The Plague
THE SUREST SIGN OF IMPENDING DEATH was the skin’s ghostly bluish tint, a pall of sickness that soon, even before the onset of rigor mortis, would turn deep purple and then slate gray. The technical term for the discoloration — first in the lips and ears — was cyanosis, a condition brought on by inadequate oxygenation of the blood. That was the death stamp of Spanish influenza. It inflamed the lung cavities until they filled with blood, sputum, and other fluids, and as the lungs slowly surrendered, the victims suffocated.
Less unfortunate sufferers of the disease endured high fevers, unbearable headaches, and severe nosebleeds, along with the customary flu symptoms of coughs, runny noses, and sore throats. Many complained of aching legs and backs, sharp muscular pains, and unremitting weakness and dizziness. But cyanosis was the real danger sign: the body’s warning that the lungs no longer could expel the liquid draining into them.
And in October 1918, as a tidal wave of Spanish influenza washed over Washington, there was virtually nothing doctors could do to stop it. The new plague was a disease with no known cause and no known cure.
That autumn, Spanish influenza spread across America — and, indeed, the entire face of the earth — with startling and relentless speed. In a single month-long burst during the waning days of World War I, the disease became the worst epidemic to afflict mankind since the Black Death of the mid-14th century. The global toll of more than 21 million deaths represented at least 1 percent of the world’s population. In the United States, nearly one in four persons came down with Spanish influenza, and more than a half million died from it.
Washington’s first warning came in early September, when Louis Brownlow, one of three commissioners who ran the District of Columbia government, received a telegram from Dr. William Woodward, who had resigned as the District’s chief health officer a year earlier to become health commissioner of Boston. Several cases of the Spanish flu had cropped up there, Woodward reported, and neither he nor anyone else in Boston knew what to do about it.
But Brownlow’s attention quickly shifted to another message in the wire: Woodward’s fear that Spanish influenza might hit the nation’s capital with peculiar severity because of the tremendous overcrowding brought on by the burgeoning wartime bureaucracy. Doctors in Washington were not, as of yet, even required to report cases of influenza. In most quarters, the disease was called simply “the grippe.”
The death watch in the nation’s capital began on September 21, 1918, when the first local fatality from Spanish influenza surfaced. Within two weeks, like many other American cities, Washington would send many of its citizens into hiding. From the onset of the epidemic, Brownlow presided over a panic-stricken city; his two fellow commissioners, W. Gwynne Gardiner and Gen. John G.D. Knight, were in bed with the disease. Schools, theaters, restaurants, and saloons were closed; parades, Liberty Loan rallies, and other public gatherings were banned; all businesses, except for grocery stores and pharmacies, were confined to the operating hours of 10 a.m. to 6 p.m.
Many Washingtonians — one-third of them, by one count — took to wearing masks in a feeble collective effort to keep influenza germs from filtering throughout the city. Streetside hugs and handshakes nearly disappeared. And coughing and sneezing in public were declared crimes punishable by fines of $50 and up.
Fear — a quiet but paralyzing brand of it — was spreading through Washington more quickly than the influenza itself. One war-inspired rumor purported that flu germs were being brewed by the billions in a German laboratory hidden somewhere in Chevy Chase, Maryland. Another had it that German agents, disguised as nurses and doctors, were delivering lethal injections of influenza into unwitting patients.
The mounting death toll from Spanish influenza was printed every day in Washington’s newspapers, soon overshadowing the body counts from the western front in France and Flanders. By early October, even with all the preventive measures in place, the devastation was escalating so quickly that Brownlow telephoned the city coroner with a grim admonition: “Be prepared for the worst.”
The worst soon came. Within a week or so, the city’s system for reporting new cases of Spanish influenza had broken down completely. There were too many thousands of them. W.E. Turton, a clerk in the vital statistics bureau of the city government, had been wearing himself out trying to keep up with the morbid reports streaming into his office every day. (By the end of the month, Turton himself would be on the influenza death list.) “At last it seemed that we had come to the end of our resources,” Brownlow later wrote. “There was a dreadful Saturday.”
