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America's Forgotten Pandemic: The Influenza of 1918
Between August 1918 and March 1919 the Spanish influenza spread worldwide, claiming over 25 million lives, more people than those perished in the fighting of the First World War. It proved fatal to at least a half-million Americans. Yet, the Spanish flu pandemic is largely forgotten today. In this vivid narrative, Alfred W. Crosby recounts the course of the pandemic during the panic-stricken months of 1918 and 1919, measures its impact on American society, and probes the curious loss of national memory of this cataclysmic event. In a new edition, with a new preface discussing the recent outbreaks of diseases, including the Asian flu and the SARS epidemic, America's Forgotten Pandemic remains both prescient and relevant. Alfred W. Crosby is a Professor Emeritus in American Studies, History and Geography at the University of Texas at Austin, where he taught for over 20 years. His previous books include Throwing Fire (Cambrige, 2002), the Measure of Reality (Cambridge, 1997) and Ecological Imperialism (cambridge, 1986). Ecological Imperialism was the winner of the 1986 Phi Beta Kappa book prize. The Measure of Reality was chosen by the Los Angeles Times as one of the 100 most important books of 1997.
356 pages, Paperback
First published March 19, 1976
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About the author
Alfred W. Crosby
29 books81 followersAlfred W. Crosby Jr. was Professor Emeritus of History, Geography, and American Studies at the University of Texas at Austin, Harvard University and University of Helsinki.
Crosby studied at Harvard University and Boston University. He was an inter-disciplinary researcher who combined the fields of history, geography, biology and medicine. Recognizing the majority of modern-day wealth is located in Europe and the Neo-Europes, Crosby set out to investigate what historical causes are behind the disparity, investigating the biological factors that contributed to the success of Europeans in their quest to conquer the world. One of the important themes of his work was how epidemics affected the history of mankind.
As early as the 1970s, he was able to understand the impact of the 1918 flu pandemic on world history. According to Hal Rothman, a Professor of History at the University of Nevada, Las Vegas, Crosby “added biology to the process of human exploration, coming up with explanations for events as diverse as Cortés’ conquest of Mexico and the fall of the Inca empire that made vital use of the physical essence of humanity. In 1972 he created the term "Columbian Exchange" in his book of the same name. The term has become popular among historians and journalists, such as Charles C. Mann, whose 2011 book 1493: Uncovering the New World Columbus Created expands and updates Crosby's original work. Crosby was also interested in the history of science and technology.
He wrote several books on this subject, dealing with the history of quantification, of projectile technology, and the history of the use of energy. He said that the study of history also made him a researcher of the future. He was very much interested in how humankind could make the future a better one. He has taught at Washington State University, Yale University, the Alexander Turnbull Library in New Zealand, and twice at the University of Helsinki as a Fulbright Bicentennial Professor, most recently in 1997–98. He was appointed an academician by Finnish president Martti Ahtisaari. He retired from the chair of Professor Emeritus of History, Geography, and American Studies of the University of Texas at Austin in 1999. Crosby’s hobbies included birdwatching and jazz, on which topic he could lecture with great expertise. He was married to linguist Frances Karttunen.
Crosby studied at Harvard University and Boston University. He was an inter-disciplinary researcher who combined the fields of history, geography, biology and medicine. Recognizing the majority of modern-day wealth is located in Europe and the Neo-Europes, Crosby set out to investigate what historical causes are behind the disparity, investigating the biological factors that contributed to the success of Europeans in their quest to conquer the world. One of the important themes of his work was how epidemics affected the history of mankind.
As early as the 1970s, he was able to understand the impact of the 1918 flu pandemic on world history. According to Hal Rothman, a Professor of History at the University of Nevada, Las Vegas, Crosby “added biology to the process of human exploration, coming up with explanations for events as diverse as Cortés’ conquest of Mexico and the fall of the Inca empire that made vital use of the physical essence of humanity. In 1972 he created the term "Columbian Exchange" in his book of the same name. The term has become popular among historians and journalists, such as Charles C. Mann, whose 2011 book 1493: Uncovering the New World Columbus Created expands and updates Crosby's original work. Crosby was also interested in the history of science and technology.
He wrote several books on this subject, dealing with the history of quantification, of projectile technology, and the history of the use of energy. He said that the study of history also made him a researcher of the future. He was very much interested in how humankind could make the future a better one. He has taught at Washington State University, Yale University, the Alexander Turnbull Library in New Zealand, and twice at the University of Helsinki as a Fulbright Bicentennial Professor, most recently in 1997–98. He was appointed an academician by Finnish president Martti Ahtisaari. He retired from the chair of Professor Emeritus of History, Geography, and American Studies of the University of Texas at Austin in 1999. Crosby’s hobbies included birdwatching and jazz, on which topic he could lecture with great expertise. He was married to linguist Frances Karttunen.
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December 13, 2021
The pandemic originated outside the United States, but was brought to the country by people traveling abroad. A respiratory disease, it was concentrated first in urban areas but soon left few places untouched. Though the ebbing of the initial wave fueled hopes that the worst of the pandemic would soon end, a second and even deadlier wave soon swept through the country. As medical officers urged people to wear masks in public, health care services were strained to their limits by the number of the infected, forcing in some places a rationing of care and a resort to emergency measures to cope with the number of patients in need of treatment.
Such a scenario is one everyone today has witnessed as the United States and the rest of the world deal with the COVID-19 virus. Yet this also describes the nation’s experience with the Spanish flu pandemic that plagued the country from its initial appearance in 1918 to the final wave of infections in 1920. In that time millions were sickened and as many as 675,000 Americans died from the complications from a virus that the nation’s best medical experts struggled to understand. Their efforts to cope with the pandemic are at the heart of Alfred Crosby’s book, which describes the course of the pandemic and identifies the ways in which it left its mark upon other events, some of which were subsequently forgotten afterwards.
America’s experience with the Spanish flu was intertwined inextricably with that of the First World War. Many of the early cases were those of soldiers and sailors returning home from abroad. The crowded conditions in the army camps where millions of draftees were being trained provided an ideal environment for the virus to be spread, while public rallies in support of the war effort further facilitated the flu’s transmission among the population. As the number of cases mounted, some Americans even speculated that the Spanish flu was being disseminated as part of a German plot to disrupt war mobilization, which was testament to the impact it was having on the nation.
Crosby describes the spread of the flu in general terms, which to a degree reflects the limitations of his sources. As he notes periodically throughout the text, reporting requirements were few, and diagnoses were often inaccurate, making the data less than comprehensive. When caseloads at their peak, medical personnel were so busy coping with the overwhelming number of patients that they had little time to maintain detailed records. This was despite the fact that, for all of the advancements in Western medicine over the past couple of generations, the only treatment available was “[w]arm food, warm blankets, fresh air, and . . . TLC—Tender Loving Care”, in the hope that by maintaining a patient’s health their body could fight off the flu before pneumonia set in.
While the limitations of the medical knowledge of the era hindered the fight against the Spanish flu, Crosby notes how the behavior of Americans was usually the greatest obstacle to fighting the spread of the virus. Crowded cities aided the spread of the disease, while many resisted the imposition of even the most basic of mask requirements, offering a range of arguments that would be unknowingly echoed by their counterparts a century later. Though the ebbing of the pandemic’s first wave in the spring and summer of 1918 fueled hopes that the initial precautions had succeeded in minimizing its impact, two more devastating ways that autumn and again in the spring of 1919 dashed such hopes. It was only with the fourth wave in early 1920 that the signs indicated that the nation had suffered through the worst of the flu, and could begin the process of recovering from its impact.
As a pioneer in the integration of biology into the study of human history, Crosby is ideally suited to write a history of the pandemic. Yet while his book is a readable overview of its subject, it suffers from three flaws. The first is its age: originally written in the mid-1970s, the decades of subsequent research on the origins and impact of the Spanish flu (some of it inspired by Crosby’s work) is missing from its pages. This has the effect of highlighting the second flaw, which is Crosby’s at times superficial analysis. His book is better at raising questions than it is at supplying answers, and while this may be a consequence of the relatively limited amount of data available to him the lack of an effort is regrettable nonetheless. The third is the book’s scope, as Crosby’s American-centric focus downplays the dynamics of what was ultimately a worldwide phenomenon. While he occasionally cites the impact of Spanish flu elsewhere, particularly in his chapters on the Paris Peace Conference, this is done primarily in service to his examination of the flu’s impact on the United States. Though a broader examination would have required considerably more research, it would also have resulted in a work better able to capture the global scale of the pandemic. All of this limits the value of Crosby’s book for readers today, which for all of its continuing value as an introduction to the Spanish flu pandemic has been surpassed in other respects by more recent studies.
