Honoria Acosta Sison

• 1st Filipina physician
• 1st Filipina graduate of an American medical school, Woman’s Medical College of Pennsylvania (1905)
• 1st Filipina surgeon
• 1st Filipina obstetrician
• 1st Filipina to perform a low segment cesarean section
• Mother of Philippine Obstetrics

Life and Career

Viewed from the flux of individual days and inevitably coming and passing to pile up towards that anticlimax which is death, no human life seems to constitute a unity. To the individual consciousness, every day, week or any longer segment of time brings nothing but chance or a range of possibilities. It can reasonably be supposed that this was how Dr. Honoria Acosta-Sison "went through" the successive instants which, in the end, added up to shape the jewel that was her life. Through each of this moments, she was of course "creating" her life, tracing the lineaments of what would become its completed form. Precisely, however, because she was building it from within, the total view of her life was not here to behold.

The total view of any life is possible only when it is complete ¾ that is, after death. But then only its external form is perceptible, its essence being the inaccessible secret of the dead. Viewed therefore from its span of eighty-two years, the life of Dr. Acosta-Sison becomes an integral whole. As a continuous creative endeavor, it divides itself naturally into four periods. The first twenty-one years from her birth up to her return from the United States after completing her medical studies constitute a sort of prelude, the solid foundation to her life work. From1910 to 1988, she was occupied with building a home and family, while practicing obstetrics and gynecology (which she helped found as a specialized field in the Philippines), improving surgical and other medical techniques, teaching at the U.P. College of Medicine, and writing scientific papers for local and foreign journals. From 1939 until her retirement from the U.P. College of Medicine in 1955, she was at the pinnacle of success, gaining unquestioned national and international recognition as a scientist, a physician and a teacher. Her last fifteen years were no less active than her youth, being filled with speaking engagements at seminars and conferences and with the incessant writing and publication of quality scientific papers in quantities she had not therefore reached.

Why she decided to become a doctor is a matter of conjecture. In 1933, nearly thirty years after the fateful decision, an article featuring her as the "first Filipina physician" affirmed that it was because "early in life" the young Honoria "was stuck with (sic) the appallingly large number of women who died when going through childbirth" and discovered that this was due to "the standard of morality of those days" which prevented the women from "summoning a male doctor to assist them during the pangs of travail." While it is indeed not impossible that much revelation should dawn upon the fifteen-year-old girl that Honoria then was, there is no contemporary evidence that they indeed push her to take up medicine. The only autobiographical sketch that Dr. Acosta-Sison attempted ends abruptly with her departure for the United States and gives no hint whatsoever as to her motivation. Nevertheless, in 1958, she was believed to have "vowed to be a doctor because she was moved by the pathetic plight of pregnant Filipino mothers" who "were succumbing to post-delivery complications aggravated, if not induced by . . . "hilots and losing their babies on account of ignorance and neglect regarding pre-natal care." Hilots, post-delivery complications, and pre-natal care became indeed important areas of research for Dr. Acosta-Sison.

The more likely reasons should perhaps be sought in young Honoria’s personality and in the specific circumstances of her times. The generation responsible for the Propaganda had ushered in an epoch of great achievements among Filipinos. With the dislocation of the Malolos Republic, their energies were diverted to creative activity. Thus, a vast resurgence in the vernacular tongues (particularly Tagalog, the language of revolutionary resistance against Spain and America) tookplace in conjunction with the renascence of the Arts. In other fields, Filipino potentials were likewise awakened. In this, the women were no less involved than the men. The more enterprising ones founded schools like the Instituto de Mujeres (Florentina Arellano, Rosa Sevilla and Susan Sevilla) or the Centro Escolar (Librada Avelino and Carmen de Luna), while the others began to seek higher education and entry into the professional schools, which had been denied hem during the Spanish regime. Aside from this élan of the nation in general and of the "weaker" sex in particular, one must also consider the opportunities offered by the tortured conscience, of an American democracy freshly converted to missionary colonialism. Priority in the training and scholarship programs was then given to skills which like medicine and engineering, were needed to help extricate the new protectorate from its perceived Asian backwardness and infirmities.

In any case, Honoria’s decision was in keeping with the independent and enterprising beat of her personality. She was not averse to try what was new and challenging. During the Spanish regime, the highest educational attainment women could aspire for had been "graduation from the Superior Normal School for Women Teachers." In 1901, therefore, when the new American government established a Normal School in Dagupan, she enrolled and,as she herself wrote, "that was my first contact with American teachers." Earlier, despite the nationalist commitment of her immediate family, she had been impressed by the good behavior of the American soldiers who entered Dagupan "not by shooting but simply threw (sic) many ten cents pieces of silver money before the townspeople," in contrast to the Katipuneros who were welcome as "kapatids" but "went up to our homes to rub us the heirloom gold and silver coins and jewelry my father treasured and clothing" (sic) and even "began to put on their feet the many pairs of shoes of my grandfather" who "scolded them roundly calling them thieves."