Others in Washington called it “Black Saturday.” On that day, October 12, more than 1,300 persons living in the city were reported to have come down with Spanish influenza (there undoubtedly were hundreds more who received no medical attention), and at least 92 others died. The Plague had descended with full fury on the nation’s capital.
THE FRIGHTENING SPECTER of a Spanish influenza epidemic first grasped the attention of Rupert Blue in the early morning hours of September 18, 1918. As Surgeon General of the United States and chief of its Public Health Service, Blue commanded a nationwide army of 180 health officers and 44 quarantine stations from within his office in the nondescript Butler Building on New Jersey Avenue.
The day before, Blue had wired the health officers of the 48 states with this brief message: REQUEST ALL INFORMATION REGARDING THE PREVALENCE OF INFLUENZA IN YOUR STATE. Now, with the reports spread out on his large mahogany desk, Blue realized the ominous proportions of influenza outbreaks. The Spanish flu not only had blanketed New England but had slithered down the length of the Atlantic seaboard to the Virginia capes. Even more worrisome, a number of states west of the Mississippi River reported pockets of influenza cases. Blue thought tie might have an epidemic on his hands, but there was not one penny in the Public Health Service budget for fighting it.
Washington itself was not all at all prepared for an outbreak of a communicable disease, let alone such a virulent strain of influenza. An influx of wartime workers had ballooned the city’s population to 417,000 — perhaps one-third above normal — creating the severest housing squeeze the city had experienced up to that time. Washingtonians by the hundreds converted their residences into boarding houses, and the federal government hastily erected temporary housing developments within the shadow of the U.S. Capitol. But even that wasn’t enough: In many parts of Washington, young government workers still were sleeping four and five to a room.
From the first influenza death on September 21 through the end of the month, District health officials might have had reason to believe the disease was under control. In fact, the epidemic was only simmering. Beginning on October 1, the death-from-influenza figures began forming a dangerous daily trend line: 23, 22, 32, 40, 49, 64. Washington newspapers could not cope with the record volume of obituaries and death notices: The Evening Star began a new column, “Prominent People Who Have Died of Influenza.”
On the theory that congestion breeds contagion, on October 2 Commissioner Brownlow ordered the city’s public schools closed indefinitely. (Days before, classes had thinned markedly because so many parents feared exposing their children to others.) At Brownlow’s urging, government agencies initiated staggered starting hours to help relieve overcrowding on city streetcars, overcrowding that was thought to hasten the spread of Spanish influenza. On the following day, Surgeon General Rupert Blue declared Washington a “sanitary zone” and subdivided the city into four self-contained districts with doctors, nurses and volunteers.
On October 4, the District commissioners ordered all public meeting places closed, including playgrounds, churches, motion-picture theaters and vaudeville houses. The big draws of the day — William S. Hart in “The Border Wireless,” Will Rogers in “Laughing Bill Hyde,” and Dorothy Gish in “Battling Jane” — disappeared from Washington marquees, as did “Flo Flo and Her Perfect 36” at the National Theater and “The Frolics of the Night” at the Palace of Burlesque. The District Pastors Federation suggested that government offices, not churches, should be closed. “It is necessary,” said the federation’s leaders, “that the spiritual dynamo be kept running at full speed.”
But it is probable that even a spiritual dynamo could not have contained the rapid spread of Spanish influenza. At least 130 of the city’s streetcar operators were home sick, which might have disabled the entire system had not so many thousands of other Washingtonians been in the same condition. The District’s fire marshal warned that his department was so debilitated by the flu that “the whole city’d burn to the ground if it ever got started.” And the boys in blue were faring no better. Police Superintendent reported 136 of his men out sick, this only two days after he had ordered them to enforce Washington’s new ordinance against spitting in public.
The federal bureaucracy was being slowed down by influenza as well. At Herbert Hoover’s Food Administration, fully half of all employees were home. And at the State, War, and Navy Building, a curious ritual occurred twice daily: Workers were herded outside en masse for half-hour periods so they could breathe, the theory went, uncontaminated air. Like so many other precautionary measures, no one really knew whether the “airing” sessions did any good — but at least they could do no conceivable harm.
