Raise the Red Flag: Cholera in Colonial Manila

My novella Tempting Hymn is the second in my series to mention the 1902 cholera epidemic in the Philippines. The book’s hero, Jonas Vanderburg, volunteered his family for mission work in the Philippines, only to lose his wife and daughters in the same outbreak that Georgina Potter dodged when she arrived in Manila in Under the Sugar Sun. Do I just need a new idea? I would argue that I’m writing about what people feared most in the Edwardian era. Before the mechanical death of the Great War, disease was the worst of the bogeymen.

Character board for Tempting Hymn part Sugar Sun steamy historical romance series
Cholera is important backstory for Jonas, the hero of my new novella, Tempting Hymn.

My books may be historical romance, but this post will not romanticize the history. Census figures put the total death toll from Asiatic cholera in the Philippines (1902-1904) between 100,000 and 200,000 people. Even that number might be low. This strain of the disease was particularly virulent, killing 80 to 90 percent in the hospitals. The disease progressed rapidly and painfully:

Often the disease appears to start suddenly in the night with a violent diarrhea, the matter discharged being whey-like, ‘rice-water’ stools…Copious vomiting follows, accompanied by severe pain in the pit of the stomach, and agonizing cramps of the feet, legs, and abdominal muscles. The loss of liquid is so great that the blood thickens, the body becomes cold and blue or purple in color…Death often occurs in less than a day, and the disease may prove fatal in less than two hours. (A.V.H. Hartendorp, editor of Philippine Magazine)

The Yanks saw cholera as a personal challenge to their colonial ideology. They had come to the Philippines to “Fill full the mouth of famine and bid the sickness cease,” in the words of Rudyard Kipling. What was the point of bringing the “blessings of good and stable government upon the people of the Philippine Islands” if they could not prove the value of their civilization with some “modern” medicine?

Cholera was not a new killer in the islands, nor did the Americans bring the disease with them. Though the Eighth and Ninth Infantries were initially blamed, the epidemic had its roots in China. As Ken de Bevoise said in his outstanding work, Agents of Apocalypse: “The volume of traffic…between Hong Kong and Manila in 1902 was so high that it is pointless to try to pinpoint the exact source.” However, just because Americans did not bring cholera does not mean that they are off the hook.

Cholera virus Edwardian medicine
Amoeba with cholera vibrio and leprosy bacillus, as pictured in the Twelfth Annual Report of the Bureau of Science in Manila, courtesy of the Internet Archive.

War weakens and disperses a population, leaving it more vulnerable to disease. And the way the war was fought south of Manila in 1902 was particularly brutal. General J. Frederick Bell had set up “protection zones” where all civilians were forced to live in close quarters without access to their homes, farms, and wells. Once cholera hit these zones, there was no escape: 11,000 people died. Even worse, mass starvation forced the general public to ignore the food quarantine, meant to keep tainted vegetables from being sold on the market. The Americans blamed Chinese cabbages for bringing cholera spirilla to the Philippines to begin with, but then gave the people no other choice but to eat (possibly contaminated) contraband to survive.

Inside Manila itself people were also quarantined—not a terrible idea on the face of it. The traditional Filipino home quarantine had worked well in the past: infected homes were marked with a red flag to signal people to stay away while loved ones were cared for. But the Americans thought bigger. They “collected” the infected and brought them to centralized hospitals outside of the city. Hospitals…detention camps…who’s to say? According to De Bevoise, eighty percent of the time, when the patient was dragged out of their home and carted off to this “hospital,” which suspiciously also housed a morgue and crematorium, that was the last their family saw of them. Despite the Manila Times portraying the Santiago Cholera Hospital as a “little haven of rest, rather than a place to be shunned,” and bragging that it was staffed by the “gentle…indefatigable, ever cheerful” Sisters of Mercy, people knew better. They would do anything to keep their family members from being taken there. They fled. They hid their sick. Because cremation was forbidden for Catholics at this time, the Filipinos hid their dead.

And the disease spread.

Cholera fire Tondo Manila during American colonial regime Philippines Edwardian Gilded Age era
Burning of the cholera-stricken lighthouse neighborhood of the Tondo district, Manila, 1902, by the health authorities. Photo courtesy of Arnaldo Dumindin.

