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January 17, 1996

Agents of Apocalypse: Epidemic Disease in the Colonial Philippines

JAMA. 1996;275(3):247. doi:10.1001/jama.1996.03530270087039

Few Americans are now aware that when the US Army invaded and conquered the Philippines between 1899 and 1902 it intruded upon and excerbated a disease disaster so intense that about one million of the islands' population of seven million died in the course of the campaign. This elegantly learned and ecologically sophisticated book explores how and why that happened and shows how first Spanish and then more vigorous American efforts to cure and control epidemic disease sometimes worked but often had unintended and unforseen consequences that actually made things worse.

De Bevoise has divided his book into two parts. The first two chapters explore the factors that made the Philippines ripe for epidemic disaster in the latter part of the 19th century. A predisposing circumstance was that Filipinos had been protected from much disease exposure by the geographic fact of their dispersal across innumerable islands, living, for the most part,