Idaho 1918-1920 Influenza Pandemic
Idaho Newspaper Clippings April 29-30, 1920
Idaho photos courtesy: the Mike Fritz Collection, History of Idaho
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The Nezperce Herald., April 29, 1920, Page 1
News Stories Briefly Told
Items of Interest Gleaned From The Daily Life of Home Folks In Town and County
The senior Mr. Mundt, of the Winona section, was taken to the state sanitarium at Orofino yesterday on account of infirmities resulting from a protracted illness following influenza.
Mrs. Harold Fike was taken to Lewiston Monday by her husband and Dr. Gist, and there at the White hospital underwent an operation for appendicitis on Tuesday. A report this morning brought the good news that she was making a satisfactory recovery.
Save your chicks by feeding O. K. chick food. For sale by all local dealers. (Adv.)
Central Ridge News
Dr. Smith and family, of Peck, motored up on the hill the last of the week.
Mr. Hamilton was called Monday to the bedside of his brother, who is ill in South Dakota.
To The Mother Of Men
On the second Monday in May the nation will observe Mothers Day. Every one knows Mothers’ Day – what it is, when it is, and for what it stands. It comes a close to our hearts as Christmas or the Fourth of July, for it is the day upon which we honor the mother of man.
The arms of motherhood form the cradle of the human race. They are the rock upon which we rest our hopes of the future, the guiding star which leads humanity through the perils of infancy and into the safe harbor of maturity. Pages upon pages could be written of the glories of our mothers, but not all of the words of the English language could do them justice. It is beyond the power of our humble pen.
All honor to the mother of man! May her days and her joys upon earth be many, and may her home in the next world be one worthy of the greatest handiwork of God.
source: The Nezperce Herald. (Nezperce, Idaho), 29 April 1920. Chronicling America: Historic American Newspapers. Lib. of Congress.
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The Nezperce Herald., April 29, 1920, Page 2
ibid, page 2)
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The Nezperce Herald., April 29, 1920, Page 4
Mrs. Fred Bicknell is improving slowly.
Mrs. Perry Ellis and Mrs. Geo. Warren have been on the sick list this week.
Miss Ruth Tefft finished a successful term of school at Westlake Friday. Westlake will employ two teachers next year.
John Decker, sawyer for the Madison Lumber Co. near Westlake, was injured Saturday and was taken to the hospital at Lewiston.
Plowing is the order of the day.
ibid, page 4)
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The Nezperce Herald., April 29, 1920, Page 6
ibid, page 6)
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The Nezperce Herald., April 29, 1920, Page 7
Local and Personal News Notes
County Agent Wade is nursing a very severe cold.
There are a number of rough places in the roads about town which could be fixed with a few moments’ work, and the saving to vehicles and the nerves of car drivers would be considerable, to say nothing of the pride we should have in keeping our roads fit.
(ibid, page 7)
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School Building, Wilder, Idaho
Photo courtesy: the Mike Fritz Collection, History of Idaho
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The Kendrick Gazette. April 30, 1920, Page 1
Over The County
Star-Mirror: [Moscow] Word was received Friday that Mrs. Wm. Taylor died at Spokane. He death was due to pneumonia, following measles. Mrs. Taylor is the daughter of Mrs. Arthur Carver, formerly Mrs. Chas. Town, of northeast of Moscow. Mrs. Taylor was born near Moscow 35 years ago, and had always lived here and at Kendrick, until two years ago when her husband moved to Innishfall, Alberta, to farm.
She leaves her husband, two sons, Charles and George, 16 and 14 years of age, her mother, Mrs. Arthur Carver of Spokane and a brother, Edgar Town, northeast of Moscow.
Genesee News: At a recent meeting of the local school board, general business was gone over thoroly [sic] and many things for the betterment of the school next year were taken up. It was decided to add another grade teacher to the corps next year and arrangements were also made for another recitation room, which will be newly furnished. It was also decided to buy four typewriters for use in the commercial course.
Troy News: Monday morning the city started the grading of main street and the side streets. The big engine and grader sure moves the dirt. The cement work on the sidewalks of the town will soon start and other improvements are coming. The cement work must start early to enable the contractors to finish before fall as a bunch of cement walks are to be laid during the summer.
source: The Kendrick Gazette. (Kendrick, Idaho), 30 April 1920. Chronicling America: Historic American Newspapers. Lib. of Congress.
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The Kendrick Gazette. April 30, 1920, Page 2
News of Lenore
Miss May Hollingsworth has been very sick at the Cottonwood hospital, with pneumonia following influenza. It is too bad as May expected to finish the eighth grade this season and had been studying diligently.
Miss Marie Hamilton, a nurse from Pullman, has been a week-end guest of Miss Irene Johnston. Irene is greatly improved from a long extended sick spell. She spent the greater part of the winter in Denver and surrounding cities. While in Longmont she contracted the flu which resulted in the dreaded plague when she reached Pueblo, Colo. From there she was compelled to return home reaching here the 9th of January.
Mrs. A. Mustoe has been in Lewiston taking treatment following a brief sick spell.
Courtney Johnston has been very sick for the last few days.
Mrs. Harry Legate of Seattle, formerly Miss Wilma Green of Cream Ridge, has been very sick and is now at the Foster hospital at Clarkston. She has greatly improved since going there.
Miss May Gilispie of Lewiston, whose folks were former Lenore residents, is very sick and is reported to be at the Dr. Fite hospital taking treatments. It seems she has a nervous breakdown. May has been putting in extra time on her studies and music which was too much for her. Her friends all wish her a speedy recovery.
We wish to congratulate Miss Francis Sutton as her first teaching experience ended with a grand success.
The Star school closed April 16th and the teacher, Miss Ames, was greatly surprised by the patrons of the school bringing each a basket dinner, which they spread out together. A very enjoyable time was reported by all. Miss Ames expects to make a trip to Wisconsin to spend the vacation with cousins.
A basket social was reported as being given at the Cream Ridge school house last Friday evening.
An earthquake reported at Kamiah which broke all the windows from the school and was generally felt over the city, makes the cold shivers run up and down one’s spine; joy, boy’s, its getting closer, we better all try and do a little better from now on.
Mrs. Frank Nixon has began carrying the mail as a sub for her husband, who expects to plant garden, etc. We wonder how Mrs. Nixon enjoys the pleasant little April showers of late.
The sun which has hid its face for so many many weeks has at last come to greet us good morning, consequently the farmers are out with the early songsters and as busy as bees putting in what may seem a late spring crop. They have all been very nervous but here’s hoping this little spell of sunshine will continue until all are through seeding.
The available supply of houses in Kendrick has been exhausted for several years. Only two or three new houses have been built here since the beginning of the war. Conditions are now becoming positively alarming. Families are having to leave town because they cannot rent the houses in which they have been living, because others who have come to town and could not find a place to rent, have bought. It’s a sure thing Kendrick has reached her maximum of population unless more houses are built.
According to the 1919 game census, submitted to O. M. Jones, state game warden, a rapid increase of big game has been recorded in the state. In eleven counties in the state the census states there are 16,575 deer. Now we do not wish to dispute the figures of the game census, but just how the game department has been able to count the deer so accurately is a mystery. The writer hunted four days last fall and only counted one deer. At that rate it would take quite a while to count the 16,575 deer without duplicating.
(ibid, page 2)
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The Kendrick Gazette. April 30, 1920, Page 5
Idaho News Paragraphs
Recent Happenings in This State Given in Brief Items for Busy Readers
Escapes from Penitentiary
Tacoma — Escaping from the federal penitentiary at McNeil island last night by means as yet unknown, George Carter, 28, is at large near Tacoma. He is a while [sic] slaver from Idaho.