Such a scenario is one everyone today has witnessed as the United States and the rest of the world deal with the COVID-19 virus. Yet this also describes the nation’s experience with the Spanish flu pandemic that plagued the country from its initial appearance in 1918 to the final wave of infections in 1920. In that time millions were sickened and as many as 675,000 Americans died from the complications from a virus that the nation’s best medical experts struggled to understand. Their efforts to cope with the pandemic are at the heart of Alfred Crosby’s book, which describes the course of the pandemic and identifies the ways in which it left its mark upon other events, some of which were subsequently forgotten afterwards.
America’s experience with the Spanish flu was intertwined inextricably with that of the First World War. Many of the early cases were those of soldiers and sailors returning home from abroad. The crowded conditions in the army camps where millions of draftees were being trained provided an ideal environment for the virus to be spread, while public rallies in support of the war effort further facilitated the flu’s transmission among the population. As the number of cases mounted, some Americans even speculated that the Spanish flu was being disseminated as part of a German plot to disrupt war mobilization, which was testament to the impact it was having on the nation.
Crosby describes the spread of the flu in general terms, which to a degree reflects the limitations of his sources. As he notes periodically throughout the text, reporting requirements were few, and diagnoses were often inaccurate, making the data less than comprehensive. When caseloads at their peak, medical personnel were so busy coping with the overwhelming number of patients that they had little time to maintain detailed records. This was despite the fact that, for all of the advancements in Western medicine over the past couple of generations, the only treatment available was “[w]arm food, warm blankets, fresh air, and . . . TLC—Tender Loving Care”, in the hope that by maintaining a patient’s health their body could fight off the flu before pneumonia set in.
While the limitations of the medical knowledge of the era hindered the fight against the Spanish flu, Crosby notes how the behavior of Americans was usually the greatest obstacle to fighting the spread of the virus. Crowded cities aided the spread of the disease, while many resisted the imposition of even the most basic of mask requirements, offering a range of arguments that would be unknowingly echoed by their counterparts a century later. Though the ebbing of the pandemic’s first wave in the spring and summer of 1918 fueled hopes that the initial precautions had succeeded in minimizing its impact, two more devastating ways that autumn and again in the spring of 1919 dashed such hopes. It was only with the fourth wave in early 1920 that the signs indicated that the nation had suffered through the worst of the flu, and could begin the process of recovering from its impact.
As a pioneer in the integration of biology into the study of human history, Crosby is ideally suited to write a history of the pandemic. Yet while his book is a readable overview of its subject, it suffers from three flaws. The first is its age: originally written in the mid-1970s, the decades of subsequent research on the origins and impact of the Spanish flu (some of it inspired by Crosby’s work) is missing from its pages. This has the effect of highlighting the second flaw, which is Crosby’s at times superficial analysis. His book is better at raising questions than it is at supplying answers, and while this may be a consequence of the relatively limited amount of data available to him the lack of an effort is regrettable nonetheless. The third is the book’s scope, as Crosby’s American-centric focus downplays the dynamics of what was ultimately a worldwide phenomenon. While he occasionally cites the impact of Spanish flu elsewhere, particularly in his chapters on the Paris Peace Conference, this is done primarily in service to his examination of the flu’s impact on the United States. Though a broader examination would have required considerably more research, it would also have resulted in a work better able to capture the global scale of the pandemic. All of this limits the value of Crosby’s book for readers today, which for all of its continuing value as an introduction to the Spanish flu pandemic has been surpassed in other respects by more recent studies.
May 10, 2020
I read this book with two rubrics in mind: it’s quality as a history of the 1918 pandemic, and the lessons we can draw from it for the COVID-19 pandemic we face today. On the first, the prose is readable, the archival work and its limitations explained, the statistical data presented is useful but not overwhelming, and the narrative is straightforward. On the second, it has mixed results.
The context of the “patriotic” surge around the American entrance into the first world war is crucial for understanding the inability and failure of government and society to respond to the pandemic, as well as its spread. The mass mobilization of society as part of the war effort spread the influenza, with soldiers alternating between travel to and from bases and the warfront and sitting tight in overcrowded barracks and transportation. Of course, mass mobilization also meant mass record keeping, and Army and Navy medical records were early indicators that a pandemic was occurring. Additionally, Crosby highlights the War Bonds rallies as vectors of the rapid spread in cities throughout the country; rallies which frequently were not called off in spite of concerns, because to do so would be unpatriotic or even a treasonous attempt to undermine the war effort.
Paranoia about disease warfare also finds its echo in the 1918 pandemic: Crosby cites a military health leader suspecting Germans of releasing the influenza in America after being dropped ashore by u-boats. “Most newspapers printed the story” (47). Additionally, Bayer Aspirin was fingered as a cause because it was a German patent, and the USPHS tested it in the middle of the pandemic to ensure it was not poisoning customers (216).
One major flaw of the book is a middle chapter spent on the flu’s impact on the Paris Peace Conference after the end of the first World War. Crosby fails to make any useful conclusion about the impact of the pandemic on world history, and the whole thing reads like an effort by someone who is beholden to the Great Man theories of history to find something useful to say about it.
The familiar theme of under-funded and under-resourced public health agencies also play a role. “The organ of government primarily responsible for maintaining the levees against infectious disease was the United States Public Health Service, but it wasn’t ready for danger of this magnitude.” (49). In this case, it was an issue of government institutions not having been built, rather than our own CDC being gutted.
Still, the USPHS centralized the intake and dissemination of information throughout the country, attempted to unify public health departments and bureaus in the 48 states, and took part in ensuring that market forces did not disrupt the provisioning of medical supplies and services. “...no division would be permitted to recruit nurses from any other division without approval from National Headquarters, and a standard schedule of nursing fees was prepared and approved by the Red cross and army and USPHS Surgeon Generals” as “various areas affected by the pandemic were beginning to bid against one another for nurses” (51). Congressional support for the USPHS was rapid after the mostly unnoticed first wave hit and the second began in the Fall, with the Service gaining a 33% increase in its annual budget by unanimous bicameral agreement (52).
Crosby notes variations in the impact of the disease, but refuses to draw conclusions or find explanations, even when they are sitting under his nose. In fact, Crosby is blase about whether anything could have been done at all to stop the spread of the influenza or blunt it’s impact. This conclusion is because he doesn’t attempt any statistical analysis from the data he has available.
Instead of looking for trends or isolating variables, Crosby just writes that sometimes people tried things and they worked, and sometimes people tried the same thing elsewhere and it didn’t work. “For instance, the density of population on the ships seems to have had no effect on the course of the epidemics of those ships. Some transports which sailed in September with 100 to 122 percent of the authorized number of soldiers aboard had an incidence of flu of about 6.9 percent. Others sailing at the same time with 90 to 93 percent of authorized capacity had an incidence rate of 20 percent” (139).
Throughout the book, he examines four different tactics: public closing orders, masks, vaccines, and organizational efforts to ameliorate the impact on communities. The same attitude towards finding conclusions occurs each time: Crosby refuses to draw conclusions from a mass of messy data simply because he doesn’t attempt to analyze it as anything other than anecdotes.
Frustratingly, even when there are cases where clear conclusions can be drawn, such as the successful masking campaign in San Francisco immediately limiting the pandemic’s impact until social pressure and a mailbombing attempt end the campaign and a second wave occurs, Crosby ignores them and retreats back to an epistemic fatalism about our ability to understand how to combat the pandemic. It isn’t until nearly the end of the book until Crosby admits he’s no “biostatician” but just a historian who can’t draw conclusions from the data he has available (257).
The book was a groundbreaking work of history shining a light on an overlooked and forgotten pandemic, so I’m not angry with Crosby for these failures, but they do dramatically limit the value. What we can take from it is examples and anecdotes around xenophobic paranoia, varied government responses, the efforts and failures of scientific institutions to combat the pandemic, and - despite Crosby’s chauvinistic failure to do the very, very obvious analysis - the racist, classist, and imperialist vectors on which the pandemic spread.
I have not yet read other histories of the 1918-19 pandemic, so I can’t compare “America’s Forgotten Pandemic” to more recent historical works, but I would not be surprised if Crosby’s book is valuable for students of the historiography of the pandemic, rather than as the most useful or intelligent history available today.
The context of the “patriotic” surge around the American entrance into the first world war is crucial for understanding the inability and failure of government and society to respond to the pandemic, as well as its spread. The mass mobilization of society as part of the war effort spread the influenza, with soldiers alternating between travel to and from bases and the warfront and sitting tight in overcrowded barracks and transportation. Of course, mass mobilization also meant mass record keeping, and Army and Navy medical records were early indicators that a pandemic was occurring. Additionally, Crosby highlights the War Bonds rallies as vectors of the rapid spread in cities throughout the country; rallies which frequently were not called off in spite of concerns, because to do so would be unpatriotic or even a treasonous attempt to undermine the war effort.