Consequently, she must have been a most eager pupil. When a call for volunteer teachers was made to handle the primary grades, the young girl of twelve raised her hand to the surprise of everyone, for she "had been studying English for only one month." She was of course accepted. Later, in 1904, she had to cajole her father into signing her application to take the examination to take the examination for "pensionados". This was another challenge, in the same manner that becoming a physician was going to be, since, as her friends pictured it, any man "would feign illness just to get her alone with a room with him." There was surfacing from within her that spirit of enterprise and independence common in the pre-Hispanic Filipina, and conserved by them to this day.

For she came from a well-to-do-family. Her most cherished memory of her father was "of a man clothed in white suit with a black top hat" returning from "trips to Calasiao and Manila." Don Macario Acosta y Sison owned some property in Dagupan, Pangasinan and was the captain of the boat operating between Manila and Pangasinan. Doubtless, this was one of the sailboats owned by the family of her mother, Pastora Dizon. At any rate, Dr. Acosta-Sison wrote that these "traveled regularly the coast towns of Luzon and even to Manila." Honoria considered her father an "old-fashioned gentleman" whohad "deep-seated in his breast a big heart that knew and understood her will" and whom she loved very much as a child.

Doña Sison was from Calasiao, Pangasinan, where Honoria herself was born on December 30,1887. Honoria never knew her mother, for she died two years after she was born. She knew her to have come from "what then was considered as an affluent family" and remembered "the framed pictures of three sailboats named after my mother, Pastora and two of her sisters." Pastora was fond of beautiful dresses which "were sewn inside a big mosquito net to prevent them from being soiled." Afterher death, her husband reverently conserved in a big narraapaprador "with crystal knobs showing flowers within" all her "gorgeous sayas and thickly embroidered piña camisas and pañuelos.

The young orphan was taken by her father to live in Dagupan with her paternal grandparents. She was shy and "liked only certain people," avoiding strangers and not being able to make friends easily. Late in life, shewould still remember "the little black dresses made for me in mourning for my mother." But she evidently had a fixation on her father; she always longed for his company" and admired him for the fact that his mind "was steeped in the sacred memory of my mother and the future of his two living children." In her short autobiography, this is the only mention of "the other living child," whose sex is not even specified, although there is fond recollection of her grandmother with her courtyard "filled with fruit trees and vegetables" and of the grandfather whom she pampered and who "was an old man with a long white beard" continually occupied at reading books in Latin, remnants of his seminary days, before he met the grandmother. Does forgetfulness mean she did not have a childhood with children, but one mainly with adults? Or was it because hers was a self-restrained nature? But her very special relation with her father she could and did not repress.

Be that as it may, her childhood must have been sheltered, in the company of her grandparents and aunts. The family was religious in the traditional way, gathering for the angelus and praying the rosary every night, with the 19th of every month being dedicated to "special prayers for St. Joseph." What would remain in her memory through the years was the "beautiful face of the Blessed Virgin surrounded by the crown of gold" and the lesson in the chant to her; "Bendita sea tu pureza y eternamente lo sea," blessed be your purity and let it be so eternally.

It was in Spanish that she held her first schooling, as her first prayers and holy chants already were. When she entered the Santisimo Rosario convent, she could already read and even recite from memory," the whole "Doctrina Christiana’ taught to children," aside from Our Father, Hail Mary and the rosary in Spanish. She stayed three years there, taking up reading, writing and arithmetic, aside from learning "how to sew, crochet and to embroider and the rudiments of Spanish grammar and history." She was, in other words, on her way to becoming the typical semi-educated woman of the Filipino principalia of late Spanish times.

The Americans came however, and she became a teacher; but it was a maestra who was at the same time learning to speak English, preparatory to absorbing the new industrial culture from the Protestant West, while receiving the magnificent salary of ₧17.00 a month, soon raised to ₧26.00, "the highest I ever receive before going to the United States in August 15,1904." America had beckoned. She would respond to the challenge.

She belonged to the second batch of pensionados, the first one, numbering a hundred, having been sent to the United States in 1903. This time, ten had been selected out of a total of 357 candidates. Two were women, Honoria and her future sister-in-law, Luisa Sison. The young Honoria chose to study medicine, apparently against the advise of her father and the entire family, probably to follow her childhood sweetheart, Antonio G. Sison, who had gone to America the preceding year as pensionado. It was to Philadelphia that she was sent, where women could then study medicine in the Women’s Medical College of Pennsylvania. In order to complete a high school education, she enrolled in the Drexel Institute and later the Brown Preparatory School. In the summer of 1906, she took up English at Cornell. In December of the same year, the Filipino Students Magazine reported that Honoria Acosta and Olivia Salamanca had finished their preparatory courses and were then in their first year in the Women’s Medical College. Salamanca was her competitor for the title of "first Filipina doctor," but Honoria would finish earlier.