My book Under the Sugar Sun began with a dramatic house burning scene, where public health officials destroyed an entire neighborhood in the name of sanitation. The road to hell is not just paved with good intentions. It is also littered the corpses of industrious, exuberant, and dogmatic government officials. Any houses found to be infected were burned, “because the nipa hut cannot be properly disinfected,” in the words of one American commissioner’s wife. People were forced to find refuge elsewhere in the city, carrying the disease with them. Because it was such a bad policy, Filipinos thought the American officials must an ulterior motive in the burnings: to drive the poor out of their homes, clear the land, and build their own palaces. The commissioner’s wife, Edith Moses, herself said: “Sometimes, when I think of our rough ways of doing things, I feel an intense pity for these poor people, who are being what we call ‘civilized’ by main force….it seems an act of tyranny worse than that of the Spaniards.”

American instructions to the sick were also confusing—and sometimes bizarre. Clean water was a necessity, but this was not something the poor had access to. Commissioner Dean C. Worcester claimed: “Distilled water was furnished gratis to all who would drink it, stations for its distribution being established through the city, supplemented by large water wagons driven through the streets.” But no other source mentions such bounty. In fact, as author Gilda Cordero-Fernando pointed out in her article, “The War on Germs,” in Filipino Heritage, most people treated distilled water like a magic tonic, it was so rare: “Asked whether a certain family was drinking boiled water, as prescribed, one’s reply was ‘Yes, regularly—one teaspoon, three times a day.’” Even worse, though, was this advice by Major Charles Lynch, Surgeon, U.S. Volunteers, which was reprinted in the Manila Times:

Chlorodyne, or chlorodyne and brandy, have been found especially useful; lead and opium pills, chalk, catechu, dilute sulphuric acid, etc., have all been used. With marked abdominal pain and little diarrhea, morphine should be given…Ice and brandy, or hot coffee, may be given in small quantities, and water, in small sips, may be drunk when they do not appear to increase the vomiting…cocaine and calomel in minute doses—one-third grains—every two hours, having been used with benefit in some cases.

Lead pills. Opium. Morphine. Chalk. Cocaine. And do you know what “calomel” is? Mercurous chloride. If the cholera doesn’t kill you, Dr. Lynch’s treatment will! Though the coffee and brandy sounds nice…

Opium children teething powder cure cholera dysentery Edwardian medicine
Dr. Moffett’s Teethina Powder, with a secret ingredient of powdered opium, claims to cure “cholera-infantum,” which is a form of severe diarrhea and vomiting. This ad is from Abilene Weekly Reflector, courtesy of the Library of Congress.

When the Americans could not control the spread of the disease with their ridiculous treatments and counterproductive policies, they blamed the epidemic on the victims. As public health historians Roy M. MacLeod and Milton James Lewis wrote:

American cleanliness was being undermined by Philippine filth.  The Manila Times lamented the cholera deaths of “clean-lived Americans.” It identified the “native boy” as “the probable means of infection” since in hotels and houses he prepared and served food and drinks to unwitting Americans. The newspaper reminded its American readers that “cholera germs exude with the sweat through the pores of the [Filipino servant’s] skin”and that “his hands may be teeming with the germs.”

Racism advertising Edwardian Gilded Age Pears Soap
Racist Pears’ soap ads of the Edwardian era. Notice that the ad on the left borrows from Kipling’s poem, “The White Man’s Burden,” and equates virtue with cleanliness. The one on the right is even more offensive, equating cleanliness (and virtue) with fair skin.

According to the Manila Times, the Americans organized their cholera hospitals by race: the tent line marked street A was “Chinatown,” street B was for the Spanish, street C for white Americans, street D for black Americans, and E through G for Filipinos. Though trade with China had been the cholera vector, Chinese-Filipinos actually had the lowest death rate of any group, including Americans. A Yankee health official ascribed this to the fact that they “eat only long-cooked and very hot food, in individual bowls and with individual chopsticks, and that they drink only hot tea.”

