Environmentalist Thinking and the Question of Disease

Causation in Late Spanish Philippines

Raquel A. G. Reyes

Journal of the History of Medicine and Allied Sciences, Volume 69, Number
4, October 2014, pp. 554-579 (Article)

Published by Oxford University Press

For additional information about this article

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 Environmentalist Thinking and
the Question of Disease Causation
in Late Spanish Philippines
RAQUEL A. G. REYES
SOAS, University of London, London, UK.
Email: rr14@soas.ac.uk; raquelreyes14@gmail.com

ABSTRACT. The scientific understanding of disease causation was crucial to

the ways in which the Spanish colonial state addressed epidemic diseases
which periodically struck nineteenth-century Philippines. Scholars have
often described Spanish colonial responses in terms of ineptitude and failure,
and have often glossed over the multiple and competing scientific theories
that preoccupied Spanish and Filipino physicians. This article examines the
work and ideas of nineteenth-century Spanish colonial and patriotic Filipino
physicians regarding disease causation in the tropical environment of the Phil-
ippines. It will focus on two key developments—Spanish environmentalist
thinking and the emerging fields of microscopy and bacteriology. Much like
the British and French colonialists, Spaniards viewed tropical climates as insa-
lubrious and conducive to disease, perceiving themselves as constitutionally at
risk in hot places, ill-suited, exposed, and vulnerable to so-called native dis-
eases. By the 1880s, however, young Filipino researchers, some of whom had
trained in Spain and France, were undertaking new research on polluted
water, malaria, and cells. Influenced by the revolutionary new discoveries
being made in bacteriology, these researchers questioned prevailing environ-
mentalist explanations and focused, for the first time, on the nature of patho-
gens and microbial pathogenesis in disease development and transmission.
But germ theory remained an idea among many. This article argues that
although late nineteenth-century studies in microscopy by Filipinos slowly
began to challenge Spanish colonial ideas, different streams of thinking over-
lapped and no single scientific explanation came to predominate.

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 Reyes : Environmentalist Thinking in Spanish Philippines 555
KEYWORDS: environmentalist thinking, Spanish colonial medicine,
Filipino scientists, scientific theories, disease causation.

I N T RO D U C T I O N

the latter decades of the nineteenth century, the Philippine

I
N
population suffered a series of epidemics that lifted death rates
significantly above those elsewhere in Southeast Asia. Episodes of
crisis mortality gave scientists and physicians urgent cause to seek out
new explanations and to find more effective epidemic control mea-
sures. Although a strong case can be made for Spanish ineptitude at
the height of the outbreaks1 to judge such responses from a modern
viewpoint as “wrong” or in terms of failure does no justice to the
concerted struggle to understand disease causation at the time. This
article considers, for the first time, the interaction of a host of
factors—preexisting medical thinking and practices, intellectual
communities, local environmental contexts, and specific social
circumstances in explaining the cause of human disease. To para-
phrase Charles Rosenberg, the varied and multifaceted “framing”
process of “perceiving, naming, and responding” to disease, involved
a range of scientific and medical persons who sought to make etio-
logic and therapeutic sense of disease in the context of the Philippine
tropical environment.2 Inevitably, Spanish colonial and patriotic Fili-
pino physicians, scientists, and sanitarians were dependent upon an
array of “time-bound intellectual tools” to hand—old and new ideas
about disease and illness, ontological orientations, the experience of

1. For descriptions of the fragmentary and haphazard nature of Spanish public health in
the late nineteenth century, see, for instance, Ken de Bevoise, Agents of Apocalypse: Epidemic
Disease in the Colonial Philippines (Princeton, New Jersey: Princeton University Press, 1995);
Warwick Anderson, Colonial Pathologies: American Tropical Medicine, Race, and Hygiene in the
Philippines (Durham and London: Duke University Press, 2006); on the response to cholera,
see Xavier Huetz de Lemps, “Les Philippines face au ‘Fantôme du Gange’: le cholera dans la
seconde moitié du XIXe siècle,” Ann. de Démog. Hist., 1990, 310 –35; Celestino P. Boncan
provides a list of the measures taken by the Superior Board of Sanitation Board (Junta Superior
de Sanidad) against cholera and smallpox in 1889 and names of the medicos titulares, doctors
who were assigned to various provinces throughout the archipelago from 1882 to 1897 in
“Historical, Political, and Economic Dimensions of Epidemics: Cholera and Smallpox
in 19th Century Philippines,” http://www.paclas.org.ph/PAPERS/Boncan.pdf.
2. Charles E. Rosenberg and Janet Golden, eds., Framing Disease: Studies in Cultural
History (New Brunswick, New Jersey: Rutgers University Press, 1992), xiii.
556 Journal of the History of Medicine : Vol. 69, October 2014
disease as physiological event, and how all these factors coexisted and
interacted with the particularities of time and place.3
What follows will focus on two developments—Spanish environmen-
talist thinking and the emerging fields of microscopy and bacteriol-
ogy. The first section of the article explores the literature on medical
geography, hygiene, and sanitation in the Philippines. Much like the
British and French colonialists, Spaniards viewed themselves as con-
stitutionally at risk in hot places, ill-suited, exposed, and vulnerable
to so-called native diseases.4 Their thinking on disease causation, in
the mid-nineteenth century, tended to combine medical geography
and a “discourse of tropicality” that sought to offer explanations in
terms of the impact of nature, the environment and climate, physical
topography, and the race or ethnicity and culture of local peoples.5
Since the eighteenth century, European imperial science, particularly
in France, had been concerned with the processes by which organisms
succeeded or failed to adjust and flourish under new environmental
conditions. Notions of ecological commensality and acclimatization, as
articulated by George-Louise Leclerc de Buffon, Jean-Baptiste Lamarck,
Georges Cuvier, and Isidore Geoffroy Saint-Hilaire, dominated scien-
tific debate on the nature of species evolution. Hispanic science had
been intellectually turned toward France under the Bourbon monarchy,
and French influence saw no signs of waning even after the appearance
of Charles Darwin’s Origin of Species in 1859. Paris rather than London
remained the beating heart of studies in comparative anatomy, zoology,

3. Owsei Temkin, “The Scientific Approach to Disease: Specific Entity and Individual
Sickness,” in Scientific Change: Historical Studies in the Intellectual, Social and Technical Conditions
for Scientific Discovery and Technical Invention from Antiquity to the Present, ed. A. C. Crombie
(New York: Basic Books, 1963), 629 –47.
4. The literature on European environmentalism during the colonial period is abundant.
See, for example, Mark Harrison, Climates and Constitutions: Health, Race, Environment and
British Imperialism in India 1600 –1850 (New York and Oxford: Oxford University Press,
1999); David Arnold, ed., Imperial Medicine and Indigenous Societies (Manchester and
New York: Manchester University Press, 1988); David Arnold, Colonizing the Body: State
Medicine and Epidemic Disease in Nineteenth-century India (Berkeley: University of California
Press, 1996); Richard H. Grove, Green Imperialism: Colonial Expansion, Tropical Island Edens
and the Origins of Environmentalism, 1600 –1860 (Cambridge: Cambridge University Press,
1995); and Philip Curtin, Death by Migration: Europe’s Encounter with the Tropical World in the
Nineteenth Century (Cambridge: Cambridge University Press, 1989).
5. For a superb discussion of tropicality, the role played by environmental and biological
determinism in medical ideas, see David Arnold, The Problem of Nature: Environment and
Culture in Historical Perspective (Oxford: Wiley, 1996).
 Reyes : Environmentalist Thinking in Spanish Philippines 557
and natural history.6 In the Philippines, Spaniards may have harbored
ideas about white European degeneration and indigenous adaptation
(that native peoples possessed physiologies and constitutions uniquely
adapted to tropical environments and terrains), but there is little to
suggest that connections were made to Darwinism and biological
evolutionism, which were being debated roughly at the same time in
Spain and in Spanish America.7 In general, Spaniards in the Philip-
pines remained wedded to discourses that spoke of environmental
miasmas, bodily humors, and a deterministic view of living creatures,
their ability to survive and adapt to new climates based on their struc-
tural characteristics.8
It was not until the 1880s that alternative ideas arose to challenge
the dominance of medical environmentalism and the sense of diffe-
rence and otherness that infused Spanish colonial medical discourse.
Filipino physicians and pharmacists, some of whom would undertake
their doctoral studies and scientific training in the medical centers of
France and Spain, became influenced by, or were at least more recep-
tive to, the development of bacteriology and microscopy being
pioneered by Louis Pasteur and Robert Koch.9
The second section of this article examines the work of three
Filipino scientists: Anacleto del Rosario (1860 –95), who investigated
water contamination; Antonio Luna (1866 –99), whose research
focused on malaria; and Francisco Liongson (1869 –1919), whose
expertise lay in microbiology. Working independently of each other
and at different times, they nevertheless came from similar intellectual
and educational backgrounds. They straddled the divide between
environmentalist thinking and microbiology. Working to introduce

