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COVID-19 From the Journal of the National Medical Association, Vol. 11, No. 4
PANDEMIC
*Read before the 21st annual session of the N.M.A., Newark, 1919.

Spanish Influenza

By T.C. Bracken, MD, Port Arthur, Texas

The recent pandemic of influenza originated probably in Spain, talks loud, a fine spray of mucus is thrown from the nose and
and thence spread rapidly, within a few months to practically every mouth. This fine spray consists of globules or bubbles of mucus
part of the known world. containing large numbers of mouth, nose and throat bacteria.
The Term “Influenza” is Italian in origin and literally translated From this you can see it is necessary for those who are infected to
means influence. It must be confessed that all the influences gov- wear a gauze mask, it is also essential for the attendants to frequently
erning this disease are not yet definitely known. wash their hands. Steps used to combat the disease in some of the
The term “La Grippe” was introduced by the French in about training camps were threefold – isolation, sanitation and education.
1712 and has been accepted as the popular name of the disease. Because of the abnormal condition incident to the war, not only
With more than 400,000 human lives snuffed out by this scourge as regards food, exposure, etc., but also as regards the congregating
in the United States, the very name “Spanish Influenza” strikes ter- of large numbers of individuals within relatively limited spaces. We
ror to the entire country. can, perhaps, picture the situation in this way. The bodies of certain
Periodic outbursts of influenza epidemics have been recorded individuals whose resistance was lowered by the vicissitudes incident
through the centuries. Hippocrates refers to an epidemic as early as to war, may have offered a particularly favorable breeding for the
412 BC. germs which set up influenza. The congregating of large numbers
The severity of the recent outbreak of influenza is not unique. of individuals within camps, munition factories, etc., afforded the
The first epidemic of La Grippe to appear in the United States oc- most ideal condition for the spread of the germs.
curred in 1647, and four great pandemics of influenza during the During their passage through a large number of individuals their
last century (1850-1833, 1836-1837, 1847-1848, 1888-1890). The virulence may have become raised. And the possibility this increased
last world-wide outbreak of 1889 is said to have originated in the virulence of the attacking germs may be the main reason for the
Far East, and within a year had visited practically every part of the severity of the symptoms as manifested in the United States. A cer-
known world. tain air of probability seems to be lent to this by the fact that the
Just what is responsible for these epidemics is not definitely resistance of the individual does not appear to be a dominant factor
known. These outbreaks of disease have differed in severity and with us. Because Spanish influenza impartially attacks the weak and
have spread according to the speed of human travel and intercourse. the strong.
Influenza is caused by a specific germ and is highly contagious at It may be a case of strong individuals being attacked by still
close range. Early in the year 1892 Pfeiffer discovered what he be- stronger germs, which acquired their high degree of injury wreaking
lieved to be the influenza bacillus. This organism has been generally power by first passing through the bodies of a large number of
accepted as the causative agent of the disease since that time. somewhat weakened and susceptible individuals in Europe.
Observers have about decided now that Pfeiffer bacillus is not In the future we will look back on this epidemic of influenza with
the cause of influenza. Reports from the various army camps during wonder and surprise; yes, in spite of our vaunted advancement, we
the recent epidemic show that the Pfeiffer bacillus was present in have utterly failed in the recent crisis.
less than 1 per cent of all cases reported. It is fair to predict that The cause of this failure of the medical profession is our igno-
with the attention influenza has claimed the causative germ will rance of preventive medicine. Our medical schools have taught di-
soon be discovered. agnosis and treatment, but not prevention of disease.
Influenza attacks the old and young of all walks of life. Exposure Certainly the old quotation is most appropriate to be used in this
to the disease is universal. It is particularly to the young – ages rang- connection, “In time of peace prepare for war.”
ing from twenty to thirty-five – but it is no respecter of ages, locality It goes without saying the United States was quite unprepared for
or previous condition of health. the recent epidemic of influenza.
The large number of deaths incident to an epidemic of influenza Like smallpox of the middle ages and typhoid fever in modern
is not due to the influenza, but almost entirely to a virulent type of warfare, influenza is the scourge bred o n the latest battlefields of
pneumonia which accompanies it. The pneumonia does not exist Europe and when the history of war is written the losses in the
as a separate epidemic, but exists as a complication. There seems to American military cantonments from this scourge will be ten times
be no doubt that there is some unexplained or peculiar relation be- greater than American deaths in European warfare.
tween these two diseases. The experience gathered from past epidemics of influenza clearly
The causative organisms are spread from the sick to the well by demonstrates the fact that for at least one or two years following
a droplet or spray infection; that is, when one sneezes, coughs or an outbreak of this disease we can expect a marked increase in the

40 San Antonio Medicine • June 2020