Paranoia about disease warfare also finds its echo in the 1918 pandemic: Crosby cites a military health leader suspecting Germans of releasing the influenza in America after being dropped ashore by u-boats. “Most newspapers printed the story” (47). Additionally, Bayer Aspirin was fingered as a cause because it was a German patent, and the USPHS tested it in the middle of the pandemic to ensure it was not poisoning customers (216).
One major flaw of the book is a middle chapter spent on the flu’s impact on the Paris Peace Conference after the end of the first World War. Crosby fails to make any useful conclusion about the impact of the pandemic on world history, and the whole thing reads like an effort by someone who is beholden to the Great Man theories of history to find something useful to say about it.
The familiar theme of under-funded and under-resourced public health agencies also play a role. “The organ of government primarily responsible for maintaining the levees against infectious disease was the United States Public Health Service, but it wasn’t ready for danger of this magnitude.” (49). In this case, it was an issue of government institutions not having been built, rather than our own CDC being gutted.
Still, the USPHS centralized the intake and dissemination of information throughout the country, attempted to unify public health departments and bureaus in the 48 states, and took part in ensuring that market forces did not disrupt the provisioning of medical supplies and services. “...no division would be permitted to recruit nurses from any other division without approval from National Headquarters, and a standard schedule of nursing fees was prepared and approved by the Red cross and army and USPHS Surgeon Generals” as “various areas affected by the pandemic were beginning to bid against one another for nurses” (51). Congressional support for the USPHS was rapid after the mostly unnoticed first wave hit and the second began in the Fall, with the Service gaining a 33% increase in its annual budget by unanimous bicameral agreement (52).
Crosby notes variations in the impact of the disease, but refuses to draw conclusions or find explanations, even when they are sitting under his nose. In fact, Crosby is blase about whether anything could have been done at all to stop the spread of the influenza or blunt it’s impact. This conclusion is because he doesn’t attempt any statistical analysis from the data he has available.
Instead of looking for trends or isolating variables, Crosby just writes that sometimes people tried things and they worked, and sometimes people tried the same thing elsewhere and it didn’t work. “For instance, the density of population on the ships seems to have had no effect on the course of the epidemics of those ships. Some transports which sailed in September with 100 to 122 percent of the authorized number of soldiers aboard had an incidence of flu of about 6.9 percent. Others sailing at the same time with 90 to 93 percent of authorized capacity had an incidence rate of 20 percent” (139).
Throughout the book, he examines four different tactics: public closing orders, masks, vaccines, and organizational efforts to ameliorate the impact on communities. The same attitude towards finding conclusions occurs each time: Crosby refuses to draw conclusions from a mass of messy data simply because he doesn’t attempt to analyze it as anything other than anecdotes.
Frustratingly, even when there are cases where clear conclusions can be drawn, such as the successful masking campaign in San Francisco immediately limiting the pandemic’s impact until social pressure and a mailbombing attempt end the campaign and a second wave occurs, Crosby ignores them and retreats back to an epistemic fatalism about our ability to understand how to combat the pandemic. It isn’t until nearly the end of the book until Crosby admits he’s no “biostatician” but just a historian who can’t draw conclusions from the data he has available (257).
The book was a groundbreaking work of history shining a light on an overlooked and forgotten pandemic, so I’m not angry with Crosby for these failures, but they do dramatically limit the value. What we can take from it is examples and anecdotes around xenophobic paranoia, varied government responses, the efforts and failures of scientific institutions to combat the pandemic, and - despite Crosby’s chauvinistic failure to do the very, very obvious analysis - the racist, classist, and imperialist vectors on which the pandemic spread.
I have not yet read other histories of the 1918-19 pandemic, so I can’t compare “America’s Forgotten Pandemic” to more recent historical works, but I would not be surprised if Crosby’s book is valuable for students of the historiography of the pandemic, rather than as the most useful or intelligent history available today.
January 20, 2017
As a student of the First World War, I've always been curious about the great Flu Pandemic of 1918. My curiosity is partially academic, this was a plague that killed at least three times as many people as the First World War, (and millions more than the Black Death of the 14th century) and yet we barely remember it.
Crosby does a good job of piecing together the progress of the flu across the United States, including chilling anecdotes, such as the city morgue overflowing in Philadelphia, or the massive mortality from flu and pneumonia on the troop ship Leviathan in the Atlantic. He also manages some fascinating contrasts in areas affected by the flu, contrasting the response in Philadelphia with that in San Francisco, where widespread masking may not have prevented the Flu from spreading, but did a great deal to tamp down on panic. He also makes a fascinating comparison of the effects of Flu on the margins of the American Empire in 1918 (The American Samoa and Alaska) He shows how draconian efforts by the U.S. Navy and the Military Governor of Samoa spared Samoans in the American colony from the massive death toll suffered by Samoans in the former German Colony (Western Samoa) then under occupation by New Zealand. On the other hand, the mortality from Flu in Alaska proved uneven, with certain areas managing to successfully quarantine the flu, while other, particularly native communities, were virtually annihilated by the disease.
Crosby is less successful in his attempts to link to Flu to world events. He points to the Paris Peace Conference in 1919 and makes the conjecture that President Woodrow Wilson's coming down with the Flu lead directly to the punitive peace terms of the Treaty of Versailles, as Wilson's incapacitation cancelled out any amelioration of the terms he might have provided. While all of this is possible, Crosby oversimplifies the situation here and lacks a "smoking gun." His evidence of Wilson being stricken by Flu is inconclusive (in light of subsequent events, it is likely that Wilson's 1919 health scare was a preview of the massive stroke that would incapacitate him for the rest of his presidency in 1920) and Crosby overlooks or underestimates the French appetite for revenge or the British desire to ensure that Germany would not have the capacity to wage war on the scale of 1914-1918 again. Wilson may have believe in his idealistic principles, his ability to enforce them, even at the height of his popularity in 1919 is questionable.
I mentioned that my interest in the 1918 Flu is only partially academic. It is also personal. In a very real sense, I am a product of that pandemic. In 1917 my Great-grandfather, Hermann Haeber married a young lady named Ella Rencke and they soon thereafter she had a child. Then the Flu struck South Texas and numbered Ella among its many victims. My Great-grandfather found himself a widower with a baby. At the same time, his brother Max Haeber also died from the Flu, leaving his wife Olga widowed with several children. For reasons that were probably as much practical as anything else, Hermann married Olga and they raised a mixed family together. Whatever their initial reasons for marrying, things must have worked out well for them, for their family eventually expanded to 13 children, the youngest of which was my Grandmother Gloria, who would have never been born were it not for the tragedy of the 1918 Influenza.
Crosby does a good job of piecing together the progress of the flu across the United States, including chilling anecdotes, such as the city morgue overflowing in Philadelphia, or the massive mortality from flu and pneumonia on the troop ship Leviathan in the Atlantic. He also manages some fascinating contrasts in areas affected by the flu, contrasting the response in Philadelphia with that in San Francisco, where widespread masking may not have prevented the Flu from spreading, but did a great deal to tamp down on panic. He also makes a fascinating comparison of the effects of Flu on the margins of the American Empire in 1918 (The American Samoa and Alaska) He shows how draconian efforts by the U.S. Navy and the Military Governor of Samoa spared Samoans in the American colony from the massive death toll suffered by Samoans in the former German Colony (Western Samoa) then under occupation by New Zealand. On the other hand, the mortality from Flu in Alaska proved uneven, with certain areas managing to successfully quarantine the flu, while other, particularly native communities, were virtually annihilated by the disease.
Crosby is less successful in his attempts to link to Flu to world events. He points to the Paris Peace Conference in 1919 and makes the conjecture that President Woodrow Wilson's coming down with the Flu lead directly to the punitive peace terms of the Treaty of Versailles, as Wilson's incapacitation cancelled out any amelioration of the terms he might have provided. While all of this is possible, Crosby oversimplifies the situation here and lacks a "smoking gun." His evidence of Wilson being stricken by Flu is inconclusive (in light of subsequent events, it is likely that Wilson's 1919 health scare was a preview of the massive stroke that would incapacitate him for the rest of his presidency in 1920) and Crosby overlooks or underestimates the French appetite for revenge or the British desire to ensure that Germany would not have the capacity to wage war on the scale of 1914-1918 again. Wilson may have believe in his idealistic principles, his ability to enforce them, even at the height of his popularity in 1919 is questionable.