Raise Moscow Teachers’ Pay
Moscow — All teachers in the Moscow schools have been reelected for another year, and a general increase of about 20 per cent was made in the salaries for next year. J. E. Turner of Payette has been elected to succeed the late John H. Rich as city superintendent.
Many Show Defects
Lewiston — The first report of Miss Minnie Heuerman, recently engaged as county nurse for Nez Perce county, covers a total of 572 children inspected for physical defects. Out of this large number only 61 were found free from physical shortcomings of some sort. The largest number of defects related to the teeth of the children, there being 444 in need of dental attention.
(ibid, page 5)
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The Kendrick Gazette. April 30, 1920, Page 7
Mr. Wells is much improved in health at this writing.
Miss Stella McClelland closed a very successful term of school, Wednesday, at the Fix Ridge school.
Dr. Smith says he is going to “hit the trail” for the jungles very soon, and will be at his office only on Mondays and Tuesdays, henceforth.
Dr. Baker was threatening in a very serious manner, to make garden, Monday.
Hugo Franks persists in breaking the speed limit these mornings, if anyone doubts this, let him watch Hugo come down a hill.
Cavendish and Teakean
S. A. Sutton is very ill at this writing.
The Cavendish primary school grades closed last Friday. The children gave a program after which dinner was served by the parents. Games were enjoyed and a very nice time had by everyone.
The school election was held at Cavendish. Claud King was elected trustee in place of W. Daniels, who is living at Coeur d’Alene.
Miss A. Rutledge will teach the summer school in the school house south of Teakean. She began her work Monday. Miss Parker will teach summer school at Elk River as soon as her Teakean school is out.
Look out for Smallpox. There is no lid on.
Ada Bower closed a successful term of school at Buckhorn last Wednesday. Buckhorn is to employ two teachers next year.
Mr. Ogden had the misfortune of losing a good milk cow.
(ibid, page 7)
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The Kendrick Gazette. April 30, 1920, Page 8
Miss Opal Thomas, who was ill for over two weeks, was able to be out again the first of the week.
Edgar Bohn’s baby died at Spokane Wednesday, from tuberculosis. The mother died about a year ago from the same cause. The body will be taken to Linden for burial.
Charles Lewis found an opal while digging in his garden this week. It is in the rough, as large as a pea and very brilliant. It appears to be flawless. This is the first time, so far as anyone knows, that an opal has ever been found here, so it is presumed it didn’t “grow” here, but was probably brought here by someone.
Big Bear Ridge
An interesting spring time program was given at the Fern Hill school house by Miss Adeline Hupp’s pupils, Friday evening. Following the program punch and wafers were served, and everyone enjoyed a social good time.
Mrs. Will Whybark was elected school director at Steele, to succeed H. L. Ingle.
Thomas Whybark is ill with the measles.
Word reached here from Moscow, that Mrs. R. P. Drury, is seriously ill at the Gritman Hospital. Mr. and Mrs. Drury were one of the earliest pioneer settlers of the ridge.
The funeral services of Mrs. K. Lathrop were held Monday afternoon.
(ibid, page 8)
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The Oakley Herald. April 30, 1920, Page 1
Hector Haight has been seriously ill since Saturday, but is recovering.
Miss Emily Wilson is back at her old post at the Gem Cash.
The funeral of Orval Snodgrass, son of James Snodgrass, was held at Albion Wednesday. The deceased was 29 years old and had been discharged from the army just a month. He had been married only two months before his untimely death. Among the Oakley people who attended the funeral were Mr. and Mrs. W. R. Gray, F. O. Peterson, Al Nelson and James F. Devine.
Four of the teachers for the Academy have been employed for the coming year and negotiations are under way for hiring the other two. J. E. Dye, Ph. D., will have charge of chemistry and physics. J. Lyman Smith and Prof. West will both retain their present positions.
L. J. Robinson, Jr., is resigning his position as principal of the public school to give his entire time to insurance business. Edward Warr will be his successor. Other teachers who have signed up for the coming year are: Miss Marion Crawford, first grade; Miss Florence De Klotz, second; Miss Rita Harper, of Albion, third; Miss Alice McMurray, fifth; Miss Frances Wilson, fourth.
Idaho State News
Wesley Morris of Presto had a leg broken while on his way to school. His horse slipped on a wet bridge, pinning the lad’s leg under him.
Miss Jean Bentley has installed a clinical laboratory in Pocatello for the benefit of the medical profession and others who need analytical work done.
Idaho’s land department sold 101,568.41 acres of state land during the first year of the cabinet form of government at a total purchase price of $2,187,034.09.
Henry C. Voss, who shot and killed Glenn Miles, a member of a charivari party which visited him and his bride the night of April 13, was found guilty of involuntary manslaughter by a jury at Coeur d’Alene. [* see Footnote 1]
Fruit syrups for beverage use, if made with flavoring extracts containing alcohol, are forbidden in Idaho. Roy L. Black, attorney general of the state, broke the sad news to a San Francisco Inquirer last week.
Since prohibition went into effect, apple cider has come into its own. This is evidenced by the fact that nine-tenths of the men arrested at Boise for being drunk attribute their state of inebriation to plain apple cider.
source: The Oakley Herald. (Oakley, Idaho), 30 April 1920. Chronicling America: Historic American Newspapers. Lib. of Congress.
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The Oakley Herald. April 30, 1920, Page 3
In And Around Town
Little Hazel Ryan had a few days illness from tonsillitis this week.
An operation for gangrene was performed on the hand of Otto Milton’s baby Tuesday.
Miss Viola Hale has been sick this week, presumably the result of something she ate Sunday. She has lain unconscious for days and it is impossible to give her medicine. There appears to be some slight change for the better now.
Wanted — a girl at the Bailey Cafe. (Adv.)
(ibid, page 3)
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The Oakley Herald. April 30, 1920, Page 6
Mr. and Mrs. Newbold of Vipont, who took smallpox last week, are improving and will be released from quarantine soon. All who were exposed have been vaccinated. No new cases has developed, and there appears to be no further danger of contagion.
(ibid, page 6)
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The Oakley Herald. April 30, 1920, Page 8
Worthington Halverson is recovering from a serious illness of pneumonia.
Mr. and Mrs. W. A. Matrindale’s baby was sick a few days this week.
(ibid, page 8)
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Montpelier Examiner. April 30, 1920, Page 1
There has been sheep shipped here for summer grazing, but owing to the bad weather the shippers have been compelled to ship feed along with them.
Will “Overall” Clubs Be Taboo In Montpelier?
Many are of the belief that the so-called overall clubs fad which is sweeping the country is simply propaganda of overalls manufacturers, and will ultimately have the effect of boosting the price of overalls sky-high while the price of clothing will remain at a standstill for a time and then the price jump higher.
Local clothing men say that invoices for new shipments of overalls show a marked increase, and that quotations received almost daily indicate that a steady increase in the price of these garments is being made by the manufacturers and jobbers. The dealers say that there is no possible chance for the clothing in their stocks to decrease in price, but on the other hand that the overall clubs will have a tendency to increase the cost of clothing still higher.
source: Montpelier Examiner. (Montpelier, Idaho), 30 April 1920. Chronicling America: Historic American Newspapers. Lib. of Congress.
