The Great Influenza: The Epic Story of the Deadliest Plague in History - John M. Barry (2004)

Notes

Abbreviations

APS

American Philosophical Society, Philadelphia

HSP

Historical Society of Philadelphia

JHU

Alan Mason Chesney Medical Archives, the Johns Hopkins University

LC

Library of Congress

NA

National Archives

NAS

National Academy of Sciences Archives

NLM

National Library of Medicine

RG

Record group at National Archives

RUA

Rockefeller University Archives

SG

Surgeon General William Gorgas

SLY

Sterling Library, Yale University

UNC

University of North Carolina, Chapel Hill

WP

Welch papers at JHU

PROLOGUE

the smartest man: Personal communication with Dr. David Aronson, Jan. 31, 2002, and Dr. Robert Shope, Sept. 9, 2002.

fifty million deaths: Niall Johnson and Juergen Mueller, “Updating the Accounts: Global Mortality of the 1918–1920 ‘Spanish’ Influenza Pandemic,” Bulletin of the History of Medicine (2002), 105–15.

“doubly dead”: Sherwin Nuland, How We Die (1993), 202.

college degree: Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical Education (1985), 113.

“vibrate and shake”: William James, “Great Men, Great Thoughts, and Environment” (1880); quoted in Sylvia Nasar, A Beautiful Mind (1998), 55.

“’Tis writ, ‘In the beginning’”: Johann Wolfgang Goethe, Faust, Part One (1949), 71.

Part I: The Warriors

CHAPTER ONE

“the hostile Sioux”: Washington Star, Sept. 12, 1876.

“For God’s sake”: New York Times, Sept. 12, 1876.

“great change in human thought”: H. L. Mencken, “Thomas Henry Huxley 1825–1925,” Baltimore Evening Sun (1925).

“voice was low, clear and distinct”: For accounts of this speech, see New York Times, Washington Post, Baltimore Sun, Sept. 13, 1876.

endowed chairs of theology: Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 237.

theories that attributed epilepsy: Roy Porter, The Greatest Benefit to Mankind (1997), 56.

“a theory is a composite memory”: Quoted in Charles-Edward Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1943), 63.

four kinds of bodily fluids: For a discussion of the theory, see Porter, The Greatest Benefit to Mankind, 42–66, passim.

“the true path of medicine”: Ibid., 77.

“recognizable only by logic”: Vivian Nutton, “Humoralism,” in Companion Encyclopedia to the History of Medicine (1993).

“our own observation of nature”: Quoted in Winslow, Conquest of Epidemic Disease, 126.

“unequalled…between Hippocrates and Pasteur”: Ibid., 142.

“Don’t think. Try.”: Ibid., 59.

“I placed it upon a rock”: Quoted in Milton Rosenau’s 1934 presidential address to the Society of American Bacteriologists, Rosenau papers, UNC.

“more simple and consistent system”: For an excellent review of this see Richard Shryock, The Development of Modern Medicine, 2nd ed. (1947), 30–31.

“sagacity and judgment”: Ibid., 4.

still seen as a manifestation: Charles Rosenberg, “The Therapeutic Revolution,” in Explaining Epidemics and Other Studies in the History of Medicine (1992), 13–14.

natural healing process: Ibid., 9–27, passim.

“profuse perspiration”: Benjamin Coates practice book, quoted in ibid., 17.

never had a peaceful bath again: Steven Rosenberg in personal communication to the author.

“withered arm of science”: Quoted in Richard Shryock, American Medical Research (1947), 7.

Michel Foucault condemned: John Harley Warner, Against the Spirit of the System: The French Impulse in Nineteenth-Century American Medicine (1998), 4.

“The practice of medicine”: Ibid., 183–84.

“Why think?”: See Richard Walter, S. Weir Mitchell, M.D., Neurologist: A Medical Biography (1970), 202–22.

“Nature answers only”: Winslow, Conquest of Epidemic Disease, 296.

“if all disease were left to itself”: Quoted in Paul Starr, The Social Transformation of American Medicine (1982), 55.

