This article examines the activities and perspectives of nineteenth-century American missionary physicians in the Hawaiian Islands. The physicians' attitudes toward Hawaiian morbidity and depopulation are viewed in relation to the greater missionary community's role in the political transformation of the island nation. The article argues that missionary physicians monitored and reported on Native Hawaiian depopulation (a result of introduced western diseases) while simultaneously advertising the islands' benefits to American consumptives, imperialists, and others. Mission doctors also failed to respond effectively to the greatest epidemiological crisis Hawai'i had ever faced: a venereal scourge with a resulting blight of Native Hawaiian infertility. As a result of these and other factors, American hegemony in Hawai'i by midcentury was a foregone conclusion.

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