Communities on the fringes of Washington were also being ravaged by Spanish influenza, and the measures to combat the plague often were less organized and more primitive. In Alexandria, for example, policemen dispensed bottles of whiskey confiscated from bootleggers to physicians and pharmacists for their use as prescription medicine. At one point, only two doctors in Alexandria were not bedridden. In Montgomery County, classes had been canceled at all public schools, but students still were required to report to their teachers every day for “treatment,” which amounted to a thorough washing.
There were masks everywhere — white-cotton-gauze gizmos donned by thousands upon thousands of Washington citizens as a safeguard against giving or receiving influenza germs. Few, however, believed they really worked. Barbers were required to wear them while giving customers shaves or haircuts, for instance, but the sale of safety razors boomed anyway. Dr. H.S. Mustard, an epidemiologist with the Public Health Service who had been appointed by the District commissioners as a sort of “health czar” for the city, thought the masks nearly useless — ”maybe as effective as fish nets against flies,” he said. Nonetheless, Dr. William Fowler, the District’s health officer, ordered 25,000 more from Red Cross volunteers, announcing at the same time that women’s veils were not an effective substitute.
“There is no cause for panic or hysteria,” Fowler said. Yet thousands of Washingtonians had little reason to agree.
THE CLIMBING DAILY DEATH TOLLS, in fact, had utterly terrorized many citizens in the nation’s capital, only making things worse. The U.S. Homes Registration Service reported that scores of Washingtonians had been locked out of their apartments by flu-dreading landlords, and the city’s district attorney was compelled to threaten prosecution. Rumors also were rife that influenza germs were being surreptitiously spread by Germans in everything from chewing gum to aspirin.
By mid-October,Washington hospitals were hopelessly crammed beyond capacity. Every bed was filled at George Washington University Hospital, but not a single nurse remained on duty — all were out with the flu. At Garfield Memorial Hospital, cots and extra mattresses were placed in the corridors to make room for new arrivals. Government offices at 612 F Street, N.W., had been hastily converted into an emergency hospital for influenza victims, but the scene there repulsed even the Public Health Service doctors who staffed it. “The only way we could find room for the sick was to have undertakers waiting at the door, ready to remove bodies as fast as the victims died,” one of them said. “The living came in one door and the dead went out the other.”
The city soon was forced to open a second and larger emergency hospital in what had been a temporary war building at 18th Street and Virginia Avenue, N.W., but even it could not handle the growing number of new influenza cases. Those with mild cases of the flu were told to stay home, though it was nearly impossible for anyone to judge the severity of a victim’s condition.
Washington’s meager force of gravediggers, thinned by influenza, simply could not keep up with the growing volume of corpses. Commissioner Brownlow discovered that the Marine Corps base at Quantico had inexplicably escaped the worst of the epidemic, so he asked for, and got, fifty soldiers to help dig graves at the city’s cemeteries. Soon there were not enough coffins. Following a tip from a railroad dispatcher, Brownlow had two carloads of them moved from the Potomac freight yard south of Washington to City Hospital. (Their intended destination had been Pittsburgh, but Brownlow said the confiscation was needed to end profiteering in the District’s casket trade.)
Nearby lumber mills stopped other projects to construct 1,500 more coffins, which were stacked in the playground of Central High School, covered with tarpaulins, and guarded by the police. Another small shipment came from Baltimore, where it was already too cold to dig graves. The District’s health officer, Dr. Fowler, was moved to denounce what he called “the coffin trust” for gouging bereaved relatives on funeral prices. “Such preying on unfortunate families in this direful time,” he said, “is nothing short of ghoulish in spirit and unpatriotic to the point of treason.”
A representative of the Casket Manufacturers Association guaranteed Fowler an adequate supply of coffins for Washington, and the city’s undertakers were asked to turn back batches of death certificates. The District of Columbia had run out of them.