In 1862 in Philadelphia: Charles Rosenberg, Explaining Epidemics and Other Studies in the History of Medicine (1992), 14.

“popular crafts of every description”: Thomsonian Recorder (1832), 89; quoted in Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (1962), 70–71.

“False theory and hypothesis”: John Harley Warner, “The Fall and Rise of Professional Mystery,” in The Laboratory Revolution in Medicine (1992), 117.

“priests’ and Doctors’ slavery”: Quoted in Rosenberg, Cholera Years, 70–71.

“a greater humbug”: John King, “The Progress of Medical Reform,” Western Medical Reformer (1846); quoted in Warner, “The Fall and Rise of Professional Mystery,” 113.

only thirty-four licensed physicians: Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (1976), 33.

“the Diminished Respectability”: Shryock, Development of Modern Medicine, 264.

court-martialed and condemned: Ludmerer, Learning to Heal, 10, 11, 23, 168.

not to treat malaria: Rosenberg, “The Therapeutic Revolution,” 9–27, passim.

“all the worse for the fishes”: Bledstein, Culture of Professionalism, 33.

“a vast deal to be done”: Quoted in Donald Fleming, William Welch and the Rise of American Medicine (1954), 8.

7,000 to 226,000: Edwin Layton, The Revolt of the Engineers: Social Responsibility and the American Engineering Profession (1971), 3.

fail four of nine courses: Ludmerer, Learning to Heal, 37 (re: Harvard), 12 (re: Michigan).

“truths that lie about me so thick”: Quoted in ibid., 25.

not know how to use a microscope: Ibid., 37.

“something horrible to contemplate”: Ibid., 48.

“can’t pass written examinations”: Bledstein, Culture of Professionalism, 275–76.

“No medical school has thought”: Ludmerer, Learning to Heal, 15.

“simply horrible”: Ibid., 25.

Against the advice: James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (1984), 125; see also ibid., 294.

“strongest evidence of this demand”: Benjamin Gilman, quoted in Flexner, American Saga, 125.

CHAPTER TWO

eightieth-birthday celebration: Flexner and Flexner, William Henry Welch, 3–8, passim.

fifteen hundred stores: Ezra Brown, ed., This Fabulous Century, The Roaring Twenties 1920–1930 (1985), 105, 244.

“beyond the capacity of an individual parent”: Quoted in Sue Halpern, “Evangelists for Kids,” New York Review of Books (May 29, 2003), 20.

work of Rudolph Virchow: Flexner and Flexner, William Henry Welch, 33.

“accurate observation of facts”: Ibid.

filled him with repugnance: Ibid., 29.

begged his cousins: Fleming, William Welch, 15.

“every noble and good quality”: Flexner and Flexner, William Henry Welch, 50.

“the light of his own mind”: Quoted in ibid., 49.

“the labyrinths of Chemistry”: Ibid., 62–63.

scientists had met in Berlin: Shryock, Development of Modern Medicine, 206.

“I can only admire”: Flexner and Flexner, William Henry Welch, 64, see also 71.

“the easiest examination”: Ibid, 62.

“a voyage of exploration”: Ibid., 76.

fifteen thousand American doctors: Thomas Bonner, American Doctors and German Universities: A Chapter in International Intellectual Relations, 1870–1914 (1963), 23.

“those who have studied abroad”: Welch to father, March 21, 1876, WP.

“a source of pleasure and profit”: Welch to stepmother, March 26, 1877, WP.

“Germany has outstripped”: Flexner and Flexner, William Henry Welch, 83.

“certain important methods”: Welch to father, Oct. 18, 1876, WP.

“carry on investigations hereafter”: Welch to father, Feb. 25, 1877, WP.

“observe closely and carefully”: Welch to father, Oct. 18, 1876, WP.

“He is almost the founder”: Welch to father, Sept. 23, 1877, WP.

“The facts of science”: Quoted in Flexner and Flexner, William Henry Welch, 87.

“constantly astonished at the wealth of experience”: Quoted in Shryock, Development of Modern Medicine, 181–82.