6. Greg Bankoff, “The Science of Nature and the Nature of Science in the Spanish and
American Philippines,” in Cultivating the Colonies: Colonial States and Their Environmental
Legacies, ed. Christina Folke Ax, Niels Brimnes, Niklas Thode Jensen, and Karen Oslund
(Athens: Ohio University Press, 2011), 80 –83.
7. Thomas F. Glick, Miguel Angel Puig-Samper, and Rosaura Ruiz, eds., The Reception of
Darwinism in the Iberian World: Spain, Spanish America and Brazil (Dordrecht, Boston,
London: Kluwer Academic Publishers, 1999). The reception of Darwin’s ideas in nine-
teenth-century Philippines is an intriguing but as yet unexplored field.
8. David Arnold, ed., Warm Climates and Western Medicine (Amsterdam and Atlanta,
Georgia: Rodopi Press, 1996), 6.
9. Under the numerous and complex racial and caste categorizations of the Spanish
colonial period, the term “Filipino” referred to persons of Spanish descent born in the
Philippines. In this article, I utilize “Filipino” in its current sense, meaning all people native
to the Philippines.
558 Journal of the History of Medicine : Vol. 69, October 2014
an understanding of how parasites and microorganisms functioned
in the production of illness, they endeavored to forge a distinctive
medical discourse that could refute colonialist allegations that the
Philippine environment was intrinsically unhealthy and that Filipino
bodies were markedly diseased and pathological. Although they could
not make their patriotism explicit, they believed the fields of bacteri-
ology and microscopy could potentially resist colonial presumptions
and agendas by wresting ideas of disease causation from prejudicial
attitudes toward the tropical environment and the physiognomy of
native bodies. This is not to argue, however, that the need to under-
stand disease causation resulted in the acceptance of a monolithic
Pasteurian germ theory, transmitted from metropole to periphery.
Instead, multiple, diverse, and conflicting theories abounded, and the
notion that a microbe played a role in disease causation was an emer-
gent discourse among many.10

A N TO N I O CO D O R N I Ú ’ S TO PO G R A F I A M É D I CA D E L A S I S L A S
F I L I P I N A S : S I C K N E S S , R AC E , A N D T H E F I V E S E N S E S
I N A T RO P I CA L C L I M AT E

Medical geography strengthened the notion that hot, wet climates,

the “torrid” zones of the earth, harbored deadly miasmas that were
exceptionally harmful to European constitutions. Indigenous peo-
ples, on the other hand, possessed physiologies that were either
immune to, or were remarkably adept at, combating native diseases.
In the mid-nineteenth-century Philippines, the most important
work to elucidate this environmental determinism was Topografia méd-
ica de las islas Filipinas, written by the Spanish military physician and
medical inspector Antonio Codorniú y Nieto. Published in 1857 and
based on travel observations and forty years of experience in the
archipelago, Codorniú’s treatise explored the relationship between
climate, topography, the culture, and folkways of local society, and
the production of pathogenic illnesses in the Philippines.11

10. In this respect, cross-cultural and comparative investigations on the reception and
local assimilation of germ theories of disease are particularly valuable. See Nancy J. Tomes
and John Harley Warner, “Introduction to Special Issue on Rethinking the Reception of the
Germ Theory of Disease: Comparative Perspectives,” J. Hist. Med. Allied Sci., 1997, 52,
7–16.
11. Antonio Codorniú y Nieto, Topografia médica de las islas Filipinas (Madrid: Impr. de
A. Gomes Fuentenebro, 1857).
 Reyes : Environmentalist Thinking in Spanish Philippines 559
Codorniú’s book had enduring appeal and would influence a range
of medical literature that included advice manuals or cartillas on
hygiene and even doctoral dissertations on medical geography writ-
ten in the late 1890s.12
Born in Barcelona in 1817, Codorniú was the son of a distin-
guished medical officer who held high-ranking posts both in the mil-
itary and the government. Possibly because of the father’s political
activities, his family was forced into exile in Mexico where the young
boy spent his formative years, returning to Madrid to study medicine
and surgery, qualifying to practice in 1838. He arrived in Manila in
1844 to take up the post of Vicecónsul Médico.13
Codorniú was a man with little patience for the fantastic and the
sensational. He was plainly contemptuous of travel accounts that told
of fabulous creatures, lustful barbarian women, and battles with mon-
sters that too often seemed to spice up many a traveler’s tale about
Spain’s far-flung colonial possession.14 His intention was to examine,
with specificity and “scientific” accuracy, the sorts of conditions and
influences that impinged on the health or illness of a human body.
Following the complex Spanish colonial racial and ethnic categoriza-
tions of the time, Codorniú classified the diverse inhabitants of the
Philippine archipelago under several types: the “negritos,” black-
skinned people of short stature; the “natives” or indios, indigenous
Filipinos; the Chinese; Chinese mestizos; Spanish mestizos (those
born in the Philippines to a Spanish father and an indigenous
mother); Filipinos, Spaniards born in the Philippines (also known as
hijos del paı́s, sons of the country); and Spaniards born in Spain and
other Europeans.15 Codorniú argued that each racial and ethnic

12. Rafael Ginard y Mas, Manual de medicina doméstica precedido del arte de conservar la salud
y puesto al alcance de todas las clases de la sociedad (Manila: Imprenta de Ramı́rez y Giraudier,
1858); and Jean-Alexandre Isaac Tschudnowsky, “Contributions à la geographie médicale de
l’archipelago malais” (Doctoral thesis, Faculté de Médecine de Paris, 1898 – 99).
13. Valentı́n Matilla Gómez, 202 Biografı́as Académicas (Madrid: Real Academia Nacional
de Medicina, 1987), 42.
14. Codorniú, Topografia, 10.
15. Recent years have seen several very good studies on race and empire in American-
occupied Philippines. See, for example, Paul A. Kramer, The Blood of Government: Race,
Empire, the United States, and the Philippines (Chapel Hill: The University of North Carolina
Press, 2006); Vicente L. Rafael, “White Love: Surveillance and Nationalist Resistance in the
U.S.,” in Cultures of United States Imperialism, ed. Amy Kaplan and Donald E. Pease (Durham,
North Carolina: Duke University Press, 1993), 185 –218; Vicente L. Rafael, “Colonial
Domesticity: White Women and United States Rule in the Philippines,” Am. Lit., 1995, 67,
639– 66; and Anderson, Colonial Pathologies.
560 Journal of the History of Medicine : Vol. 69, October 2014
group was affected differently by the tropical environment and suc-
cumbed to illness in different ways: “Each race, each group of Man,
each family, each individual, has different constitutions, inclinations,
customs, and other particular attributions dictating more or less their
adaptability to the country.”16 For instance, the “negritos,” living
closest to nature, appeared to possess robust constitutions—they were
the least exposed to civilization, indolent and passionate in nature,
dwelling in forests in the mountains of Mariveles, Zambales, and
Camarines. Contrastingly, Tagalogs, residing mainly in the Hispan-
ized areas of Manila and its environs, were seen as civilized, intelli-
gent, but physically weak and prone to the corruption that was part
of life in cities and towns.17
Codorniú’s discussion of the characteristic features of a tropical cli-
mate; social customs and diet, and differences in physiology, tempera-
ment, and even the mental capacity of races and ethnic groups of the
Philippine archipelago would, in certain respects, foreshadow much
later work written by Europeans on the illnesses of hot countries,
which debated and compared the susceptibility of different races to
epidemic diseases.18 Codorniú’s key point—that environment shaped
a people’s character, physiology, and adaptability—placed at center
stage the dynamics of geography and culture. His related point—that
bodies themselves responded differently according to their constitu-
tions, temperament, and geographic locale—introduced an impor-
tant dimension of racial politics that was imperial in thrust and scope.
Thirdly, he stressed the importance of understanding differences in
bodily responses to morbid climates. For Codorniú, the body itself
acted as a kind of barometer by which the healthiness of environ-
ments may be measured.
Of particular interest in Topografia is Codorniú’s discussion of how
the Philippine tropical climate affected sensory perception. Although
occupying but a small part of Codorniú’s study, the section on climate
and the senses, or the ways in which heat, humidity, the air, and
the light of the tropics affected touch, taste, smell, hearing, and vision,
is worth highlighting here because his contention that human