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Montpelier Examiner. April 30, 1920, Page 3
Prominent Folks Testify
After Influenza Heart and Circulation Bad
Baker City, Oregon: — “I was taken with Influenza, January 4th and also had a nervous breakdown. My stomach was so bad I did not retain any food for three or four weeks and I was troubled with gas and sourness. I doctored with my two favorite doctors and a Chiropractic who said my nerves were so badly deranged that I was on the verge of hysteria. My heart was bad and circulation so bad that my limbs were almost paralyzed. One day I sent for a copy of Dr. Pierce’s Common Sense Medical Adviser, which I read and decided to make a trial of Dr. Pierce’s medicines. At that time I was only able to stay up for a few minutes at a time. After taking two bottles I was able to be on my feet all day. I am now able to eat anything without discomfort and never have the dryness in my mouth in the morning or any bowel trouble. The ‘Pleasant Pellets’ and the ‘Medical Discovery’ according to directions, and the salt baths as directed in the ‘Medical Adviser’ were all I used. I walk 18 or 19 blocks at a time now and feel no ill effects.
“Will always recommend Dr. Pierce’s remedies.” – Mrs. Wm. Hoggard, 2630 Church St.
(ibid, page 3)
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Montpelier Examiner. April 30, 1920, Page 4
Mrs. Walter Sarback went to Salt Lake Tuesday and will remain there with her husband, who is confined to the hospital in that city.
Mrs. James Lindsay was called to Idaho Falls yesterday on account of the illness of her son.
Dr. Ashley has purchased a Ford coupe from Bear Lake Motor Co.
County Seat News
Bery Bunderson of St. Charles is here at the Sutton hospital suffering from a severe attack of appendicitis. At present Mr. Bunderson’s condition is considered extremely critical.
Mrs. Emma Clayton is again at her home in Paris after spending some time at the L. D. S. hospital in Salt Lake City, where she underwent an operation.
Owing to the rapid drying of the streets, levelers are busy at work. A large tractor, operated by William Jensen, is being used, and excellent results are being noticed. The tractor is able to pull drags requiring several teams, and is finishing the work much more rapidly than has been possible with horse-power.
(ibid, page 4)
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Montpelier Examiner. April 30, 1920, Page 9
Notes From Geneva
Hay is very scarce in Geneva, but as yet there has been no stock lost. We still have snow in Thomas Fork valley. If warm weather doesn’t come soon the stock will have to suffer very much. We hope the weather will be in our favor so the snow will soon go off and the stock saved.
(ibid, page 9)
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Montpelier Examiner. April 30, 1920, Page 10
St. Charles Notes
Bert Bunderson of St. Charles was taken down suddenly with appendicitis Sunday evening and was hurriedly removed to Paris where a successful operation was performed.
The feed situation has not improved sufficiently here to make us safe, but a cooperative system has been adopted by all the farmers whereby a division of the hay on hand will be made, and in this way there will be enough to feed all the horses in the community and enable the farmers to complete their spring work. Cattle has been turned out and the available feed will be used entirely for the horses.
(ibid, page 10)
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Montpelier Examiner. April 30, 1920, Page 11
Notice To Chicken Owners
There is an ordinance providing that chickens must be shut up for the summer beginning on May 1st. This is to notify you that this ordinance will be strictly enforced, and all owners of chickens are hereby notified to pen up their chickens. Complaints have already been made that chickens have damaged neighboring property.
By Order of Chief of Police.
(ibid, page 11)
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Montpelier Examiner. April 30, 1920, Page 14
John A. Sharp of Vernon, Utah, who suffered a paralytic stroke in this city a few months ago while engaged as a school teacher, is reported as improving rapidly. Mr. Sharp spent sixteen weeks in hospitals.
S. W. Mathews of Liberty was in town Monday. Mr. Mathews reports the roads in the country drying rapidly and that they will soon be in passable condition.
(ibid, page 14)
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The Caldwell Tribune. April 30, 1920, Page 1
Fred McConnell, county surveyor, broke his ankle Tuesday when his car, which was upon a jack, was backed into by another auto, slipped from the jack, catching his ankle. The muscles and ligaments were badly torn and the bones crushed.
Ted Hicks was arrested Tuesday in Boise on the charge of forgery, and brought here for hearing. His hearing was held Wednesday morning, and as it was his second offense he was sentenced to the reform school at St. Anthony. He is 14 years of age, and recently forged a check in Boise, it is alleged, for the sum of $50. Deputy Sheriff Andrews left Wednesday evening with the boy in his custody.
L. W. Hardy was arrested Wednesday for selling goods without a license, and taken before Police Judge Maxey, who fined him $5. He then procured a license to peddle the rest of the day.
source: The Caldwell Tribune. (Caldwell, Idaho), 30 April 1920. Chronicling America: Historic American Newspapers. Lib. of Congress.
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The Caldwell Tribune. April 30, 1920, Page 2
Elderly Hobo Mooches Room From City Jail
“Dad” Van Dorn was Enjoying Life until Officers Caught Him in Cell at Nampa
Nampa — For several nights last week “Dad” John Van Dorn, 65-year-old knight of the road, used a cell at the city jail for his sleeping quarters. He had discovered that he could slip in the side door of the jail, pick out an unoccupied cell, spend a restful night, and slip out in the morning unobserved.
But Sunday evening the officers, in bringing in another prisoner, discovered “Dad” and turned the key on him. Now it develops that he is a confirmed vagrant, having wandered over the west for the past 15 years. He is getting so infirm that he finds it difficult to pay his way as he goes and an effort will be made to have him committed to the poor farm at Caldwell.
Van Dodrn has several children in different parts of the west but it is said that he is such a crabid [sic] old fellow that he cannot live with them.
He said yesterday that since his wife died in Montana 15 years ago he has led a roving existence, staying only a short time in any one place. He has worked as a farm hand, miner, sheep herder and carpenter.
(ibid, page 2)
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The Caldwell Tribune. April 30, 1920, Page 4
Miss Bernice Weymouth is sick at her home.
Miss Alice Barrett is teaching this week for Miss Dora Stevens who is ill.
(ibid, page 4)
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The Caldwell Tribune. April 30, 1920, Page 5
Local And Personal
Mr. and Mrs. Allen of Logan street are now busy taking care of their children who have measles.
Charles Higgins is at Steensland hospital taking treatment for rheumatism.
Mr. Edwards of Arthur street died Wednesday night after an operation, from a complication of diseases. Funeral arrangement have not been made.
(ibid, page 5)
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The Caldwell Tribune. April 30, 1920, Page 7
Items of Interest From Surrounding Territory
Marble Front Items
We are glad to report the arrival of a baby boy at the home of Mrs. Lizzie Vaughn.
We are glad to note that Mrs. Charles Robertson is improving in health.
The Misses Hammars, sisters of Carl Hammar, are very highly esteemed as teachers and have both contracted for next year at good salaries.
The Canyon school has decided to close with a picnic at Curtis park on Friday.
(ibid, page 7)
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The Caldwell Tribune. April 30, 1920, Page 8
Items of Interest From Surrounding Territory
Arena Valley Items
Mrs. J. P. Butler has been on the sick list several days.
Mrs. Sam Seiber went to Caldwell Monday where she has been receiving medical aid for some time.
Miss Irwin and Miss Riddle, state and county health workers, were in the valley last Wednesday inspecting sanitary conditions and ascertaining how well the community has complied with the general “clean up” campaign. They will be here again later.
Miss Margaret Knowlton, county superintendent, visited the Arena school last week.
Ten Davis News
Little Floy Evans fell from the cement steps at the school house Monday and broke her arm.
Edith Adams is quite ill with the measles.
Waldo Eby’s little daughter has been ill the past week.
There is to be an entertainment and box social at Lake Lowell school house on Saturday night, May 1st.
Several herds of cattle were moving through this vicinity the first of the week.
Essie Conklin is home with the measles.
Mrs. Barnes is down with the measles.
Mr. Nichols was able to be out in the yard Friday for the first time in several weeks.
