The Great Influenza

by John M. Barry

  'Remember the 3 Cs': For example, Rocky Mountain News, Sept. 28, 1918, quoted in Stephen Leonard, 'The 1918 Influenza Epidemic in Denver and Colorado,' Essays and Monographs in Colorado History, essays no. 9, (1989), 3.

  'The danger' is so grave': JAMA 71, no. 15 (Oct. 12, 1918), 1220.

  'None of the cases' serious': Arizona Republican, Sept. 23, 1918.

  'My first intimations': William Maxwell, 'Influenza 1918,' American Experience.

  'we were next': Lee Reay, 'Influenza 1918,' American Experience.

  'Spanish hysteria': Luckingham, Epidemic in the Southwest, 29.

  'What's true of all the evils': Quoted in Sherwin Nuland, How We Die (1993), 201.

  gone back to being a doctor: interview with Pat Ward, Feb. 13, 2003.

  nothing but brief obituaries: See, for example, JAMA 71, no. 21 (Nov. 16, 1918).

  'Germans have started epidemics': Doane made the statement in Chicago and was quoted by the Chicago Tribune, Sept. 19, 1918. The story appeared in many papers nationally, for example, the Arizona Republican, same date.

  'prepared the public mind': Parsons to Blue, Sept. 26, 1918, entry 10, file 1622, RG 90, NA.

  'well back of the lines': Ibid.

  'we wonder which': Ibid.

  Police ruled it a suicide: Associated Press, Oct. 18, 1918; see also Mobile Daily Register, Oct. 18, 1918.

  41 percent of the entire population: U.S. Census Bureau, Mortality Statistics 1919, 30-31; see also W. H. Frost, 'Statistics of Influenza Morbidity,' Public Health Reports (March 1920), 584-97.

  'this help never materialized': A. M. Lichtenstein, 'The Influenza Epidemic in Cumberland, Md,' Johns Hopkins Nurses Alumni Magazine (1918), 224.

  'everything possible would be done': Parsons to Blue, Oct. 13, 1918, entry 10, file 1622, RG 90, NA.

  'Panic incipient': Parsons to Blue, Oct. 13, 1918, entry 10, file 1622, RG 90, NA.

  '[W]hole city in a panic': J. W. Tappan to Blue, Oct. 22 and Oct. 23, 1918, entry 10, file 1622, RG 90.

  125 died: Leonard, '1918 Influenza Epidemic,' 7.

  'shot gun quarantine': Durango Evening Herald, Dec. 13, 1918, quoted in Leonard, '1918 Influenza Epidemic,' 8.

  'which may be deemed appropriate': Memo by E. L. Munson, Oct. 16, 1918, entry 710, RG 112.

  'a terrible calamity': Gunnison News-Chronicle, Nov. 22, 1918, quoted in Leonard, '1918 Influenza Epidemic,' 8.

  'right at our very doors': Susanna Turner, transcript of unaired interview for 'Influenza 1918,' American Experience, Feb. 27, 1997.

  'almost afraid to breathe': Dan Tonkel, transcript of unaired interview for 'Influenza 1918,' American Experience, March 3, 1997.

  'Farmers stopped farming': Ibid.

  'It kept people apart': William Sardo, transcript of unaired interview for 'Influenza 1918,' American Experience, Feb. 27, 1997.

  'Nobody was coming in': Joe Delano, transcript of unaired interview for 'Influenza 1918,' American Experience, March 3, 1997.

  illegal to shake hands: Jack Fincher, 'America's Rendezvous with the Deadly Lady,' Smithsonian Magazine (Jan. 1989), 131.

  'starving to death not from lack of food': 'An Account of the Influenza Epidemic in Perry County, Kentucky,' unsigned, Aug. 14, 1919, box 689, RG 200, NA.

  arrived' Saturday and left Sunday: Shelley Watts to Fieser, Nov. 11, 1918, box 689, RG 200, NA.

  mortality reached 30 percent: Nancy Baird, 'The 'Spanish Lady' in Kentucky,' Filson Club Quarterly, 293.

  'he'd spray the money': Patricia J. Fanning, 'Disease and the Politics of Community: Norwood and the Great Flu Epidemic of 1918' (1995), 139-42.

