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With the Philippine-American War after the signing of the Treaty of Paris in 1898, he was among the most prominent Filipinos who joined the American side and advocated the incorporation of the Philippines into the United States.
when the USA in 1898 declared war on Spain, Paterno urged the revolutionaries to defend Spanish rule against the Americans, and he continued to urge resistance to the USA during the Philippine-American war.
When captured, he swore allegiance to the USA, and was subsequently appointed President of the Consultative Assembly.