She obtained high ratings in her subjects, getting the anatomy prize in 1908. In the previous year, she had also become the editor-in-chief of the Philippine Review, the former Filipino Students Magazine, the official organ of the Filipino students, which had been founded in 1905 to defend "the interest and aspirations of the Filipino people in America." In 1909, she graduated from medical college, "the first woman of her nationality to become a physician." Because of her good scholastic record, she was given a chance to specialize in obstetrics for another year as a resident in the Maternity Hospital of her alma mater. In February 7, 1910, she returned to the Philippines.

Her father died while she was in the United States. There could be no question of coming back for the burial not only because of the distance involve but likewise because her studies had to be completed in a prescribe period of four years. However, she was later able to stay another year of specialization. She went back to the Philippines and could well have indulged in "the pleasant thought" that if her father was alive, he would have been there at her arrival and "among the first to congratulate his daughter on being the first of her kind in the Philippines to become a doctor of medicine." But lying perhaps much deeper in her mind was "the big mission [she had] to perform — a mission that would redound to the benefit of her sex and of the country in general."

She immediately became a full-time assistant in obstetrics (with a salary of ₧1,500 per annum, she did not forget to record in her curriculum vitae!) at Saint Paul’s Hospital, which had only recently been established, together with the Civil Hospital and the Mary Johnston Hospital, to add to the San Juan de Dios Hospital, "the oldest in the Philippines." The Government had then also already started a medical school with teaching clinics in surgery, obstetrics and pediatrics at Saint Paul’s. The school was later to become the College of Medicine and Surgery, the first unit of the present University of the Philippines, where she would enter as Instructor in obstetrics in July 1912.

Obstetrics cases were then generally delivered at home under the care of hilots, who had no instruction whatsoever in asepsis. In all the four hospitals in Manila, there were only 32 Filipinos born from July 1,1908 to June 30, 1909, whereas in the Philippine Medical School, for the period from June 1, 1907 until March 31, 1910, just a month before Dr. Acosta-Sison started to work there, only seven deliveries per month took place "with a maternal mortality of 12% and fetal mortality of 35%." Most of the cases had been abandoned by the hilots and the traditional midwives or comadronas.

It was evident that a campaign had to be launched to wean the Filipinas away from the hilots "whose main claim in their trade was that they had delivered so many cases." They were ashamed to be seen by men and "would often rather than die than be attended by them." Dra. Acosta-Sison joined the other doctors to attract "our poor parturients to the hospital." They literally had to go around in calesas and stop pregnant women in the streets in order to invite them to see the staff of Saint Paul’s and later the Philippine General Hospital. Dr. Fernando Calderon, the Chief of Pediatrics then, "used also to give Tagalog lecture to gatherings of women in poor districts," It was indeed a quasi-seminary effort which in the end be rewarded, "so that a few years afterwards instead of going out of our way to make patients enter the hospital, we had to discharge them earlier than usual to accommodate new applicants."

The earliest articles of the pioneer Filipino doctors then, including Dra. Acosta-Sison were on prenatal and postnatal care, as well as such complications as rupture of the uterus, infections connected with childbirth and placenta previa or childbirth with the afterbirth coming out first. Child care was still a matter of tradition. Uterine rupture was oftentimes caused by the hilots technique of the salag or "the forceful pushing downward of the fundus done preferably by two persons, one on each side." Babies often died of tetanus and the mothers of childbirth complications. The hilots sometimes practiced the sara, which consisted of "making squat over hot embers a few days after delivery," so that "severe burns of the vulva and buttocks" resulted.

Of the three articles on obstetrics written by Fililino physicians in 1910, Dra. Acosta-Sison wrote one, the first in the English language, the other two being in Spanish by the much older Dr. Calderon. It dealt on the care of the partuent woman before and after childbirth. She had seen how so many Filipinas "were succumbing to post-delivery complications . . . [and] losing their babies on account of ignaorance and neglecting pre-natal care," as G. Garchitorena-Goloy would later write concerning Dr, Acosta-Sison’s choice of the medical profession as a vovation. In May, 1911 she read before the Manila Medical Society a paper on the incidence of placeta previa in Manila, with a report of twenty-two cases, later published in the Bulletinof the same society.

