Modernising Flu: Re-aligning Medical Knowledge of the ‘Most Protean Disease’

Bresalier, Michael

doi:10.1057/978-1-137-33954-6_3

Michael Bresalier⁴

Part of the book series: Medicine and Biomedical Sciences in Modern History ((MBSMH))

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Abstract

Four epidemics that swept across the world between 1889 and 1894 spurred the first large-scale and state-organised medical investigations of influenza. Among the most important were British ‘collective investigations’ organised by the Medical Department of the Local Government Board. Drawing on Britain’s vast communication networks and major developments in medicine, these investigations aligned new clinical, epidemiological, and bacteriology ways of knowing to define influenza as an infectious disease. ‘Modern influenza’ came into being in the early 1890s as new disease entity that was distinguished from ‘traditional’ influenza rooted in eighteenth century medicine. Crucial to the identity of this new influenza was the characterisation of the so-called ‘influenza bacillus’ as the specific causative of the disease. While historians have dismissed the bacillus as the wrong agent, this chapter examines how it gained legitimacy and how it was used in laboratory, clinical and public health medicine. Although its role as the ‘germ of influenza’ was disputed, work on the bacillus was decisive in redefining influenza as an infectious disease intimately connected to the conditions of the modern world.

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Notes

1.
Major Greenwood, ‘The History of Influenza, 1658–1911’, in Ministry of Health, Report on the Pandemic of Influenza, 1918–19, Reports on Public Health and Medical Subjects, No. 4 (London: HMSO), 20.
2.
Greenwood, ‘History of Influenza’, 23–24.
3.
Ministry of Health, Report on the Pandemic of Influenza, vi.
4.
For the historiography and specific changes in Britain, see Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865–1900 (Cambridge: Cambridge University Press, 2000), 1–15.
5.
Oswald Leichtenstern, ‘Influenza’, in Julius Mannaberg and Oswald Leichtenstern (Eds.), Malaria, Influenza and Dengue (Philadelphia and London: W.B. Saunders & Co., 1898), 523.
6.
Leichtenstern, ‘Influenza’, 523.
7.
For a definitive account of the Medical Department’s epidemiological investigations see, Jacob Steere-Williams, The Filth Disease: Typhoid Fever and the Practices of Epidemiology in Victorian England (Rochester, NY: University of Rochester Press, 2020).
8.
David K. Patterson, Pandemic Influenza, 1700–1900: A Study in Historical Epidemiology (Totowa, NJ: Rowman & Littlefield, 1986).
9.
Patterson, Pandemic Influenza, 29–48. For contemporary accounts, see Charles Creighton, ‘Influenzas and Epidemic Agues’, in idem., A History of Epidemics in Britain, Vol. II (London: Cambridge University Press, 1894), 306–433; Theodophilus Thompson, Annals of Influenza or Epidemic Catarrhal Fever in Great Britain from 1510–1837 (London: The Sydenham Society, 1852).
10.
From 1861 until 1888, influenza deaths in London went above 50 once (1864); in the 1870s, they exceeded 25 once (1870); from 1880 to 1888, they averaged 7.7 per year. Registrar-General, Fifty-Fourth Annual Report of the Registrar-General, 1891 (London: HMSO, 1892), xiii–xiv.
11.
Ministry of Health, Report on the Pandemic of Influenza, 23.
12.
All figures are from the Sixty-Third Annual Report of the Registrar General, 1900 (London: HMSO, 1902), ixvi.
13.
Ministry of Health, Report on the Pandemic of Influenza, 23–24.
14.
Local Government Board, Report on the Influenza Epidemic of 1889–1890, Vol. XXXIV (London: HMSO, 1891); Local Government Board, Further Report and Papers on Epidemic Influenza, 1889–92, Vol. VLII (London: HMSO, 1893).
15.
Anne Hardy, ‘On the Cusp: Epidemiology and Bacteriology at the Local Government Board, 1890–1905’, Medical History, 42 (1998), 330–335; Jacob Steere Williams, ‘Performing State Medicine During Its ‘Frustrating’ Years: Epidemiology and Bacteriology at the Local Government Board, 1870–1900’, Social History of Medicine, 28.1 (2015), 82–107.
16.
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17.
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18.
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19.
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20.