16. Codorniú, Topografia, 17.

17. Ibid., 21.
18. See, for instance, Fernand Roux, Traité pratique des maladies des pays chauds: maladies des
système lymphatique et cutané (Paris: G. Steinheil, 1888); and Fernand Roux, Traité pratique des
maladies des pays chauds: maladies infectieuses générales (Paris: G. Steinheil, 1889).
 Reyes : Environmentalist Thinking in Spanish Philippines 561
reaction—the body’s biological responses, primarily through sensory
perception—would for decades remain the cornerstone in understand-
ing and explaining disease in the Philippines. “Exterior agents” were
perceived on the human body, explained Codorniú, “by the intermedi-
ary of the senses.”19 The senses, according to Codorniú, also delineated
clear racial differences between European and native. For instance, the
visual sense of Filipinos and Europeans was starkly different. The former
retained good vision well into advanced age; the latter suffered from
debilitated vision due to the excessive quantity of bright light in the
tropics. Because of good vision, a great majority of Filipinos, observed
Codorniú, could read and write, could weave and embroider cloth and
hats of exquisite quality. If a Filipino felt some irritation in his eyes, this
could be easily corrected by his special constitution and temperament.20
On the other hand, the bright rays of the sun, and the heat which
quickly dried the earth and produced dust, took their toll on the eye-
sight of Spaniards and other Europeans. Under tropical conditions,
Europeans, thought Codorniú, were prone to ambliopia (amblyopia),
reduced vision in the eyes (popularly known today as “lazy eyes”).
Those especially vulnerable were the colony’s Spanish civil servants—
government employees whose time was spent at a desk. Care and
hygiene, Codorniú advised, needed to be observed if eyesight was to be
preserved. Windows should be opened slowly to allow the eyes to
become gradually accustomed to the light; eyes should be protected
from glare, periodically rested, and carefully and regularly bathed in
cold water mixed with a little wine or spirits.21
A distinguishing feature of medical geography was that it concep-
tualized the tropics as uniquely dangerous to the European body. It
assumed that tropical diseases were distinctive and diseases familiar to
Europe took forms that were far more virulent and deadly in tropical
climes. Geography, vegetation, and climate—the high temperatures,
humidity, the glare of the sun, the winds, and rain—were the “modi-
fications” of the country (“los modificadores del Paı́s”) that imposed
upon human wellbeing, and elicited distinct bodily reactions, such as
boils and suppurations on the skin, inflammations in the ears, and
sores in the mouth. The enervating climate produced apathy,

19. Codorniú, Topografia, 254.

20. Codorniú, Topografia, 257.
21. Ibid., 258.
562 Journal of the History of Medicine : Vol. 69, October 2014
promoted a “horror of work and movement, inertia of the digestive
organs and a general nervous over-excitement.”22 Certain parts of the
unacclimatized European body, according to Codorniú, were partic-
ularly at risk in the Philippines’ tropical environment—the nervous
system, the heart, the liver, and the stomach. Hot climates affected a
woman’s patterns of menstruation; illnesses such as vomiting, diar-
rhea, heart palpitations, hemorrhages and hemorrhoids, sadness, and
nostalgia were common among Europeans.23
Codorniú made little attempt to identify precise causes of sickness
and disease. Rather, his general approach was to range widely, to sit-
uate disease within the particular and local social and environmental
landscapes of the Philippine archipelago, and to observe and describe
the signs of disease manifested on European and native bodies.
Such thinking was not confined to human bodies, but extended to
plant and animal life, informing State attitudes and approaches to ani-
mal breeding programs and the propagation of introduced species.
Zootechny—the scientific breeding of plants and animals—was
anchored on the principle that processes of acclimatization could be
managed by progressive adaptation. A prime example of such engi-
neering was the bid to improve the size and stature of horses in the
Philippines, which were considered lamentably diminutive in size
and weak in strength. As Greg Bankoff has recounted, it was widely
held that the Philippine tropics accounted for the horse’s progressive
diminution since the animal was first introduced in the late sixteenth
century. Such beliefs, Bankoff writes, were not without their “moral
overtones,” and they provided “justification for imperial interven-
tion.”24 But despite concerted efforts throughout the 1880s to halt
the retardation of the domestic horse by breeding with Arab blood-
stock imported from British India, the ostensible degenerative effects
of a tropical climate seemed to be impossible to reverse.25

22. Ibid., 103.

23. Ibid., 42– 44. Cordoniu’s worries about European degeneration and illness from the
disease of “nostalgia” while residing in the Philippine tropics is given concise attention by
Anderson, Colonial Pathologies, 76–77.
24. Greg Bankoff, “A Question of Breeding: Zootechny and Colonial Attitudes toward
the Tropical Environment in the Late Nineteenth-Century Philippines,” J. Asian Stud.,
2001, 60, 413 –37.
25. Other ecological formulations specifically in relation to endotherms are Bergmann’s
Rule, proposed by Carl Bergmann in 1847, and Allen’s Rule, proposed by Joel Asaph Allen in
1877, the latter stating that endotherms in colder climates are in possession of shorter append-
ages. Interestingly, the last thirty years have seen new questions raised by “anthropometric
 Reyes : Environmentalist Thinking in Spanish Philippines 563
H OW TO T R E AT P H I L I P P I N E D I S E A S E S : T H E L I T E R AT U R E O N
H Y G I E N E A N D S A N I TAT I O N

