00:14:37] Host: Now we're a couple of years into the war when Black enlistment happens, which does, as you mentioned, creates an opportunity for northern Black men and emancipated slaves to fight for a cause but also prove themselves as worthy Americans, but it also creates this threat for those whites who believe in this ranking of races.

[00:15:05] Leslie: Right. It's important to remember that white army officials and the federal government and the northern state governments were all entirely opposed to Black enlistment, with very few exceptions. It was only as the war lasted much longer than anyone anticipated and as the human cost of the war to white communities became extremely high that there was popular support for Black enlistment.

The introduction of the draft in the summer of 1863 greatly increased a willingness for Black men to suffer military service, and finally, the fact that over the course of the war, hundreds of thousands of enslaved people abandoned their owners and abandoned slavery and made their way to Union lines, so they were already working on behalf of the Union Army. Men and women were digging ditches or doing laundry or splitting firewood, so they were already working for the union cause the question was, would men be trusted with a rifle? That was basically the issue.

Finally, the War Department says, "Yes." After the Emancipation Proclamation, they wholeheartedly invest in Black enlistment in certain conditions, that is, in segregated regiments because white men would not soldier with Black men, with white commanders only because the army did not want there to be any situation where white soldiers had to take orders from a Black officer, and also with less pay.

Other components of Black men's military experience was also riddled with discrimination and exploitation. It was an avenue. Many believed, whites and African Americans believed this could be an avenue towards citizenship rights for Black men, but they also encountered an organization that was really quite thoroughly racist, and so they encountered discriminatory treatment throughout the course of the war.

[00:17:30] Host: Now, we have this research arm of the Sanitary Commission with unprecedented access to numbers of soldiers of different races, and now you have this large number of Black soldiers at their disposal and this is where that making of race comes into play. Let's talk about this astronomer of all people who led the charge for the measuring anthropometric differences of men from different races.

[00:18:11] Leslie: Right. First of all, it's important to recognize that the Sanitary Commission and the army's interest in medical and scientific research around issues of what race was and how it could be measured, this began only after the first two years of the war where there was already research being done on whites, so that kind of foundation had been built. The Sanitary Commission and the army were both very invested in documenting the medical history of this first modern war in the United States. They were very interested in why people were dying of disease rather than wounds. This is the first war where they have to figure out how you mend soldiers who are victims of modern warfare. That was in place, but once Black soldiers are enlisted, both civilians and military medical officials become very interested in how they could make use of Black soldiers who were available to them. This brings up Benjamin Gould. Benjamin Gould was an astronomer. He had the first PhD in astronomy in the US. He was internationally known. He was one of the nation's leading scientists, and, honestly, for reasons I'm not clear on, in 1864, he accepts an offer from the Sanitary Commission to direct a program that was already in place.

Before the Civil War, in 1859, the landscape designer for the Central Park in New York City had begun a project of measuring the workers who were mainly immigrant men, and he was interested in the differences between, "American men and immigrant men." He started this project, and the Smithsonian Institution was interested. The Sanitary Commission took this on early in the war, and so they began measuring white men, everything about them that could be measured was being measured. As I said, then we have Black enlistment, and Benjamin Gould accepts this post now to direct this project.

Gould is shocked that here it was almost a year into Black enlistment and no one had thought about measuring Black men yet, and he redirects the project to measure as many Black soldiers, and, I should say, Native American soldiers, as he could gain access to. This was a shift, and so the questions and the rationale for the program shift as well, because now it's concerned with documenting race, proving that race exists in the body, proving that Black men's heels were larger in width than white men's, or their arms were longer, or their brains were smaller because their skulls were smaller, so any way you could attempt to prove a difference in whites and Blacks, the Sanitary Commission was interested in.

[00:21:40] Host: Again, it's proving these elements of inferiority, that these pre-assumed elements, it's not researching to see what are the differences, it's we want to prove this point that we already believe.

[00:21:57] Leslie: Right. I have to say I'm not sure that they thought about it that boldly, "Let's go prove Black inferiority." They just assumed it was there and all they had to do was measure to provide the data. Gould trains these 10, 12 examiners using a variety of equipment, equipment, again, that measured the length and circumference of every part of the body, but also measured the ability to take a deep breath, measured strength on a device that you would pull, measured the facial angle, that is the shape of the skull, measure the circumference of the skull. They had quite a range of equipment that was actually specifically designed so it could be carried from regiment posts to regiment posts to regiment posts, and they would set up shop in Black regiments and try to persuade Black soldiers to submit to measuring.

[00:23:02] Host: It didn't just end, this research carried on through the battles and into the cadavers and the casualties of war as well.

[00:23:16] Leslie: Yes, this is an important part of the research that I did, and in some ways, the most upsetting and difficult to do research on and to write about, because it was not only the living bodies of Black soldiers that the Sanitary Commission but mostly the army were interested in, it was also those who were deceased, the soldiers and the refugees from slavery who died during and immediately after the war. We have to understand that at this point in the history of medicine in the United States, it was actually very difficult as someone going to medical school to have access to a cadaver.

