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.

Now Someone Say How This Began: The Spanish-American War of 1898 (Part I)

The historical backdrop of my books is the Spanish-American War of 1898, when the United States acquired the Philippines, Puerto Rico, and Guam for the low, low price of $20 million. What a bargain!

American readers, how long did you study this war in your high school history classes? Maybe for like a day? A half a day? The Spanish-American War has been getting more attention recently but not nearly as much as it deserves. Frankly, everything Americans know about their country’s role in the world stems from this tipping point. Whether you agree with it or not, American “exceptionalism”—the idea that America’s democratic history, transparent legal system, and free market economy make it especially suited to transform the world for good—was born here.

“Here’s to the girl I left behind.” (Photograph from the Library of Congress.) Doesn’t war look like fun?

Before 1898, America’s overseas interventions were relatively minor. Sure, we had lots of scuffles in our yard (Texas and Mexico), and the US intervened in Chile, Brazil, and Nicaragua in the 1890s. And, admittedly, we almost got in a tussle with Britain over Venezuela, but that was settled by appointed commissioners (none of whom were actually Venezuelans). But outside of Central and South America—what James Monroe had declared a US “sphere of influence”—the Yanks claimed only small bits of territory, including a portion of the Samoan islands.

Most Americans had little appetite for conquest, as a group of American planters and US Marines found out when they overthrew the legal monarchy of Hawaii in 1893. They wanted the US to annex the islands, but President Grover Cleveland, an anti-imperialist, refused. At that time, the mood of the public was: “What are you boneheads doing? Why do we want Hawaiian problems when we have problems galore here on Main Street?” I’m paraphrasing.

So Hawaii went into limbo. More on them later. And then a depression hit in 1893—a big one. In fact, it was the worst American economic crisis to date (in a time of peace), and remains one of the worst in American history. And that was when everything changed.

An 1896 melodrama based upon the Panic of 1893.

The cause of the panic was, ironically, progress. Railroads turned a patchwork of small agricultural markets into a single large one. That plus mechanization and improved farming techniques drove down prices and put small farmers out of business—or in terrible debt, which led to a debate over abandoning the gold standard. Though manufacturing blossomed in the cities, conditions were appalling. Professional strikebreakers, including private security firms like the Pinkertons, were still a thing, and labor disputes were violent on all sides. In the end, wages stayed low, which meant there were not enough customers to buy all the stuff the country produced.

May 5, 1893: panic on the stock exchange as captured in Leslie's Illustrated Newspaper.
May 5, 1893: panic on the stock exchange as captured in Leslie’s Illustrated Newspaper.

You get the picture. What was the answer? People began to think: “If we can’t sell our goods here, let’s hawk them abroad, like the Europeans do! We should be able to sell to China, too. Commodore Perry already opened Japan for everybody. Oh, and by the way, you’re welcome!” I’m paraphrasing again.

Anti-labor propaganda that uses the memory of the 1893 depression to encourage a free trade agenda.

Americans began to get hungry for empire—but should that empire be an economic or a territorial one? Some said we needed the land, men such as Frederick Jackson Turner, who bemoaned the closing of the American frontier in 1890. He said the expansion across the West was where Americans had grown strong and manly. Sure, a lot of pioneers died in the process, but the virtually unlimited forests and plains available for the taking had ensured that America would never become a feudal society dominated by a small class of land-owning nobles. And now that we had settled everything from New York to San Francisco, where would we go? Space? No, not yet.

(And, no, Turner was not concerned about the Indians or the Mexicans—their lives, their rights, their culture, or their children. America was so racist at this time that the word “racism” did not exist yet; systemic discrimination based upon race or ethnicity was normal. See my related discussion here. The military that brought you the Indian Wars would eventually bring you the Spanish-American and Philippine-American Wars. The very same officers, in fact.)

Alfred Thayer Mahan, photographed in 1904. “The Story of the Spanish Armada” was a promotional book and poster published in 1898 to celebrate America’s victory.

On the other hand, one influential group of strategists said that what we needed was reach, not largesse. We needed ports—lots and lots of them around both oceans. Captain Alfred Thayer Mahan, a professor at the Naval War College, thought it imperative that America protect its sea lanes with a strong navy, which would be “the arm of offensive power.” To do that, America needed coaling stations all around the Caribbean and Pacific, à la the Portuguese maritime empire. Mahan particularly insisted that “no foreign state should henceforth acquire a coaling position within three thousand miles of San Francisco.” (By the way, coal would still be king for another twenty years or so. The oil era will not change our priorities, merely the pins in the map.)

Talk like this inspired a whole generation of imperialists. A prominent young lawyer in Indiana named Alfred J. Beveridge articulated this group’s position so cogently that his oratory alone propelled him to a seat in the United States Senate:

American factories are making more than the American people can use; American soil is producing more than they can consume. Fate has written our policy for us; the trade of the world must and shall be ours. And we will get it as our mother [England] has told us how. We will establish trading-posts throughout the world as distributing-points for American products. We will cover the ocean with our merchant marine. We will build a navy to the measure of our greatness. Great colonies governing themselves, flying our flag and trading with us, will grow about our posts of trade. Our institutions will follow our flag on the wings of our commerce. And American law, American order, American civilization, and the American flag will plant themselves on shores hitherto bloody and benighted, but by those agencies of God henceforth to be made beautiful and bright.

Note that Beveridge believed in the full colonial system, with all the rights and responsibilities that entailed. He was eager to take up Rudyard Kipling’s call to the “The White Man’s Burden”: “To wait in heavy harness, on fluttered folk and wild—your new-caught, sullen peoples, half-devil and half-child.” Though Kipling and Beveridge were born three years and a hemisphere apart, they were kindred spirits.

Cartoon from the April 1899 issue of Judge magazine.

Theodore Roosevelt agreed. It was time to “have done with childish days,” and time to “search your manhood,” in Kipling’s words. Roosevelt wanted conquest, even if it meant war. Maybe especially if it meant war. He said:

We do not admire the man of timid peace…Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to take rank with those poor spirits who neither enjoy much nor suffer much, because they live in the gray twilight that knows not victory nor defeat.

“The man behind the gun will settle this war,” from Puck. Now this is a piece of propaganda that romance writers can really get behind. Nudge, nudge.

He saw no danger of “an over-development of warlike spirit.” In fact, just the opposite. He worried most about becoming “a wealthy nation, slothful, timid, or unwieldy.” We remember Teddy Roosevelt best for his adage to “speak softly, and carry a big stick,” but honestly I see no evidence of soft speaking in his public record. This quote of his is far more representative: “Peace is a goddess only when she comes with sword girt on thigh.”

Roosevelt was hungry for war, and he was not alone. But where? Against whom? And how would he rally an isolationist public recovering from depression and bring them all the way to war? Enter Spain, stumbling awkwardly into the room.

Continue reading Part 2 here.

(The featured image is from an 1898 patriotic poster, found at the Library of Congress.)