I mentioned that my interest in the 1918 Flu is only partially academic. It is also personal. In a very real sense, I am a product of that pandemic. In 1917 my Great-grandfather, Hermann Haeber married a young lady named Ella Rencke and they soon thereafter she had a child. Then the Flu struck South Texas and numbered Ella among its many victims. My Great-grandfather found himself a widower with a baby. At the same time, his brother Max Haeber also died from the Flu, leaving his wife Olga widowed with several children. For reasons that were probably as much practical as anything else, Hermann married Olga and they raised a mixed family together. Whatever their initial reasons for marrying, things must have worked out well for them, for their family eventually expanded to 13 children, the youngest of which was my Grandmother Gloria, who would have never been born were it not for the tragedy of the 1918 Influenza.
August 12, 2011
I think this book is complimentary to Gina Kolata's work on the same topic. There is obviously some overlap. They both discuss the epidemic in 1918 and 1919 and they both discuss research since up to points of their respective dates of publication. Kolata's book spends less time on the epidemic and more time on the progression of research since leading up to isolating the 1918 strain of flu. The bulk of Crosby's book focuses on the epidemic and its impact on American and European civilians and military personel, relating it to world events at that time. There is some discussion of flu research since, although much less progress had been made at the time Crosby's book was published, so he probably had less to say about it. He did spend more time than Kolata discussing the research and theories about flu that did not pan out. Put together both books provide and extremely comprehensive review of the 1918 flu and twentieth century flu research since. All the set needs now is a book discussing the progress made in the 21st century, possibly detailing the connection betweent he 1918 flu pandemic and the 2009 flu pandemic. I would be interested in reading more on that.
March 23, 2020
A reviewer of this book years ago started his review with this: "I think this book is complimentary to Gina Kolata's work on the same topic." And it's interesting because I was going to say basically the same thing, which would have looked stupid, so I'm glad I read through some reviews. That said, I do think Kolata's book is the better one, possibly more interesting to me personally, although I agree with the reviewer in thinking they compliment each other well. As I write this, it's March 2020 and the world is experiencing its first major pandemic since that one, and to this point, the similarities are eery. However, I think it would help people have some context as well as a glimpse of the probable future, no matter how grim, so I definitely recommend anyone looking at this at the time of my writing this invest in researching and reading this book, Gina's "Flu" or others like them, because I think it's important to educate ourselves in light of the present situation. Hence, recommended.
June 3, 2020
The reason why I was interested in reading this is obvious. I've never been through a pandemic until now, and I wanted to learn about the one from 1918 that kept being cited in the media.
I must have heard of this pandemic before, but it was probably passing mentions in other books. I mean, I've read books on WWI and Woodrow Wilson, so it's incredible that I knew so little about it.
While the information in this book was extensive, I was often lulled into inattention by long passages of statistics, which I found to be the least interesting parts.
The most interesting parts were the human stories, how the pandemic affected real people and what came after. There was a fascinating chapter about its effect on the Paris peace talks, and there is a suggestion, because Wilson was so weak at that time, and because it led to certain people being elected to the Senate, that the pandemic had an impact that led to WWII.
I must have heard of this pandemic before, but it was probably passing mentions in other books. I mean, I've read books on WWI and Woodrow Wilson, so it's incredible that I knew so little about it.
While the information in this book was extensive, I was often lulled into inattention by long passages of statistics, which I found to be the least interesting parts.
The most interesting parts were the human stories, how the pandemic affected real people and what came after. There was a fascinating chapter about its effect on the Paris peace talks, and there is a suggestion, because Wilson was so weak at that time, and because it led to certain people being elected to the Senate, that the pandemic had an impact that led to WWII.
July 5, 2020
A reasonably sized history of the 1918-1919 pandemic, written in 1990. Some uncanny parallels with the Covid-19 pandemic.
February 8, 2021
The most striking thing to me is that human behavior and government response/policy (or lack thereof) remains unchanged since the 1918 pandemic. One would have hoped we could have learned our lesson the first time.
This was a good read, and I feel well-versed in the 1918 pandemic. The writing got thick at times. I wonder what a 'popular' or 'journalistic' author could do with this strong content which got buried occasionally by academic author Dr. Crosby. HIGHLY RECOMMENDED for those interested in WWI, pandemics/health policy, Alaska, science research, cultural or military history
SPOILERS below...
Highlights of what I learned, with some quotes applicable to the SARS-CoV-2 Pandemic (remember, this book was written in 2003)
- The pandemic behaved differently depending on where it was... the front line, boot camps, urban cities, isolated islands, ships. Regarding WWI - the flu illness did more "damage to the war effort" than battle deaths. Those ill with flu pulled critical human & physical resources away from the battles.
-Most of the histories of this pandemic are pulled from cities (newspapers documented numbers and events) and naval ship records
- The "line dividing the body from its environment is at its thinnest in the lungs". Typically, death curves with Flu are the very young and the elderly - creating a "U" curve. This particular pandemic had a W curve - many young adults were taken. Super-spreader events - war bond celebrations, victory parades - contributed to a faster spread.
- Conspiracy theories were plentiful about the origins of the Spanish Flu - most of which targeted enemies of the times. Minorities and immigrants were also targets of dominant culture's suspicion.
Asymptomatic spread was confirmed, and strong antibodies appeared in tests decades later.
- Social support structures must be considered in building a response. In the case of the 1918 pandemic, adults with young children fell ill and were unable to care for their children. In some cases, especially in Alaska, children froze or starved to death because adults were incapacitated.
- Flu does not leave a 'lasting mark' on its victims like pox or polio did. The lack of disfigurement lessens the fear people have of it, and as such, lowers the response to a flu pandemic. Flu low mortality rate contributes to a 'lack of fear' and thus flu is often ignored as a serious medical condition. In the case of the 1918 pandemic, it moved so fast through communities that responses were often too late to make a difference in prevention.
-"China, which tops the list the world in its numbers of humans, aquatic birds, and pigs, has bene the source of many new flu strains since 1918 and will be again." pg.xiii [Note: SARS-CoV-2 is not flu, but I found it interesting this 2003 book identified China as 'the hotspot' for pandemic origins.]
-"There is a bitter little pill of a joke currently circulating among infectious disease experts. It is short: The nineteenth century was followed by the twentieth century, which was followed by the... nineteenth century" (pg.xiii)
-"The factors at work in the pandemic were so numerous and the ways in which they canceled or gained power from one another are so obscure that very few generalities can be drawn." pg. 64
"Spanish influenza had a withering hand on all of the essential services." pg.75 (specifically phone operators, manufacturing, embalming/burial services, 1st responders). Volunteer services saved thousands through medical care, transportation, food prep, child care.
-"Very few health officers and no communities as a whole really appreciated the devastation the pandemic could wreak until experiencing it." pg.92
-Masking (see page 101-9) [interesting quote from 1918 that could have been written in 2020: "mask regulations subversive of personal liberty and constitutional rights"], and school/business/entertainment closures, and fear or authority and those of difference (minorities, immigrants, race), travel quarantines/bans will always be controversial during pandemics.
This was a good read, and I feel well-versed in the 1918 pandemic. The writing got thick at times. I wonder what a 'popular' or 'journalistic' author could do with this strong content which got buried occasionally by academic author Dr. Crosby. HIGHLY RECOMMENDED for those interested in WWI, pandemics/health policy, Alaska, science research, cultural or military history
SPOILERS below...
Highlights of what I learned, with some quotes applicable to the SARS-CoV-2 Pandemic (remember, this book was written in 2003)
- The pandemic behaved differently depending on where it was... the front line, boot camps, urban cities, isolated islands, ships. Regarding WWI - the flu illness did more "damage to the war effort" than battle deaths. Those ill with flu pulled critical human & physical resources away from the battles.
-Most of the histories of this pandemic are pulled from cities (newspapers documented numbers and events) and naval ship records
- The "line dividing the body from its environment is at its thinnest in the lungs". Typically, death curves with Flu are the very young and the elderly - creating a "U" curve. This particular pandemic had a W curve - many young adults were taken. Super-spreader events - war bond celebrations, victory parades - contributed to a faster spread.
- Conspiracy theories were plentiful about the origins of the Spanish Flu - most of which targeted enemies of the times. Minorities and immigrants were also targets of dominant culture's suspicion.
Asymptomatic spread was confirmed, and strong antibodies appeared in tests decades later.
- Social support structures must be considered in building a response. In the case of the 1918 pandemic, adults with young children fell ill and were unable to care for their children. In some cases, especially in Alaska, children froze or starved to death because adults were incapacitated.
- Flu does not leave a 'lasting mark' on its victims like pox or polio did. The lack of disfigurement lessens the fear people have of it, and as such, lowers the response to a flu pandemic. Flu low mortality rate contributes to a 'lack of fear' and thus flu is often ignored as a serious medical condition. In the case of the 1918 pandemic, it moved so fast through communities that responses were often too late to make a difference in prevention.
-"China, which tops the list the world in its numbers of humans, aquatic birds, and pigs, has bene the source of many new flu strains since 1918 and will be again." pg.xiii [Note: SARS-CoV-2 is not flu, but I found it interesting this 2003 book identified China as 'the hotspot' for pandemic origins.]
