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‘The portraits of disease’ explores the link between the symbolic use of diseases and the propagation of ideologies. It traces the origins of the term ‘Sick Man of Asia’ back to British newspapers in the mid-eighteenth century and its development into a metaphor for actual pathogens. The author contends that coloniality and pathogens share similarities, as both are highly transmissible and cannot be seen with the naked eye. The text also examines the influence of German-influenced microbiological research in the Japanese Empire on the expansion of public health methods and institutions in Taiwan, Korea and north-eastern China. This study calls for a broader conversation about the intersections between science, ideology and power in our contemporary global context.