On the eve of the war, a medical student's experience dissecting a cadaver was regarded as the gold standard of medical education. You couldn't really understand human physiology in the human body unless you understood anatomy. Not by studying charts, but through hands-on experience with cadavers. Before the Civil War, there was actually an illegal trade in cadavers, and this is where we get the idea of grave robbers. There was this underground economy where the graves of the nation's most vulnerable, so enslaved people, the poor, Black people, people buried in potter's graves in public cemeteries. Those fresh graves would be unearthed and the cadavers sold to medical schools. 

Then we have the war and we have an abundance of cadavers, so suddenly that thing that was the measure of medical professionalization was available to anyone with an interest, regimental surgeons, hospital workers, hospital surgeons. What we see happen during the war, especially among military medical men, is a real desire and demonstrated impulse to anatomize the human remains of Black men and women.

[00:25:42] Host: This term, really quickly, this is not, you mentioned, not the same as an autopsy to study the cause of death or what led to a death. This is us in high school with a fetal pig or a frog and figuring out how the body works.

[00:26:03] Leslie: This is dissection and removing the different organs, perhaps weighing some or measuring them, and taking careful notes. That's dissection, or if you're actually removing things, that's anatomization. This is what we see is not a rise of autopsies of Black soldiers and civilians, but a rise of dissection and anatomization. A handful of that I've been able to find, I'm sure that's not all, but a handful of these white medical men actually published pamphlets containing the case reports of their dissections of Black soldiers. Now, these are surgeons who also performed autopsies on white soldiers, but it was their access to Black soldiers and their writing about it for published forms.

There's an assumption there that there's an interested audience, which indicates something, it tells us something, an interest in the makeup of the Black body as though it would be something different. We know that at least some of this interest was driven by a presumption of racial difference. Okay? Then we look at what's happening in hospitals where Black soldiers and Black refugees from slavery are being treated and are dying in very large numbers in places like Washington DC or Nashville or Memphis or St. Louis, and what we see there is simply a convenient use of the human remains of African Americans because they're there in abundance.

In other words, in some instances, the medical professionals didn't care that they were Black, they just simply had access to them because they died in such large numbers. The fact that many of these military hospital employees and officers conducted dissections of Black civilians, raises a really important question because this work that the army wanted medical staff to do was supposed to be about the medical history of the war and the military conflict.

If that's the case, why are they so interested in Black civilians who aren't dying from battlefield wounds, they're dying because of starvation, and disease that was running rampant in these refugee camps where former slaves gathered. In some ways, this reveals all of the inconsistencies of ideas about race that Black bodies can be conveniently neutrally human when it serves whites, or they can be raced and different when it serves white.

[00:29:17] Host: Now I want to connect this, I mean, there's so much more I want to dive in. We're not even covering the families of those soldiers and civilians who weren't able to bury their children, their siblings, or whoever, but I do want to take it into the future. In your research, was this racialized medicine, was this an incentive for the study of eugenics as we move forward?

[00:29:49] Leslie: Absolutely. The mounds of both quantitative data and qualitative surveys and questionnaires and reports observations, the published articles, this creates a massive database, which would be used well into the 20th century by race scientists and medical professionals who were interested in advancing racist medicine and racist medical science. Eugenics was a part of that, this impulse to measure bodies as a way to demonstrate how race is expressed in the human body. The army would continue to do those kinds of research projects during World War I and World War II.

We know in World War I and World War II, people of color who were in the service were used as victims of experimentation with things like mustard gas and racist science as a whole relied on much of this data. The data that Benjamin Gould helps collect and then publish reappears in the footnotes of race scientists well into the 20th century, and among those who tried to challenge the false premises that that work relied on was W.E.B. Du Bois who did this massive study of people in Philadelphia, of African Americans in Philadelphia, and he noted that this project was in part to challenge the assumptions that underlay Gould's dataset.

[00:31:36] Host: Where we are now, how much of this-- I can't even call it misunderstanding because it's these preconceived notions of racial biology and anatomy, how much of that is still existent in our medical practices?

[00:31:55] Leslie:  It is endemic today in our medical practices. I have to preface this by saying I don't do research on the 20th and 21st century, but there are many really incredible scholars who have done this research. Helen Washington, Dorothy Roberts, Vanessa Northington Gamble. There's a number of people who have very carefully exposed how racist medicine and racist science continues in medical schools today.

It continues in, for example, race correction that's used in diagnostics and in certain medical devices like spirometers, they continue to use something called a race correction. We know that pharmaceutical companies are now targeting particular ethnic and racial groups with specific pharmaceuticals that suggests that, again, that Black physiology is by nature different from that of whites. Medical students continue to graduate believing in the human body being a reflection of differences in race.

It's so pervasive that it's really frightening, and most importantly, it means that people of color are not getting adequate healthcare. Their pain is not satisfactorily addressed by their physicians. They are suspicious of white hospitals, of hospitals where they are the minority, where they don't encounter physicians of color. Because there is a long history of maltreatment and discrimination, its impact is something that we live with today and that some people die from today.

[00:33:51] Host: If you would like to continue the conversation, visit chapman.edu/wilkinson to learn more. To access recommended books from our guests for further learning and for more socially conscious content, visit us at pastforward.org or follow us at Apple, Spotify, or wherever you podcast.