Pox_ An American History - Michael Willrich [87]
No doubt American military doctors believed their dispatches presented realistic accounts of the beliefs and practices of a backward “Oriental” people. In fact, these dispatches drew upon a common Western language of medical high modernism that had developed in the long nineteenth-century era of nation-state formation and colonial expansion. Within the ever widening world of cross-cultural contact, European and American physicians measured the civilization of subordinate groups along a scale of sanitary evolution. Although in this case U.S. surgeons were talking about Filipinos they encountered in the zones of combat and occupation, the nineteenth-century medical literature teemed with strikingly similar descriptions of the “primitive” health practices of Native Americans on the western reservations, Mexican Americans in the southwestern borderlands, African Americans in the rural South, Puerto Ricans of the Cordillera Central, and the “new” immigrants from Southern and Eastern Europe streaming into America’s industrial cities. European and American tropical medicine was embedded in a larger cultural and scientific process—one so homogeneous in its assumptions as to constitute a common project. Self-consciously modernizing nations used medical knowledge to comprehend, categorize, and govern the most marginal peoples within their territories. Tropical medicine was never merely a handmaiden of colonial domination, but it served that purpose exceedingly well.
Of course, for the Filipinos smallpox was not a figment of anyone’s colonial imagination. The disease stole children from families. It left thousands blind or scarred. In the absence of effective preventive measures, smallpox was an unavoidable fact of life—like the passing of the seasons. According to American estimates, forty thousand Filipinos died annually from smallpox during the final years of Spanish rule and the early years of the Philippine-American War. Army surgeons working in the provinces reported that between one third and one half of the inhabitants had already suffered smallpox. Greenleaf reckoned that the children of the islands were “practically the only susceptible persons, the adult population being as a rule immune and representing the ‘survival of the fittest.’” Although smallpox did the greatest harm to the islands’ poorest inhabitants, it did not spare the most elite. In March 1900, Aguinaldo’s own infant son died of smallpox while in U.S. captivity in Manila.80
The Filipinos were not indifferent to the many diseases that afflicted their families. Popular conceptions of health, disease, and medicine varied from place to place in the archipelago, combining indigenous traditions with Christian teachings and Western medical ideas acquired from the Spanish. Filipinos did not simply reject Western medical ideas; they incorporated those that seemed to work into their own systems of belief. According to commonly held Filipino medical beliefs, diseases could be caused by natural events: smallpox was known to be a disease of the dry months and was expected to wash away with the rains. Or diseases could be brought on by supernatural forces; if smallpox persisted through the rainy season, local healers used rituals to appeal to the spirits. Americans expressed dismay at the Filipinos’ practice of treating sickness and death as social events that required the close presence of friends and relatives. The occupiers used strong measures to compel Filipinos to remove the sick from their crowded huts, to promptly bury the dead, or destroy clothing contaminated with smallpox. Some Filipino practices must have fostered the spread of small-pox, but they also powerfully expressed the relationships of family to community and between the natural and supernatural orders.81
Many Filipinos had formed specific ideas about the various Western medical practices that the Spaniards had tried (usually halfheartedly) to introduce into their lives. Filipinos could be receptive to Western medical ideas and medicines—at least those that