-"There is a bitter little pill of a joke currently circulating among infectious disease experts. It is short: The nineteenth century was followed by the twentieth century, which was followed by the... nineteenth century" (pg.xiii)
-"The factors at work in the pandemic were so numerous and the ways in which they canceled or gained power from one another are so obscure that very few generalities can be drawn." pg. 64
"Spanish influenza had a withering hand on all of the essential services." pg.75 (specifically phone operators, manufacturing, embalming/burial services, 1st responders). Volunteer services saved thousands through medical care, transportation, food prep, child care.
-"Very few health officers and no communities as a whole really appreciated the devastation the pandemic could wreak until experiencing it." pg.92
-Masking (see page 101-9) [interesting quote from 1918 that could have been written in 2020: "mask regulations subversive of personal liberty and constitutional rights"], and school/business/entertainment closures, and fear or authority and those of difference (minorities, immigrants, race), travel quarantines/bans will always be controversial during pandemics.
April 22, 2020
This was an excellent book. I have read one other book on the Spanish Influenza Pandemic of 1918-1919, but it’s aims were different. This is a scholarly book, complete with footnotes. (The history major I me was very pleased to see this.)
What struck me, first, was the similarities to the COVID-19 issues in 2020, and second how apt the title is. The world has forgotten the Spanish Flu, and doesn’t take the flu seriously enough under normal conditions, much less under such dire circumstances as we face this year.
Having two degrees in history, I can tell you that not all books on history are this easy to read. I’m in the minority amongst historians in thinking that this is an important quality. Who cares how ground-breaking your research is if no one can get through your book to get the point? This one I did and I enjoyed learning something new.
What struck me, first, was the similarities to the COVID-19 issues in 2020, and second how apt the title is. The world has forgotten the Spanish Flu, and doesn’t take the flu seriously enough under normal conditions, much less under such dire circumstances as we face this year.
Having two degrees in history, I can tell you that not all books on history are this easy to read. I’m in the minority amongst historians in thinking that this is an important quality. Who cares how ground-breaking your research is if no one can get through your book to get the point? This one I did and I enjoyed learning something new.
April 19, 2020
This is probably the best book written about the 1918 pandemic. I've read several others but this one had the most impact.
January 2, 2012
This is by far the scariest book I have ever read and the worst part about it is the fact that it's true! I read this book shortly before the H1N1 virus started making headlines earlier this year. The current strain is closely related to the strain from 1918. "Official" estimates at that time were that close to 30 million people died, but modern day historians and scientists think that many people died in India alone! Some estimates go as high as 100 million!
Crosby does a fantastic job of informing while keeping things interesting in a genre that is often written in a dry text-book style. Crosby uses dozens of anecdotal accounts from those who witnessed the pandemic; doctors, nurses, children, immigrants, soldiers, and everyone in between. Crosby also makes some interesting connections between the devastating impacts of influenza and world events. An example of this is the way WWI was fought. Crosby believes that fighting was heavily influenced by the fact that young healthy males were hit the hardest by the Spanish Influenza. This demographic also happened to be the same one that the free world was depending on to remain free. Crosby asserts that the outcome of the war, which culminated with the Treaty of Versailles, was also influenced by the pandemic. Pres. Woodrow Wilson and other leaders were struck down with the virus. Crosby questions these key negotiators abilities' given their mental and physical states. He argues that the "resolution" agreed upon was perhaps hastily written so that the sick parties could end their misery and go home. History shows us that only a few years later, an oppressed and disgruntled Germany (who were not consulted while the terms of the treaty were being written) started a second World War.
I am not a history major, or even a college grad (yet), but I found this book easy to read and easy to understand all while being informative.
Crosby does a fantastic job of informing while keeping things interesting in a genre that is often written in a dry text-book style. Crosby uses dozens of anecdotal accounts from those who witnessed the pandemic; doctors, nurses, children, immigrants, soldiers, and everyone in between. Crosby also makes some interesting connections between the devastating impacts of influenza and world events. An example of this is the way WWI was fought. Crosby believes that fighting was heavily influenced by the fact that young healthy males were hit the hardest by the Spanish Influenza. This demographic also happened to be the same one that the free world was depending on to remain free. Crosby asserts that the outcome of the war, which culminated with the Treaty of Versailles, was also influenced by the pandemic. Pres. Woodrow Wilson and other leaders were struck down with the virus. Crosby questions these key negotiators abilities' given their mental and physical states. He argues that the "resolution" agreed upon was perhaps hastily written so that the sick parties could end their misery and go home. History shows us that only a few years later, an oppressed and disgruntled Germany (who were not consulted while the terms of the treaty were being written) started a second World War.
I am not a history major, or even a college grad (yet), but I found this book easy to read and easy to understand all while being informative.
January 1, 2020
“America’s Forgotten Pandemic” by Alfred W. Crosby (first published in 1976 with a second edition in 2003) is an in-depth look at the Spanish Influenza of 1918-1919 that gripped the world and caused more deaths than the total of military and civilian mortalities in World War I … and the influenza was much speedier. Between August 1918 and March 1919, 25 million people became victims of this influenza. The premise of the book is that while today we still remember and study World War I, we have pretty much forgotten the Spanish Influenza pandemic.
Alfred Crosby (1931-2018) was a distinguished professor of History primarily at the University of Texas at Austin. Two of his major works – "The Columbian Exchange: Biological and Cultural Consequences of 1492" (1972), and "Ecological Imperialism: The Biological Expansion of Europe, 900–1900" (1986) – were ground-breaking works that used biology to explain much of the success of European exploration of the New World. Being an academic, his books took on an academic aura and never reached mass popularity; it would take Jerod Diamond with "Guns, Germs, and Steel" (1997) to write the popular version of Crosby’s ideas. With "America’s Forgotten Pandemic" Crosby takes an in-depth view of another major event and brings in biology and science to help explain its parts and pieces … and once again his work reads like an academic tome in places, but that should not dissuade one from trying it on for size.
Takeaways: One of the fascinating takeaways from this book is the age disparity in the influenza’s mortality. Generally speaking, epidemics usually are hardest on the youngest and the oldest in the population … but the Spanish Influenza was hardest on the mid-age group, those in their twenties and thirties, whom one would have expected to survive the easiest. Another fact is that Black Americans who usually suffer higher death rates than whites from respiratory diseases suffered less in the Influenza Pandemic. Also Immigrants had a higher death rate than those born in the United States.
This tale is replete with facts and figures that describe the pandemic in ways one might never have considered, and for this alone it is a good read. Consider for example that American servicemen often brought the Spanish Influenza with them to Europe and back again when returning. Crosby also touches on the effects of Swine Influenza and its import on the human Spanish Influenza. This narrative ends up a tale of virology versus bacteriology. All-in-all, this is a good book filled with detail. Recommended.
Alfred Crosby (1931-2018) was a distinguished professor of History primarily at the University of Texas at Austin. Two of his major works – "The Columbian Exchange: Biological and Cultural Consequences of 1492" (1972), and "Ecological Imperialism: The Biological Expansion of Europe, 900–1900" (1986) – were ground-breaking works that used biology to explain much of the success of European exploration of the New World. Being an academic, his books took on an academic aura and never reached mass popularity; it would take Jerod Diamond with "Guns, Germs, and Steel" (1997) to write the popular version of Crosby’s ideas. With "America’s Forgotten Pandemic" Crosby takes an in-depth view of another major event and brings in biology and science to help explain its parts and pieces … and once again his work reads like an academic tome in places, but that should not dissuade one from trying it on for size.
Takeaways: One of the fascinating takeaways from this book is the age disparity in the influenza’s mortality. Generally speaking, epidemics usually are hardest on the youngest and the oldest in the population … but the Spanish Influenza was hardest on the mid-age group, those in their twenties and thirties, whom one would have expected to survive the easiest. Another fact is that Black Americans who usually suffer higher death rates than whites from respiratory diseases suffered less in the Influenza Pandemic. Also Immigrants had a higher death rate than those born in the United States.
This tale is replete with facts and figures that describe the pandemic in ways one might never have considered, and for this alone it is a good read. Consider for example that American servicemen often brought the Spanish Influenza with them to Europe and back again when returning. Crosby also touches on the effects of Swine Influenza and its import on the human Spanish Influenza. This narrative ends up a tale of virology versus bacteriology. All-in-all, this is a good book filled with detail. Recommended.
July 30, 2021
Reading this in 2021 for, well, obvious reasons.
I don't subscribe to the "history repeats itself" school of thought and was not really looking for any eternal pandemic truths by picking up Crosby's book. More some perspective and a general understanding of the pandemic that came before this one. I also was reading for some additional context to use as I craft some new lectures and lessons on this pandemic since students have requested more materials on this event.
