This article expands our understanding of state–society interactions in rural Algeria under French colonial rule, focusing specifically on villages in the eastern department of Constantine. I analyze previously unstudied administrative records, newspapers, petitions, and complaints to show how sanitary regulations and medical expertise came to shape relationships among villagers, local elites, and the colonial state from the early 20th century. Villagers responded to state-led medicalization by seeking the protection of medical doctors, not only from disease but also from the state itself. In particular, they sought to avoid heavy-handed treatment by qaʾids and local elites who applied disease control measures without appropriate medical knowledge. Furthermore, close examination of petitions sent during World War I suggests that hardships experienced by rural communities during the war accentuated nascent feelings of entitlement across demographic, ethnic, and religious communal boundaries toward state medical treatment.