The epidemic reached its peak in Manila in July 1902, and in the provinces in September 1902, before running its course. Its decline was probably due to the heavy rains cleansing the city, increased immunity among the remaining population, and a strategic call by the Archbishop of Manila to encourage Filipinos to bury their dead quickly—but Americans still congratulated themselves on their efforts. And they had worked hard, it is true: Dr. Franklin A. Meacham, the chief health inspector, and J. L. Judge, superintendent of sanitation in Manila, died from exhaustion. The Commissioner of Public Health, Lt. Col. L. M. Maus, suffered a nervous breakdown. Even the American teachers on summer vacation were encouraged to moonlight as health inspectors—for free, in the end. The wages paid to them by the Police Department were deducted from their vacation salaries because no civil employee was allowed to receive two salaries at once. (The relevant Manila Times article explaining this policy is not online, but its title, “Teachers are Losers” is worth mentioning.)

Cholera epidemic in American colonial Philippines in Gilded Age
The hope of a quick end to the cholera outbreak was dashed by July and August 1902, as shown in these three articles from the San Francisco Call, the Akron (Ohio) Daily Democrat, and the Butte (Mont.) Inter Mountain.

All their hard work might have been for nought, though. Filipino policies of quarantine would have probably been more effective, had they been given the chance to work. Whipping up the population into a panic was exactly what the Americans should not have done. In the name of containing the disease, they caused the real carriers—people—to disperse wider and faster throughout the country. We all need to be on guard against such hubris, which is why I write my love stories in the middle of strange settings like cholera fires and open insurrections. Come for the sexy times, stay for the political history. Enjoy!

Featured image is of the cholera squad hired by the Americans in the Philippine outbreak of 1902. Photo courtesy of the Library of Congress.

Gilded Age Ganja

By now you have heard the results of the 2016 election: marijuana won. Well, at least in four states. California, Maine, Massachusetts, and Nevada legalized recreational use. Also, Arkansas, Florida, and North Dakota legalized certain medical uses. You can see which way the smoke is blowing. Maine’s marijuana question passed by less than one percent of the vote, but that ambivalence does not express the sea-change in American attitudes towards pot. According to the Washington Post, more than 1 in 5 Americans now “now live in states where the recreational use of marijuana is, or soon will be, legal.”

But how long has it been illegal? Would it surprise you to know only 80 years, since 1937? In fact, would it surprise you know that during the colonial era, cannabis was not only legal but—in 1619— required of all farmers in Virginia to plant? And that cannabis served as legal tender in Virginia, Pennsylvania, and Maryland? This may be stretching the truth a little, but only a little. I am conflating two strains of plants: hemp and marijuana. What is the difference? Well, both are the same species—cannabis sativa—but marijuana has significantly higher levels of the intoxicant delta-9-tetrahydrocannabinol (THC). However, until recently, hemp has been more commercially productive. Its strong fibers can be used for rope, paper, textiles, plastic, food, biofuel, and animal feed.

In the colonial era, it was cordage and textile uses that made cannabis so versatile. Not that people throughout history did not know of the more recreational properties, of course. Throughout Asia and Europe, cannabis was used for pain relief, spiritual escapes, and a nice little high after work. But we do not need to go that far back. After all, this blog focuses on the Gilded Age at the turn of the twentieth century—and this is when attitudes towards marijuana changed.

An advertisement for Dr. James's cannabis tonic, courtesy of The Library of Congress.
An advertisement for Dr. James’s cannabis tonic, courtesy of The Library of Congress.

You see, in the Edwardian era, cannabis was legal. That is what they called it, too: cannabis. Or, if one wanted to be a little more flash: Indian hemp, ganja, or (in a more potent preparation) hashish. One of the most popular Edwardian uses for cannabis was as a foot soak for corns. But it was also sold as a cure for consumption, bronchitis, asthma, veterinary indigestion, and simple coughs. It was not until 1906 that over-the-counter products had to declare any cannabis on their labels, but before then any number of “remedies” could have given a nice tipple. Keep in mind that this was also the era when cocaine was sold for toothaches, heroin was advertised in medical journals, and tincture of opium (laudanum) was packed in doses for infants. So, there was that.

A smattering of Edwardian remedies, courtesy of The Telegraph, ProCon.org, and Wikimedia Commons.
A smattering of Edwardian remedies, courtesy of The Telegraph, ProCon.org, and Wikimedia Commons.