While a bit dated and certainly not predictive of the 2020-? COVID pandemic, this book is a solid account of the early 20th-century flu pandemic. This book is more of a military history than I expected, but that did allow me to understand better the connections between this flu pandemic and World War I.
Some elements went far beyond my needs, and I'll confess to skimming some of the more medical-heavy portions. Their inclusion does suggest a thorough effort on Crosby's part to present a full history of the event.
If there are take-a-ways for the current pandemic, while there were still challenges to get the public to wear masks, there was also a lot less undermining of authority and a general emphasis on lending a hand and all doing your part.
I don't subscribe to the "history repeats itself" school of thought and was not really looking for any eternal pandemic truths by picking up Crosby's book. More some perspective and a general understanding of the pandemic that came before this one. I also was reading for some additional context to use as I craft some new lectures and lessons on this pandemic since students have requested more materials on this event.
While a bit dated and certainly not predictive of the 2020-? COVID pandemic, this book is a solid account of the early 20th-century flu pandemic. This book is more of a military history than I expected, but that did allow me to understand better the connections between this flu pandemic and World War I.
Some elements went far beyond my needs, and I'll confess to skimming some of the more medical-heavy portions. Their inclusion does suggest a thorough effort on Crosby's part to present a full history of the event.
If there are take-a-ways for the current pandemic, while there were still challenges to get the public to wear masks, there was also a lot less undermining of authority and a general emphasis on lending a hand and all doing your part.
March 18, 2020
A book I’ve been meaning to get to for a very long time and it felt like the right time to finally read it.
My only complaint is that I wish that the many numbers were grounded with more individuals stories. It’s hard to imagine thousands of people dying in a week in a particular city. I also wish that there had been a little more on nonwestern countries—in particular, India. So I liked the chapter on Samoa and Alaska, which were at least outside mainstream US and outside the scope of the first world war.
A bit disheartening for the moment, especially since many of the public and government reactions are so similar to what we’re experiencing now. But that’s history for ya!
My only complaint is that I wish that the many numbers were grounded with more individuals stories. It’s hard to imagine thousands of people dying in a week in a particular city. I also wish that there had been a little more on nonwestern countries—in particular, India. So I liked the chapter on Samoa and Alaska, which were at least outside mainstream US and outside the scope of the first world war.
A bit disheartening for the moment, especially since many of the public and government reactions are so similar to what we’re experiencing now. But that’s history for ya!
June 11, 2020
Really dull and plodding, even though I was quite interested in the subject and am a former academic. I could have slogged through it if it was an assignment, but for fun? No, thanks.
June 12, 2023
See, this is why we need history.
It's also a devastating example of what happens when we fail to recall it, or learn from it. As said George Santayana, "Those who cannot remember the past are condemned to repeat it" ("The Life of Reason: The Phases of Human Progress" (1905-1906), Vol. I, Reason in Common Sense). A similarly famous sentiment, perhaps because it's so accurate, goes like: "People will not look forward to posterity, who never look backward to their ancestors" (Edmund Burke, "Revolution in France"). What follows here is perhaps the most prototypical example in the last century.
I'm going to let Professor Alfred Crosby (1931-2018), sometimes referred to as "The Father of Environmental History," one of my all-time favorite scholars, speak for himself, as he did in the preface to this edition. Thirty years after this book was first published, it's become prophesy fulfilled. He writes as follows:
"When I wrote this book at the beginning of the 70s, its subject matter, the 1918 pandemic, seemed more of academic than immediate interest. Insofar as I could see 15 years ago, neither influenza nor any other disease was among humanity's greatest immediate dangers. War was still running free, but the other traditional killers, symbolized by the Horsemen of the Apocalypse, were under a tight rein, at least in the advanced societies. For instance, a person died of infection only if very young, very old, weakened by alcoholism or physical injury, or extremely unlucky. The loss of a 20-year-old to communicable disease in the US seemed as likely as his being hit by a falling tree.... Tuberculosis and polio were only bad memories for citizens of the advanced societies, and smallpox was well on its way to extinction everywhere. The characteristic sin of the time vis-a-vis public health and medical science was hubris.
"Now hubris had given way to anxiety. Seekers after Lyme disease need only don shorts and sandals and scuff through a New England or New York meadow; and of course we all quail before the world-wide pandemic of AIDS. Scientists know amazingly more about molecular biology, pathogens and immunology than they did 15 or 20 years ago, but the bad guys, the pathogens, particularly the newly recognized ones, seem to the general public to have become nastier faster than scientists have become smarter. Whatever may be the truth of that, it is certainly true that unthinking confidence in our public health officials and medical scientists is in sharp decline. Anyone still swelling with hubris simply has not been paying attention....
"The last such experience took place in 1918, when influenza killed tens of millions, rolling across continents and oceans so swiftly that public health institutions were still preparing for the onslaught after it had passed. That pandemic baffled science and reduced the experts to recommending mass adoption of ineffective gauze masks, and even to inoculating thousands with vaccines that were no better (and with luck, no worse) than useless. If we want to know how we react to calamitous surges of disease, we should take a look at the 1918 flu. And if we went to avoid a reprise of that ordeal, we should reexamine it, because we still do not know why it was as bad as it was."
Prophetic indeed.
Crosby was a historian in some respects generations ahead of his time - he was a groundbreaking scholar who utilized a multi-disciplinary approach well before it became fashionable, and now, even essential. His primary areas of research focused on the cultural and biological changes which occurred in the wake of the (re)discovery of the New World. Synthesizing methods from history, geography and biology, as I strive to do also in my own research, Crosby was a true pioneer in the field of interdisciplinary history. According to a New York Times article, his fascination with environmental history stemmed from a near-obsession with Christopher Columbus in boyhood, a still-much-revered figure during his upbringing in the 1930s and 40s.
As a result, Crosby realized early on the biological consequences of New-World, Old-World contact. As a result, his research spawned an entire sub-field based on what is now termed The Colombian Exchange. In a 2011 interview, he stated regarding this novel approach intended to fill what was then a gaping hole in scholarship: “We were thinking politically and ideologically, but very rarely were historians thinking ecologically, biologically.”As an environmental historian who studies ancient agriculture and resource use, Crosby has been one of my inspirations since I began my academic journey decades ago, now, not least on account of his writing style, which speaks to a far broader audience than the academic specialists who are the usual focus of these fields.
"America's Forgotten Pandemic" is still a technical academic monograph, but it is highly accessible to a more-than-typical general audience, even if it's somewhat statistic-heavy, another of Crosby's hallmarks. He has also been called a "demographic historian," for that reason, as data are also his forte. That doesn't entail pages and pages of charts and graphs, however; they're used herein rather sparingly, as Crosby has a great talent for making reams of data accessible as a comprehensive and intelligible narrative, which is an enviable talent. This book proceeds both chronologically and geographically, looking at the various waves and phases of the pandemic, as well as the responses, or, rather and often, the lack thereof, in particularly hard-hit areas, such as Philadelphia, the most devastated city in the nation, Chicago, and other densely-populated urban centers.
So, what was the Influenza Pandemic of 1918-1919? It's a forgotten pandemic no more, as it's been frequently referenced during the modern COVID-19 pandemic of the last three years. I often wonder what Crosby would have said about our present predicament, had he lived to see it. The 1918 pandemic was caused by an unusually deadly influenza virus, now identified as an H1N1 influenza A variant (rather than a coronavirus variant), which first appeared in the US in what appears to be March, 1918, in Kansas, with additional cases identified in France, Germany and the UK by April. Two years later, nearly a third of the global population, or half a billion people, had been infected.
It has been described as the deadliest pandemic in human history, at least in terms of numbers, if not percentages. That dubious distinction probably belongs to The Black Death, an outbreak of bubonic plague in the fourteenth century, which may have killed a third or more of the world's human population. As even in the modern day, death reporting during the Great Pandemic of 1918 was spotty and uncertain, however: even with modern technology, one of the primary criticisms of the current death toll has been that doctors are often less than accurate about who has died FROM COVID-19, or WITH it. The same was true a century ago, to an even greater extent, which the book admirably describes; as such, death estimates remain unknown, and controversial, but typically range from 17 to as high as 50 million; some wildly exaggerated estimates claim that the eventual death toll topped 100 million. In reality, the figure probably lies somewhere around 20 million, more than the entire death toll caused by WWI.
