Thesis ID: CBB436948495

To Serve and to Heal: Native Peoples, Government Physicians, and the Rise of a Federal Indian Health Care System, 1832-1883 (2019)


Silva, Kelly Bokosky (Author)
Klein, Rachel (Advisor)

University of California, San Diego
Klein, Rachel
Publication date: 2019
Language: English

Publication Date: 2019
Physical Details: 220

Beginning in the 1830s, a nascent federal Indian health care system emerged in conjunction with the acquisition of indigenous lands. This system began with provisions for physicians’ care and the distribution of smallpox vaccines. It expanded over the course of the 1840s and 1850s to include the employment of physicians across reservation, the deployment of military and civilian physicians to treat Native peoples at the centers of smallpox outbreaks, and federal funds for the construction of reservation hospitals. This expansion of federal power in the West served both federal and Native interests. For some Native peoples, engaging in health care services was an adaptive strategy at a time when the power dynamics between themselves and the federal government had shifted dramatically. Removal and the westward expansion of America’s white settler population exposed many Native peoples to the spread of infectious diseases. While many retained and utilized their traditional healers, the flexibility of indigenous world views and medical practices allowed for the integration of federal health care services into their communities. Physicians, however, were first and foremost agents of the state. Their care helped facilitate removal, appease moral apprehensions over the direction of US-Indian policy, protect white settler communities at the periphery, and held promise to support a healthy labor force. Federal responsibility and oversight of Native health became part of the bureaucratic administration of Indian Affairs in 1873 with the formation of a Medical and Educational Division. Within this structure physicians helped the federal government to construct Native health as a marker of racial and cultural difference, as the product of behavior rather than the result of governmental policies. Within this new structure, physicians provided the state with justification for its increasingly invasive intervention into Native lives. Examining the expanding role of physicians alongside the bureaucratization of Indian health services connects this project to the broader national narrative of the expansion of federal power and governance in the second half of the nineteenth century, particularly the changes and transformations during the period of Reconstruction. It also reveals how the extension of empire evolved into political contestations not only over land, but also Native bodies.

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Authors & Contributors
Hochman, Gilberto
Abreu, Laurinda
Bhattacharya, Sanjoy
Cameron, Mary M.
Carstairs, Catherine
Dale, Pamela
Health and History
História, Ciências, Saúde---Manguinhos
Medical History
Asian Medicine: Tradition and Modernity
Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Canadian Historical Review
Bloomsbury Academic
Cornell University Press
Harvard University Press
Oxford University Press
Health care
Medicine and government
Public health
Physicians; doctors
Indigenous peoples; indigeneity
Dawson, Bertrand Edward, Viscount Dawson of Penn
Time Periods
19th century
20th century
18th century
20th century, early
16th century
17th century
Great Britain
United States
World Health Organization (WHO)
American Medical Association
American Red Cross
National Health Service (Great Britain)
Ireland. Local Government Board

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