In the meantime, she had, "united her faith," with that of Dr. Antonio G. Sison who had entered St. Paul’s earlier as resident in Medicine. Dr. Sison was also from Pangasinan, where there are many Sisons . . . who are not related in any way." He had studied in San Alberto-Magno, a school which used to be operated by the Dominican fathers some twelve to fourteen kilometers from Lingayen, before taking his college degree at the Liceo de Manila, which he represented at the competitive examinations for membership in the first batch of Filipino pensionados to the United States. They had known each other "since their childhood days" and there in the foreign and, they had doubtless promised to get married when both came back to the Philippines. The marriage took place on November 26, 1910 in Lourdes Church in Intramuros very early in the morning, for they were to go to Pangasinan afterwards. Only a few persons were presents with the famous Dr. Baldomero Roxas, then Associate in Obstetrics as one of the sponsors.

The young couple would not have children immediately, but they were soon able to build a house in 1913, not far from the Philippine General Hospital which had been organized in 1911 and where both of them working. Previous to that they were renting a house in Ermita, near the U.P. College of Medicine. The new house was in the countryside at the time, an area surrounded by talahib; Dr, Sison Jr. recalls that Taft Avenue was opened only in the late thirties. To reach La Salle from their house, he had to take in his adolescent years, the old San Andres-Leon Guinto route.

Dra. Acosta-Sison was extending her scientific horizons. In 1912, the year she was appointed Instructor in Obstetrics at the U.P. College of Medicine, she developed a curious interest in elephantiasis, publishing an article on a congenital form of this affliction in the Bulletin of the Manila Medical Society. She also inquired into the obstetrical practices of the Igorots in 1913, one of the first investigations by a Filipino in what would later be called medical anthropology. In 1914, she attracted great attention in the regional assembly of Doctors and Pharmacists in the Philippines, with a paper on the pelvic and head measurements of Filipinos. The first of its kind in anthropology and medicine written by a Filipino, it responded to a need for more data on Filipina parturients and babies, a realization that American materials might not after all beutilizable in the Philippines.

Then, for four years from 1915 to 1918, she did not produce any scholarly work, as if in condolence with Europe and the World at war; but during this period she showed a sudden interest for German, going through the whole process of certification at the U.P., in order to enroll in this language at the College of Liberal Arts for the school year 1915-1916. Germany was then not only at war with most of Europe but was also making an immense impact on world science. Dra. Acosta-Sison was not going to allow herself to be left behind.

In 1918, even as the First World War was grinding to a halt, Dra. Acosta-Sison went with her husband on an observation trip to the United States, staying to work for a while at John Hopkins Hospital with Dr. Williams. Upon their return in the Philippines, the couple would start agitating for the creation of a new department of gynecology separate from those of surgery and obstetrics at the U.P. College of Medicine. Dean Calderon, Dra. Acosta-Sison’s former chief in Obstetrics, "appointed himself as the Chief of the [new] Department," with its staff being taken from both surgery and obstetrics. Only Calderon and Dra. Acosta-Sison came from the latter department, the others originating from surgery. The new department was inaugurated in the school year 1922-1923, with six courses opened. It was only from the school year 1925-1926 however, that Dra Acosta-Sison was given a course, the Gynecological Dispensary, which she shared with Dr. Aniceto Mandanas.

The Sison couple also brought back to the Philippines something just as new as gynecology, although rather more obstetrical in nature. When Dra. Acosta-Sison reported for duty on January 21, 1919, to the Department of Obstetrics, she was expecting her first baby. It was born on May 1,1919 and baptized Antonio, after the father. As he was later to speculate, his mother had probably prayed for a child to Our Lady of Perpetual Help in Boston, the couple’s patron saint. Two other children would follow Antonio Jr. at regular intervals. Honoria was born on January 22, 1921, while the third one, Pastora, named after her grandmother, came on November 28, 1923. Probably by design, Dra. Sison did not have other children thereafter. She could now concentrate more fully on her work as doctor and scientist.

Even while she was having her babies, she not only continued to serve as head of the parturient clinic at the P.G.H. and as assistant professor at the U.P., but likewise published scientific papers, seven of them from 1919 to 1923, even as she wrote in 1922 the first book by a Filipino physician on pre-natal care. The articles dealt principally with pregnancy and childbirth particularly the causes of premature labor, uterine rupture and the manual extraction of the placenta. She had continued her research on the pelvic measurements of Filipinas in relation to the hand-size of new-born Filipinos, publishing her result in 1919 in the Philippine Journal of Science. It came as no surprise, therefore, that she was promoted to the ranks of Associate Professor of Obstetrics in 1924, while becoming a member of the new department of gynecology at the University of the Philippines.