In essence, the Great Influenza epidemic was the result of a perfect storm of unfortunate factors, mostly as a result of the Great War. Propaganda czars on both sides concealed evidence of the deadly outbreak, other than in neutral Spain, whose reporters were free to publish accurate reports - hence the name, Spanish Influenza, although it certainly didn't start there, nor was it the epicenter. This strain had a particularly high mortality for young adults, rather than what is normally seen, that is, among the very young and very old. As in the present day, this virus triggered a cytokine storm, which devastated the immune systems of even young, healthy adults. Responsible for the appalling death toll were, again, a perfect storm of factors: wartime mobility and particularly overcrowding, malnourishment, poor hygiene and a lack of modern medicine, especially antibiotics, which is likely what kept the modern-day pandemic from being much worse. Modern drugs and ventilators are largely what has kept the death toll from being much higher.
As in the present day, however, once the virus became entrenched in the population, there was almost nothing to stop the spread. All efforts, including, again, the useless masking, closing of public places and businesses, and efforts at quarantining entire swaths of the population did absolutely nothing to stop it. What else hasn't changed? The ignorance and arrogance of impotent doktor-gods, was manifest for all to see: they devastatingly underestimated the danger of the disease, and, worse, their ability to contain it. "On the same day that flu was made reportable, the news broke that ... the director of the laboratories of the Phipps Institute of Philadelphia, had indicated the cause of Spanish influenza: Pfeiffer's bacillus [wrong]. This, the "Inquirer" stated, has 'armed the medical profession with absolute knowledge on which to base its campaign against this disease.'"
Even worse, others made proclamations in the vein of "with such confidence among medical men, why shouldn't the rest of the community go about what it considered the most pressing business of the day?" including a kickoff wartime parade which drew some 200,000 people into the Streets of Philadelphia - with lethal consequences. The case was similar in Chicago, where health officers dramatically underplayed the seriousness of the disease, with one even stating that "There is no special reason I know of to fear an outbreak of disease in our city," Chicago, because "we have the Spanish Influenza situation well in hand now," even before, as Crosby notes, the situation had really even developed. Philadelphia became the hardest-hit city in the nation, with Chicago and other major metropoleis not far behind. As in our present day, Philadelphia and other major cities shortly thereafter closed all schools, churches and other public gathering places - too little, too late.
The moral of the story is really in the preface. I wish that public health officials had read this book prior to the present pandemic, but not surprised that most probably hadn't. It was thought that something like this just couldn't happen in the present day, because modern medicine, including its reliance on an early warning monitoring-tracking system, had advanced to the degree that something like the pandemic a century ago just wasn't possible - see by way of example the gratefully short-lived and limited Ebola outbreak, which for the first time in history reached the United States... but we were wrong.
Diseases are, simply put, smarter than us, and some are more genius than others. I know it's kind of an old-fashioned notion that we can "learn lessons" from history... but, as in this case, we can't afford not to. Acknowledging what had failed in the past may have had a positive impact in the present. But, now, as then: too little, too late. Maybe we'll be better prepared, with less hubris, for the next go-round... because there will, without fail, be one.
It's also a devastating example of what happens when we fail to recall it, or learn from it. As said George Santayana, "Those who cannot remember the past are condemned to repeat it" ("The Life of Reason: The Phases of Human Progress" (1905-1906), Vol. I, Reason in Common Sense). A similarly famous sentiment, perhaps because it's so accurate, goes like: "People will not look forward to posterity, who never look backward to their ancestors" (Edmund Burke, "Revolution in France"). What follows here is perhaps the most prototypical example in the last century.
I'm going to let Professor Alfred Crosby (1931-2018), sometimes referred to as "The Father of Environmental History," one of my all-time favorite scholars, speak for himself, as he did in the preface to this edition. Thirty years after this book was first published, it's become prophesy fulfilled. He writes as follows:
"When I wrote this book at the beginning of the 70s, its subject matter, the 1918 pandemic, seemed more of academic than immediate interest. Insofar as I could see 15 years ago, neither influenza nor any other disease was among humanity's greatest immediate dangers. War was still running free, but the other traditional killers, symbolized by the Horsemen of the Apocalypse, were under a tight rein, at least in the advanced societies. For instance, a person died of infection only if very young, very old, weakened by alcoholism or physical injury, or extremely unlucky. The loss of a 20-year-old to communicable disease in the US seemed as likely as his being hit by a falling tree.... Tuberculosis and polio were only bad memories for citizens of the advanced societies, and smallpox was well on its way to extinction everywhere. The characteristic sin of the time vis-a-vis public health and medical science was hubris.
"Now hubris had given way to anxiety. Seekers after Lyme disease need only don shorts and sandals and scuff through a New England or New York meadow; and of course we all quail before the world-wide pandemic of AIDS. Scientists know amazingly more about molecular biology, pathogens and immunology than they did 15 or 20 years ago, but the bad guys, the pathogens, particularly the newly recognized ones, seem to the general public to have become nastier faster than scientists have become smarter. Whatever may be the truth of that, it is certainly true that unthinking confidence in our public health officials and medical scientists is in sharp decline. Anyone still swelling with hubris simply has not been paying attention....
"The last such experience took place in 1918, when influenza killed tens of millions, rolling across continents and oceans so swiftly that public health institutions were still preparing for the onslaught after it had passed. That pandemic baffled science and reduced the experts to recommending mass adoption of ineffective gauze masks, and even to inoculating thousands with vaccines that were no better (and with luck, no worse) than useless. If we want to know how we react to calamitous surges of disease, we should take a look at the 1918 flu. And if we went to avoid a reprise of that ordeal, we should reexamine it, because we still do not know why it was as bad as it was."
Prophetic indeed.
Crosby was a historian in some respects generations ahead of his time - he was a groundbreaking scholar who utilized a multi-disciplinary approach well before it became fashionable, and now, even essential. His primary areas of research focused on the cultural and biological changes which occurred in the wake of the (re)discovery of the New World. Synthesizing methods from history, geography and biology, as I strive to do also in my own research, Crosby was a true pioneer in the field of interdisciplinary history. According to a New York Times article, his fascination with environmental history stemmed from a near-obsession with Christopher Columbus in boyhood, a still-much-revered figure during his upbringing in the 1930s and 40s.
As a result, Crosby realized early on the biological consequences of New-World, Old-World contact. As a result, his research spawned an entire sub-field based on what is now termed The Colombian Exchange. In a 2011 interview, he stated regarding this novel approach intended to fill what was then a gaping hole in scholarship: “We were thinking politically and ideologically, but very rarely were historians thinking ecologically, biologically.”As an environmental historian who studies ancient agriculture and resource use, Crosby has been one of my inspirations since I began my academic journey decades ago, now, not least on account of his writing style, which speaks to a far broader audience than the academic specialists who are the usual focus of these fields.
"America's Forgotten Pandemic" is still a technical academic monograph, but it is highly accessible to a more-than-typical general audience, even if it's somewhat statistic-heavy, another of Crosby's hallmarks. He has also been called a "demographic historian," for that reason, as data are also his forte. That doesn't entail pages and pages of charts and graphs, however; they're used herein rather sparingly, as Crosby has a great talent for making reams of data accessible as a comprehensive and intelligible narrative, which is an enviable talent. This book proceeds both chronologically and geographically, looking at the various waves and phases of the pandemic, as well as the responses, or, rather and often, the lack thereof, in particularly hard-hit areas, such as Philadelphia, the most devastated city in the nation, Chicago, and other densely-populated urban centers.
So, what was the Influenza Pandemic of 1918-1919? It's a forgotten pandemic no more, as it's been frequently referenced during the modern COVID-19 pandemic of the last three years. I often wonder what Crosby would have said about our present predicament, had he lived to see it. The 1918 pandemic was caused by an unusually deadly influenza virus, now identified as an H1N1 influenza A variant (rather than a coronavirus variant), which first appeared in the US in what appears to be March, 1918, in Kansas, with additional cases identified in France, Germany and the UK by April. Two years later, nearly a third of the global population, or half a billion people, had been infected.
It has been described as the deadliest pandemic in human history, at least in terms of numbers, if not percentages. That dubious distinction probably belongs to The Black Death, an outbreak of bubonic plague in the fourteenth century, which may have killed a third or more of the world's human population. As even in the modern day, death reporting during the Great Pandemic of 1918 was spotty and uncertain, however: even with modern technology, one of the primary criticisms of the current death toll has been that doctors are often less than accurate about who has died FROM COVID-19, or WITH it. The same was true a century ago, to an even greater extent, which the book admirably describes; as such, death estimates remain unknown, and controversial, but typically range from 17 to as high as 50 million; some wildly exaggerated estimates claim that the eventual death toll topped 100 million. In reality, the figure probably lies somewhere around 20 million, more than the entire death toll caused by WWI.