Codorniú’s advice resonated for many years in the pages of medical

manuals and works on Philippine nosology written to assist European
medical practitioners in the treatment of illnesses in the Philippines.26
Much of this literature focused on the survival needs of Europeans,
and the advice offered was framed with reference to differing topog-
raphies, social conditions, and the local inhabitants. Sanitation and
hygiene were emphasized, and the efficacy of combining European
medicines with local drugs. Medical manuals had been in circulation
in the Philippines since the eighteenth century and had often been
written or translated into vernacular languages by missionary priests.
Father Fernando Santa Maria’s Manual de medicinas caseras, para consuelo
de los pobres indios, for example, adapted the Enlightenment ideas of
the eighteenth-century French physician Samuel Auguste Tissot.
First published in 1768, the book was translated into Tagalog in 1883
and continued to be in use until 1905.27
The manuals and cartillas de higienica of the 1880s and 1890s
eschewed the style of “secret recipe books” and the use of age-old
materia medica, including, for example, the excreta, urine, and blood
of animals and humans that peppered the works of priests. Instead,
“scientific” methods were emphasized with the use of statistics, and
clinical and pathological inquiries. These later works were as impor-
tant as the many learned scientific and medical journals that appeared

historians” who track how populations around the world have changed in stature over time.
The central hypothesis they propose is that where “height variations within a population are
largely genetic . . . height variations between populations are mostly environmental.” “The
Height Gap: Why Europeans Are Getting Taller and Taller and Americans Aren’t” by Bur-
khard Bilger, The New Yorker, April 5, 2004. http://www.newyorker.com/archive/2004/04/
05/040405fa_fact?currentPage=all.
26. See, for example, Pedro Saura y Coronas, De la fiebre hipertermica perniciosa de Manila
(Madrid: Establecimiento Tipografico de E Jaramillo y Co., 1891); Enrique Mateo Barcones,
Estudios para una nosologı́a Filipina (Madrid: Imprenta y Litografı́a del asilo de Huérfanos del
Sagrado Corazón de Jesús, 1895); Jean-Alexandre Isaac Tschudnowsky, “Contributions à la
geographie médicale de l’archipelago malais” (Doctoral thesis, Faculté de Médecine de Paris,
1898–99).
27. Fr. Fernando de Santa Maria, Manual de medicinas caseras para consuelo de los pobres Mai-
cling casaysayan nang sarisaring gamot na magagamit sa bahay nang maguihauanhan ang manga
mahirap, lalong lalo sa manga bayang ualang mabuting medico, at ualang botica. Tinagalog at pina-
mutihan nang ilang notas ni D. Antonio Florentino Puansen, Maestro sa Latinidad (Manila:
Imprenta de Esteban Balbas, 1883).
564 Journal of the History of Medicine : Vol. 69, October 2014
in the mid-1880s and early 1890s in producing and disseminating
knowledge about illnesses and their treatments in the Philippine trop-
ics. Moreover, in contrast to journals whose circulation was limited to
pharmacists and medical professors within the Faculty of Medicine
and Pharmacy, they strived for wide appeal.28
The cartillas advertised themselves as a sort of everyman’s medical
instruction booklet, a practical and straightforward aid in the recogni-
tion and treatment of illnesses. Published locally, the cartillas were
written by Spaniards and either sought to address medical practition-
ers or students or aimed to bring current medical debates to the wider
attention of the Spanish and Filipino reading public. A notable exam-
ple was Arte de cuidar de enfermos, a booklet on personal hygiene writ-
ten for Filipinos by the Spanish mestizo T. H. Pardo de Tavera.29
Usually, though, cartillas carried descriptions of illnesses, exotic and
familiar, that were firmly rooted in doctors’ experiences in the
Philippines. One example that had no pretensions to sophistication
was the Manual Filipino de medicina y cirugı́a practicas (Filipino Manual of
Practical Medicine and Surgery). Published in Manila in 1884 by Fran-
cisco Capelo Juan, a professor of therapeutics and materia medica at
the Faculty of Medicine in Manila, the Manual repeatedly recom-
mended the observance of scrupulous hygiene and a moderate life-
style. Further, the remedies it carried happily incorporated local
materia medica into European medical therapies.30 For instance, in
the treatment of sexually transmitted diseases, the Manual stressed
absolute sexual abstinence (even the observance of physical distance
between the sexes), and thorough washing of the extremities using

28. Boletı́n de medicina de Manila; Revista farmacéutico de Filipinas; and the Crónicas de ciencias
médicas. For a discussion on the importance of locally published medical and scientific jour-
nals in India and Brazil, see Mark Harrison, “A Question of Locality: The Identity of
Cholera in British India, 1860 –1890,” in Warm Climates and Western Medicine, ed. Arnold,
133– 60; and Julyan G. Peard, “Tropical Medicine in Nineteenth-century Brazil: The Case
of the ‘Escola Tropicalista Bahiana,’ 1860 –1890,” in ibid., 108 –33.
29. The only such work known to have been authored by a Filipino is T. H. Pardo de
Tavera’s Arte de cuidar enfermos (Manila: Tipografia de Chofre y Comp., 1895). This work was
translated from Spanish to Tagalog by Inigo Regalado y Corcuera and published as Paraan sa
pag-aalaga sa maysaquit (Manila: Imprenta de J. Atayde, 1895).
30. D. Francisco Capelo Juan, Manual Filipino de medicina y cirugı́a practicas para uso de lo
medicos, cirujanos, practicantes, mediquillos util y necesario, Tomo I Primera Edición (Binondo,
Manila: Establecimiento Tipo-litográfico de M. Perez, 1884).
 Reyes : Environmentalist Thinking in Spanish Philippines 565
solutions of copper and zinc sulphates infused with leaves from roses
and guava.31
In addition to discourses on safeguarding individual constitutions,
medical topography, climatology, and environmentalism continued to
provide foci and direction for the new literature on hygiene and sani-
tation. Writing for European travelers or colonial personnel unac-
quainted with the archipelago, González y Martı́n, a physician at the
Universidad Central de Madrid, counseled avoidance of specific
localities and seasons associated with disease. His ambitious study on
hygiene and the conservation of health, entitled Filipinas y sus habi-
tantes: lo que son y lo que deben ser (Philippines and its inhabitants: what
they are and what they should be) shows that as late as 1896, Spanish
medical writers were wont to summarize the dangers to European
health posed by the Philippines in terms of the country’s fertile lush-
ness, “fertilidad,” and its unhealthiness, “insalubridad.”32
In hot, fluctuating temperatures and high humidity, a European
body needed to stay cool and fresh by bathing, wearing clothing of
loose, light fabrics, and practicing moderation. Hydrotherapy, advised
González y Martı́n, staved off a variety of illnesses in the tropics
including “impoverishment of the blood” arising from excessive
sexual intercourse in high temperatures and humidity.33 Similarly,
Dr. Victor Suarez Caopalleja, writing in 1897, optimistically believed
that routine observance of personal hygiene and cleanliness could
alleviate the physical discomforts experienced by Europeans residing
in the tropics. Suarez’s advice was simple—“plentiful water,” special
care in looking after the skin, and a “wise disposition” would ensure
the wellbeing of European bodily functions.34 Benito Francia, the
inspector general of Manila’s public board of health and a well-known
Spanish hygienist, railed against local customs that he felt encouraged
filthy environments and rank, unhealthy living: the improper disposal
of waste and dirty water; allowing pigs to snuffle in the waste and
mud beneath houses; permitting young children of both sexes to

31. Ibid., 357.

32. R. González y Martı́n, Filipinas y sus habitantes: lo que son y lo que deben ser (Béjar: Est.
Tip. De la viuda de Aguilar, 1896), 77.
33. R. González y Martı́n, Estudio Teórico-Practico sobre el empleo del agua en la hygiene y pato-
logı́a aguda y destinado á los medicos jóvenes, escolares de la facultad (Manila: Imprenta de Amigos
del Paı́s, 1889).
34. Anderson, Colonial Pathologies, 78.
566 Journal of the History of Medicine : Vol. 69, October 2014
sleep together in one room; and preventing the free circulation of air
by keeping doors and windows closed. As a sanitary reformer in the
Philippines, Francia believed that diseases were caused by filthy bod-
ies, locales, and “impure” atmospheric conditions. He sensibly rec-
ommended cold, short baths to prevent skin eruptions, reinvigorate
the appetite, and improve circulation. In 1894, he wrote at length on
the place of air in the conservation of health and the prevention of ill-
ness.35 Francia adhered closely to miasmatic thinking about “aire”
and the “atmósfera” which, he wrote, sometimes became contami-
nated by harmful gases, or ferment from decayed animals or vegeta-
tion.36 It is likely that what Francia had in mind here was malaria or
“marsh fevers” produced, it was still thought, by fetid emanations.
Yet, interestingly, Francia went on to recommend the salubriousness
of forested areas, places most feared for malarial fever: “The sur-
roundings of a forest, when not too dense [but] with sufficient space
for the circulation of air and the entry of sunshine, is very helpful,
because the trees supply the atmosphere a great quantity of oxygen,
protection from excessive heat, cover from the fierce winds and nour-
ishment for natural springs.”37 Forests, in Francia’s view, played an
important role in improving one’s health, the surrounding environ-
ment, and the cleanliness of the air.
Cartillas gave a prominent role to public and private hygiene, sanita-
tion reform, and local conditions, especially the action of external
“environmental” factors in explaining disease. Works on Philippine
nosology, on the other hand, treated diseases of the tropics as analogous
to those found in temperate countries. The assumption that Europeans
were constitutionally ill-suited to high temperatures, humidity, and
sunlight remained more or less unvarying, although some authors, like
Enrique Mateo Barcones, argued that women from the tropics suffered
no more and no less than women from temperate climes when it came
to female afflictions: “the syndrome, as with the treatment, was equal”

