Michael Furgiuele

HIST 673

Review of The Great Influenza: The Epic Story of the Deadliest Plague in History

September 14, 2005

 

In 1918, two crises devastated the world – World War I and the spread of an infectious and elusive virus, which ravaged the nations of the world.  John Barry provided a unique review of the influenza that wrapped medical advancements with resource depletion within the context of World War I and how military and political ambitions, incompetence, and best intentions affected the search for the cause and treatment for this disease.

            By the beginning of the twentieth-century, attention to medical training and research had “remained quite literally almost unchanged from the time of Hippocrates more than two thousand years earlier” (Barry 2004, 6). By 1901, “the definition of a properly qualified medical profession had still yet to emerge” (Roberts 1999, 125). Medical training at the start of the influenza disease was virtually nonexistent.  People claimed medical degrees without training, laboratory or research experience and, in many cases, students “never touch a single patient and still get a medical degree” (Barry 2004, 6). 

Prior to 1918, there were advances in medicine, and research took a step toward identifying diseases: their causes, treatment and cure. As the barrier in science was falling, scientists studied anatomy, circulation, interactions, and combined medical research with scientific and even mathematical knowledge to identify ailments and potential treatments.  During the Civil War, “American medicine had begun to inch forward” (Barry 2004, 30).  Advancements included surgical techniques and anatomy – but continued to neglect the connection of ailments with diseases, especially infectious diseases. In addition, there were those who believed that medical training was essential and that experimentation on the causes and possible control of diseases was required.   It took the efforts of philanthropists and scientists to change the course of medical research.  Men like Johns Hopkins, who “leaving behind a trust of $3.5 million to found a university and hospital” (Barry 2004, 33) and the Rockefeller family, who established the Rockefeller Institute for Medical Research. The Carnegie Foundation undertook a review of medical schools at the start of the 1900s – enforcing a rating of medical schools and called for an increase in standards toward education and research.

 In addition, there were men, like William Henry Welch, who changed the professional standards and encouraged a course of experimentation.  Simon Flexner embodied the notion of peer review as a means of understanding medicine.  Flexner “welcomed disagreement, expected friction and interaction” (Barry 2004, 78).  Later, Rufus Cole, Director of the Rockefeller Institute, “was adamant that people caring for patients do the research on them” (Barry 2004, 81).

            As Europe concentrated on war, American isolationism, demanded by the people, broke down[1].  Woodrow Wilson was President of the United States and at the start of America’s introduction to war went against the call for isolation, and promoted the plan to wipe out the enemy and enrich the power and prestige of America at all cost[2].  However, as plans continued to involve American service members into action, a unique illness hit Haskell County, Kansas in 1918.  The symptoms were similar to those of influenza – however, the intensity of the symptoms was different from those experienced before.  Patients were complaining of “violent headache and body aches, high fever, nonproductive cough” (Barry 2004, 93).  Within a few weeks, more patients were diagnosed with similar symptoms.  The pattern of the influenza was also different.  Instead of primarily attacking the young and the elderly, this influenza was striking at the core of “the strongest, the healthiest, the most robust people in the country” (Barry 2004, 93).

            The influenza started small and began to spread.  America was not alone.  Europe was also feeling the ravages of a new strain of influenza.  The impact of the disease was devastating.  On the front, offensives planned by each side were rapidly changed or cancelled as soldiers fell ill and ranks thinned by the disease.  The disease spread by contact and most pronounced in urban rich areas, which developed rapidly during the early twentieth-century America[3] as well as military bases due to the close proximity of soldiers and the fact that many bases were over capacity.  A lack of knowledge by the medical profession as to the cause and precautions necessary to fight the disease confused and enraged the population who turned on each other to hold the spread of infection from one family to another, using home remedies to fight the infection.  While local governments and researchers produced warnings for the public such as avoiding crowds and wearing masks (Barry 2004), most of the recommendations were useless in fighting the spread of the disease.  Additionally, the war machine required that positivism and patriotism should be placed above all else.  Many American papers refused to carry articles on the disease and the military refused to alleviate the number of soldiers being crammed into installations.  Wilson’s “full engagement would jam millions of young men into extraordinary tight quarters in barracks built for far fewer” (Barry 2004, 131).  These close quarters in the military enhanced the spread of contagion in a similar fashioned as it had in heavily populated urban centers[4].

            In America, handling the increasing number of cases and mounting death toll from the disease was not coming from the military, Federal, or local governments – but from the physicians, research centers, and directly from the people.  Scientists followed the path of the disease, trying in vain to discover the pathogen and isolate the cause, determine a treatment and provide sufficient vaccine to cover the large-scale impact throughout the world.  Civic organizations – like those in Philadelphia, which was severely hit by the disease, took charge over floundering civil leaders – enrolling volunteers, supporting hospitals and encouraging aid to all those who require it. 

            While the estimated death toll from the influenza is believed to be between 20 and 100 million people, it is “impossible to state with any accuracy the death toll. The statistics are estimates only and one can only say that the totals are numbering” (Barry 2004, 396).