In essence, the Great Influenza epidemic was the result of a perfect storm of unfortunate factors, mostly as a result of the Great War. Propaganda czars on both sides concealed evidence of the deadly outbreak, other than in neutral Spain, whose reporters were free to publish accurate reports - hence the name, Spanish Influenza, although it certainly didn't start there, nor was it the epicenter. This strain had a particularly high mortality for young adults, rather than what is normally seen, that is, among the very young and very old. As in the present day, this virus triggered a cytokine storm, which devastated the immune systems of even young, healthy adults. Responsible for the appalling death toll were, again, a perfect storm of factors: wartime mobility and particularly overcrowding, malnourishment, poor hygiene and a lack of modern medicine, especially antibiotics, which is likely what kept the modern-day pandemic from being much worse. Modern drugs and ventilators are largely what has kept the death toll from being much higher.
As in the present day, however, once the virus became entrenched in the population, there was almost nothing to stop the spread. All efforts, including, again, the useless masking, closing of public places and businesses, and efforts at quarantining entire swaths of the population did absolutely nothing to stop it. What else hasn't changed? The ignorance and arrogance of impotent doktor-gods, was manifest for all to see: they devastatingly underestimated the danger of the disease, and, worse, their ability to contain it. "On the same day that flu was made reportable, the news broke that ... the director of the laboratories of the Phipps Institute of Philadelphia, had indicated the cause of Spanish influenza: Pfeiffer's bacillus [wrong]. This, the "Inquirer" stated, has 'armed the medical profession with absolute knowledge on which to base its campaign against this disease.'"
Even worse, others made proclamations in the vein of "with such confidence among medical men, why shouldn't the rest of the community go about what it considered the most pressing business of the day?" including a kickoff wartime parade which drew some 200,000 people into the Streets of Philadelphia - with lethal consequences. The case was similar in Chicago, where health officers dramatically underplayed the seriousness of the disease, with one even stating that "There is no special reason I know of to fear an outbreak of disease in our city," Chicago, because "we have the Spanish Influenza situation well in hand now," even before, as Crosby notes, the situation had really even developed. Philadelphia became the hardest-hit city in the nation, with Chicago and other major metropoleis not far behind. As in our present day, Philadelphia and other major cities shortly thereafter closed all schools, churches and other public gathering places - too little, too late.
The moral of the story is really in the preface. I wish that public health officials had read this book prior to the present pandemic, but not surprised that most probably hadn't. It was thought that something like this just couldn't happen in the present day, because modern medicine, including its reliance on an early warning monitoring-tracking system, had advanced to the degree that something like the pandemic a century ago just wasn't possible - see by way of example the gratefully short-lived and limited Ebola outbreak, which for the first time in history reached the United States... but we were wrong.
Diseases are, simply put, smarter than us, and some are more genius than others. I know it's kind of an old-fashioned notion that we can "learn lessons" from history... but, as in this case, we can't afford not to. Acknowledging what had failed in the past may have had a positive impact in the present. But, now, as then: too little, too late. Maybe we'll be better prepared, with less hubris, for the next go-round... because there will, without fail, be one.
February 6, 2014
I always wanted to read a history of the pandemic and finally got my chance. I didn't find too many books on the subject. I was hoping for a social history of the event. This book didn't provide that. It was interesting and provided much statistical information, and how authorities try to deal with the influenza but their was very little about the social impact of the disease. At the end of the book the author explains why the limited social history of the pandemic. It was a very short event, lasting only months in the fall of 1918 and spring of 1919 for the most part. And of course it was in the middle of the WWI and people were more concentrated on the war. It was interesting to read how the pandemic may have changed the course of history when President Wilson had become ill with the influenza and could not be present during the negotiations for the end of the war. So Germany was dealt with harshly, mostly because of the French and Wilson's softer approach, which may have prevented WWII, was cast aside. It's always interesting for me to read histories like this for the sidelights. I did find out that Babe Ruth was called a Bolshevik during a baseball game. In fact he and his whole team as well as the opposing team were all called Bolsheviks as they refused to play a game in the 1918 World Series unless they were paid more. Another thing I learned was how rabidly patriotic the Americans were during this period. Though not quite what I was looking for still a good read. And as far as a social history. The author does mention one book, written by a woman, that does give more of a social history of the pandemic.
Want to read
December 30, 2007I had seen books and information about the Flu pandemic of 1918 and it is shocking how devasting this was. It was a form (I think) of avian flu which is scary because of recent incidents with asian bird flu issues. The 1918 strain was estimated to have killed between 50 to 100 million people based in some data I have seen. That is so scary.
I loved reading "Hot Zone" by Preston years ago and took some medical geography courses in college. I just find it fascinating how these medical detectives track down the virus and work to solve the puzzle of getting it - hopefully protecting us in the process. It also brings to light how America has the resources to create and store possible vaccines yet poorer countries are left to suffer. Always have the hope that one day we can actually help one another especially in the face of future pandemics. I found it very startling too that pharmaceutical companies are so driven by money that vaccines are not considered to be profitable and are in small production worldwide - daily meds that people take make much more money.
I loved reading "Hot Zone" by Preston years ago and took some medical geography courses in college. I just find it fascinating how these medical detectives track down the virus and work to solve the puzzle of getting it - hopefully protecting us in the process. It also brings to light how America has the resources to create and store possible vaccines yet poorer countries are left to suffer. Always have the hope that one day we can actually help one another especially in the face of future pandemics. I found it very startling too that pharmaceutical companies are so driven by money that vaccines are not considered to be profitable and are in small production worldwide - daily meds that people take make much more money.
August 26, 2018
This is the second book I've read this year on the influenza of 1918; it also happens to be the 100 year anniversary of the pandemic. The first book was "Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It" by Gina Kolata. While that book's subtitle was the main thrust of the book--the search for the virus--"America's Forgotten Pandemic" is more a history of the time and how the epidemic affected the era and people at the time. This is not surprising, as the late Dr Crosby was a professor of history and geography. It also makes for a more interesting book on the subject. The topic is covered in a well-rounded manner, and only occasionally falls into textbook-speak.
December 19, 2008
A good chronicle of events that transpired in the 6 months prior to September 1918 and the six months after. The descriptions of what happened at Ft Devens and the naval prison on Deer Island in Massachusetts were of particular interest to me. I found it interesting that the government was issuing vaccines during and after the epidemic as a placebo. They actually had no idea what was going on. The idea of bacteria and virus was only about 50 years old at the time.
November 3, 2014
Very readable, and a useful overview. The constant, recurring theme was how much existing health systems and social systems--like systems of managing the dead--broke down under the stress of this incredibly fast-moving virus. In some ways, cities were lucky that it went so quickly; things like shortages of morticians and gravediggers were not long-lived.
The best chapter is the look at Samoa and Alaska: it demonstrates a very strong role for human agency in disease management.
The best chapter is the look at Samoa and Alaska: it demonstrates a very strong role for human agency in disease management.
June 27, 2016
More of a history book than anything else. It is saved by a few chapters full of memorable anecdotes, but the statistics in this book drag on and on until you're glazed over and numb. The afterward discusses why Americans seem to have forgotten about the 1918 influenza pandemic. If living through the pandemic is anything like reading this book about it, I think I understand why it has been largely forgotten.
December 9, 2007
Though it's considered to be one of the best sources on the flu pandemic of 1918, I found this book to be incredibly dry. Maybe it's my video-game, Hollywood blockbuster, TV violence up-bringing, but it felt as if it read like a roster of how many soldiers got sick and how many died in every single army company across the globe.
April 19, 2009
Bought it, set it aside. Started it, set it aside. It is well-written and interesting from an historical perspective, and full of stuff people just don't think about. (i.e., what was going on overseas during the War as people died at home in America from influenza.)
I have yet to get past page 50! But I WILL finish this book!
I have yet to get past page 50! But I WILL finish this book!
January 4, 2019
It was amazing to realize what a world wide impact this influenza breakout had and how many millions perished. The author includes many citations as well as several tables of statistics. I am still marveling at the impact the breakout had on the war and Wilson's results at the Paris Peace Conference. Further, I benefited from the discussion why today this event is so obscure and unknown.
May 5, 2007
first published as epidemic and peace (before the recent bird flu concerns), this title more accurately describes its contents. still a great read if you are interested in the ways people and the government approach dealing with epidemic diseases throughout history.
April 18, 2010
A very readable account of the flu pandemic of 1918. Almost to the point of a research paper but it was easy to skip the graphs and other notations.
Amazing the virulence and shortness of the disease--
Amazing the virulence and shortness of the disease--
November 18, 2010
Probably would have gotten more out of it if I wasn't using it for my lit review.
It was full of useful information and graphs. An updated edition would be nice, especially on some of the correlations between H1N1.
It was full of useful information and graphs. An updated edition would be nice, especially on some of the correlations between H1N1.
February 14, 2010
It was okay. It's scary to see how in about one year, a disease that could not be stopped spread around the world and killed so many,. However, the book is not written in a very interesting way.
December 18, 2010
This is an utterly fascinating book and I highly recommend it to any disease/history enthusiasts.
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