35. Benito Francia y Ponce de Leon, Cartilla Higiénica y prontuario de algunas medicinas de
uso común en Filipinas (Manila: Tipo-Litografı́a de Chofré, 1894). Francia published a second
volume the following year Una Cartilla Higiénica (Pandacan: Imprenta de Paris-Manila,
1895).
36. Francia, Cartilla Higiénica, 9.
37. Ibid., 11. On malaria and the forested uplands of the Philippines, see De Bevoise,
Agents of Apocalypse, especially 142 –64.
 Reyes : Environmentalist Thinking in Spanish Philippines 567
he thought, at least for women.38 Like the cartillas, the literature on
Philippine nosology rarely ventured far from the cognitive parameters
of medical topography. Barcones’s work, entitled Estudios para una
Nosologı́a Filipina, provides a notable exception. For what was possibly
the first time, microbes were included in the discussion of disease.

I N T RO D U C I N G T H E I N F E C T I O U S M I C RO B E : F E V E R S I N E N R I Q U E
M AT E O B A R CO N E S ’ S N O S O LO G Í A F I L I P I N A

Discussions on the European predisposition to fevers in the tropics are

commonplace in medical literature from the seventeenth century
onwards.39 “Malarial fever” was a broad and vague term that might
describe a range of miasmatic diseases arising from “bad” air. Worboys
states that it was only after 1850 that differentiation occurred on the
basis of “symptomology, pathological anatomy . . . and aetiology.”
Prior to germ theory, remittent and intermittent fevers were thought
to arise either from malarious conditions or the effects of heat on the
constitution, the “chill theory.”40 Barcones’s Nosologı́a Filipina, pub-
lished in 1895, identified several types of fever prevalent in the Philip-
pines that fell under the rubric “endemic illnesses.” They ranged from
malarial wasting (caquexia palúdica) and cutting or shooting malaria (pal-
udismo barbado) to continuous fever (fiebres continuas) and serious fever
(fiebres graves). As detailed by Barcones, each type of fever manifested
variations and degrees of symptoms (stages of cold, hot, and excessive
sweating), but all appeared to broadly conform to “remittent,” “inter-
mittent,” and “paroxysmal” fevers, today identified with malaria.41 For
this variety of fevers, Barcones broadly posited two related but differing
explanations. The first supposed that the malarial parasite flourished in
soil composed mainly of decaying and fermenting vegetation. Follow-
ing descriptions by Laverán, Barcones thought the parasite was poly-
morphous, appearing as spherical, flagellae, crescent, or flower-shaped.
The environmental conditions of the Philippines, in his view, were

38. Enrique Mateo Barcones, Estudios para una Nosologı́a Filipina (Madrid: Imprenta y
Litografı́a del Asilo de Huérfanos, 1895), 135.
39. See, for instance, the study by David Henley, Fertility, Food and Fever: Population, Econ-
omy and Environment in North and Central Sulawesi, 1600 –1930 (Leiden: KITLV Press, 2005).
40. Michael Worboys, “Germs, Malaria and the Invention of Mansonian Tropical Medi-
cine: From ‘Diseases in the Tropics’ to ‘Tropical Diseases,’” in Warm Climates and Western
Medicine: The Emergence of Tropical Medicine, 1500–1900, ed. David Arnold (Amsterdam:
Rodopi, 1996), 186.
41. Ibid., 182.
568 Journal of the History of Medicine : Vol. 69, October 2014
particularly conducive to the life cycle of the parasite—high humidity
in the atmosphere together with high temperatures producing lush
vegetation that quickly decomposed. The resulting ferment and putre-
faction poisoned the atmosphere and served as a vehicle for all types of
infectious germs.42
Barcones’s second explanation proposed an “infectious microbes”
theory: the penetration of unhealthy germs (germenes morbosos) within
an organism to produce a “local infection.” A break in the skin or
mucous membranes provided other points of entry and places where
microbes could develop. The occurrence of a general infection, on the
other hand, was harder to apprehend. Infection could occur via a path-
ological reaction toward virtually anything; or by the presence of toxins
in blood giving rise to a struggle between microbial agents and
“organic cells.” A general infection was characterized by a period of
incubation of uncertain length of time when the patient could present
no symptoms.43
Published three years before Ronald Ross made his discovery, in
1898, that mosquitoes acted as vector hosts for the malarial parasite,
Barcones’s study made no mention of vectors, much less vector
control measures.44 To his mind, there were two explanations for
fever—malarial parasites in the soil conveyed to the atmosphere by
evaporation and rain; and second, the penetration of infectious
microbes. Barcones was apparently unaware that at about the same
time, Patrick Manson was investigating the life cycle of filarial-worms
and developing his ideas on the differing role of bacteria and parasites
in disease.45 Barcones’s arguments followed the scholarship of several
European scientists—Eberth, Pasteur, Laverán, Koch, and Meyer, and
he clearly intended to demonstrate how these explanations operated

42. Barcones, Nosologı́a Filipina, 200.

43. Ibid., 227.
44. There was, at any rate, a tendency amongst European health officials to downplay the
importance of vector control at the time. See Randall M. Packard, The Making of a Tropical
Disease: A Short History of Malaria (Baltimore: Johns Hopkins University Press, 2007), 125.
45. Patrick Manson’s initial findings on filarial worms was read in 1878 before the Linnean
Society and soon after published by the Society’s Journal. His investigations on malarial blood
appeared in the British Medical Journal in 1894 under the title “On the Nature and Significance
of the Crescentic and Flagellated Bodies in Malarial Blood,” BMJ, 1894, 2, 1306–8. On the
failure of late nineteenth-century British and American scientists to develop a generalized para-
sitic theory of disease that fruitfully exploited connections between parasitology and bacteriol-
ogy, see John Farley, “Parasites and the Germ Theory of Disease,” in Framing Disease, ed.
Rosenberg and Golden, 33–49.
 Reyes : Environmentalist Thinking in Spanish Philippines 569
under local conditions, in the tropical environment particular to the
Philippines. Barcones showed that the two explanations coalesced
neatly in a particular fever that appeared in a class all by itself: the
“pernicious hyperthermic fever of Manila” (fiebre hipertérmica perni-
ciosa de Manila). First proposed by the physician Pedro Saura in 1891,
this particular fever was believed to be distinctive to Manila and to
flourish in the hottest months of the year, April and May, when the
atmosphere was intolerably warm and humid.46 Of uncertain etiol-
ogy, it was thought that the fever was caused by the ferment from the
large amounts of decomposing vegetation that clogged the Pasig
River, the city’s main waterway. The parasite was spread by the humid
atmosphere or was carried in drinking water, and upon entering the
blood stream penetrated and destroyed red blood cells.47
Barcones appeared to have a foot in both camps. He continued to
think about malaria in terms of symptomology and miasma in much
the same way as other Spanish sanitarians and physicians based in the
Philippines. He also appeared to accept the idea that pathogenic
organisms, bacteria or parasites, could act as causative agents that
could come from the soil and be transmitted by air and water. He
recognized the validity of taking blood samples in the diagnosis of
pathological change, noting the destruction of red blood cells as well
as changes in the appearance of the spleen and liver. The influence of
Barcones’s work is unclear. The Spanish colonial government had
been investing in research on cholera and malaria for at least a decade
before the publication of Barcones’s study. Indeed, what seemed to
capture the interest of the colonial government was the work being
undertaken not by Spaniards but by Filipinos.