As associate professor of obstetrics, the lady doctor did not confine her scientific interest in her specialization. She of course kept on her old line of research, analyzing a case of complete inversion of the uterus in 1924, another of umbilical hemorrhage accompanied by deep jaundice in 1925, and maternal mortality among Filipinas in 1926. But she also got interested in the tuberculosis in its relation to childbirth even as she wrote popular articles in the Bulletin of the San Juan de Dios Hospital on what a Filipino wife or prospective mother should know (1927) or on the utter needlessness of the so-called "perils" of motherhood (1928). She became an inventor of obstetrical instruments. In 1927, she wrote in the American Journal of Obstetrics and Gynecology about her new sagittal pelvimeter and its importance in the management of parturient labor and also presented the newly invented obstetrical forceps to facilitate the delivery of the fetal head.

For nine months in the same year, she went on an observation trip to Europe, visiting hospitals in Berlin, Dresden, Vienna, Paris, London and Dublin, where she saw the popularity of laparotrachelotomy or the surgical section of the abdominal wall for diagnosis or further surgery, in lieu of the classical cesarian section. Upon her return, she perform such an operation, the first one in the Philippines, In February 1928 upon a patient with severe eclampsia ( a toxemia of pregnancy) and a closed cervix, in an attempt to save the child. The child was saved, although the mother died of toxemia. This encourage her to perform further operations which were more completely successful. In August of the same year, at the age of forty, she became Acting Head of the Department of Obstetrics, being also appointed Lecturer in Prenatal Care at the School of Public Health Nursing in 1929. She had by then published something like twenty-seven scientific and popular articles in her special field. She had just started.

From 1930 to 1938 inclusive, she wrote forty papers and a book, Obstetrics for Nurses (1936), averaging more than three contributions per year and constituting more than one-half of the seventy (70) publications on obstetrics and gynecology for the period. She was continuing her old research directions, while doing some popular articles for the benefit of women and young people. She had also begun to be interested in nutrition in relation to the parturient and the newly-born and older babies, and more importantly, in chiricepithelioma or choriocarcinoma, malignant tumor arising spontaneously in the ovary following pregnancy, which was to become a special subject of research for after she wrote the first article in the Philippines in its clinical forms in 1937. Earlier, in 1934, she had presented to the medical world a simplified technique of the podalicversion a manual operation of turning the fetus feet in the uterus to aid in delivery.

The thirties had indeed carried her to a very high plane of scientific competence. It was also then that she began to write "unexcelled literary essays" in national magazines and newspapers. In 1933, she was seen as a woman never too busy to have wholesome recreation with her three children and to engage in social and literary work. Her writings "on life, health, happiness, children, the home, in fact in subjects that are not wholly interrelated with medicine" pictured her to be "a woman with broad outlook and a fine civic spirit." Aside from this, she had also gone back to college, enrolling at the U.P. from the summer of 1930 up to the end of the first semester, 1936-37. She took up Philosophy, where she had relatively good grades, and Psychology, where her grades were all excellent. She was particularly interested in oriental philosophy, systematic psychology, the psychology of adolescence and experimental psychology related to work and fatigue.

Towards the later thirties, she was the mother of three adolescents and she was at the peak of a career which entailed a great amount of dedicated work. Her trip in 1934 to the United States to accompany her husband who had become the personal physician of the then Senate President Quezon, was a welcome respite. In 1935, while continuing as physician at the Philippine General Hospital and as Associate Professor of Obstetrics at the U.P., she became a Class A Lecturer on Maternal Hygiene at the Postgraduate School of Public Health. In 1937, she was also appointed Associate Professor of Gynecology, thus adding to her normal load at the U.P. College of Medicine the task of handling lectures and conferences in gynecological subjects. By October 1938, she was part-time Professor of Obstetrics, with a salary of ₧2,500 per annum. It was also in the same year, the thirtieth anniversary of the founding of the University of the Philippines, that she was chosen as delegate to represent the Philippines in recognition of her almost three decades of teaching.

The year 1939 began a new phase in her career, that recognition here and abroad, even as she engaged in more intensive and creative research activity. With her colleagues, she organizes then the Philippine College of Surgeons. On recommendation of the Board of National Research Council, she went in September as the Philippine Commonwealth Delegate to the First American Congress in Obstetrics and Gynecology at Cleveland Ohio, where she presented a paper on the pathologic lesions in eclampsia, a malady with convulsions resembling epilepsy resulting from some actual disturbances of the nervous centers caused by anatomical lesion. She stayed on to be the Philippines member at the 29th Clinical Congress of Surgeons in Philadelphia held on October 16-20, 1939. The war which broke out in Europe prevented her from returning by way of this continent which had continued to fascinate her since her sojourn there a dozen years before.