The fear of Spanish influenza was so pervasive that the city’s suicide rates slowly inched upward. One 22-year-old man, described by the District coroner as “despondent and hopeless of escaping the white plague,” shot himself with a pistol. A 36-year-old employee of the telephone company, Alexander Reynolds, had crossed the brink after being alone for three days with a raging fever. Overtaken by delirium, he slashed at his throat without effect and then jumped out of his apartment window. Newspaper articles recounting the gruesome details did little to comfort those in similar states of desperation.
There was paranoia everywhere, but the apex may have been reached within the uppermost echelons of the Army Sanitary Corps. Its chief, Major Victor Vaughan, a man of mathematical mind, had set out to calculate the statistical implications of the plague. In the span of one week, he found, only ten people — by passing influenza germs on to ten others — could, in pyramid fashion, infect a million others. That conclusion set one of his deputies, Captain George Palmer, to thinking: In a single day, he wondered, how many chances might the average person have to acquire influenza germs?
Palmer’s experiment, an ordinary-clay odyssey through the nation’s capital, frightened him tremendously. His list of potential sources of infection included the flush handles on toilets, doorknobs, coffee cups, dollar bills, and the pens for public use in banks; hand-shaking and stamp-licking; and even the copy of The Washington Post he bought from a newsboy. At day’s end, Palmer’s list of chances for direct-contact infection numbered 118, which he dutifully upped to 119 when he switched off his bedroom light to go to sleep.
One of the products of Palmer’s painstaking research was this warning to Washingtonians: “Abandon the universal practice of shaking hands. Substitute some other less intimate method of salutation!”
NO CORNER OF WASHINGTON WAS LEFT UNTOUCHED by Spanish influenza, from the elegant homes along 16th Street to the ramshackle flats of “Banana Row” on the edge of the city’s market district. Outbreaks followed no discernible geographic pattern, nor were any ethnic or racial groups singled out. Its wrath was unpredictable and sudden.
For many, the only possible escape from influenza meant abandoning Washington altogether, and thousands of federal employees were reported to be “leaving the city on account of the plague,” in the words of The Evening Star. There was, however, no refuge. Newspaper accounts had tended to exaggerate the concentration of the epidemic in the nation’s major cities, simply because little reliable information was available from rural communities with no standard reporting systems. Search parties sent out by the U.S. Coast Guard, in fact, found entire Eskimo villages wiped out by influenza as they traveled through remote Alaskan regions.
Washingtonians had every reason to be bewildered by an avalanche of anti-flu advice, some of it issued from the most respected medical quarters. The Army’s Surgeon General, for example, published a 12-point plan for “personal defense against Spanish influenza.” Rule Nine: “Don’t let the waste products of digestion accumulate — drink a glass or two of water on getting up.” Rule Eleven: “Avoid tight clothes, tight shoes, tight gloves — seek to make nature your ally, not your prisoner.”
Other doctors lashed out at a fearful and hapless citizenry. Said Washington physician Noble Barnes: “Persons at large sneezing and coughing should be treated as a dangerous menace to the community, properly fined, imprisoned, and compelled to wear masks until they are educated out of that ‘Gesundheit!’ and ‘God bless you!’ rot.” There was even this bit of doggerel aimed at elevator operators, bank tellers, barbers, and post-office clerks: “Obey the laws/And wear the gauze,/Protect your jaws/From septic paws.”
Other civic-minded measures seemed eminently more effective, including the operation spearheaded by the Motor Ambulance Corps of the Red Cross. These women were joined by other volunteers from the Associated Charities, Salvation Army, Gospel Mission, and Central Union Mission to comb through Washington in search of the sick and the dead. Soup kitchens operated twenty-four hours a day, and the Model T trucks of the Motor Ambulance Corps took nurses and nourishment to those who could not be moved or for whom there was no room in the city’s hospitals.
The fleet was augmented by a few chauffeured limousines, on loan from wealthy Washingtonians who wanted to do their part in the fight against influenza. Even the legendary “Flo Flo” and her burlesque cohorts pitched in at the city’s emergency influenza hospital on F Street.