F I L I P I N O S A N D T H E M I C RO S CO P E : T H E E M E R G E N C E O F
M I C RO S CO P Y A N D B AC T E R I O LO GY I N T H E P H I L I P P I N E S

Marcos Cueto’s analysis of Peruvian science from the mid-nineteenth

to the early twentieth century has sought to show how intellectual con-
tinuities, contradictions, and ambivalences became embedded in the
style and context of local scientific practice as it occurred “at the
periphery” and “under conditions of adversity.” Identifying factors that

46. Pedro Saura y Coronas, De la fiebre hipertermica perniciosa de Manila (Madrid: Tip. de
E. Jaramillo), 42.
47. Barcones, Nosologı́a Filipina, 219.
570 Journal of the History of Medicine : Vol. 69, October 2014
help characterize the style and functions of local science, Cueto
included “the use of utilitarian and nationalistic arguments to justify
science, the use of economical and accessible technologies, and the
construction of horizontal, national, and international networks of
communication.”48 These observations find resonance in the Philippine
case, where patriotically minded Filipino scientific practitioners, like
their Peruvian counterparts, worked outside of large research teams
and with meager resources, while making routine use of microscopes
in their work and keeping abreast of the latest French and Italian
scientific literature.
The final section of this article explores the work of three Filipinos:
Anacleto del Rosario, who investigated water pollution in Manila in
the 1880s; Antonio Luna, who studied malaria in the early 1890s; and
Francisco Liongson, a Chinese-Filipino who specialized in micro-
biology. Unlike the two younger men, Rosario did not leave the
Philippines to complete his education in universities in Spain and
France and spent his brief but brilliant career entirely in the Philippines.
Yet there are some important commonalities: Luna and Liongson
were members of a renowned group of intellectual, patriotic Filipinos
known as the propagandistas, a group of young men who studied in
European capitals and campaigned for political and social reform in
the Philippines.49 All three men completed their bachelor’s degrees at
the Ateneo de Manila before going on to train at the Dominican-run
Universidad de Santo Tomas in Manila, where they received their
licentiates in pharmacy and medicine. Rosario and Luna worked in
some capacity for the Municipal Laboratory of Manila established
in 1888,50 and all three men were profoundly influenced by Pasteurian
medicine and made full use of the microscope to examine the links
between microorganisms and illness.
However, the work of these men was not bound by any sense of
common purpose or distinguished by an intention to take a critical
stand on traditional and colonial understandings of disease causation.

48. Marcos Cueto, “Natural History, High-Altitude Physiology and Evolutionary Ideas
in Peru,” in The Reception of Darwinism in the Iberian World, eds. Glick et al., 92.
49. See Raquel A. G. Reyes, Love, Passion and Patriotism: Sexuality and the Philippine Propa-
ganda Movement, 1882–1892 (Singapore and Seattle: National University of Singapore Press in
association with University of Washington Press, 2008).
50. A brief survey of the Spanish colonial state’s scientific undertakings is given by
Warwick Anderson, “Science in the Philippines,” Philipp. Stud., 2007, 55, 293 –98.
 Reyes : Environmentalist Thinking in Spanish Philippines 571
Their writings show that they were deeply engaged with current
debates taking place in Europe, and they struggled to bring to bear
the new, modern science of microbiology on the specific diseases and
conditions of the colony.
Anacleto del Rosario had the earliest start of the three in this
work. Known as the “father of Philippine laboratory science,”
Rosario was a pioneer in microscopy in the Philippines. He was
awarded his licenciado in 1882 enabling him to begin practice at the
age of twenty-two with a special interest in cholera. In the year of his
graduation, he was appointed as a pharmacist-member of Manila’s
Sanitary Commission and served in a quarantine out-station during
an epidemic. He undertook bacteriological examinations of cholera
stools, though was unsuccessful at isolating a pure culture of cholera
vibrio. Though he would die at the early age of thirty-five, Rosario
was a prolific researcher and worked on the chemical analyses of adul-
terations in alcohols and medicines and published in 1890 a major
study on the mineral springs of the archipelago.51 His research on the
Pasig River, first published in the bulletin of the Royal Economic
Society in 1885 and subsequently as a monograph a year later, was
entitled Los olores del Pasig (The Odours of the Pasig).52 It was the first
major study of water pollution undertaken in the Philippines.
The Pasig River was considered pestilential. Until 1882, when
completion of the Carriedo Waterworks finally provided clean, pota-
ble water, filtered and piped from the Marikina River to the city’s res-
idents, the poor in particular had little choice but to rely upon the
Pasig’s fetid waters.53 Yet, although its miasmatic emanations were
well known, nobody fully understood why it made people sick and
why it smelled so awful. The state of the river was of long-standing
concern for the colonial authorities for reasons other than health.
Choked with vegetation, the river had become an inefficient water-
way. Commercial boats travelling along the Pasig inland to Laguna de
Bay were moving too slowly. Apparently motivated more by the need
to safeguard profit and less by an interest in health and sanitation, the

51. José Centeno, Anacleto del Rosario y Sales, and José De Vera y Gómez, Memoria
descriptiva de los manantiales minero-medicinales de la isla de Luzon (Madrid: Manuel Tello,
1890).
52. Anacleto del Rosario y Sales, Los olores del Pasig (Manila: Est.Tipo., 1886), 52.
53. Francisco de Mas y Otzet, Carriedo y sus obras memoria de los obras pias de los pobres y del
agua instituidas (Manila: Ramirez y Giraudier, 1882).
572 Journal of the History of Medicine : Vol. 69, October 2014
Governor General in co-operation with a commercial association
took the first bureaucratic steps toward cleaning the river between
1852 and 1853.54 In 1860, the city’s superintendent of sanitation
sprung into action. He called for a section of the river to be cleaned
immediately, for it had become so clogged with filth that it was virtu-
ally impassable for the delivery boats that plied its length. Attention
was also given to stinking urban spaces. In a bid to address the noxious
stench of urine that seemed to saturate the public market places of
Tondo and Binondo, funding of 290 Mexican dollars was allocated in
1862 for the installation of two latrines.55 Two major cholera epidem-
ics later, hygiene and sanitation became an urgent priority. Spanish
officials ordered major public places to be cleaned and disinfected
and instituted a general crackdown on local customs deemed unhy-
gienic. In particular, local rituals to mourn the dead that involved
leaving the cadaver unburied for several days and parading the corpse
through the streets to the Church were expressly forbidden.56 During
the brief hiatus that occurred between the 1882 and 1888 epidemics,
Rosario, a young and gifted Filipino professor of chemistry, was
appointed to analyze the waters of the Pasig.
His study, Los Olores, sought to “determine the chemical factors
causing the [river’s] unhealthy emanations” and was undertaken, he
wrote, “in the name of science and the hygiene of the Filipino
pueblo.”57 His thinking, he stated, had been most influenced by Louis
Pasteur and works on the microscope and on parasitology by the
noted French histologist and biologist Charles Philippe Robin
(1821 –55).58 Rosario attributed the “fetid gases” and reduced water
clarity to the overgrowth and decomposition of Protoccocus, a unicel-
lular algae. His book also presented a detailed examination of the
physical characteristics of the microorganisms present in the water,
which included descriptions of numerous types of bacteria, such as
Vibrio serpentulum and fever-inducing Spirillum.