War was also threatening in the Pacific when she came back, but her work and research continued. In 1940, she came out with five papers, including the one she delivered at the Congress in Cleveland and another concerning her observations there and at the Clinical Congress of Surgeons. The latter was later summarized in her report to the National Research Council of the Philippines. Aside from the more scientific observations, Dra. Acosta-Sison ventured the opinion that:

"By and large, modesty aside, the Filipino physicians and the hospitals in the Philippines, taking into consideration the size of the country and the state of our financial resources, can hold their own and be proud of their achievements . . . Filipino physicians possess as good judgment and as much ability, skill and power of growth, and as high a sense of responsibility as any physicians elsewhere. The difference lies only in the wealth of material resources which enables the scientist abroad to work in modernly equipped laboratories and clinics, with adequate personnel and thus to utilize and enlist in his aid all the modern instruments and devices that science has produced."

She was then honoring the individual, hardworking men and women of her profession, while underlining the inadequateness of their socio-economic milieu. It was at the same time a tribute to the resourcefulness and the immense possibilities of her people.

While two other papers dealt on extrauterine and abdominal pregnancy, one reported on an attempt to reproduce the organic lesions of eclampsia, the disease which had begun to preoccupy her even before the Cleveland congress. In the same year of 1940, at the age of fifty-two, she received her first honorary doctorate in science, fittingly from the Philippine Women’s University. The following year she was elected vice-president of the Philippine Medical Association, whose Council likewise appointed her Associate Editor of the Association’s journal. She also became acting head of the Department of Obstetrics in the U.P. College of Medicine, whose Mu Sigma Phi Fraternity and Sorority awarded her with an oil portrait together with a write-up recognition of her efficient service to the institution.

About this time the war came to her native land, with a new imperial power seeking to do the Filipinos good. Of this war which brought "the four horses of Apocalypse across the fair face of our land," she was later to say that it "brought us far greater damage than destruction of houses, the onslaught of famine and disease, and the loss of countless lives; it snatched from our hold our moral mooring. Dra. Acosta-Sison was indeed affected by the profound dislocation that it engendered. For, while she had still published three papers in 1941, she could only present a paper on her favorite subject of chorioepithelioma at a seminar of her college in 1942. During the entire Japanese Occupation, no work of hers saw print. She nonetheless continued to work, even becoming Professor and Head of the Department of Obstetrics both at the U.P College of Medicine and at the Philippine General Hospital and, the Professor of Gynecology. Her curious spirit was not dampened. In line with her interest in the low caesarian section of laparotrachelotamy, she learned from a Japanese surgeon the "low spread technique’ in the same operation and became the first to follow it in the P.G.H. through all the vicissitudes of her country and family, she realized she had to go on serving and improving her own mastery of the medical profession.

When liberation came, she published a spate of medical articles, eight in 1946 alone and an average of 4⅓ per year thereafter till 1955 inclusive, when she retired from government service, after two extensions.

At the liberation of Manila, she was appointed Chief of Obstetrics and Gynecology of the Provisional Philippine General Hospital, organized by the U.S. Army, with a salary of ₧224.00 per month. When the Commonwealth took over, she was recalled to U.P. as Professor and Head of the Department of Obstetrics, while also serving as Professor of Gynecology without compensation.

Of the thirty-nine articles that she wrote from 1946 till her retirement in 1955, at least seven were on chorioepithelioma, on which she would become, in the words of J.V. Greenhill, "the world’s greatest authority." It was for the twelfth edition of the same Greenhill’s textbook on Obstetrics that she wrote the chapter "Diseases of the Chorion. Hydatidiform on Mole, Syncytioma and Choriocareinema." For her research work on choriocarcinoma, another name for chorioepithelioma she likewise won an award from the Philippine College of Surgeons on November 3, 1954. She also concentrated on a related subject, the incidence of hydatidiform sole, which she found later to generally followed by choriocareinoma. The other papers dealt on her accustomed subjects of research, including eclampsia, diseases incident to pregnancy and childbirth, nutrition, and the techniques of operative and on-operative delivery.

Even as she was writing and researching for these papers, she was teaching at the U.P. College of Medicine and serving as physician at the Philippine General Hospital. In 1946, she became a founding member and the first president of the Philippine Obstetrical and Gynecological Society, to which post she was re-elected once, being conferred the Forth Honorary Fellowship of the Society in 1951. It was likewise the year she received a citation from the U.P. Medical Alumni Society as "the foremost Philippine woman physician" of her country and the Presidential Medal for Medical research on the occasion of the fifth anniversary of the Philippine Republic. The preceding year, she had been accorded the Medical Award of the Federation of Women’s Clubs of the Philippines. She had also gone3 to New York to read a paper before the Fourth American and First International Congress in Obstetrics and Gynecology as delegate of the Philippine Medical Association, the Philippine Obstetrics and Gynecologic Society, and the Philippine Republic. On the way to the Congress, she had stopped at Women’s Medical College of Pennsylvania to be conferred the title of Doctor of Science, honoris causa, on the occasion of the centenary celebration of her alma mater.