See, for example, Steere-Williams, The Filth Disease, 172–223; Joanne L. Brand, Doctors and the State: The British Medical Profession and Government Action in Public Health, 1870–1912 (Baltimore: Johns Hopkins Press, 1965), 73–75.
21.
Hardy, ‘On the Cusp’, 330–335.
22.
Worboys, Spreading Germs, 234–276.
23.
William Coleman, Yellow Fever in the North: The Methods of Early Epidemiology (Madison: University of Wisconsin Press, 1987), 186.
24.
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25.
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26.
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27.
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28.
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29.
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30.
F.B. Smith, ‘The Russian Influenza in the United Kingdom’, Social History of Medicine 8 (1995), 60.
31.
Patterson, Pandemic Influenza, 8.
32.
Patterson, Pandemic Influenza, 8.
33.
A.H. Gale, Epidemic Diseases (London: Penguin Books, 1959), 47.
34.
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35.
Harry Marks, ‘Until the Sun of Science…the True Apollo of Medicine Has Risen’: Collective Investigation in Britain and America, 1880–1910’, Medical History 50 (2006), 147–166.
36.
Coleman, Yellow Fever, 186.
37.
‘Henry Franklin Parsons (1846–1913)’, 1355.
38.
‘Henry Franklin Parsons (1846–1913)’, 1356.
39.
Parsons, Report on the Influenza Epidemic of 1889–1890, 13.
40.
Parsons, Report on the Influenza Epidemic of 1889–1890, 120.
41.
Frank Clemow, ‘Epidemic Influenza’, Public Health, 24 (1890), 358–366.
42.
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43.
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44.
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45.
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46.
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47.
Parsons, Report on the Influenza Epidemic of 1889–1890, 78.
48.
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49.
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50.
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51.
Clemow, ‘Epidemic Influenza’, 362.
52.
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53.
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54.
See, for example, Tomes The Gospel of Germs, 80–81.
55.
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56.
‘Letter to the Editor’, The Times (13 January 1890), 10.
57.
‘The Spread of Influenza’, BMJ (3 May 1890), 1026.
58.
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59.
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60.
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61.
Clemow, ‘Epidemic Influenza’, 366.
62.
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63.
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64.
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65.
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66.
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67.
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68.
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69.
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70.
Richard Sisley, A Study of Influenza and the Laws of England Concerning Infectious Diseases (London: Longman’s, Green, and Co., 1892).
71.
Parsons, Report on the Influenza Epidemic of 1889–1890, 118.
72.
Peter Eade, ‘Influenza in 1891’, BMJ (8 August 1891), 309.
73.
Smith, ‘Russian Influenza’, 68.
74.
Louis Parkes, Hygiene and Public Health (London: H.K. Lewis, 1892); B.A. Whitelegge, Hygiene and Public Health (London: Cassell, 1894).
75.
‘Official Report on Epidemic Influenza’, Lancet (11 July 1891), 79.
76.
Major Greenwood, ‘A General Discussion of the Epidemiology of Influenza’, in Report on the Pandemic of Influenza, 1918–19, Ministry of Health, Reports on Public Health and Medical Subjects, No. 4 (London: HMSO, 1920), 190.
77.
Greenwood, ‘History of Influenza’, 27.
78.
‘The Epidemic of Influenza’, The Times (28 December 1889), 7.
79.
Parkes, Hygiene and Public Health, 460.
80.
Parsons, Report on the Influenza Epidemic of 1889–1890, x.
81.
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82.
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83.
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84.
Richard Sisley, ‘Influenza and the Laws of England Concerning Infectious Diseases: Proceedings of Society of Medical Officers of Health’, Public Health, 4 (1892), 136–142.
85.
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86.
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87.