54. AHN Ultramar, Leg.5165/35 Num.2.

55. AHN Ultramar, Leg. 5188/59.
56. Such practices had been officially discouraged since at least the mid-nineteenth cen-
tury by secular officials, but in 1887, Manila’s Governor General, in several communiqués to
the Archbishop of Manila, was particularly emphatic. AHN 5267/4 Num.10.
57. Rosario, Los olores, 52.
58. Ibid., 8.
 Reyes : Environmentalist Thinking in Spanish Philippines 573
Assessing the impact of Rosario’s findings on Spanish colonial
responses to later cholera epidemics is difficult. His recommendation
to dredge the river was never implemented, and American scientists
ignored his work when they dealt with cholera again at the turn of
the century. But Rosario’s attempt to identify and describe the nature
of microorganisms was an innovative approach taken at a time when
much of colonial state policy turned on working out more effective
sanitation procedures in relation to miasma.
Antonio Luna was intrigued by the microbial origins of malaria.
Honored in 1892 with a government scientific commission, he
thought it of great importance to conduct a study on a disease that was
a scourge on his country. Inspired by lectures he had heard in Paris
delivered by distinguished luminaries in microbiology and microscopy
such as Elie Metchnikoff and Paul Latteux, and fascinated by the para-
sites identified by Alphonse Laverán and a number of Italian microbiol-
ogists, he focused his research on hematozoa, blood parasites, and
sought to identify and understand their nature and characteristics.
Born in the Manila district of Binondo to parents from the Ilocos
region, Luna was trained in both pharmacy and microscopy. He went
to Europe in 1886 at the age of twenty, studying first in Barcelona,
where he finished the Licentiate in Pharmacy before pursuing a doc-
toral course at the Universidad Central de Madrid. Thereafter, he
worked in pharmaceutical laboratories in Ghent and Paris under
Metchnikoff and Latteux and also enrolled in a course on microbiolog-
ical technique given by Metchnikoff and Roux in Paris in the winter
of 1892.59 He contributed articles to a number of Spanish and French
scientific journals and, in 1892, was commissioned by the governor
general of the Philippines to lead a scientific commission to study ill-
nesses of bacteriological origin by taking observations in the hospitals
of Manila.60 In 1893, in Madrid, he published a brief but well-received
monograph on malaria entitled El hematozoario del paludismo.61

59. Luna’s name appears in No.12 Cours de Microbie Technique du Nov. 15– Dec. 31,
1892. Fonds de l’Institut Pasteur (Paris): Direction 1887 –1940 MTC 4 –5.
60. His comission is titled “Concediendo a D. Antonio Luna una comisı́on cientı́fica en Filipinas
para el estudio de las enfermedades de origen bacteriologico” dated 1892 in Legajo no. 5282/26
Archivo Historico Nacı́onal de Madrid (Ultramar).
61. Antonio Luna, El hematozoario del paludismo: su estudio experimental (Madrid: Estableci-
miento tipográfico de G. Pedraza, 1893).
574 Journal of the History of Medicine : Vol. 69, October 2014
Praised by the Spanish scientist Antonio Pulido for being an inci-
sive little work (“trabajito”) on medical science and experimental
pathology, Luna’s book was intended as an “experimental study on
the microbial origins” of malaria, which, he wrote, had been inspired
by the various analyses he had encountered of malarial blood which
contained the parasites discovered by Laverán and the Italian microbi-
ologists.62 Luna sought to show that malaria was an illness of parasitic
origin and not linked to Bacillus malariae, as proposed by Klebs and
Crudeli.63
Luna was well aware of previous thinking that attributed environ-
mental origins to malaria. Finding the “true malaria microbe,” Luna
recalled, had long evaded scientists. Microorganisms, especially those
found in decaying matter from marshy swamps and rivers, were
thought to float in the atmosphere and eventually find their way into
the human blood stream. Mid-nineteenth-century scholars working in
disparate areas—the United States, Ceylon, Calcutta, and Senegal—
had speculated on the “cryptogamous” origins of the disease and tried
to work out the role of certain plants and fungi and the release of spores
into the air; still others claimed to have discovered the presence of a
tiny cell of vegetal origin in human urine and sweat that appeared to
act as the causative agent of infection.64 Italian scientists working in
Florence and Rome in the 1870s examined algae in canal waters and
microorganisms found on beaches. Luna initially followed the research
of Klebs and Crudeli, German and Italian microbiologists, respectively,
who concentrated their attention on the bacteriological analyses of
swampy waters. In 1879, Klebs and Crudeli had examined the air and
waters of Italian marshes and managed to extract a stick-shaped bacillus,
which produced an intermittent fever similar to malaria when intro-
duced into the blood stream of rabbits. Such experiments, Luna
reflected, were not unfamiliar among scientists of the time. Anthrax
bacillus had been injected into piglets, resulting in elevated tempera-
tures within sixteen to twenty hours; a similar result was obtained with
Streptoccus erysipelatus, which brought on the acute bacterial infection
erysipelas that caused high fever, shaking, chills, vomiting, and general
malaise. The findings of Klebs and Crudeli seemed to point to

62. Luna, El hematozoario, n.p.

63. Ibid., 13.
64. Ibid., 14 –15.
 Reyes : Environmentalist Thinking in Spanish Philippines 575
something new, however, and scientists repeated their experiments
under similar laboratory conditions and tested on dogs with the same
results.65
The scientific rigor with which these activities were undertaken
gave Luna pause for thought. The waters of his homeland, the rivers,
lakes, and swamps, had still to be subjected to careful bacteriological
analyses—or as he put it with some poetic cheek: “Who knows what
they keep in their curling currents of liquid masses, virgins to the gaze
of students of modern science!”66 It is quite likely that Luna had in
mind his Manila colleague Anacleto del Rosario when he went on to
prescribe, perhaps with an arrogance he could scarcely disguise, the
analytical methods of European, particularly Paris-based, scientists with
which he had become familiar: a certain Doctor Miquel, the director
of a municipal observatory in Paris, “has an excellent method for this
sort of [bacteriological] analysis”; A. Girard, director of a municipal
laboratory had a “simple, safe, elegant and easy” way to handle gelatin
plates; Robert Koch offered his now famous “Postulates” for establish-
ing the microbial cause of disease; and Roux’s procedures formulated
to test the waters of Lyon, would all, remarked Luna, yield successful
results when applied to Philippine waters.67 But Luna did not dwell on
the issue of water. His encounter with Laverán’s discoveries, combined
with the influence of his maestro Metchnikoff, persuaded him to re-
direct his focus away from water and the environment and he began to
concentrate on what could be found in the blood of malaria sufferers.
Metchnikoff, director of microbial investigations at the Institut Pas-
teur, had recommended that microscopic studies of blood be used to
reveal the existence of the malarial microorganisms “hematozoarios.”
Working in collaboration with one of his elder brothers, José Luna, a
physician serving in the hospitals of Manila, Antonio Luna obtained
blood samples from malarial patients identifying and comparing the
microorganisms he saw against Laverán’s discoveries. Luna described
eighteen forms in four broad categories of shape: spherical, flagellate,
crescent, and segmented. The spherical-shaped parasites, the most
common, he found to be the same in nature and action as those