“the greatest and most useful”: Quoted in ibid., 182.

“the first men to be secured”: Quoted in Flexner and Flexner, William Henry Welch, 93.

“a modest livelihood”: Ibid., 106.

“cannot make much of a success”: Ibid., 112.

“the drudgery of life”: Ibid.

CHAPTER THREE

“leak knowledge”: Ibid., 70.

“a larger circle of hearers”: Quoted in ibid., 117.

“poisoning of half the population”: John Duffy, A History of Public Health in New York City 1866–1966 (1974), 113.

the zymote theory: For more on zymotes see Phyllis Allen Richmond, “Some Variant Theories in Opposition to the Germ Theory of Disease,” Journal of the History of Medicine and Allied Sciences (1954), 295.

laurel wreath “such are given to the brave”: Paul De Kruif, Microbe Hunters (1939), 130.

“What was theory”: Charles Chapin, “The Present State of the Germ Theory of Disease,” Fists Fund Prize Essay (1885), unpaginated, Chapin papers, Rhode Island Historical Society.

“powerless to create an epidemic”: Michael Osborne, “French Military Epidemiology and the Limits of the Laboratory: The Case of Louis-Felix-Achille Kelsch,” in Andrew Cunningham and Perry Williams, eds., The Laboratory Revolution in Medicine (1992), 203.

“however bright the prospect”: Flexner and Flexner, William Henry Welch, see 128–32.

“not be so cheaply earned”: Welch to stepmother, April 3, 1884, WP.

“in no way discuss with him”: Ibid.

“on a high plane of loneliness”: Flexner and Flexner, William Henry Welch, 136, see also 153.

“deliberately break off relationships”: According to Dr. Allen Freeman, quoted in ibid., 170.

“already has a German reputation”: Welch to father, Jan. 25, 1885, WP.

the greatest name in science: Florence Sabin, Franklin Paine Mall: The Story of a Mind (1934), 70.

“a small chemical lab”: Sabin, Franklin Paine Mall, 24.

“What we shall consider success”: Flexner and Flexner, William Henry Welch, 225.

“which will cost $200,000”: Sabin, Franklin Paine Mall, 112.

“You make the opportunities”: Ibid.

“the real pioneer of modern”: Martha Sternberg, George Sternberg: A Biography (1925), see 5, 68, 279, 285.

build a theory on the right ones: An anecdote related by Dr. Steven Rosenberg, July 1991.

“keystone of the arch”: Flexner and Flexner, William Henry Welch, 165.

“putting an opponent down”: Ibid., 151.

“the richness of the world”: Ibid., 230.

“atmosphere of achievement”: Ibid., 165.

“never anything quite like it”: John Fulton, Harvey Cushing (1946), 118.

CHAPTER FOUR

“no evidence of preliminary education”: Flexner and Flexner, William Henry Welch, 222.

“long and painful controversy”: Ludmerer, Learning to Heal, 53.

“The talk was of pathology”: Fulton, Harvey Cushing, 121.

“what was true of Harvard”: Shryock, Unique Influence of Johns Hopkins, 8.

“and want no others”: Quoted in Ludmerer, Learning to Heal, 75.

“to one man—Franklin P. Mall”: Shryock, Unique Influence, 20.

“whether they were saved”: Michael Bliss, William Osler: A Life in Medicine (1999), 216.

fifty-three became professors: Bonner, American Doctors and German Universities, 99.

“the whole still concert”: William G. MacCallum, William Stewart Halsted (1930), 212.

“violate all the best precedents”: Flexner and Flexner, William Henry Welch, 263.

“flick of a wrist”: Ludmerer, Learning to Heal, 128.

endowments totaled $500,000: Shryock, Unique Influence, 37.

marvelous curative agent: Victor A. Vaughan, A Doctor’s Memories (1926), 153.

“an epoch in the history of medicine”: Flexner and Flexner, William Henry Welch, 207.

“a body of research”: Wade Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D. (1941), 238.

“little less than lunatic”: Frederick T. Gates to Starr Murphy, Dec. 31, 1915, WP.