The ever-widening circle of contagion soon claimed two new victims — Commissioner Brownlow and Dr. Mustard — though both passed the three-day danger period and were adjudged to have only mild cases of the flu. Brownlow later recounted a tragic episode that was all too common in influenza-stricken Washington. “The night I collapsed I had just been to the telephone,” he wrote. “A girl had called to say that she and three other girls had a room together, that two of the girls were dead, another was dying, and she was the only one not stricken; would I please get some help there. I managed to get the police department, and I found someone to go to that house. When the policeman got there, there were four dead girls in the room.”
Dr. Fowler, as the city’s health officer, was the ranking District official left untouched by the disease, and he ordered that twenty-five tent hospitals be constructed on the Mall to help cope with the overflow from other facilities. All were in operation by nightfall. “I believe or at least hope that the crest of the contagion has been reached,” Fowler said. “However, I am not to be understood as saying that we have mastered the situation.”
IN THE LAST WEEK OF OCTOBER, as Spanish influenza began to slip out of Washington as mysteriously as it had entered, the disease claimed more than 21,000 lives across the United States. During the same week, 2,700 Americans died in combat as Allied troops thrust the Germans back across the ruined countrysides of France and Belgium. By the end of its course, the Spanish influenza epidemic had taken more than 548,000 lives in the United States — at least five times the number of Americans who lost their lives in battle overseas.
Two years later, the British Ministry of Health reported that the worldwide influenza epidemic of 1918 ranked “not lower than third, and perhaps second, upon the roll of great pestilences.” The only historical rivals, it noted, might have been the plague of Justinian’s reign, which extended over fifty years, and the Black Death of the 14th century, which lasted for three. The Spanish influenza, by contrast, wrought virtually all of its devastation in the span of just three months.
When U.S. health authorities plotted the toll of Spanish flu deaths in American cities, they discovered eerily similar patterns: a sprinkling of cases one week; a slight escalation in volume the next; an outright explosion of reported cases and deaths during the next two weeks or so; then, over the next two weeks, a measured and downward drop toward normal.
By the end of 1918, District health officials had counted 30,695 cases of Spanish influenza, more than 23,000 of them in October alone. But they estimated that these reported cases reflected only 60 percent of the persons actually receiving some kind of medical attention, pushing the total number of Washingtonians afflicted to more than 51,000.
The actual death toll from Spanish influenza within the District of Columbia, by the reckoning of health officials, was 2,028. Another 1,298 deaths were attributed to pneumonia, and almost all of them probably resulted from influenza. There were also, in Commissioner Brownlow’s estimation, hundreds of other deaths resulting from miscellaneous medical complications.
By November 4, roughly one month since Spanish influenza had reached epidemic proportions in Washington, the death rate had bottomed out, and the terror subsided. “The worst,” Brownlow said, “was over.” The District commissioners reopened the schools, motion-picture theaters, and vaudeville houses. President Woodrow Wilson, who found a weekly dose of relief from the rigors of the White House at B.F. Keith’s, was in the audience when the theater resumed with a new show, “The American Ace.” One week later, Wilson would find relief of another kind: The Armistice ended the fighting in Europe.
For decades to come, the world’s finest medical detectives tried without success to track the cause of Spanish influenza. The anomalies continue to puzzle: Why, for example, did reindeer in Labrador and Lapland, and baboons in South Africa and Gibraltar, mysteriously die in great numbers in 1918? Why did no trace of influenza virus linger in the frozen bodies of Eskimos exhumed thirty-three years later? And why did this particular strain of influenza strike most ferociously at healthy adults from twenty-five to twenty-nine years of age? These and dozens of other questions have never been answered.
Spanish influenza — or feebler remnants of it — occasionally showed up in Washington during the winter of 1918 and autumn of 1919, but there were comparatively few reported cases of it. Commissioner Brownlow and Dr. Fowler were urged by some to again close the schools, churches, theaters, and other public gathering places. A few politicians advocated a law that would have required every person venturing outside to wear a gauze mask.
Both Brownlow and Fowler argued that these kinds of measures would be a depressing spectacle, and would deprive citizens of some psychological relief from the sickness around them. As it turned out, they were right. The Plague did not return.
This article originally appeared in the December/January 1983 issue of Regardie’s.
Bill Hogan