65. Ibid., 17.

66. Ibid., 19. The quote in Spanish reads: “Quién sabe lo que guardarán en sus rizadas
corrientes esas masas lı́quidas, vı́rgenes á las miradas investigadoras de la moderna ciencia!”
67. Luna, El hematozoario, 19.
576 Journal of the History of Medicine : Vol. 69, October 2014
described by Laverán and the Italian microbiologist Marchiafava.
They engulfed red corpuscles, remained on them until the latter
turned pale, and split away only once the parasite had gorged itself.68
Moreover, using samples of blood from malarial patients in the
Philippines, Luna found that there were degrees of difference in the
action and behavior displayed by sphere-shaped parasites indicating
what seemed to be the existence of subcategories. While some joined
onto (yuxtapuestos) red blood cells, others moved freely or segmented,
forming flower-shapes.69
Luna was building his ideas on the foundations of bacteriology
pioneered by French and Italian microbiologists and he appeared to
be on the cusp of developing his own original research on the specif-
icity of malarial parasites in the Philippines. Luna believed the para-
sites he had seen were not bacteria. But why he thought this was so,
and whether he intended to use his data to build a parasitic germ the-
ory is not clear. To paraphrase the question posed by Worboys, to
what extent were “germs seen as parasitic and parasites as the germs
of disease?”70 Antonio Luna’s preliminary study appeared to be head-
ing toward an answer for the first part of the question. But events
forced Luna to abandon his research. On his return to the Philippines
in 1894, he took up an appointment as a chemist at the Municipal
Laboratory of Manila, but two years later, he was arrested on suspi-
cion of being a separatist and was exiled to Spain. He returned again
to the Philippines in mid-1898, and when war broke out against the
American occupation in 1899, he was appointed as Director of War
of the newly formed Philippine Republic. Later that year, tragically,
disaffected subordinates assassinated him.
To some extent, the question of how cells responded to pathogenic
microbes passed next to Francisco Liongson, a wealthy Chinese-mestizo
with a passion for science. At about the same time that Luna was writ-
ing El hematozoario, Liongson was working on his doctoral dissertation
at the Universidad Central de Madrid in the same faculty as the cele-
brated Spanish scientist Ramon y Cajal. Like his compatriot, Liongson
became interested in microbiology and was preoccupied with labora-
tory work on cells. Unlike Luna, he did not confine his research to

68. Ibid., 31.

69. Ibid., 44.
70. Worboys, “Germs,” 188.
 Reyes : Environmentalist Thinking in Spanish Philippines 577
malaria but endeavored to explore the wider relationship between para-
sites and pathogenic microbes and their role in producing infectious dis-
eases. As he wrote enthusiastically: “These little organisms named
pathogenic microbes, whose actions and activities are incompatible
with the cellular activity of our organization, are the object of our stud-
ies and are the origin of this science called Microbiology.”71 In 1895, he
published his doctoral dissertation entitled La célula ante el microbio (The
Cell before the Microbe).
Liongson was working out the actions taken by cells under attack by
pathogenic microbes and the means with which the latter influenced
the former.72 He dwelt at some length on the physical nature and ana-
tomical characteristics of cells, dealing with their construction, consis-
tency, and activity within an organism. His discussion concerning
vulnerability to infection, largely already familiar in medical discourse,
turned on a host of factors—certainly, air and water, but also tacked on
were “passionate spirits,” indigestion, and changes in residence particu-
larly moving from small towns or villages to big and crowded cities;
other factors echoed the tenets of medical geography—climate, heat,
and cold; the age, sex, profession, and general physical character of a
person.
Based on Pasteur’s work, Liongson classified microbes as bacteria
whose differing shapes indicated categories of distinct species of cells.
Hence, spherical microorganisms were known as Micrococo, small
stick-like forms were Bacilo, Vibria were spiraled curls, and so on.
Liongson’s thinking was moving in several directions. His study
explored the efficacy of vaccination, and he supported the idea that
this method produced resistance to infection within the organism.
His understanding was that lymph, when introduced in the body,
remained permanently. He admitted that there was the possibility of
natural immunity, though he was unable to propose an explanation as
to the precise conditions by which natural immunity was obtained.
Liongson was convinced that various germs have different ways of
producing infection and grasped the idea that the ways in which the
organism defends itself against attacks from germs had to be different

71. Francisco Liongson Toncio, La célula ante el microbio (Madrid: Imprenta de Diego
Pacheco Latorre, 1895), 4.
72. The full quote reads: “Los medios de accı́on de la célula cuando se ve acometida por
otra patógena constituı́da por el microbio, y los procedimientos y medio con que dispone
éste para influir sobre aquélla.” Ibid., 8.
578 Journal of the History of Medicine : Vol. 69, October 2014
too. His core argument was that the way cells functioned determined
how resistance was principally carried out.73
CO N C L U S I O N

The processes by which germ theories came to be applied in the trop-

ics in the late nineteenth century, the historian Michael Worboys
argues, were grounded in the social dynamics of Western colonialism.
In his analysis, there was not a simple or single germ theory to be trans-
ferred to problems of disease in the tropics, but a host of sometimes
conflicting theories about the nature, action, and spread of germs. Dif-
fering opinions, vested professional interests, and the politics of British
colonial imperialism all acted to shape the meanings that came to be
attached to germ ideas and practices in India during 1890s.74 This view
of germ theory—as eclectic, multiple, politically charged, and invested
with competing agendas—is useful to bear in mind when we look
at the emergence of germ ideas in late-nineteenth century Spanish
Philippines.
I have argued here that Spanish medical discourse, by the late-
nineteenth century, constituted a confluence of ideas drawn from
medical topography, hygiene, and sanitary science. On the one hand,
Spanish colonial medical practitioners continued to adhere to old
environmentalist paradigms of disease and perceived the Philippine
tropics as strange and malevolent—an idea that hewed closely to the
discourse of tropicality so central to imperialist ventures. The message
that indigenous life-forms were uniquely adapted to withstand heat
and humidity, and that nonindigenous life-forms suffered under hot,
moist climates was as entrenched in late Spanish Philippines as it was
in British India and the Netherlands Indies. But there was also an
increasing belief in science and its ability to combat the perils of the
tropics and to control the effects of a humid climate on bodies
through intervention. Spanish physicians counseled their newly
arrived compatriots to take specific precautions and observe regimes

73. After the Philippine revolution of 1896 –1902, Liongson devoted more of his time to
politics and agriculture (he had inherited extensive sugar estates) than to scientific research.
In the early 1900s, however, he headed the Health Board in his home province of Pampanga,
where he worked to control cholera and smallpox epidemics and to eradicate Hansen’s dis-
ease. He died of anthrax in 1919. John A. Larkin, The Pampangans: Colonial Society in a Philip-
pine Province (Berkeley: University of California Press, 1972), 163 –65; Senado de Filipinas,
Diario de Sesiones, Cuarta Legislatura, Tomo III (Manila: Bureau of Printing, 1919), 718 –20.
74. Worboys, “Germs,” 186.
 Reyes : Environmentalist Thinking in Spanish Philippines 579
of hygiene; the Spanish colonial state embarked on programs of pub-
lic sanitary reform and was not averse to limited investments in the
scientific research of young Filipinos who took their inspiration from
the path-breaking work being undertaken in Europe.
Was there a chance for a paradigm shift and the clear ascendance of
bacteriology? At first sight, it would appear not. Filipino scientists were
inclined to retain aspects of the still dominant paradigm of environ-
mentalism, and their work, it could be argued, illustrated the malleabil-
ity of germ theories. But the appropriation of Western scientific and
medical knowledge by Filipino scientists was far from derivative. Their
thinking on water-borne bacterial organisms, malarial parasites, and
the structure and nature of cells was certainly influenced by the works
of others, but they also drew on their own experience of the Philippine
environment and were careful to adapt Western scientific knowledge
to an understanding of those specific local conditions. As in other colo-
nial contexts, the processes of knowledge transfer followed multiple
paths and directions. Second, they were fundamentally convinced that
only through rigorous scientific methods and the application of careful
laboratory technique could causation be proved. By putting technical
knowledge and a scientific understanding of the nature of microorgan-
isms at center stage—by concentrating on what could be seen under a
microscope—Filipino scientists introduced an emergent scientific dis-
course that did not have climate, tropical nature, native bodies, and
local customs at its heart. In the 1880s and early 1890s, their research
signaled the beginnings of a key shift in thinking about disease causa-
tion in Southeast Asia.
AC K N OW L E D G M E N T S

I am grateful to Peter Boomgaard, Warwick Anderson, David

Arnold, Greg Bankoff, and Jim Richardson. I also much appreciated
the helpful and stimulating comments from the anonymous reviewers
for the JHMAS and from Chris Crenner, the journal’s editor.
FUNDING

Research for this work was supported by the British Academy and an
Early Modern History of Medicine in Southeast Asia fellowship from
the Royal Netherlands Institute of Southeast Asian and Caribbean
Studies (KITLV) in Leiden.