The honors that she receive spurred her to work harder. On July 8, 1952, she was awarded a diploma and a medal by the Manila Medical Society for her "outstanding contribution in the fields of obstetrics and gynecology." The following year in November, she was an official delegate of the Philippine College of Surgeons to the Eight Pacific Congress and the Fourth Far Eastern Prehistoric Congress in Manila. On September 26, 1953, she was accorded the Founder’s Award for the Association de Damas Filipinas on its Ruby Anniversary for "her contribution and service to the growth of the Association." On December 19, the Philippine Obstetrical and Gynecological Society remembered her with a citation, as, its founder-first president. In 1954, she was at the 47th Annual Meeting of the Philippine Medical Association, presenting two papers on chorioadenoma, a tumor, and chorioepithelioma. In the next annual meeting, she read four papers, two on chorioepithelioma and two-on eclampsia. In the same year, from March 18 to June 10, she was in Australia and New Zealand for scientific investigations for the President of the Republic. In 1955, she was finally retired from government service, after having been extended twice. The U.P. Department of Obstetrics remembered her with a plaque of appreciation "for 45 years of devoted service, inspiring leadership and outstanding achievement in the field of obstetrics in this country." The Faculty of the College of Medicine followed suit, commending on April 22 her "45 years of service devoted to medical education of the youth, to the administration of the sick and ailing, and to the elevation of the medical standards and ethics." In the same month the U.P. Board of Regents appointed her Emeritus Professor of Obstetrics and Gynecology. In June finally, she received at the Manila Hotel the Presidential (Magsaysay) Award for being "a torch bearer in the Feminist Movement on the occasion of the Golden Jubilee of the National Federation of Women’s Clubs."

Her life of service, work and research had by no means ended. From 1956 to 1966, she wrote at least sixty-five papers, much more than what she wrote during the twenty-year period from 1933-1952, the peak of her career before retirement. At the age of seventy-eight she published an article on choriocarcinoma. Aside from this, she continued to teach the 4th and 5th year medical students as Emeritus Professor at the U.P. College of Medicine, stopping only in 1968 "when age and infirmity prevented her from carrying on." In 1958, we have a picture of her as seventy-year-old physician still practicing at the Philippine General Hospital:

Every morning about 7:30 a.m. she walks up that corridor, a white-haired, white-uniformed, short, stocky figure, trudging hastily, if [with] difficulty, past the surgical ward, the medical yard, the gynecological ward until she reaches the office where she daily keeps the many appointments on her crowded hospital schedule. She walks, head inclined downward in habitual disregard for everything except the path before her, deep in concentration, untilm she comes across a colleague or a student and her face breaks into a sudden bright smile. Except for the deliberate unevenness of her footfalls, she still moves with a certainty of direction unusual of her age.

Both at the P.G.H. and the U.P., she was serving without compensation, although with the same dedication.

Almost immediately after her retirement, the Board of Directors of the Philippine Obstetrical and Gynecological Society appointed her member of the Committee on National Mole and Chorioepithelioma Registry of the Philippines. She also became chairman of the Maternal Mortality Review of the same Society, a position which she would occupy till 1958. In the same year of 1956, she was practically everywhere. From January 28—February 8, she attended the First Regional Meeting of the Medical Women’s International Association, presiding over the symposium on the toxemias of pregnancy. On March 18, she received a diploma of merit from the U.P. Medical Alumni for her "distinguished work as professor of obstetrics, in grateful acknowledgement of her vital role in medical education, character development and intellectual guidance of these medical graduates who have been her students." For Medicine Week, she spoke on September 18 at the Far Eastern University on the unwholesome obstetrical practice among Filipinos. She even found time to address the Medical Society of her native Pangasinan on hemorrhage after childbirth.