“to become a pioneer”: Ibid.

accepting the Jew: James Thomas Flexner, American Saga, 241–42.

“every letter handwritten”: Ibid., 278.

“not have anything to do with”: Benison and Nevins, “Oral History, Abraham Flexner,” Columbia University Oral History Research Office; Flexner, American Saga, see 30–40.

“never heard a heart or lung”: James Thomas Flexner, American Saga, 133.

“great gaps”: Ibid., 421.

“He read…as he ate”: Benison and Nevins, “Oral History, Abraham Flexner.”

“days of acute fear”: James Thomas Flexner, American Saga, 239.

“a museum in print”: Peyton Rous comments, Simon Flexner Memorial Pamphlet, Rockefeller Institute of Medical Research, 1946.

“His mind was like a searchlight”: Corner, History of the Rockefeller Institute, 155.

“final as a knife”: Ibid.

“or they can be bled further”: Flexner to Cole, Jan. 21, 1919, Flexner papers, APS.

“Individuals were as nothing”: Peyton Rous comments, Simon Flexner Memorial Pamphlet.

mortality rate fell to 31.4 percent: Simon Flexner, “The Present Status of the Serum Therapy of Epidemic Cerebro-spinal Meningitis,” JAMA (1909), 1443; see also Abstract of Discussion, 1445.

“Remarkable results were obtained”: Ibid.

a shouting match ensued: Wade Oliver, Man Who Lived for Tomorrow, 300.

“mortality rate of 25 percent”: M. L. Durand et al., “Acute Bacterial Meningitis in Adults—A Review of 493 Episodes,” New England Journal of Medicine (Jan. 1993), 21–28.

“I advise the publication”: Flexner to Wollstein, March 26, 1921, Flexner papers.

“Before night your discovery”: Corner, History of the Rockefeller Institute, 159.

“frequent ballyhoo of unimportant stuff”: Ibid., 158.

“he also was tender”: Saul Benison, Tom Rivers: Reflections on a Life in Medicine and Science, An Oral History Memoir (1967), 127.

“made to believe”: Corner, History of the Rockefeller Institute, 155.

“I won’t expect anything”: Ibid., 158.

“a great inspiration”: Heidelberger, oral history, 1968, NLM, 66.

“an organism, not an establishment”: Peyton Rous comments, Simon Flexner Memorial Pamphlet.

“science isolated Dr. Koch”: For an account of this meeting see Wade Oliver, Man Who Lived for Tomorrow, 272–76.

CHAPTER FIVE

“wasn’t afraid to fight”: Benison, Tom Rivers, 30, 70, 204.

“quite remarkable in that way”: Heidelberger, oral history, 83.

“Cole was adamant”: Benison, Tom Rivers, 70.

“urged to undertake experimental work”: Benison, Tom Rivers, 68.

“results were better than the system”: Quoted in Flexner and Flexner, William Henry Welch, 61.

Not until 1912 would Harvard: Fleming, William Welch, 4.

a blistering…report: Vaughan, A Doctor’s Memories, 440.

fifty-seven medical schools: Ludmerer, Learning to Heal, 116.

only eight thousand members: Paul Starr, The Social Transformation of American Medicine (1982), 109.

“my initial visit to Baltimore”: Ludmerer, Learning to Heal, 172.

“make better farmers”: Ibid., see 169–73.

6,843 locations: Meirion Harries and Susie Harries, The Last Days of Innocence: America at War, 1917–1918 (1997), 15.

“to…legitimize…” capitalism: E. Richard Brown, Rockefeller’s Medicine Men (1979), quoted in Starr, Social Transformation, 227.

thirty-one states denied licensing: Ludmerer, Learning to Heal, 238–43.

still 25 percent less: Shryock, Development of Modern Medicine, 350; Ludmerer, Learning to Heal, 247.

“The AMA deserved…the credit”: Fulton, Harvey Cushing, 379.

$154 million into medicine: Ludmerer, Learning to Heal, 192–93.

“the sole argument for putting”: Charles Eliot to Abraham Flexner, Feb. 1 and Feb. 16, 1916, WP.