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88.
Elisabeth Heaman, St. Mary’s: The History of a London Teaching Hospital (Montreal: McGill Queen’s University Press, 2003), 89–118; Keir Waddington, Medical Education at St Bartholomew’s Hospital 1123–1995 (London: Boydell Press, 2003), 115–145; for the reception and use of bacteriology, see Rosemary Wall, Bacteria in Britain: 1880–1939 (London: Pickering & Chatto, 2013).
89.
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90.
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93.
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94.
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95.
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96.
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97.
Richard Sisley Epidemic Influenza, 6.
98.
John F. Goodhart, ‘Influenza’, in Thomas Clifford Albutt (Ed.), A System of Medicine (London: Macmillan and Co., 1896), 690.
99.
Thompson, Influenza, or Epidemic Catarrhal Fever, 6. This was a revised edition of his father’s 1852 manual, Thompson, Annals of Influenza (1852).
100.
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101.
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102.
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103.
Seymour Taylor, ‘Notes on Epidemic Influenza’, Lancet (25 January 1890), 187.
104.
Taylor, ‘Notes on Epidemic Influenza’, 187.
105.
Taylor, ‘Notes on Epidemic Influenza’, 187.
106.
For diagnostic practices at Barts, see Rosemary Wall, ‘“Natural”, “Normal”: Discourse and Practice at Sr. Bartholomew’s Hospital, London, and Addenbrooke’s Hospital, Cambridge, 1880–1920’, Forum: Qualitative Social Research, 8.1 (2007), http://nbnresolving.de/urn:nbn:de:0114-fqs0701174.
107.
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108.
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109.
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110.
West, ‘The Influenza Epidemic of 1890’, 217.
111.
West, ‘The Influenza Epidemic of 1890’, 217.
112.
See Peacock, On the Influenza. Peacock’s description was used in Quain’s Dictionary of Medicine until 1894, when it was revised by Dawson Williams.Williams noted that an adaptation of Peacock’s original classification was ‘very widely accepted’. See Richard Quain, A Dictionary of Medicine (London: Longmans, Green and Co, 1894), 960.
113.
Thompson, Influenza, or Epidemic Catarrhal Fever.
114.
West, ‘The Influenza Epidemic of 1890’, 196–197.
115.
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116.
West, ‘The Influenza Epidemic of 1890’, 196.
117.
‘Influenza’, The Medical Annual (London: Simpkin, Marshall, Hamilton, Kent & Co, 1890), 529.
118.
Examples can be found in Goodhart ‘Influenza’; Alexander Wheeler and William R. Jack, Wheeler’s Handbook of Medicine and Therapeutics (Edinburgh: E&S Livingstone, 1903); Thomas Dixon Savill, A System of Medicine (London: J&A Churchill, 1903), 645; J.W.S. Moore, ‘Influenza’, in J.W. Ballantyne (Ed.), Encyclopaedia Medica (Edinburgh: Green & Son, 1919), 502–533.
119.
See Watson, Lectures on the Principles of Physic, 43–46.
120.
Matthew Thomson, ‘Neurasthenia in Britain: An Overview’, in Marijke Gijswijt-Hofstra and Roy Porter (Eds.), Cultures of Neurasthenia from Beard to the First World War (Amsterdam: Rodofi, 2001), 77–96.
121.
Samuel West, ‘An Address on Influenza’, Lancet (28 April 1894), 1047–1052.
122.
Julius Althaus, Influenza: Its Pathology, Symptoms, Complications, and Sequels (London: Longmans, 1892), 13–20.
123.
Benjamin Ward Richardson, ‘Epidemic Neuroparesis’, Asclepiad, 9 (1892), 19–37.
124.
Benjamin Ward Richardson, ‘Influenza as an Organic Nervous Paresis’, Asclepiad, 8 (1891), 178–179.
125.
Wilfred Harris, ‘The Nervous System in Influenza’, The Practitioner (August 1907), 85.
126.
Harris, ‘The Nervous System in Influenza’, 70.
127.
See Honigsbaum, A History of the Great Influenza Pandemics, 82–117.
128.
Anson Rabinbach, The Human Motor: Energy, Fatigue, and the Origins of Modernity (Berkeley: University of California Press, 1990), 146–178.
129.
Thomson, ‘Neurasthenia in Britain’, 80.
130.
Histories of respiratory disease have focused on tuberculosis. See, F.B. Smith, The Retreat of Tuberculosis, 1850–1950 (London: Croom Helm, 1988); Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Baltimore: Johns Hopkins University Press, 1994); Helen Bynum, Spitting Blood: The History of Tuberculosis (Oxford: Oxford University Press, 2012).
