Colonial Pathologies: American Tropical Medicine, Race and Hygiene in the Philippines (review)

The principal theme of the book, reiterated in eight chapters, is that after the American conquest of the Philippines in the wake the Spanish-American War (1899) American Public Health and Military authorities attempted to “sanitize” the indigenous population. The American “sanitizers” took it for granted that they were carrying out the first steps necessary for the conversion of people they regarded as “Oriental” savages into American-style, God-fearing, middle-class citizens who would not be out of place in Peoria, Illinois or Main Street, Minnesota. To illustrate this point Anderson quotes innumerable officials, among them Victor G. Heisen. Heisen was the director of the public health program from 1905 to 1915. In his memoirs he stated that:

At the end of the Spanish American War [and the acquisition of the Philippines] the United States was confronted with large responsibilities in the field of tropical sanitation . . . an entire nation had to be rehabilitated . . . so long as the Oriental was allowed to remain disease ridden, he was a constant threat to the Occidental who clung to the idea that he could keep himself healthy in a small disease-ringed circle.

[qu. p. 69]

This “civilizing mission” concept is the ideological “construct”—central to the entire book—which cries out for “an expansion of the historical understanding.” [last phrase on p.161]

Looking beyond the constraints imposed by the discipline of the history of medicine as it existed in the 1960s, a mainstream historian addressing the task of expanding understandings about the American medical presence in the newly conquered Philippines would immediately pose a series of questions. The first of these would bring the historian into the domain of the “Hegemonic Imperial Discourse” school. Now much used by historians of the Non-west, this newish analytical tool was inspired in part by the writings of the philosopher, Michel Foucault (d. 1984: mentioned by Anderson on pp.161–2, 249, 297). But going beyond Foucault (and his ahistorical generalizations) the mainstream historian would ask “When and where did the Hegemonic Imperial Discourse ‘construct’ take its rise?” Which elements in this “construct” (as applied in the Philippines) were distinctively “American” and which elements were adaptations of English and French ideas created initially for use in their European homelands, and then re-crafted for application to their colonies overseas?

These questions could usefully be posed, for instance, in the context of Anderson’s chapter four “Excremental Colonialism”[pp 104–139] which contains statements like: “As Americans attempted to erase or abstract their corporality, Filipinos had become the chief and most generous sources of contaminating matter … [they were] often seen as ‘promiscuous defecators’ transgressing colonial safe havens” etc.[p.128–129]. In responding to a statement like this one must ask whether this anal hang-up was original to the Americans or was it something they had imported from England? I am inclined to the latter view. Writing in the “Sanitary Progress Report in India” put out by the British Secretary of State for India in 1870, Florence Nightingale (1820–1910, spokesperson for the Neo-Sanitarian clique who had recently gained control of the Public Health establishment of India) stated that the people of India “had been living amidst their own filth for twenty centuries, infecting the air with it, poisoning the ground with it and polluting the water they drink with it. Some of them even think it a holy thing to drink filth”. We also know that the Surgeon General of the United States Army requested and received copies of these India Office Reports [London: India Office Library V/ 24/ 3675 (vol 2) p 41: I. O.L. V/ 24/ 3678, (Sanitary, June 1873–June 1874, p 1). The American anal hang-up, as Anderson tells us, was largely concerned with cholera (a fecal-oral disease). So too was the British hang up.

In his text and in his bibliography, Anderson mentions Ronald Hyam...