  'send for the priest': From Red Cross pamphlet: 'The Mobilization of the American National Red Cross During the Influenza Pandemic 1918-1919' (1920), 24.

  'shouted orders through doors': Leonard, '1918 Influenza Epidemic,' 9.

  'taught that they were safer at work': C. E. Turner, 'Report Upon Preventive Measures Adopted in New England Shipyards of the Emergency Fleet Corp,' undated, entry 10, file 1622, RG 90, NA.

  absentee records were striking: Ibid.

  'the first problem': Arizona Republican, Nov. 8, 1918.

  'H. G. Saylor, yellow slacker': Arizona Gazette, Oct. 11, 1918.

  'a city of masked faces': Arizona Republican, Nov. 27, 1918.

  'Phoenix will soon be dogless': Arizona Gazette, Dec. 6, 1918.

  'BONG! BONG! BONG!': Mrs. Volz, transcript of unaired interview 'Influenza 1918,' American Experience, Feb. 26, 1997.

  'Ice is also great': Robert Frost, 'Fire and Ice,' originally published in Harper's, 1920.

  'akin to the terror of the Middle Ages': 'Mobilization of the American National Red Cross,' 24.

  CHAPTER THIRTY

  'two colored physicians': Converse to Blue, Oct. 8, 1918, entry 10, file 1622, RG 90, NA.

  'urgent need of four nurses': Rush wire to Blue, Oct. 14, 1918, entry 10, file 1622. RG 90, NA.

  'No colored physicians': Blue to Converse, Oct. 10, 1918, entry 10, file 1622, RG 90.

  'impossible to send nurses': Rush wire to Blue, Oct. 14, 1918, entry 10, file 1622, RG 90, NA.

  house to house searching: Report, Oct. 22, 1918, box 688, RG 200, NA.

  go to the ticket booth: Carla Morrisey, transcript of unaired interview for 'Influenza 1918,' American Experience, Feb. 26, 1997.

  'urgent call on physicians': See, for example, JAMA 71, no. 17 (Oct. 26 1918): 1412, 1413.

  'Infection was prevented': James Back, M.D., JAMA 71 no. 23, (Dec. 7, 1918), 1945.

  'saturated with alkalis': Thomas C. Ely, M.D., letter to editor, JAMA 71, no. 17, (Oct. 26, 1918): 1430.

  injected people with typhoid vaccine: D. M. Cowie and P. W. Beaven, 'Nonspecific Protein Therapy in Influenzal Pneumonia,' JAMA (April 19, 1919), 1170.

  'results were immediate and certain': F. B. Bogardus, 'Influenza Pneumonia Treated by Blood Transfusion,' New York Medical Journal (May 3, 1919), 765.

  forty-seven patients; twenty died: W. W. G. MacLachlan and W. J. Fetter, 'Citrated Blood in Treatment of Pneumonia Following Influenza,' JAMA (Dec. 21, 1918), 2053.

  hydrogen peroxide intravenously: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 10, Influenza (1934), 1287.

  homeopaths claiming no deaths: T. A. McCann, 'Homeopathy and Influenza,' The Journal of the American Institute for Homeopathy (May 1921).

  'effect was apparent': T. Anastassiades, 'Autoserotherapy in Influenza,' Grece Medicale, reported in JAMA (June 1919), 1947.

  therapy in The Lancet: Quoted in Thomson and Thomson, Influenza, v. 10, 1287.

  'prompt bleeding': 'Paris Letter,' Oct. 3, 1918, in JAMA 71, no. 19 (Nov. 9, 1918).

  In disease as in war: Quoted in Van Hartesveldt, 1918-1919 Pandemic of Influenza, 82.

  'keep your feet dry': Arizona Gazette, Nov. 26, 1918.

  'a powerful bulwark for the prevention': All these and others reproduced under title 'Propaganda for Reform' in JAMA 71, no. 21 (Nov. 23, 1918), 1763.

  'Use Vicks VapoRub': Seattle Post-Intelligencer, Jan. 3, 1919.