131.
West, ‘The Influenza Epidemic of 1890’, 202.
132.
West, ‘An Address on Influenza’, 1052.
133.
West, ‘An Address on Influenza’, 1049.
134.
West, ‘An Address on Influenza’, 1049.
135.
Lori Loeb, ‘Beating the Flu: Orthodox and Commercial Responses to Influenza in Britain, 1889–1919’, Social History of Medicine, 18.2 (2006), 203–224.
136.
‘Influenza’, Lancet (21 December 1889), 1293.
137.
Loeb, ‘Beating the Flu’, 208.
138.
Loeb, ‘Beating the Flu’, 208.
139.
See, for example, Peter Eade, ‘Influenza’, Medical Annual (1893), 295–298; W. Broadbent, ‘Note on the Therapeutics and Prophylaxis of Influenza by Quinine’, Practitioner, 78.1 (January 1907), 13.
140.
Thomas Horder, ‘General Principles in the Treatment of Influenza’, Lancet (28 December 1918), 871. Horder reviewed the state of treatment as it had developed from the 1890s.
141.
Loeb, ‘Beating the Flu’, 211–216.
142.
One product, marketed by the Carbolic Smoke Ball Company, gave rise to one of the most important cases in contract law, which remains a key legal precedent. See, A.W.B. Simpson, ‘Quackery and Contract Law: The Case of the Carbolic Smoke Ball’, The Journal of Legal Studies, 14.2 (1985), 345–389; Janice Dickin McGinnis, ‘Carill v. Carbolic Smoke Ball Company: Influenza, Quackery, and the Unilateral Contact’, Canadian Bulletin for the History of Medicine, 5 (1988), 121–141.
143.
William Osler, The Principles and Practices of Medicine (London: Young & Pentland, 1895), 92–93.
144.
Osler, The Principles and Practices of Medicine, 94.
145.
‘Concerning Influenza’, BMJ (23 January 1892), 184.
146.
Robert Donaldson, ‘The Bacteriology of Influenza—With Special Reference to Pfeiffer’s Bacillus’, in F.G. Crookshank (Ed.), Influenza: Essays by Several Authors (London: William Heinemann, 1922), 153.
147.
Alfred W. Crosby, America’s Forgotten Pandemic—The Influenza of 1918 (Cambridge: Cambridge University Press, 1989), 269.
148.
See James F. Goodhart, ‘Influenza’, in Thomas Clifford Albutt (Ed.), A System of Medicine, vol. 1 (London: Macmillan and Co., 1896), 679–700; Abel Heywood, Influenza: Its Causes, Cure and Prevention (Manchester: Abel Heywood & Son, 1902); Fredrick T. Lord, ‘Influenza’, in William Osler (Ed.), A System of Medicine (London: Henry Frode, 1915), 534–549.
149.
Crosby, America’s Forgotten Pandemic, 269.
150.
Donaldson, ‘The Bacteriology of Influenza’, 153.
151.
Tognotti, ‘Scientific Triumphalism’, 103.
152.
For the mixed reception of Koch’s bacteriology in Germany, see Christoph Gradmann, Laboratory Disease: Robert Koch’s Medical Bacteriology, trans. Elborg Forster (Baltimore: Johns Hopkins University Press, 2009).
153.
For patterns of reception in Britain, see Worboys, Spreading Germs and Wall, Bacteria in Britain.
154.
Friedrich Löeffler first set out the procedures in 1883. See, Kodell C. Carter, ‘Koch’s Postulates in Relation to the Work of Jacob Henle and Edwin Klebs’, Medical History, 29 (1985), 353–373.
155.
See Worboys, Spreading Germs for extensive discussion of Klein’s career and different schools of British bacteriology; Michael Worboys, ‘Klein, Edward Emanuel (1844–1925)’, in Oxford Dictionary of National Biography (Oxford University Press, 2004) [online edn, Jan 2008 http://www.oxforddnb.com/view/article/57359]; William Bulloch, ‘Emanuel Klein’, Journal of Pathology and Bacteriology, 28 (1925), 684–699.
156.
Donaldson, ‘The Bacteriology of Influenza’, 141–143.
157.
Op. cit. Wilfried Witte, ‘The Plague That Was Not Allowed to Happen: German Medicine and the Influenza Pandemic of 1918–19 in Baden’, in Howard Phillips and David Killingray (Eds.), The Spanish Influenza Pandemic of 1918–19: New Perspectives (London: Routledge, 2003), 53.
158.
‘Influenza’, Lancet (9 January 1892), 99.
159.
Edward E. Klein, ‘Some Remarks on the Influenza Bacillus’, BMJ (23 January 1892), 171; ‘Concerning Influenza’, BMJ (23 January 1892), 184.
160.
‘The Influenza Bacillus’, BMJ (30 January 1892), 235.
161.
‘Royal Commission on Influenza’, BMJ (30 January 1892), 247; ‘The Official Influenza Inquiry’, BMJ (6 February 1892), 299.
162.
Local Government Board, Further Report and Papers on Epidemic Influenza, 1889–92 (Local Government Board London: HMSO, 1893), x.
163.
See Worboys, Spreading Germs, 211–212.
164.