She was no less active in the following year. She was delegate of the Philippine Obstetrical and Gynecological Society to the First Asiatic Congress in Obstetrics and Gynecology held in Tokyo, Japan on April 2-4, 1957, presenting her "studies on Microscopically diagnosed chorioepthelioma" within the section on Deaths due to Belated Treatment. Back in the Philippines, on June 9,1957 she was awarded a certificate naming her "honorary alumna" of the U.P. College of Medicine. She was at the 50th annual P.M.A. meeting, with three papers, and at the 13th annual Philippine College of Surgeons meeting, with another set of three papers. At the First Filipino Family Conference, in the Philippine Women’s University she represented the Philippine Medical Women’s Association. She did not forget the Pangasinan Medical Society which heard her in Dagupan on another analysis of post-child-birth hemorrhage. She also talked on "pre-natal care" at Botica Boie on behalf of the Philippine Women’s Medical Association and on the effect of outside work on the health of mothers at a joint meeting of P.M.W.A., the Mental Health Association, and the Philippine Federation of Private Medical Practitioners. In December, she received the first prize of ₧600 from the Manila Medical Society for "the best clinical research work."

At the age of seventy, in 1958, she went abroad to Montreal, Canada, as delegate of the Philippine Obstetrical and Gynecological Society, the Philippine College of Surgeons, the Philippine Research Council and the Philippine General Hospital to the Second World Congress of the International Federation of Gynecology and Obstetrics, held from June 19-28. In this Congress she presented a paper showing the relationship between low protein intake and the high incidence of hydatidiform mole and chorionic malignancy in the Philippines and other Asian countries. On the way back, she was guest speaker at the Staff Conference of the U.S. Army Medical Center in Camp Zawa, Japan, speaking there again on her favorite hydatidiform mole and choriocarcinoma. Back in the Philippines, she continued her busy schedule such as the fourth annual Philippine College of Surgeons meeting where she read three papers: at the 51st annual Philippine Medical Association meeting, where she presented a paper; and at the Midwifery School, Manila Central University, where she gave a more popular talk on pre-natal care. There were also more awards and plaques, from the Philippine Obstetrical and Gynecological Society, the Association de Damas Filipinas and the Postgraduate Assembly of the Manila Medical Society.

The source of awards, certificates and other honors seemed to be inexhaustible. In 1959, she received six of them, the most important being the fifty-year medal from her alma mater in celebration of the Golden Anniversary of her graduation (1909-1959), the "Most Outstanding Woman Physician" award from the Philippine Medical Women’s Association, the "Most Outstanding Practitioner of Manila" plaque from the Philippine Medical Association. From 1960-1964, there were at least twenty of these honors, the most remarkable being the P.M.A. bronze diploma of merit for fifty years of dedicated service to humanity through unselfish devotion to the principles and ideas of the medical profession and for the valuable contributions to . . . medical science" (April 28,1962), as well as the citation from the U.P. Board of Regents for her "long and loyal service to the devoted commitment to the calling of a scholar and scientist, an exampler to the students and an esteemed colleague to her peers." (September 28, 1963)

Her professional activities did not slacken for all the honors conferred to upon her. In 1959, she submitted a paper for the 52nd P.M.A. meeting, delivered the 71st Luis Guerrero lecture at the University of Santo Tomas on "gestational chorionic malignancy", and presented three papers on her favorite hydatidiform mole, chorioadenoma and choriocarcinoma at the 15th P.G.S. annual meeting. In 1960, she again read a paper at the 53rd P.M.A. annual convention (May 23-28) and another one on the hydatidiform mole at the 16th P.C.S. annual convention in December. In 1961, she again attended both annual conventions, presenting two papers for the P.M.A. and three for the P.C.S. In 1962, at the age of sevety-four, she went to Cebu to read a paper on choriocarcinoma before the 55th P.M.A. conference. In Manila, she also presented another paper on the same subject before the first plenary meeting of the Philippine Academy of Sciences and Humanities. In 1963, she was at the 9th Congress of the Medical Women’s International Association in Manila. While she read no paper here, she presented one at the 56th P.M.A. annual convention and still another, this time on "Choriocarcinoma in the Philippines", before the Philippine College of Surgeons on November 23,1963, for which she received a plaque of appreciation and a cash prize. But this was not enough. In 1964, she would still leave the country top present a paper at a seminar in obstetrics and gynecology in San Francisco U.S.A. Subsequent to the seminar, she was also invited to speak before three medical societies in the same city. They also wanted to here at Denver, Colorado, but she had to decline the invitation because she was anxious to return to the Philippines.

She was then seventy-six years and the trip must have taxed her considerably. But she still had a lot of energy in her, fro she would retire from active life only in 1968, at the age of eighty. Even then, she had lived a life full for at least three active persons. Yet she was to live two years more, in complete possession of her facilities. When she quietly passed away on January 19,1970 at he age of eighty-two, she was a victim of lobar pneumonia, a disease particularly fatal to the old. Outside, in the streets, the youth were in turmoil, the nation was in the grips of deep crisis, momentous changes were in the air. (http://www.oocities.org/scientists_phil/sisonlifeandcareer.html)

Gallery of Illustrious Filipinos (1917), by Manuel Artigas (Volume I, p. 52-54)