  'vaccinated' immune to the disease': Numerous papers both in and outside New York City, see, for example, Philadelphia Public Ledger, Oct. 18, 1918.

  thousands of dosages more: John Kolmer, M.D., 'Paper Given at the Philadelphia County Medical Society Meeting, Oct. 23, 1918,' Pennsylvania Medical Journal (Dec. 1918), 181.

  'some prophylactic value': George Whipple, 'Current Comment, Vaccines in Influenza,' JAMA (Oct. 19, 1918), 1317.

  death rate' 52 percent: Egbert Fell, 'Postinfluenzal Psychoses,' JAMA (June 7, 1919), 1658.

  'now has available': E. A. Fennel, 'Prophylactic Inoculation against Pneumonia,' JAMA (Dec. 28, 1918), 2119.

  'none is available for distribution': Major G. R. Callender to Dr. W. B. Holden, Oct. 7, 1918, entry 29, RG 112, NA.

  'still in the experimental stage': Acting surgeon general to camp and division surgeons, Oct. 25, 1918, entry 29, RG 112, NA.

  'health officers in th
eir public relations': Editorial, JAMA 71, no. 17, (Oct. 26, 1918), 1408.

  'may arouse unwarranted hope': Editorial, JAMA 71, no. 19 (Nov. 9, 1918), 1583.

  eighteen different kinds: Fincher, 'America's Rendezvous,' 134.

  'large doses hypodermically': Friedlander et al., 'The Epidemic of Influenza at Camp Sherman' JAMA (Nov. 16, 1918), 1652.

  'No benefits were gained': Ibid.

  Sentries guarded all trails: Engineering News-Record 82 (1919), 787, quoted in Jordan, Epidemic Influenza, 453.

  could become 'extinct': Kilpatrick to FC Monroe, Aug. 7, 1919; see also Mrs. Nichols, 'Report of Expedition,' July 21, 1919, RG 200.

  'people of Alaska consider': U.S. Congress, Senate Committee on Appropriations, 'Influenza in Alaska' (1919).

  176 of 300 Eskimos: W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 31.

  'frozen to death before help arrived': U.S. Congress, Senate Committee on Appropriations, 'Influenza in Alaska.'

  'few adults living': Mrs. Nichols, 'Report of Expedition.'

  'heaps of dead bodies': Ibid.

  'starving dogs dug their way': Ibid.

  'Whole households lay inanimate': Eileen Pettigrew, The Silent Enemy: Canada and the Deadly Flu of 1918 (1983), 28.

  'left us to sink or swim': Ibid., 31.

  killed over one hundred dogs: Richard Collier, The Plague of the Spanish Lady: The Influenza Pandemic of 1918-1919 (1974), 300.

  laid 114 bodies in the pit: Pettigrew, Silent Enemy, 30.

  one-third of the population died: Ibid., 33.

  Metropolitan Life Insurance: Jordan, Epidemic Influenza, 251.

  In Frankfurt the mortality: Van Hartesveldt, 1918-1919 Pandemic of Influenza, 25.

  'too exhausted to hate': Fincher, 'America's Rendezvous,' 134.

  'remarkable for the severity': Pierre Lereboullet, La grippe, clinique, prophylaxie, traitement (1926), 33, quoted in Diane A. V. Puklin, 'Paris,' in Van Hartesveldt, 1918-1919 Pandemic of Influenza, 77.

  'obliterating whole settlements': Jordan, Epidemic Influenza, 227.

  only a single sailor died: Crosby, America's Forgotten Pandemic, 234.

  46 percent of the blacks would be attacked: Jordan, Epidemic Influenza, 204-5.

  the state of Chiapas: Thomson and Thomson, Influenza, v. 9, 165.

  attack rate of 33 percent: 'Rio de Janeiro Letter,' JAMA 72 no. 21, May 24, 1919, 1555.

  In Buenos Aires: Thomson and Thomson, Influenza, v. 9, 124.

  In Japan: Ibid., 124. 364 die in the sixteen days: Jordan, Epidemic Influenza, 224.

  'filled with bodies': Ibid., 225.

  Talune brought the disease: Rice, Black November, 140.