Part II: The Swarm

CHAPTER SIX

“A slow rain fell”: Santa Fe Monitor, Feb. 28, 1918.

didn’t suffer fools: Material on L. V. Miner comes from an interview with his daughter-in-law Mrs. L. V. Miner Jr. on Aug. 27, 1999, and granddaughter Catherine Hart in July 2003, and from Kansas and Kansans (1919).

hold the train for him: For a description of a typical western practice, especially in Kansas, see Arthur E. Hertzler, The Horse and Buggy Doctor (1938) and Thomas Bonner, The Kansas Doctor (1959).

“sick with pneumonia”: Santa Fe Monitor, Feb. 14, 1918.

“influenza of severe type”: Public Health Reports 33, part 1 (April 5, 1918), 502.

“Most everybody over the country”: Santa Fe Monitor, Feb. 21, 1918.

“John will make an ideal soldier”: Santa Fe Monitor, Feb. 28, 1918.

“animosity towards me”: Maj. John T. Donnelly, 341st Machine Gun Battalion, Camp Funston, RG 393, NA.

“to exercise command”: Commanding General C. G. Ballou, Camp Funston, to Adjutant General, March 12, 1918, Camp Funston, RG 393.

“overcrowded and inadequately heated”: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 415.

CHAPTER SEVEN

“arrival of American troops in France”: F. M. Burnet and Ellen Clark, Influenza: A Survey of the Last Fifty Years (1942), 70.

“a special instance” among infectious diseases: Bernard Fields, Fields’ Virology, (1996), 265.

mutate much faster: Ibid., 114.

“mutant swarm”: J. J. Holland, “The Origin and Evolution of Viruses,” in Microbiology and Microbial Infections (1998), 12.

“certain randomness to the disease”: Ibid., 17.

CHAPTER EIGHT

resist putrefaction: Quoted in Milton Rosenau notebook, Dec. 12, 1907, Rosenau papers, UNC.

influenza kills more people: Harvey Simon and Martin Swartz, “Pulmonary Infections,” and R. J. Douglas, “Prophylaxis and Treatment of Influenza,” in section 7, Infectious Diseases, in Edward Rubenstein and Daniel Feldman, Scientific American Medicine (1995).

“It’s equally likely”: Peter Palese, personal communication with the author, Aug. 2, 2001.

“attacked at once”: W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 26.

“entirely depopulated”: Ibid.

“as in a plague”: John Duffy, Epidemics in Colonial America (1953), 187–88, quoted in Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920, A Social History” (1976), 31.

“youngest as well as the oldest”: Beveridge, Influenza, 26.

“all weer sick”: Quoted in Pettit, “Cruel Wind,” 32.

more people died from influenza: Beveridge, Influenza, 26–31.

Part III: The Tinderbox

CHAPTER NINE

“The rat serves one useful function”: Major George Crile, “The Leading War Problems and a Plan of Organization to Meet Them,” draft report, 1916, NAS.

“The war sentiment”: Randolph Bourne, “The War and the Intellectuals,” The Seven Arts (June 1917), 133–46.

“I am sure that my heart”: Arthur Walworth, Woodrow Wilson, v. 2 (1965), 63.

“I will not cry ‘peace’”: Walworth, Woodrow Wilson, v. 1, 344.

“Once lead this people into war”: Walworth, Woodrow Wilson, v. 2, 97.

“It isn’t an army we must shape”: Stephen Vaughn, Holding Fast the Inner Lines: Democracy, Nationalism, and the Committee on Public Information (1980), 3.

“the poison of disloyalty”: David Kennedy, Over Here: The First World War and American Society (1980), 24.

“Thank God for Abraham Lincoln”: Walworth, Woodrow Wilson, v. 2, 101.

“an imperative necessity”: Walworth, Woodrow Wilson, v. 2, 97.

“governed by public opinion”: Kennedy, Over Here, 47.

“casual or impulsive disloyal utterances”: Vaughn, Holding Fast the Inner Lines, 226; Kennedy, Over Here, 81.

