Fevered Measures: Public Health and Race at the Texas-Mexico Border, 1848–1942 by John McKiernan-González (review)

John McKiernan-González’s Fevered Measures delivers a well-researched account of public health initiatives by the United States and Mexico following the U.S.-Mexico War (1846–48) up to World War II. Fevered Measures calls our attention to a series of case studies along the Texas-Mexican border while prioritizing the ever changing medical and political frameworks U.S. and Mexican officials used to treat the threat of epidemic disease to their respective nations. McKiernan-González argues that medical borders drawn by public health officials crossed political borders to protect American citizens. Moreover, the constant movement of American medical officers across state and international borders suggests that medical borders were not only different, but shaped the definitions of U.S. citizenship by designating those that belonged and those that were threats to the general polity. This study yields to an understanding of intersecting medical, political, and diplomatic initiatives that formulated interpretations of citizenship, race, civil liberties, public health, and national security.

McKiernan-González begins his analytical narrative with a case study following the U.S.-Mexico War. Early in the military campaign, occupying troops from the United States suffered numerous losses due to disease, exposing a military reality that lead to the shaping of diplomatic proceedings in Mexico. Although Mexican officials wanted American troops out of their country immediately, the reality of the fevers during the summer of 1847 delayed troop evacuation and representatives from both countries agreed to an exit strategy that would help the Americans avoid the sickly season in lowland Mexico. This early example sets the tone for the book as it demonstrates that public health concerns were intimately tied to policy and, at times, superseded political and diplomatic agendas. However, the role of public health and policy moved beyond the battlefield and McKiernan-González shifts the focus to military quarantines in South Texas and concludes that U.S. medical officials medically separated and segregated “Mexican Texas” from the rest of the state (21). The intersecting agendas of public health, local autonomy, and citizenship came to a head at the turn of the twentieth century as labor demands and migration due to revolution demanded a stricter and harsher treatment of epidemic threats posed by Mexican migrants.

Fevered Measures yields a detailed understanding of policy and practice along the border, especially during periods of intense conflict. During the Mexican Revolution public health initiatives grew more complex as Mexican refugees and laborers sought shelter and work in American border communities. Many migrants lived in poorly developed dwellings that U.S. public health officials viewed as vectors for disease, especially typhus. As a result, working-class Mexican sections of El Paso were destroyed and condemned, further marginalizing the city’s poor. In addition, newspapers of the time treated epidemics, Mexican revolutionaries, and female political agitators interchangeably and symbolically fused disease and disorder.

The ambitious attempt by McKiernan-González to trace the transnational trajectory of public health policy over a nearly one-hundred-year period is masterfully achieved through extensive binational research and a sharp lens into the evolving practice of public health evidenced by a case study approach. Moreover, readers are left with a pragmatic narrative that demonstrates the intersecting and divergent pathways of medical and political borders as medical officials, politicians, and the polities of both nations sought the protection of their respective interests. Lastly, we are privy to a classic and comprehensive understanding of the U.S.-Mexico border region as a space in constant transition yielding to the multiple factors that contribute to its existence. The vivid and rich narrative of Fevered Measures should reach both an academic and popular audience on both sides of the Texas-Mexico border.