This essay assesses clinical photographs of leprosy patients created by the Hawai‘i Board of Health in the late nineteenth and early twentieth centuries, or what may be the most extensive visual cataloging of indigenous, Asian, and immigrant bodies in America’s Pacific empire. Building on theoretical and methodological approaches to archives as a process rather than a source, I follow the trail of these clinical images through time and space, from their emergence within a photographic practice of medical management and segregation in Hawai‘i to their prolific circulation in transnational political and medical arenas. Offering spectacular evidence of the racialized and sexualized pathology of colonial peoples, these photographs were tightly regulated but increasingly viewed as clinical erotica after the United States incorporated Hawai‘i as a territory in 1900. The essay further suggests the “affective excess” that can disrupt the photograph’s medical surveillance, as social intimacies and care between Hawaiian patients bloom within the frame.

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