Pox_ An American History - Michael Willrich [79]
In all three tropical theaters, the Army Medical Corps responded to the first threats of smallpox by cleaning the troops’ immediate geographical environments and vaccinating the bodies of the natives who inhabited them. Gradually, the military surgeons would turn their attentions outward to the health of the native population as a whole. As they did, their campaigns would assume a scale and intensity they could not have anticipated when the war with Spain began. The most formidable efforts took place at the farthest reaches of the new American empire, in Puerto Rico and the Philippines.
Lieutenant Colonel John Van Rensselaer Hoff steamed into the port of San Juan in October 1898. It must have felt good to have the stench of Camp Thomas behind him; unlike most Army medical officers Hoff was struck by the natural beauty of this “fair isle.” The port had been churning all month, as ships off-loaded American goods and personnel and the last remaining Spanish soldiers and officials left the island. The incoming chief surgeon of the U.S. Army’s new Department of Puerto Rico had nothing but contempt for his predecessors. “Robbed of all superfluities,” Hoff declared, “the real reason we are in the Antilles today is because our people had determined to abate a nuisance constantly threatening their health, lives, and prosperity.” Of course, there had been “other factors of certain value, strategic, mercantile, humanitarian and sentimental,” Hoff conceded. But all these merely underscored the true casus belli: “Spain was maintaining a pesthole at our front door and we could no longer endure it.” Forget the Maine. In Hoff’s decidedly contrarian view, the Spanish-American War was at bottom a police action, taken against a delinquent neighbor that had allowed its properties to overflow with yellow fever and smallpox. Compared with Cuba, Puerto Rico was the lesser threat, but this island, too, “stretched a threatening hand toward our shore.” According to the police power tradition, the proper response to a nuisance was to abate it—kick out the bad neighbor and clean up the place.49
Fifty years old and full of vigor, Hoff had one of those nineteenth-century careers whose very contemplation induces in the modern mind a sharp sense of historical vertigo. In Hoff’s half century, industrial capitalism—with its steamships and telegraph wires and guns—had shrunk the seas, shortened the horizon, and accelerated time itself. Thus it was that Hoff, a Dutch-descended native of the Empire State, could serve during the 1890s in the last of the U.S. Army’s frontier Indian Wars, an imperialist venture in its own right, and the first of its modern overseas colonial wars. (The career-to-date of Hoff’s fellow New Yorker, Theodore Roosevelt, galloped across a similarly improbable canvas: from ranching in the Dakota Badlands to inspecting tenement sweatshops in Manhattan to storming San Juan Hill.)50
In an era when few American physicians had much formal training, Hoff, a second-generation Army medical officer, graduated from Union College and earned his medical degree from the College of Physicians and Surgeons in New York. He practiced surgery in western Army forts, lectured in college classrooms, and traveled in Europe, where he studied the medical services of the great European armies. Hoff distinguished himself on those battlefields Gilded Age America had to offer, the brutal and increasingly one-sided engagements with the western Indian tribes. In 1890, he led a detachment of Hospital Corps litter bearers in the Battle of Wounded Knee, the Army’s last major engagement with the Sioux, earning the Distinguished Service Cross for his “conspicuous bravery and coolness under fire.” A Protestant in a missionary age, he believed his sanitary work in Puerto Rico and later in the Philippines exemplified the duties