Flu, Etc.

Most of us are accustomed to what is commonly called “flu”: a term shortened by familiarity from “influenza,” a variation of the word influence, describing “an epidemic formerly attributed by astrologers to the influence of heavenly bodies” (Webster’s Unabridged Dictionary, Second Ed., p. 1276).

Actually, flu is a viral invasion of the body that has by now assumed myriad forms. Medical researchers tell us that, by the time one variety is identified, new forms are already active.

Every season, therefore, produces a number of new deaths as well as new methods to combat flu. Overall, the flu viruses today appear to be relatively low-level menaces, although they regularly claim a number of lives.

That was not true when influenza first appeared. Its origins are unknown. It appeared—seemingly from nowhere—in the spring of 1918 and was called Spanish flu because that was where its effects first became visible.

After a relatively mild first appearance, influenza reappeared in the autumn of 1918 and spread through the people of the world at a terrifying rate.

Later researchers have mentioned that this spread was, in part, attributable to the movements of huge numbers of troops crowded into ships and camps, and that this alone may have been responsible for the high rate of deaths among young adults between 20 and 30 years of age. Within months of its huge outbreak in the autumn of 1918, Spanish influenza spelled death in numbers that outstripped the results of combat.

Public health officials were powerless against it; physicians had no sure remedies. San Francisco health authorities ordered everyone to appear in public behind gauze masks, probably because influenza symptoms resembled colds at first. The secondary stage was pneumonic, the final stage was, remarkably often, death.

Medicine at the time was confronted by a complete mystery. Microscopes could not then detect viruses: it was not until the 1930s that medical researchers were actually able to identify influenza. Nor, for that matter, were medical researchers of 1918 receptive to the idea of unceasing, rapid mutations: they were still bound to theories of immutable bacteria.

That does not mean that the health authorities or physicians, confronted with a worldwide pandemic, admitted a lack of knowledge. Medicine does not—and perhaps cannot—function that candidly. Sick people need doctors, nurses, hospitals, medicines, prescriptions, and assurances: medical theatrics alone can often, mysteriously, spell the difference between life and death.

As people were felled first in hundreds, then in thousands, then in hundreds of thousands in country after country, city after city, all sorts of wild and desperate remedies were tried. Patients were wrapped in hot and/or cold sheets, dosed with laxatives, subjected to steam baths, to quinine, to drams of hot whiskey and to an incredible assortment of “nature” cures. As always, some recovered, and credited whatever remedies they experienced, but no single remedy appeared consistently successful—excepting, for a time, quarantine.

At its peak, influenza struck more than 25 percent of the population of the United States. Total deaths reached over 675,000—a figure higher than all the persons lost in the armed services during the war. Philadelphia, hardest hit, had 700 deaths a day during the peak. Remote areas were especially hard hit: deaths in Alaska and the Samoan Islands reached as high as 30 percent of the population.

Hospitals and morgues were overwhelmed. A coffin shortage developed: in some places bodies remained unburied for as long as a week. Authorities staggered the hours of opening and closing businesses, factories and theaters to reduce congestion. Telephone service was cut in half; schools, churches, and shipyards were closed. This nation was not unique: the rest of the world was just as sick, and mortalities reached astronomic proportions. The actual number of dead will never actually be known, but the records indicate, after careful combing, that many more than 20 million died.

In 1919, however, the disease vanished as mysteriously as it had appeared. There have, as we know, been recurrences ever since, but their impact has been relatively minor compared to the horrors of 1918–1919.

One of the many mysteries that remain regarding this event, however, is the fact that most historians of the period do not mention it. Yet according to Alfred E. Crosby, author of the book titled America’s Forgotten Pandemic: The Influenza of 1918 (Cambridge Univ. Press, 1990), “nothing else in human history, be it war, famine or disease, has ever killed so many people in so brief a time.”

He wonders, with good reason, why greater attention has not been paid to this terrible calamity. And The Times Literary Supplementreviewer, Allan M. Brandt, in discussing Crosby’s query, says: “Implicit in our failure adequately to recognize the significance of epidemic disease in shaping human history is a core psychological defense. Those forces beyond human control … are most quickly repressed. They affront our belief that we control our destiny and fundamentally shape our world” (Oct. 26–Nov. 1, 1990, p, 1158).

Precisely. The world of 1918 was embroiled in a frightful war, launched on the assumption that we can “control our destiny and fundamentally shape our world”—and both that war and the pandemic that drew a curtain across its close proved exactly the opposite.

The fact is that we do not control our destinies and we cannot shape the world as we choose. It is not our world; we neither own nor control it. We are temporary residents, living on short-term leases, cancelable without notice. We are, for our tools and libraries, experts and specialists, imperfectly equipped to understand the forces that surround—and even invade—us.

The world turns away from the memory of the flu epidemic, noted Mr. Brandt in the TLS, much as “many attempt to forget AIDS. In context of our time,” he concluded, “1918 seems much closer.”