Colonial pathologies: American medicine in the Philippines, 1898-1921

This dissertation examines American tropical medicine in the Philippines, and, in doing so, explores a number of local changes in the theory and practice of public health, therapeutics, and medical research. It is a study of a far-reaching Western attempt to reassess and reorder knowledge of disease and pathophysiology in the colonial tropics. At the turn of the century, American physicians in the Philippines, then under the military government, increasingly sought to deflect onto portable microorganisms the pathological agency that had once been securely located in the physical constituents of the environment. The transmission of these germs could be traced, ever more efficiently and persuasively, through the region's insect and human populations. The local human population's clinical resistance to the diseases with which they had apparently evolved, once considered absolute, now seemed limited: physicians argued that Filipinos' partial immunity to many tropical diseases was enough to render many of them carriers, rather than victims, of the biological pathogens to which alien white colonizers still seemed uniquely vulnerable. During the next twenty years, American health officials further elaborated the social implications of this new biological pathology. If evolutionary processes had apparently fashioned Filipinos as potential reservoirs of threatening tropical pathogens, then unhygienic racial custom and habit seemed to ensure that this potential would be realized. Health officials concentrated on suppressing, or at least regulating, Filipino behavior patterns that appeared to them both insanitary and innate--through education and supervision they hoped, over many generations, to implant in the islands a more hygienically ordered American way of life. But with the "filipinization" of the civil service after 1914, explanations of disease carriage and transmission based on social class begin to replace the more explicitly racial doctrines of the Americans. The new tropical medicine, informed by the investigations of the medical laboratory, was thus as much a versatile method of defining human potential, and for policing colonial social boundaries, as it was a means of controlling the regional disease ecology.