At this point, cannabis customers considered themselves more “cosmopolitan” than the average drug user. Some men believed cannabis to be a female aphrodisiac: “It is just the thing to rouse the wild demimondaine instinct that lurks in the back of the heads of some romantic girls.” A more broadminded pot philosopher said: “It has been contended by an astute philosopher that true happiness will only be possible when time and space are abolished. Well, this is what hashish temporarily accomplishes.”

Hemp had its partisans, too. At the turn of the twentieth century, there was a worldwide shortage of naval cordage. When the United States took the Philippines as a colony, they found a local substitute: abaca, or Manila hemp. This is an entirely different species—a type of banana plant, actually—but its fibers were similar to cannabis sativa. This was the only export of the Philippines that the American colonial government allowed to be freely traded, as long as it was sold only to the States. (Later, during World War II, another hemp shortage so threatened the naval war effort that the government handed out seeds and gave draft deferments for farmers willing to grow it. They even made a film called “Hemp for Victory.”) The problem for Mr. Hemp, though, was that his cousin ruined the party, at least in the United States.

If everyone was so happy with their cannabis—both plants—in the Edwardian era, what happened? The 1910 Mexican Revolution! Um, what? No, really. The unrest south of the border sent large numbers of refugees into the United States. Cue the xenophobic backlash. What better evidence of the insidious social ills brought by these new immigrants than a dangerous new drug that turned American children into imbeciles?

A 1922 diatribe against the evils of marijuana in the Ogden Standard-Examiner, courtesy of The Library of Congress. That is a pretty risqué illustration.
A 1922 diatribe against the evils of marijuana in the Ogden Standard-Examiner, courtesy of The Library of Congress. That is a pretty risqué illustration.

That is when the name of the intoxicant changed. It was no longer cannabis, or Indian hemp, or ganja. It was marijuana—an Anglicization of the Latin American term marihuana, which itself came from either Chinese immigrants, Angolan slaves, or just a spontaneous combination of Maria and Juana. We don’t really know. The point was to portray the drug as something new, something wicked, something “loco” that would cause “incurable insanity.” The delivery system used by Mexicans—smoking—was evidence of this distinction.

One newspaper account said:

After three or four puffs the beginner’s mind becomes confused. There is, at first, a harmless sort of mental exhilaration. All the worries and sordidness in the user’s life fade away. He finds himself floating through space as if on a cloud and doing everything, in fancy, that he ever wanted to do….Then comes a period in which hallucinations dominate the addict. Motive-less merriment or maudlin emotion usually follows, after which a pugnacious attitude ensues.

Pugnacious? Yep. Others agreed. They said that marijuana was “more ruinous in its effects than cocaine, heroin, opium, morphine, or any of the others.” Another suggests curing a marijuana addiction with cocaine, which he believes is less habit-forming. It may be true that the drug then was not the same as the drug today, but racism was also a factor, at least in the late 1910s and the 1920s. The irony is that Mexico banned marijuana in 1920—17 years before the United States—and yet Americans still blamed the “infection” on them. For example, a Mohave County sheriff wrote up a public account of a run-in he had with a “bad Mexican,” a man appropriately named Marijuana for the substance that he sold. This kind of tale filled the papers.

But the anti-marijuana movement really gained traction in the Great Depression. This may be because this is when the drug became more popular with white Americans, or it may be because of the breakdown in social norms that came with high unemployment and population dispersal. And then a movie called Reefer Madness hit the screens in 1936. In the movie, a group of young smokers see their enjoyable evening go from casual fun to promiscuous sex to crushing depression to suicide. Within a year, the Marijuana Tax Act was passed, “restricting possession of the drug to individuals who paid an excise tax for certain authorized medical and industrial uses” (PBS).

That’s not the same thing as totally illegal, right? It took the conservative backlash of the 1970s and 1980s to do that. But maybe we have come full circle to the Summer of Love—or, as the case may be, to the Winter of Love. But, who knows? Pot is still illegal under federal law, and though the Obama administration adopted a policy of noninterference with the states in 2013, President-Elect Donald Trump might not feel the same way. As a boarding school teacher in Massachusetts, I am not terribly excited about the idea of patrolling dorms in a pot-accessible state. But maybe I will buy some for my mother for her corns…

(Featured image is an ad for Pico’s cough remedy, courtesy of the Library of Congress.)