(ibid, page 8)
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The Caldwell Tribune. April 30, 1920, Page 9
Items of Interest From Surrounding Territory
Ray Lantzer, the thirteen year old son of Mr. and Mrs. G. E. Lantzer, had his leg broken near the ankle, while playing ball at the Midway school Monday.
The regular monthly meeting of the Midway P. T. A. will be held at the school house Friday afternoon May 7. The annual election of officers will be held and considerable other business of importance is to be transacted. It is hoped there will be a good attendance.
Mrs. Charles Day is in a Caldwell hospital for a few days having undergone a minor operation.
A move is being made to consolidate school district 73 and the Fargo district with Wilder, that outlying homes may have better school advantages. Some opposition has developed and the proposition may not be decided for some time.
Margaret Jamieson was home from school for over a week with a very bad cold.
Mr. Sam Stitzel is taking care of a case of mumps.
At the school election, April 19, Mr. Harry Reynolds and Mr. Preston were chosen as the new directors. The $8000 bond was raised and the district was taxed with a 10 mills levy. The work on the new school building has begun.
The Gem school was allowed half a holiday last Friday afternoon and about twenty-two of them with their teacher went to Jump creek canyon. Most of them climbed the rocks to the second falls and two claimed they had been to the third falls. Everybody had a good time and everything went well with the exception of some worn-out shoe soles and some missing lunches.
A pretty shower was ushered onto Mrs. George Lidell last week when a number of her lady friends entered her house and brought several dainty little things which we can not enumerate in this paper.
(ibid, page 9)
Charivari – alternatively spelled shivaree or chivaree and also called skimmington (ride), was a European and North American folk custom in which a mock parade was staged through a community accompanied by a discordant mock serenade. Since the crowd aimed to make as much noise as possible by beating on pots and pans or anything that came to hand these parades are often referred to as rough music….
[North America] In some communities the ritual served as a gentle spoof of the newlyweds, intended to disrupt for a while any sexual activities that might be under way. In parts of the midwest US, such as Kansas, in the mid 1960-1970s, shivaree customs continued as good natured wedding humour along the lines of the musical Oklahoma!. Rituals included wheeling the bride about in a wheelbarrow or tying cowbells under a wedding bed. This ritual may be the base of the fastening of tin cans to the newlyweds car.
The Influenza Pandemic of 1918
by Molly Billings, June, 1997
The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as “Spanish Flu” or “La Grippe” the influenza of 1918-1919 was a global disaster.
In the fall of 1918 the Great War in Europe was winding down and peace was on the horizon. The Americans had joined in the fight, bringing the Allies closer to victory against the Germans. Deep within the trenches these men lived through some of the most brutal conditions of life, which it seemed could not be any worse. Then, in pockets across the globe, something erupted that seemed as benign as the common cold. The influenza of that season, however, was far more than a cold. In the two years that this scourge ravaged the earth, a fifth of the world’s population was infected. The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children. It infected 28% of all Americans (Tice). An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war. Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy (Deseret News). An estimated 43,000 servicemen mobilized for WWI died of influenza (Crosby). 1918 would go down as unforgettable year of suffering and death and yet of peace. As noted in the Journal of the American Medical Association final edition of 1918:
“The 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man’s destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all — infectious disease,” (12/28/1918).
An Emergency Hospital for Influenza Patients
The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger). People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly “develop the most viscous type of pneumonia that has ever been seen” and later when cyanosis appeared in the patients, “it is simply a struggle for air until they suffocate,” (Grist, 1979). Another physician recalls that the influenza patients “died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth,” (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip rope to the rhyme (Crawford):
I had a little bird,
Its name was Enza.
I opened the window,
The influenza pandemic circled the globe. Most of humanity felt the effects of this strain of the influenza virus. It spread following the path of its human carriers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific (Taubenberger). In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people (Brown). The influenza pandemic circled the globe. Most of humanity felt the effects of this strain of the influenza virus. It spread following the path of its human carriers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific (Taubenberger). In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people (Brown). The Great War, with its mass movements of men in armies and aboard ships, probably aided in its rapid diffusion and attack. The origins of the deadly flu disease were unknown but widely speculated upon. Some of the allies thought of the epidemic as a biological warfare tool of the Germans. Many thought it was a result of the trench warfare, the use of mustard gases and the generated “smoke and fumes” of the war. A national campaign began using the ready rhetoric of war to fight the new enemy of microscopic proportions. A study attempted to reason why the disease had been so devastating in certain localized regions, looking at the climate, the weather and the racial composition of cities. They found humidity to be linked with more severe epidemics as it “fosters the dissemination of the bacteria,” (Committee on Atmosphere and Man, 1923). Meanwhile the new sciences of the infectious agents and immunology were racing to come up with a vaccine or therapy to stop the epidemics.
The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. The recombination of its surface proteins created a virus novel to almost everyone and a loss of herd immunity. Recently the virus has been reconstructed from the tissue of a dead soldier and is now being genetically characterized. The name of Spanish Flu came from the early affliction and large mortalities in Spain (BMJ,10/19/1918) where it allegedly killed 8 million in May (BMJ, 7/13/1918). However, a first wave of influenza appeared early in the spring of 1918 in Kansas and in military camps throughout the US. Few noticed the epidemic in the midst of the war. Wilson had just given his 14 point address. There was virtually no response or acknowledgment to the epidemics in March and April in the military camps. It was unfortunate that no steps were taken to prepare for the usual recrudescence of the virulent influenza strain in the winter. The lack of action was later criticized when the epidemic could not be ignored in the winter of 1918 (BMJ, 1918). These first epidemics at training camps were a sign of what was coming in greater magnitude in the fall and winter of 1918 to the entire world.
The war brought the virus back into the US for the second wave of the epidemic. It first arrived in Boston in September of 1918 through the port busy with war shipments of machinery and supplies. The war also enabled the virus to spread and diffuse. Men across the nation were mobilizing to join the military and the cause. As they came together, they brought the virus with them and to those they contacted. The virus killed almost 200,00 in October of 1918 alone. In November 11 of 1918 the end of the war enabled a resurgence. As people celebrated Armistice Day with parades and large parties, a complete disaster from the public health standpoint, a rebirth of the epidemic occurred in some cities. The flu that winter was beyond imagination as millions were infected and thousands died. Just as the war had effected the course of influenza, influenza affected the war. Entire fleets were ill with the disease and men on the front were too sick to fight. The flu was devastating to both sides, killing more men than their own weapons could.
With the military patients coming home from the war with battle wounds and mustard gas burns, hospital facilities and staff were taxed to the limit. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Since the medical practitioners were away with the troops, only the medical students were left to care for the sick. Third and forth year classes were closed and the students assigned jobs as interns or nurses (Starr,1976). One article noted that “depletion has been carried to such an extent that the practitioners are brought very near the breaking point,” (BMJ, 11/2/1918). The shortage was further confounded by the added loss of physicians to the epidemic. In the U.S., the Red Cross had to recruit more volunteers to contribute to the new cause at home of fighting the influenza epidemic. To respond with the fullest utilization of nurses, volunteers and medical supplies, the Red Cross created a National Committee on Influenza. It was involved in both military and civilian sectors to mobilize all forces to fight Spanish influenza (Crosby, 1989). In some areas of the US, the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteer in the hospitals at night (Deseret News). Emergency hospitals were created to take in the patients from the US and those arriving sick from overseas.