“from good motives”: Richard W. Steele, Free Speech in the Good War (1999), 153.

two hundred thousand APL members: Joan Jensen, The Price of Vigilance (1968), 115.

“seditious street oratory”: Ibid., 96.

“ninety percent of all the men”: Kennedy, Over Here, 54.

“What the nation demands”: Quoted in Jensen, Price of Vigilance, 79.

“Every German or Austrian”: Ibid., 99.

“What had been folly”: Kennedy, Over Here, 74.

“spreads pessimistic stories”: Vaughn, Holding Fast the Inner Lines, 155.

“sinister intrigue”: Jensen, Price of Vigilance, 51.

Two Communist parties: Robert Murray, Red Scare: A Study in National Hysteria (1955), 16, 51–53.

“That community is already in the process”: Learned Hand speech, Jan. 27, 1952, quoted in www.conservativeforum.org/authquot.asp?ID915.

“Truth and falsehood are arbitrary”: Vaughn, Holding Fast the Inner Lines, 3.

most citizens were “mentally children”: Kennedy, Over Here, 91–92.

climbed onto a chandelier: Interview with Betty Carter, April 1997.

“one white-hot mass”: Vaughn, Holding Fast the Inner Lines, 3.

“intellectual cohesion—herd-instinct”: Bourne, “War and the Intellectuals,” 133.

“the noblest of all mottoes”: Vaughn, Holding Fast the Inner Lines, 141.

“I am Public Opinion”: Ibid., 169.

“every printed bullet”: Murray, Red Scare, 12.

“To fight for an ideal”: Vaughn, Holding Fast the Inner Lines, 126.

“questionable jokes”: Philadelphia Inquirer, Sept. 1, 1918.

“Force to the utmost!”: Walworth, Woodrow Wilson, v. 2, 168.

“exert itself in any way”: Red Cross news release, Aug. 23, 1917, entry 12, RG 52, NA.

“delivered at any point”: Aug. 24, 1917 memo, entry 12, RG 52, NA.

“Confectioners and restaurants”: See, for example, the Arizona Gazette, Sept. 26, 1918.

“go down to roll bandages”: William Maxwell, unaired interview re Lincoln, Illinois, Feb. 26, 1997, for “Influenza 1918,” American Experience.

“Military instruction under officers”: Committee on Education and Training: A Review of Its Work, by the advisory board, unpaginated, appendix. C. R. Mann, chairman, RG 393, NA.

“mobilization of all physically fit registrants”: Memo to the Colleges of the U.S. from Committee on Education and Training, Aug. 28, 1918; copy found in Camp Grant files, RG 393, NA.

CHAPTER TEN

“The Academy now considers”: Quoted in Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 366.

More soldiers had died of disease: United States Civil War Center, www.cwc.lsu.edu/cwc/other/stats/warcost.htm.

not a single microscope: Victor Vaughan, A Doctor’s Memories (1926), 410.

“virgin” human population: Interview with Dr. Peter Palese, March 20, 2001.

killing 5 percent of all the men: Memo on measles, undated, RG 112, NA; see also Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 409.

rotating his attention: David McCullough, The Path Between the Seas: The Creation of the Panama Canal, 1870–1914 (1977), 425–26.

“extremes the sexual moralist can go”: William Allen Pusey, M.D., “Handling of the Venereal Problem in the U.S. Army in Present Crisis,” JAMA (Sept. 28, 1918), 1017.

“A Soldier who gets a dose”: Kennedy, Over Here, 186.

“no longer a danger”: C. P. Knight, “The Activities of the USPHS in Extra-Cantonment Zones, with Special Reference to the Venereal Disease Problem,” Military Surgeon (Jan. 1919), 41.

test the antitoxin: Flexner and Flexner, William Henry Welch, 371.

“[U]nit will be arranged”: Colonel Frederick Russell to Flexner, June 11, 1917, Flexner papers, APS.

no mere cosmetic change: George A. Corner, A History of the Rockefeller Institute: 1901–1953, Origins and Growth (1964), 141.

