Book Reviews: 1918 Flu and Britain

I recently finished these two books:

Great Influenza    20th century Britain

I would recommend both  books to anyone interested in the topics. I have read books about the 1918 influenza pandemic before, but this one went into more detail about the state of medicine leading up to the pandemic, the relationship of politics to the spread of flu, and the story of the scientists who tried desperately to find a way to fight the disease — or even understand it.

It is hard for us to believe, but the idea that germs cause illness did not occur until the mid-1800s, and even then, it took a long time to be accepted by the medical establishment. Evidence-based practice was unknown to most doctors; the common method of treatment was the “heroic” method, which meant that doctors administered many types of treatment in the hope that one of them would work. This included surgery, often without anesthesia, although the use of ether and chloroform was accepted by the Civil War. Most American medical schools in the 19th century did not require students to have a high school diploma or any science courses. This was different from European medical schools, which were much more demanding of their students. It was not until the creation of Johns Hopkins in 1876 that any American school was anywhere near comparable.

The transition from heroic to evidence-based medicine was not complete when the pandemic began in 1918. It is believed that it started in a small town in Kansas, then spread to nearby Camp Funston via army recruits. Due to the movements of troops during wartime, the disease quickly spread. This strain of influenza was exceptionally contagious and had the ability to kill quickly. Today, most people who die from influenza are either very young or very old, and often they die from complications rather than the flu itself. In 1918-1919, some did die from complications, but this virus was able to kill young, healthy men and women, such as those going off to war and the medical personnel who treated them. At this time, 100 years later, scientists believe that these deaths were due to an overreaction of the individuals’ immune systems. In essence, it was their own bodies that killed them.

Although doctors worked hard to find ways to prevent the spread of flu, they were often stymied by their own government, which did not want to publicize the disease because it would reduce morale during wartime. Censorship of the media was responsible for the misnomer “Spanish flu;” Spain did not participate in WWI, so when it began having cases of flu, they were publicized.

The flow of American troops to Europe and other parts of the world led to huge losses by both sides from influenza. The pandemic eventually spread all over the world, even to remote islands of the Pacific and equally remote towns in the Arctic. Any place which had any contact whatsoever with the outside became infected with the virus. In the end, 50-100 million people around the world died (3-5%).

My second book, Twentieth Century Britain: A Very Short Introduction, lived up to its name (it was quite short), but it was exactly what I was looking for. I am a big Agatha Christie fan, and sometimes I was puzzled by the context of her books because I didn’t have much knowledge of what Britain was like. This book actually started with WWI and ended in 2000. It covered both domestic and foreign politics, social disruptions and policies, and culture. A major fact I did not know is that Britain has had three political parties that varied in popularity at different times. On occasion, a fourth party emerged, but it usually joined with another party in a few years. I knew that Britain was in debt following WWI, but I did not realize how serious the debt was. I also did not realize the extent of nationalization of industries. This book answered many of my questions.

I am now reading a book about the Epidemic Intelligence Service (if I haven’t already mentioned it, I enjoy reading about medicine, especially disease outbreaks), which I will probably finish by the end of the month, so that I will get my three books for February.

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