The pandemic affected everyone. With one-quarter of the US and one-fifth of the world infected with the influenza, it was impossible to escape from the illness. Even President Woodrow Wilson suffered from the flu in early 1919 while negotiating the crucial treaty of Versailles to end the World War (Tice). Those who were lucky enough to avoid infection had to deal with the public health ordinances to restrain the spread of the disease. The public health departments distributed gauze masks to be worn in public. Stores could not hold sales, funerals were limited to 15 minutes. Some towns required a signed certificate to enter and railroads would not accept passengers without them. Those who ignored the flu ordinances had to pay steep fines enforced by extra officers (Deseret News). Bodies pilled up as the massive deaths of the epidemic ensued. Besides the lack of health care workers and medical supplies, there was a shortage of coffins, morticians and gravediggers (Knox). The conditions in 1918 were not so far removed from the Black Death in the era of the bubonic plague of the Middle Ages.
In 1918-19 this deadly influenza pandemic erupted during the final stages of World War I. Nations were already attempting to deal with the effects and costs of the war. Propaganda campaigns and war restrictions and rations had been implemented by governments. Nationalism pervaded as people accepted government authority. This allowed the public health departments to easily step in and implement their restrictive measures. The war also gave science greater importance as governments relied on scientists, now armed with the new germ theory and the development of antiseptic surgery, to design vaccines and reduce mortalities of disease and battle wounds. Their new technologies could preserve the men on the front and ultimately save the world. These conditions created by World War I, together with the current social attitudes and ideas, led to the relatively calm response of the public and application of scientific ideas. People allowed for strict measures and loss of freedom during the war as they submitted to the needs of the nation ahead of their personal needs. They had accepted the limitations placed with rationing and drafting. The responses of the public health officials reflected the new allegiance to science and the wartime society. The medical and scientific communities had developed new theories and applied them to prevention, diagnostics and treatment of the influenza patients.
The Public Health Response
The responses of the Public Health Departments in Europe and in the United States represented the ideas prevalent in society and in the scientific community. While most of the measures were solidly grounded in the current scientific concepts, they could also be traced back to Medieval and even Classical times of plague and pestilence. The idea of contagion prompting quarantines and isolation dates back to the Justinian Plague. However, epidemiological work by Snow and others in the 19th century did further these notions of contagion and understanding of transmission. Public Health Departments grew out of these advances and the belief in the ability of man to control nature. Sanitation, vaccination programs and other public hygiene efforts in the late 19th century enabled public health officials to gain power and authority. However, the Influenza Pandemic of 1918-19 challenged the public health agencies. The massive morbidities from the common illness of influenza were mysterious and frightening. Many of the measures formerly known to work were ineffective. They were not prepared for an event of this magnitude, lacking the organization and infrastructure and constrained by the war. Yet, the great war provided the rhetoric of nationalism necessary to usher in these authoritative responses and losses of liberty.
The public health authorities in both the United States and Europe took up fundamental measures to control epidemics that dated back to Medieval times of the Bubonic Plague. They aimed to reduce the transmission of the pathogen by preventing contact. They framed their public health orders in scientific ideas of their understanding of how the influenza microbe spread through the air by coughing and sneezing, and their conception of the pathogenesis of influenza. Since they concluded that the pathogen was transmitted through the air, efforts to control contagion were organized to prevent those infected from sharing the same air as the uninfected. Public gatherings and the coming together of people in close quarters was seen as a potential agency for the transmission of the disease. The public health authorities believed that good ventilation and fresh air were “the best of all general measures for prevention, and this implies the avoidance of crowded meetings,” (BMJ, 10/19/1918). This translated into the controversial and imperative measure of closing of many public institutions and banning of public gatherings during the time of an epidemic.
The rigidity of these regulations varied immensely with the power of the local health departments and severity of the influenza outbreak. In the United States, the Committee of the American Public Health Association ( APHA) issued measures in a report to limit large gatherings. The committee held that any type of gathering of people, with the mixing of bodies and sharing of breath in crowded rooms, was dangerous. Nonessential meetings were to be prohibited. They determined that saloons, dance halls, and cinemas should be closed and public funerals should be prohibited since they were unnecessary assemblies. Churches were allowed to remain open, but the committee believed that only the minimum services should be conducted and the intimacy reduced. Street cars were thought to be a special menace to society with poor ventilation, crowding and uncleanliness. The committee encouraged the staggering of opening and closing hours in stores and factories to prevent overcrowding and for people to walk to work when possible (JAMA, 12/21/1918). Some of the regulations in Britain were milder, such as limiting music hall performances to less than three consecutive hours and allowing a half-hour for ventilation between shows (BMJ, 11/30/1918). In Switzerland, theaters, cinemas, concerts and shooting matches were all suspended when the epidemic struck, which led to a state of panic (BMJ, 10/19/1918). This variation in response was most likely due to differences in authority of the public health agencies and societal acceptance of their measures as necessary. This necessitated a shared belief in the concept of contagion and some faith in the actions of science to allow them to overcome this plague.
The most frequently discussed and debated public health measure in the journals of the period was the closure of the schools. In Britain the prevalence of the epidemic led to the closure of the public elementary schools (BMJ, 11/30/1918). In France, students with any symptoms and their siblings were to be excluded from school. If three fourths of the students were absent then the whole class was to be dismissed for 15 days (JAMA, 12/7/1918). Some believed closing schools to be a useful measure to control infection but complained that it often occurred too late, after most students and teachers were sick (BMJ, 10/19/1918). In the United States, school closure was not as widely accepted. One article in JAMA said that, “the desirability of closing schools in a large city in the presence of an epidemic is a measure of doubtful value,” (10/5/1918). The APHA Committee debated its value too, questioning the effectiveness against the loss of educational standards. Generally, school closure was thought to be less effective in large urban metropolises than in rural centers where the school represented the point of dissemination of the infectious agent. The closing of schools and other public institutions as public health regulations to reduce the epidemic was not universally accepted. One editorial in the BMJ states that “every town-dweller who is susceptible must sooner or later contract influenza whatever the public health authorities may do; and that the more schools and public meetings are banned and the general life of the community dislocated the greater will be the unemployment and depression,” (12/21/1918).
The more restrictive methods of infection control issued by public health departments were quarantines and the isolation of the ill. These measures required a sacrifice of individual liberty for the societal good and therefore required a strong public health authority. Both the Illinois and New York State Health Departments ordered that patients must be quarantined until all clinical manifestations of the illness subsided. They held that the danger of the influenza epidemic was so grave that it was imperative to secure isolation for the patient (JAMA, 10/12/1918). The members of the APHA committee agreed in their report, saying that patients with influenza should to be kept in isolation. Because of the strain on facilities, only severe cases were to be hospitalized while mild influenza patients were to remain at home. The APHA also supported institutional quarantines to protect people from the outside world in establishments like asylums and colleges (JAMA, 12/21/1918). The use of institutional quarantines was applied to the many military training camps set up in the United States to prepare soldiers for war. These camps, with masses of men from throughout the country, were prime targets of huge influenza epidemics. The men were kept in strict isolation once ill and entire camps was often quarantined (JAMA, 4/12/1919). These measures were easily implemented in these camps where men were already committed to their country and the authority of the government.
The Committee of the American Public Health Association (APHA) issued a report outlining appropriate ways to prevent the spread and reduce the severity of the epidemic. They noted first that the disease was extremely communicable and “spread solely by discharges from the nose and throats of infected persons.” They sought to prevent infection by breaking the channels of communication such as droplet infection by sputum control. They believed that infection occurred by the contamination of the hands and common eating and drinking utensils. Thus they called for legislation to prevent the use of common cups and to regulate coughing and sneezing. They wanted to initiate education programs and publicity on respiratory hygiene about the dangers of coughing, sneezing and the careless disposal of nasal discharges. They aimed to teach people the value of hand-washing before eating and the advantages of general hygiene (JAMA, 12/21/1918). Public Health Departments issued Flu Posters to educate the community and reduce the spread of infection. The members also noted that the response should vary according to the type of community and the living conditions. Measures were to be adapted to rural or metropolitan areas, with a centralized coordination to enforce compulsory reporting and canvassing for cases.