Andrew Mendelsohn and Christoph Gradmann respectively have developed this argument. J. Andrew Mendelsohn, ‘Cultures of Bacteriology: Formation and Transformation of a Science in France and Germany, 1870–1914’, Unpublished Ph.D. Dissertation (Princeton, 1996); Christoph Gradmann, ‘A Harmony of Illusions: Clinical and Experimental Testing of Robert Koch’s Tuberculin, 1890–1900’, Studies in History and Philosophy of Biological and Biomedical Sciences, 35.3 (2004), 465–481.
165.
Fredrick W. Andrewes, ‘The Work and Needs of the Pathological Department’, St. Bartholomew’s Hospital Journal, 11 (1904), 105–109; idem., ‘The Beginnings of Bacteriology at Barts’, St Bartholomew’s Hospital Journal, 35 (1928), 100–104, 116–117.
166.
Edward E. Klein, ‘Report on Influenza in Its Clinical and Pathological Aspects’, in Further Report and Papers on Epidemic Influenza, 1889–92 (London: HMSO, 1893), 85.
167.
Richard Pfeiffer and M. Beck, ‘Weitere Mittheilungen über den Influenza-Erreger’, Deutsche Medicinische Wochnenschrift, 18 (1892), 465.
168.
Richard Pfeiffer, ‘Preliminary Communication on the Exciting Causes of Influenza’, BMJ (16 January 1892), 128.
169.
Shibashuro Kitasato, ‘On the Influenza Bacillus and the Mode of Cultivating It’, BMJ (16 January 1892), 128.
170.
Koch’s view was reported in The Times, ‘The Influenza Bacillus’ (8 January 1892), 3.
171.
‘Epitome of Current Literature’, BMJ (25 June 1892), 104; Klein ‘Report on Influenza’, 93.
172.
Richard Pfeiffer, ‘Die Aetiologie der Influenza’, Zeitschrift für Hygiene, 12 (1893), 357–386.
173.
Klein, ‘Report on Influenza’, 119.
174.
Klein ‘Report on Influenza’, 266–270.
175.
Klein, ‘Report on Influenza’, 150.
176.
Klein, ‘Report on Influenza’, 120–121.
177.
Klein, ‘Report on Influenza’, 121.
178.
Klein, ‘Report on Influenza’, 121.
179.
These criteria were summed up in Klein’s 1893 report.
180.
‘The Etiology of Influenza’, Lancet (8 April 1893), 810.
181.
This echoes Worboys’ argument that a key factor in British doctors’ reception of Koch’s tubercle bacillus was ‘the congruence between the reported properties of the bacillus and their clinical experience of the disease syndrome, Spreading Germs, 211–212.
182.
‘The Bacillus of Influenza’, Lancet (20 May 1899), 1378–1379.
183.
‘The Influenza Epidemic—Report of the Medical Department of the Local Government Board’, BMJ (26 August 1893), 488.
184.
Richard Pfeiffer, ‘Die Aetiologie der Influenza’, 357–386.
185.
‘Endemic Influenza’, Lancet, 12 February (1898), 449.
186.
Leichtenstern, ‘Influenza’, 591–592.
187.
Thomas Clifford Allbutt, ‘Influenza’, The Practitioner, LXXVII (1907), 1–10; William Gray, Influenza, with Special Reference to Some Peculiar Symptoms (London: H.K. Lewis, 1897).
188.
‘Influenza’, Lancet (18 March 1899), 778.
189.
‘Influenza’, Lancet (14 January 1899), 103.
190.
‘Influenza’, Lancet (14 January 1899), 103.
191.
L. Stephen Jacyna, ‘The Laboratory and the Clinic: The Impact of Pathology on Surgical Diagnosis in the Glasgow Western Infirmary, 1875–1910’, Bulletin of the History of Medicine, 62 (1988), 384–406.
192.
Anne Digby, The Evolution of British General Practice, 1850–1948 (Oxford: Oxford University Press, 1999), 53ff.
193.
‘Influenza’, Lancet (18 March 1899), 778.
194.
Pfeiffer, ‘Die Aetiologie der Influenza’, 357–386.
195.
Local Government Board, Further Report and Papers on Epidemic Influenza, ix.
196.
Provisional Memorandum Upon Precautions Advisable at Times When Epidemic Influenza Threatens or Is Prevalent, Local Government Board (London: HMSO, 1892), xi.
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198.
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204.
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P.N. Panton, Clinical Pathology (London: J&A Churchill, 1913), 133.
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Allbutt, ‘Influenza’, 2.
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A. Newsholme, ‘Influenza from a Public Health Standpoint’, The Practitioner, 78 (1907), 119.
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Allbutt, ‘Influenza’, 1.

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Department of History, Heritage, and Classics, Swansea University, Swansea, UK
Michael Bresalier

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Bresalier, M. (2023). Modernising Flu: Re-aligning Medical Knowledge of the ‘Most Protean Disease’. In: Modern Flu. Medicine and Biomedical Sciences in Modern History. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-33954-6_3

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DOI: https://doi.org/10.1057/978-1-137-33954-6_3
Published: 01 August 2023
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