  In Chungking one-half the population: Public Health Reports, Sept. 20, 1918, 1617.

  doubled that of the: Jordan, Epidemic Influenza, 222.

  case mortality rate: Mills, 'The 1918-19 Influenza Pandemic (The Indian Experience,' The Indian Economic and Social History Review (1986), 27.

  arrived with the dead and dying: Richard Gordon, M.D., Great Medical Disasters (1983), 87; Beveridge, Influenza: The Last Great Plague, 31.

  For Indian troops: Jordan, Epidemic Influenza, 246.

  7,044 of those patients died: Memo to Dr. Warren from Dr. Armstrong, May 2, 1919, entry 10, file 1622, RG 90, NA.

  'littered with dead and dying': 'London Letter,' JAMA 72, no. 21 (May 24, 1919), 1557.

  firewood was quickly exhausted: Mills, 'The 1918-19 Influenza Pandemic,' 35.

  Close to twenty million: Ibid., 4; Kingsley Davis, The Population of India and Pakistan (1951), 36.

  'civilization could easily' disappear': Collier, Plague of the Spanish Lady, 266.

  Part IX: Lingerer

  CHAPTER THIRTY-ONE

  measles requires an unvaccinated: Quoted in William McNeill, Plagues and Peoples (1976), 53.

  'no longer a master': H. G. Wells, War of the Worlds, online edition, www.fourmilab.ch/etexts/www/warworlds/b2c6.html.

  worst numbers came from Camp Sherman: George Soper, M.D., 'The Influenza Pandemic in the Camps,' undated, unpaginated, RG 112, NA.

  last five camps attacked: Ibid.

  'failed when' carelessly applied': Ibid.

  'when it first reached the state': Wade Frost quoted in David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 9, Influenza (1934), 215.

  'relatively rarely encountered': Edwin O. Jordan, Epidemic Influenza (1927), 355-56.

  'influenza has not passed': 'Bulletin of the USPHS,' Dec. 11, 1918, quoted in JAMA 71, no. 25 (Dec. 21, 1918), 2088.

  twenty-seven epidemic ordinances: Dorothy Ann Pettit, 'A Cruel Wind: America Experiences the Pandemic Influenza, 1918-1920, A Social History' (1976), 162.

  places closed (for a third time: Ibid., 177.

  '99% proof against influenza': June Osborn, ed., Influenza in America, 1918-1976: History, Science, and Politics (1977), 11.

  teachers volunteered as nurses: See Alfred W. Crosby, America's Forgotten Pandemic: The Influenza of 1918 (1989), 91-116, passim.

  'how gallantly the city': Quoted in ibid., 106.

  worst on the West Coast: Osborn, Influenza in America, 11.

  quarantine of incoming ships: W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 31.

  not even one-quarter that of Italy: K. D. Patterson and G. F. Pyle, 'The Geography and Mortality of the 1918 Influenza Pandemic,' Bulletin of the History of Medicine (1991), 14.

  'the influenza plague': Quoted in Lucy Taksa, 'The Masked Disease: Oral History, Memory, and the Influenza Pandemic,' in Memory and History in Twentieth Century Australia (1994), 86.

  'I can recall the Bubonic Plague': Ibid., 79.

  'inoculated against the Bubonic Plague': Ibid., 83.

  'I can remember that': Ibid., 79-85, passim.

  CHAPTER THIRTY-TWO

  'not considered in this report': Egbert Fell, 'Postinfluenzal Psychoses,' JAMA (June 1919), 1658.

  'profound mental inertia': Thomson and Thomson, Influenza, v. 10, 772.

  'influenzal psychoses': G. Draggoti, 'Nervous Manifestations of Influenza,' Policlinico (Feb. 8, 1919), 161, quoted in JAMA 72 (April 12, 1919), 1105.

  'serious mental disturbances': Henri Claude M.D., 'Nervous and Mental Disturbances Following Influenza,' JAMA (May 31, 1919), 1635.

  'an active delirium': Martin Synnott, 'Influenza Epidemic at Camp Dix' JAMA (Nov. 2, 1918), 1818.

  'mental depression': Jordan, Epidemic Influenza, 35.

  'Nervous symptoms': Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 159.