Public Health agencies applied the principles of contagion to methods of hygiene and a regard for ventilation in their suggestions for reducing the spread of the illness and preventing disease. They held that well ventilated, airy rooms promoted well-being, (BMJ, 11/16/1918). Preventative measures built upon the same ideas of transmission and the germ theory of disease. These ideas were practiced in the hospitals as special influenza wards for influenza patients were created and the number of beds per ward was decreased to reduce the transmission of the disease. Those with complications such as pneumonia were separated from the rest to prevent the others from progressing to this more fatal state (BMJ, 11/2/1918). Sheets were hung between the beds to mimic isolation in limited closed quarters to provide a cubicle for each patient. No patient was allowed to leave their bed until they were fever free for 48 hours. In the military camps, soldiers were instructed to eat 5 feet apart in the mess halls. Head to foot sleeping was also implemented to reduce the sharing of air space (JAMA, 4/12/1919). One camp used these ideas of prevention via ventilation and boasted of their results. They claimed their rampant influenza epidemic terminated once men were kept out in the open with sunlight or in open, airy halls and prevented from gathering (JAMA, 12/14/1918).
One of the key aspects of prevention was the use of disinfection and sterilization methods. The practical prevention guidelines utilized the recent developments made by Lister and others of the necessity antiseptic conditions. All bedding and rooms were to be periodically disinfected to kill whatever pathogen pervaded them. In naval ambulance trains this was executed by washing down the train with a weak izal antiseptic solution (BMJ, 11/23/1918). The produced sputum, thought to be riddled with the microbe, was to be destroyed. In one hospital the sputum cups were emptied and disinfected twice daily, while nasal discharges were collected in paper napkins. An antiseptic hand solution was placed conveniently for those on duty in the influenza ward (JAMA, 4/12/1919). One French report also suggested that the staff of influenza wards should wear blouses inside the ward and remove them when leaving (BMJ, 11/2/1918). These disinfection procedures of prevention utilized scientific ideas of germ theory to reduce transmission.
The gauze mask was another prevention method using similar ideas of contagion and germ theory. In the United States it was widely accepted for use in hospitals among health care workers. The face masks consisted of a half yard of gauze, folded like a triangular bandage covering the mouth, nose and chin (BMJ, 11/2/19118). These gauze masks acted to prevent the infectious droplets from being expelled by the mouth and from the hands, contaminated with microbe from being put to the mouth. The barrier from the hands was thought to be more important than the barrier from the air. The mask was also worn in some regions by the general population. In San Francisco the gauze masks were made a requirement of the entire population in a trial ordinance. This was later expanded to include San Diego in December. This rhyme was a popular way to remind people of the ordinance.
They found that the mask wearing led to “a rapid decline in the number of cases of influenza,” (JAMA, 12/28/1918). A study in the Great Lakes, however, did not find such beneficial results. Mask wearing by hospital corps did not have an effect on the incidence of disease as 8% who used the mask developed infection while only 7.75% of non-mask wearers did (JAMA, Vol. 71, No. 26). Despite these results, the masks were commonly used by many in an effort to avoid the pandemic influenza disease.
The members of the APHA committee also suggested ways to increase the natural resistance to the illness. They stated that nervous and physical exhaustion should be avoided. People were encouraged to maintain proper rest, to get fresh air and maintain general hygiene. The French report also encouraged avoiding over-fatigue and exposure to the cold (BMJ, 11/2/1918). The Royal College of Physicians shared this opinion saying that the chilling of the body should be prevented by wearing warm clothing out of doors. They also claimed that good nourishment of food and drink was desirable, saying that chill and over-exertion…have evil consequences,” (BMJ, 11/16/1918). These methodologies unlike the preventative measures do not appear to have a strong scientific basis. Rather, they reflect common societal ideas about the wellness and the ability to fight infection. Thus to a degree, the medical and public health officials were still using common sense notions to combat this new infectious terror.
One method of preventing infection, however was more scientific, more elaborate and more controversial. This was the gargling and rinsing out of the nasopharynx with antiseptic solution. Physicians held that since the disease was transmitted through the upper respiratory passages, it made sense to disinfected the nose and mouth to prevent infection. One method was to gargle with warm water mixed with chlorinated soda. A Dr. F. W. Alexander recommended electrolytic disinfection fluid as mouth wash for influenza to be gargled and sniffed up the nose (BMJ, 11/2/1918). Others gargled and sprayed the nasopharynx with a weak solution of carbolic acid and combined it with quinine to prevent infection (BMJ, 11/23/1918). A more serious method of cleansing and disinfecting the nasal spaces and upper air passages was suggested by Dr. James Bach. He advocated a powder of boric acid and sodium bicarbonate. The powder was to be blown into the nose which would then dissolve and by osmotic pressure induce mucus flow to wash the membranes (JAMA, 12/7/1918). This method has a scientific basis but little scientific proof of efficacy. They worked as well as some of the treatments invented to cure influenza which were based on scientific ideas but not scientific results. The APHA members believed that gargling had no value as they cleared out the protective mucus barrier to infection.
The American Public Health Association committee members believed that the best way to prevent infection was through the use of vaccines. Vaccines could prevent or mitigate infection with influenza and the frequently fatal complications of the illness due to the influenza bacillus or strains of streptococci and pneumonococci. They believed that the current vaccines under development should be tested and administered if useful to prevent infection. The committee suggested the use of the experimental vaccines on susceptibles with equal subjects and controls and under proper scientific methodology. However, they acknowledged that the cause of the influenza was unknown and therefore an effective vaccine had no “scientific basis,” (JAMA, 12/21/1918). These public health officials shared the perceptions of the scientific and medical community of the influenzal disease and its origins.
The Medical and Scientific Conceptions of Influenza
Scientific ideas about influenza, the disease and its origins, shaped the public health and medical responses. In 1918 infectious diseases were beginning to be unraveled. Pasteur and Koch had solidified the germ theory of disease through clear experiments clever science. The bacillus responsible for many infections such as tuberculosis and anthrax had been visualized, isolated and identified. Koch’s postulates had been developed to clearly link a disease to a specific microbial agent. The petri dish was widely used to grow sterile cultures of bacteria and investigate bacterial flora. Vaccines had been created for bacterial infections and even the unseen rabies virus by serial passage techniques. The immune system was explained by Paul Erhlich and his side-chain theory. Tests of antibodies such as Wasserman and coagulation experiments were becoming commonplace. Science and medicine were on their way to their complete entanglement and fusion as scientific principles and methodologies made their way into clinical practice, diagnostics and therapy.
