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article reprinted in “Public Health Reports 2006 Supplement 1,” PHR, 121 (2006): 47–49. See also Foster, “Demands of Humanity,” ch. 3, 7–8; and Mariola Espinosa, Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878–1930 (Chicago: University of Chicago Press, 2009).

49 Hoff, “Share of the ‘White Man’s Burden,’ ” 797, 796.

50 James Robb Church, “John Van R. Hoff,” Military Surgeon (1920), 204–7. “Approves Hoff Memorial,” NYT, Jan. 26, 1931, 14. Gillett, Army Medical Department, 84–87, 197 note 15. See Jacob A. Riis, Theodore Roosevelt, the Citizen (New York: The Outlook Co., 1904).

51 Church, “John Van R. Hoff,” esp. 205. John Van Rensselaer Hoff, “Experience of the Army with Vaccination as a Prophylactic Against Smallpox,” Military Surgeon (1911), 492.

52 Gillett, Army Medical Department, 258. Hoff, “Experience of the Army with Vaccination,” 493. C. H. Alden, “Puerto Rico; Its Climate and Its Diseases,” NYMJ, 74 (1901), 21.

53 Alden, “Puerto Rico,” esp. 19. For a useful contemporary overview of the island, from the Army’s perspective, see USPRMG 1900.

54 USPRMG 1900, 26, 152. Alden, “Puerto Rico,” 19–22, esp. 19. Report of Brig. Gen. Geo. W. Davis, U.S.V. on Civil Affairs of Puerto Rico 1899 (Washington, 1900), 18.

55 Major Azel Ames, “Vaccination of Porto Rico—A Lesson to the World,” Pacific Medical Journal, 45 (1902), 518. Alden, “Puerto Rico,” 19. USPRMG 1900, 94.

56 USPRMG 1900, 19–20, 23, 26. Downes v. Bidwell, 182 U.S 244 (1901). See Robert McGreevey, “Borderline Citizens: Puerto Ricans and the Politics of Migration, Race, and Empire, 1898–1948,” PhD diss., Brandeis University, 2008.

57 George M. Sternberg, “Smallpox,” in USWDAR 1899, Reports of the Chiefs of Bureaus, 596–602, esp. 598. Ames, “Compulsory Vaccination Essential,” 722. George G. Groff, “Vaccinating a Nation,” MN, Nov. 25, 1899, 679. Alden, “Puerto Rico,” 21.

58 Hoff, “Experience of the Army with Vaccination,” 492. “Small-Pox Scare,” PI, Oct. 9, 1898. “Deaths in Porto Rico,” DMN, Dec. 24, 1898, 3. Dr. S. H. Wadhams, “Smallpox in Puerto Rico,” YMJ, 6 (1899–1900), 279.

59 George Foy, “The Introduction of Vaccination to the Southern Continent of America and to the Philippene [sic] Islands,” Janus, 2 (1897–98): 216–20. See José G. Rigau-Perez, “The Introduction of Smallpox Vaccine in 1803 and the Adoption of Immunization as a Government Function in Puerto Rico,” Hispanic American Historical Review, 69 (1989): 393–423; Catherine Mark and José G. Rigau-Perez, “The World’s First Immunization Campaign: The Spanish Smallpox Vaccine Expedition, 1803–1813,” BHM, 83 (Spring 2009), 63–94.

60 Rigau-Perez, “Introduction of Smallpox Vaccine.”

61 Hoff, “Experience of the Army with Vaccination,” 492. USPRMG 1900, 150. Alden, “Puerto Rico,” 21. Groff, “Vaccinating a Nation,” 679–80. José G. Rigau-Perez, “Strategies That Led to the Eradication of Smallpox in Puerto Rico, 1882–1921,” BHM, 59 (1985), 75–88, esp. 79.

62 USPRMG 1900, 153.

63 “General Orders, No. 7,” Jan. 27, 1899, in USWDAR 1899, 572–73. C. H. Lavinder, “The Marine-Hospital Service,” in USPRMG 1900, 277–81.

64 Ames, “Compulsory Vaccination Essential,” 723.

65 Azel Ames published two detailed accounts of the vaccination campaign. Ames, “Compulsory Vaccination Essential” and “Vaccination of Porto Rico.” See Bhattacharya, Fractured States, 52–69; De Bevoise, Agents of Apocalypse, 105.

66 Ames, “Vaccination of Porto Rico,” 513. As a special commissioner with the Massachusetts Department of Labor in the 1870s, Ames published a pioneering study of women in industry. Ames, Sex in Industry: A Plea for the Working Girl (Boston: James R. Osgood and Company, 1875). Azel Ames appeared frequently in the newspapers. See “Suspension of a Boston Doctor from the Pension Bureau,” BG, Nov. 15, 1883, 6; “Indicted for Pension Frauds,” NYT, Mar. 26, 1884, 2; “Not Agreed as to His Guilt,” ibid., Jun. 25, 1885, 3; “Dr. Azel Ames Dead,” BG, Nov. 13, 1908, 8. He fell on hard times after returning from Puerto Rico, filing for bankruptcy in 1902. He died in the