  'melancholia, hysteria, and insanity': Thomson and Thomson, Influenza, v. 10, 263.

  'involvement of the nervous': Ireland, Influenza, 160.

  'muttering delirium which persisted': Ireland, ed., Medical Department of the United States Army in the World War, v. 12, Pathology of the Acute Respiratory Diseases, and of Gas Gangrene Following War Wounds (1929), 141-42.

  'central nervous system': Ibid., 119.

  'Infectious psychosis': Ibid., 13.

  increase in Parkinson's: Frederick G. Hayden and Peter Palese, 'Influenza Virus,' in Clinical Virology (1997), 928.

  'influenza may act on the brain': Jordan, Epidemic Influenza, 278-80.

  'profound influence on the nervous system': Thomson and Thomson, Influenza, v. 10, 768.

  'influence suicide': I. M. Wasserman, 'The Impact of Epidemic, War, Prohibition and Media on Suicide: United States, 1910-1920,' Suicide and Life Threatening Behavior (1992), 240.

  'wide spectrum of central nervous system': Brian R. Murphy and Robert G. Webster, 'Orthomyxoviruses' (1996), 1408.

  'membranes surrounding the brain': P. K. S. Chan et al., 'Pathology of Fatal Human Infection Associated With Avian Influenza A H5N1 Virus,' Journal of Medical Virology (March 2001), 242-46.

  'meninges of the brain': Doug
las Symmers, M.D., 'Pathologic Similarity Between Pneumonia of Bubonic Plague and of Pandemic Influenza,' JAMA (Nov. 2, 1918), 1482.

  'hemorrhages into gray matter': Claude, 'Nervous and Mental Disturbances,' 1635.

  'across to central nervous systems': Interview with Robert Webster, June 13, 2002.

  'have been exceeding miserable': Diaries, House collection, Nov. 30, 1918, quoted in Pettit, 'Cruel Wind,' 186.

  'all too generous': New York Telegram, Jan. 14, 1919, quoted in Ibid.

  'lost the thread of affairs': Quoted in Arthur Walworth, Woodrow Wilson, v. 2 (1965), 279.

  'a greased marble': Tasker Bliss, quoted in Bernard Baruch, Baruch: The Public Years (1960), 119, quoted in Crosby, America's Forgotten Pandemic, 186.

  1,517 Parisians died: From Great Britain Ministry of Health, 'Report on the Pandemic of Influenza' (1920), 228, quoted in Crosby, America's Forgotten Pandemic, 181.

  'grave proportions' in Paris': 'Paris Letter,' March 2, 1919, JAMA 72, no. 14 (April 5, 1919), 1015.

  'the principles laid down': Walworth, Woodrow Wilson, v. 2, 294.

  'severe cold last night': Grayson wire to Tumulty, 8:58 A.M., April 4, 1919, box 44, Tumulty papers, LC.

  'The President was taken violently sick': Grayson to Tumulty, April 10, 1919, marked PERSONAL AND CONFIDENTIAL, box 44, Tumulty papers.

  'taking every precaution': Grayson wire to Tumulty, 11:00 A.M., April 8, 1919, box 44, Tumulty papers.

  'he manifested peculiarities': Walworth, Woodrow Wilson, v. 2, 297.

  'we will go home': Edith Wilson, My Memoir (1939), 249, quoted in Crosby, America's Forgotten Pandemic, 191.

  'a cook who keeps her trunk': Quoted in Walworth, Woodrow Wilson, v. 2, 398.

  'began to drive himself': Cary Grayson, Woodrow Wilson: An Intimate Memoir (1960), 85.

  'push against an unwilling mind': Herbert Hoover, America's First Crusade (1942), 1, 40-41, 64, quoted in Crosby, America's Forgotten Epidemic, 193.

  'lacked his old quickness': Hugh L'Etang, The Pathology of Leadership (1970), 49.

  obsessed with such details: Elbert Smith, When the Cheering Stopped: The Last Years of Woodrow Wilson (1964), 49.

  'never the same after': Irwin H. Hoover, Forty-two Years in the White House, (1934) 98.

  'so worn and tired': Grayson to Tumulty, April 10, 1919, box 44, Tumulty papers.