The Clinical Descriptions of Influenza
Patients with the influenza disease of the epidemic were generally characterized by common complaints associated with the flu. They had body aches, muscle and joint pain, headache, a sore throat and a unproductive cough with occasionally harsh breathing (JAMA, 1/25/1919). The most common sign of infection was the fever, which ranged from 100 to 104 F and lasted for a few days. The onset of the epidemic influenza was peculiarly sudden, as people were struck down with dizziness, weakness and pain while on duty or in the street (BMJ, 7/13/1918). After the disease was established the mucous membranes became reddened with sneezing. In some cases there was a hemorrhage of the mucous membranes of the nose and bloody noses were commonly seen. Vomiting occurred on occasion, and also sometimes diarrhea but more commonly there was constipation (JAMA, 10/3/1918). A few physicians associated psychoses with influenza infection. One article says that “the frequency of mental disturbances accompanying the acute illness in the epidemic has been the subject of frequent comment,” (JAMA, 1/25/1919) The danger of an influenza infection was its tendency to progress into the often fatal secondary bacterial infection of pneumonia. In the patients that did not rapidly recover after three or four days of fever, there is an “irregular pyrexia” due to bronchitis or broncopneumonia (BMJ, 7/13/1918). The pneumonia would often appear after a period of normal temperature with a sharp spike and expectorant of bright red blood. The lobes of the lung became speckled with “pneumonic consolidations.” The fatal cases developed toxemia and vasomotor depression (JAMA, 10/3/1918). It was this tendency for secondary complications that made this influenza infection so deadly.
In the medical literature characterizing the influenza disease, new diagnostic techniques are frequently used to describe the clinical appearance. The most basic clinical guideline was the temperature, a record of which was kept in a table over time. Also closely monitored was the pulse rate. One clinical account said that “the pulse was remarkably slow,” (JAMA, 4/12/1919) while others noted that the pulse rate did not increase as expected. With the pulse, the respiration rate was measured and reported to provide clues of the clinical progression. Patients were also occasionally “roentgenographed” or chest x-rayed, (JAMA, 1/25/1919). The discussion of clinical influenza also often included analysis of the blood. The number of white blood cells were counted for many patients. Leukopenia was commonly associated with influenza. The albumin was also measured, since it was noted that transient albuminuria was frequent in influenza patients. This was done by urine analysis. The Wassermann reaction was another added new test of the blood for antibodies (JAMA, 10/3/1918). These new measurements enabled to physicians to have an image of action and knowledge using scientific instruments. They could record precisely the progress of the influenza infection and perhaps were able to forecast its outcome.
The most novel of these tests were the blood and sputum cultures. Building on the germ theory of disease, the physicians and their associated research scientists attempted to find the culprit for this deadly infection. Physicians would commonly order both blood and sputum cultures of their influenza and pneumonia patients mostly for research and investigative purposes. At the military training camp Camp Lewis during a influenza epidemic, “in all cases of pneumonia…a sputum study, white blood and differential count, blood culture and urine examinations were made as routine,” (JAMA, 1/25/1919). The bacterial flora of the nasopharynx of some patients was also cultured since droplet infection was where the disease disseminated. The collected swabs and specimens were inoculated onto blood agar of petri dishes. The grown up bacterial colonies were closely studied to find the causal organism. Commonly found were pneumococcus, streptococcus, staphylococcus and Bacillus influenzae (JAMA, 4/12/1919). These new laboratory tests used in the clinical setting brought in a solid scientific, biological link to the practice of medicine. Medicine had become fully scientific and technologic in its understanding and characterization of the influenza epidemic.
Treatment and Therapy
The therapeutic remedies for influenza patients varied from the newly developed drugs to oils and herbs. The therapy was much less scientific than the diagnostics , as the drugs had no clear explanatory theory of action. The treatment was largely symptomatic, aiming to reduce fever or pain. Aspirin, or acetylsalicylic acid was a common remedy. For secondary pneumonia doses of epinephrin were given. To combat the cyanosis physicians gave oxygen by mask or some injected it under the skin (JAMA, 10/3/1918). Others used salicin which reduced pain, discomfort and fever and claimed to reduce the infectivity of the patient. Another popular remedy was cinnamon in powder or oil form with milk to reduce temperature (BMJ, 10/19/1918). Finally, salt of quinine was suggested as a treatment. Most physicians agreed that the patient should be kept in bed (BMJ, 7/13/1918). With that was the advice of plenty of fluids and nourishment. The application of cold to the head, with warm packs or warm drinks was also advised. Warm baths were used as a hydrotherapeutic method in hospitals but were discarded for lack of success (JAMA, 10/3/1918). These treatments, like the suggested prophylactic measures of the public health officials, seemed to originate in the common social practices and not in the growing field of scientific medicine. It seems that as science was entering the medical field, it served only for explanatory, diagnostic and preventative measures such as vaccines and technical tests. This science had little use once a person was ill.
However, a few proposed treatment did incorporate scientific ideas of germ theory and the immune system. O’Malley and Hartman suggested to treat influenza patients with the serum of convalescent patients. They utilize the theorized antibodies to boost the immune system of sick patients. Other treatments were “digitalis,” the administration of isotonic glucose and sodium bicarbonate intravenously which was done in military camps (JAMA, 1/4/1919). Ross and Hund too utilized ideas about the immune system and properties of the blood to neutralize toxins and circulate white blood cells. They believed that the best treatment for influenza should aim to: “…neutralize or render the intoxicant inert…and prevent the blood destruction wit its destructive leukopenia and lessened coagulability,” (JAMA, 3/1/1919). They tried to create a therapeutic immune serum to fight infection. These therapies built on current scientific ideas and represented the highest biomedical, technological treatment like the antitoxin to diphtheria.
The Etiology of Influenza in 1918
During the 1890 influenza epidemic, Pfeiffer found what he determined to be the microbial agent to cause influenza. In the sputum and respiratory tract of influenza patients in 1892, he isolated the bacteria Bacillus influenzae , which was accepted as the true “virus” though it was not found in localized outbreaks (BMJ, 11/2/1918). However, in studies of the 1907-8 epidemic in the US, Lord had found the bacillus in only 3 of 20 cases. He also found the bacillus in 30% of cultures of sputum from TB patients. Rosenthal further refuted the finding when he found the bacillus in 1 of 6 healthy people in 1900 (JAMA, 1/18/1919). The bacillus was also found to be present in all cases of whooping cough and many cases of measles, chronic bronchitis and scarlet fever (JAMA, 10/5/1918). The influenza pandemic provided scientists the opportunity to confirm or refute this contested microbe as the cause of influenza. The sputum studies from the Camp Lewis epidemic found only a few influenza cases harvesting the influenza bacilli and mostly type IV pneumococcus . They concluded that “the recent epidemic at Camp Lewis was an acute respiratory infection and not an epidemic due to Bacillus influenzae ,” (JAMA, 1/25/1919). This finding along with others suggested to most scientists that the Pfeiffer’s Bacillus was not the cause of influenza.
In the 1918-19 influenza pandemic, there was a great drive to find the etiological agent responsible for the deadly scourge. Scientists in their labs were working hard, using the cultures obtained from physician clinics, to isolate the etiological agent for influenza. As a report early in the epidemic said, “the ‘influence’ of influenza is still veiled in mystery, ” (JAMA, 10/5/1918). The nominated bacillus influenzae bacteria seemed to be incorrect and scientists scrambled to isolate the true cause. In the journals, many authors speculated on the type of agent– was it a new microbe, was it a bacteria, was it a virus? One journal offered that “the severity of the present pandemic, the suddenness of onset…led to the suggestion that the disease cannot be influenza but some other and more lethal infection,” (BMJ, 11/2/1918). However, most accepted that the epidemic disease was influenza based on the familiar symptoms and known pattern of disease. The respiratory disease of influenza was understood to give warning in the late spring of its potential effects upon its recrudescence once the weather turned cold in the winter (BMJ, 10/19/1918). One article with foresight stated that “there can be no question that the virus of influenza is a living organism…it is possibly beyond the range of microscopic vision,” (BMJ, 11/16/1918). Another article confirmed the idea of an “undiscovered virus” and noted that pneumococccci and streptococci were responsible for “the gravity of the secondary pulmonary complications,” (BMJ, 11/2/1918). The article went on to offer the idea of a symbiosis of virus and secondary bacterial infection combining to make it such a severe disease.
The investigators as they attempted to find the responsible agent for the influenza pandemic were developing ideas of infectious microbes and the concept of the virus. The idea of the virus as an infectious agent had been around for years. The articles of the period refer to the “virus” in their discussion but do not consistently use it to be an infectious microbe, distinctive from bacteria. The term virus has the same usage and application as bacillus. In 1918, a virus was defined scientifically to be a submicroscopic infectious entity which could be filtered but not grown in vitro . In the 1880s Pasteur developed an attenuated vaccine for the rabies virus by serial passage way ahead of his time. Ivanoski’s work on the tobacco mosaic virus in 1890s lead to the discovery of the virus. He found an infectious agent that acted as a micro organism as it multiplied yet which passed through the sterilizing filter as a nonmicrobe. By the 1910s several viruses, defined as filterable infectious microbes, had been identified as causing infectious disease (Hughes). However, the scientists were still conceptually behind in defining a virus; they distinguished it only by size from a bacteria and not as an obligate parasite with a distinct life cycle dependent on infecting a host cell.
The influenza epidemic afforded the opportunity to research the etiological agent and develop the idea of the virus. Experiments by Nicolle and Le Bailly in Paris were the earliest suggestions that influenza was caused by a “filter-passing virus,” (BMJ, 11/2/1918). They filtered out the bacteria from bronchial expectoration of an influenza patient and injected the filtrate into the eyes and nose of two monkeys. The monkeys developed a fever and a marked depression. The filtration was later administered to a volunteer subcutaneously who developed typical signs of influenza. They reasoned that the inoculated person developed influenza from the filtrate since no one else in their quarters developed influenza (JAMA, 12/28/1918). These scientists followed Koch’s postulates as they isolated the causal agent from patients with the illness and used it to reproduce the same illness in animals. Through these studies, the scientists proved that influenza was due to a submicroscopic infectious agent and not a bacteria, refuting the claims of Pfeiffer and advancing virology. They were on their way to discerning the virus and characterizing the orthomyxo viruses that lead to the disease of influenza.
These scientific experiments which unravel the cause of influenza, had immediate preventative applications. They would assist in the effort to create a effective vaccine to prevent influenza. This was the ultimate goal of most studies, since vaccines were thought to be the best preventative solution in the early 20th century. Several experiments attempted to produce vaccines, each with a different understanding of the etiology of fatal influenza infection. A Dr. Rosenow invented a vaccine to target the multiple bacterial agents involved from the serum of patients. He aimed to raise the immunity to against the bacteria, the “common causes of death,” and not the cause of the initial symptoms by inoculating with the proportions found in the lungs and sputum (JAMA, 1/4/1919). The vaccines made for the British forces took a similar approach and were “mixed vaccines” of pneumococcus and lethal streptococcus. The vaccine development therefore focused on the culture results of what could be isolated from the sickest patients and lagged behind the scientific progress.
source: Stanford EDU
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Link to Idaho 1919 Influenza Pandemic (Part 33)
Link to Idaho 1919 Influenza Pandemic (Part 34)
Link to Idaho 1919 Influenza Pandemic (Part 35)
Link to Idaho 1919 Influenza Pandemic (Part 36)
Link to Idaho 1919 Influenza Pandemic (Part 37)
Link to Idaho 1919 Influenza Pandemic (Part 38)
Link to Idaho 1919 Influenza Pandemic (Part 39)
Link to Idaho 1919 Influenza Pandemic (Part 40)
Link to Idaho 1919 Influenza Pandemic (Part 41)
Link to Idaho 1919 Influenza Pandemic (Part 42)
Link to Idaho 1919 Influenza Pandemic (Part 43)
Link to Idaho 1919 Influenza Pandemic (Part 44)
Link to Idaho 1919 Influenza Pandemic (Part 45)
Link to Idaho 1919 Influenza Pandemic (Part 46)
Link to Idaho 1919 Influenza Pandemic (Part 47)
Link to Idaho 1919 Influenza Pandemic (Part 48)
Link to Idaho 1919 Influenza Pandemic (Part 49)
Link to Idaho 1919 Influenza Pandemic (Part 50)
Link to Idaho 1919 Influenza Pandemic (Part 51)
Link to Idaho 1919 Influenza Pandemic (Part 52)
Link to Idaho 1919 Influenza Pandemic (Part 53)
Link to Idaho 1919 Influenza Pandemic (Part 54)
Link to Idaho 1919 Influenza Pandemic (Part 55)
Link to Idaho 1919 Influenza Pandemic (Part 56)
Link to Idaho 1919 Influenza Pandemic (Part 57)
Link to Idaho 1919 Influenza Pandemic (Part 58)
Link to Idaho 1919 Influenza Pandemic (Part 59)
Link to Idaho 1919 Influenza Pandemic (Part 60)
Link to Idaho 1919 Influenza Pandemic (Part 61)
Link to Idaho 1919 Influenza Pandemic (Part 62)
Link to Idaho 1919 Influenza Pandemic (Part 63)
Link to Idaho 1919 Influenza Pandemic (Part 64)
Link to Idaho 1919 Influenza Pandemic (Part 65)
Link to Idaho 1920 Influenza Pandemic (Part 66)
Link to Idaho 1920 Influenza Pandemic (Part 67)
Link to Idaho 1920 Influenza Pandemic (Part 68)
Link to Idaho 1920 Influenza Pandemic (Part 69)
Link to Idaho 1920 Influenza Pandemic (Part 70)
Link to Idaho 1920 Influenza Pandemic (Part 71)
Link to Idaho 1920 Influenza Pandemic (Part 72)
Link to Idaho 1920 Influenza Pandemic (Part 73)
Link to Idaho 1920 Influenza Pandemic (Part 74)
Link to Idaho 1920 Influenza Pandemic (Part 75)
Link to Idaho 1920 Influenza Pandemic (Part 76)
Link to Idaho 1920 Influenza Pandemic (Part 77)
Link to Idaho 1920 Influenza Pandemic (Part 78)
Link to Idaho 1920 Influenza Pandemic (Part 79)
Link to Idaho 1920 Influenza Pandemic (Part 80)
Link to Idaho 1920 Influenza Pandemic (Part 81)
Link to Idaho 1920 Influenza Pandemic (Part 82)
Link to Idaho 1920 Influenza Pandemic (Part 83)
Link to Idaho 1920 Influenza Pandemic (Part 84)
Link to Idaho 1920 Influenza Pandemic (Part 85)
Link to Idaho 1920 Influenza Pandemic (Part 86)
Link to Idaho 1920 Influenza Pandemic (Part 87)
Link to Idaho 1920 Influenza Pandemic (Part 88)
Link to Idaho 1920 Influenza Pandemic (Part 89)
Link to Idaho 1920 Influenza Pandemic (Part 90)
Link to Idaho 1920 Influenza Pandemic (Part 91)
Link to Idaho 1920 Influenza Pandemic (Part 92)
Link to Idaho 1920 Influenza Pandemic (Part 93)
Link to Idaho 1920 Influenza Pandemic (Part 94)
Link to Idaho 1920 Influenza Pandemic (Part 95)
Link to Idaho 1920 Influenza Pandemic (Part 96)
Link to Idaho 1920 Influenza Pandemic (Part 97)
Link to Idaho 1920 Influenza Pandemic (Part 98)
Link to Idaho 1920 Influenza Pandemic (Part 99)
Link to Idaho 1918 Influenza Pandemic Ads (Part 100)
Link to Idaho 1919 Influenza Pandemic Ads (Part 101)
Link to Idaho 1920 Influenza Pandemic Ads (Part 102)