“best from these classes”: Notes on meeting of National Research Council executive committee, April 19, 1917, NAS.

half of all those…fit for service: Arthur Lamber, “Medicine: A Determining Factor in War,” JAMA (June 14, 1919), 1713.

army had fifty-eight dentists: Franklin Martin, Fifty Years of Medicine and Surgery (1934), 379.

replaced labels on drug bottles: Lavinia Dock, 1909, quoted in Soledad Mujica Smith, “Nursing as Social Responsibility: Implications for Democracy from the Life Perspective of Lavinia Lloyd Dock (1858–1956)” (2002), 78.

“at once sever my connection”: Lavinia Dock et al., History of American Red Cross Nursing (1922), 958.

“carry out the plans”: Ibid., 954.

CHAPTER ELEVEN

“Every single activity”: Editorial, Military Surgeon 43 (Aug. 1918), 208.

“The consideration of human life”: John C. Wise, “The Medical Reserve Corps of the U.S. Navy,” Military Surgeon (July 1918), 68.

“they should be bayonetted”: “Review of Offensive Fighting by Major Donald McRae,” Military Surgeon (Feb. 1919), 86.

“I was very glad”: Flexner and Flexner, William Henry Welch, 371.

lowered the death rate: H. J. Parish, A History of Immunization (1965), 3.

banned all sales: Wade Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D. (1941), 378.

enough typhoid vaccine for five million: Vaughan to George Hale, March 21, 1917, Executive Committee on Medicine and Hygiene, general file, NAS.

“sent to any one of the camps”: Flexner to Russell, Nov. 28, 1917, Flexner papers.

“prevention of infectious disease”: Flexner to Vaughan, June 2, 1917, Flexner papers.

“Although pneumonia occurs”: Rufus Cole et al., “Acute Lobar Pneumonia Prevention and Serum Treatment” (Oct. 1917), 4.

“as if the men had pooled their diseases”: Flexner and Flexner, William Henry Welch, 372.

“How many lives were sacrificed”: Vaughan, A Doctor’s Memories, 428–29.

“Not a troop train”: Ibid., 425.

three thousand were sick enough: Ireland, Communicable Diseases, 415.

complications of measles: Vaughan, A Doctor’s Memories, 57.

average death rate from pneumonia: Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920, A Social History” (1976), 56.

“never in their confidence”: Ibid., 3.

“seem to have deserted me”: John M. Gibson, Physician to the World: The Life of General William C. Gorgas (1989), 242.

“send directions for Avery’s”: Welch diary, Jan. 2, 1918, WP.

CHAPTER TWELVE

evidence that the influenza virus: J. A. McCullers and K. C. Bartmess, “Role of Neuraminidase in Lethal Synergism Between Influenza Virus and Streptococcus Pneumoniae,” William Osler, Osler’s Textbook Revisited (1967), Journal of Infectious Diseases (2003), 1000–1009.

“To bleed at the very onset”: 00.

“Pneumonia is a self-limited disease”: Ibid.

“true inwardness of research”: Quoted in McLeod, “Oswald Theodore Avery, 1877–1955,” Journal of General Microbiology (1957), 540.

“An acute need for privacy”: René Dubos, “Oswald Theodore Avery, 1877–1955,” Biographical Memoirs of Fellows of the Royal Society, 35.

“as if a mask dropped”: Ibid.

“a natural born comedian”: Donald Van Slyke, oral history, NLM.

about Landsteiner’s personal life: René Dubos, The Professor, the Institute, and DNA (1976), 47.

notified he’d won the Nobel: Saul Benison, Tom Rivers: Reflections on Life in Medicine and Science, an Oral History Memoir (1967), 91–93.

“motives that lead persons to art or science”: Quoted in Dubos, Professor, 179.

“a sweeping metabolic theory”: Ibid., 95.

CHAPTER THIRTEEN

“Protection in man is inferior”: Rufus Cole et al., “Acute Lobar Pneumonia,” 4.

“lead all diseases”: Ibid.

“diseases amongst the troops”: See, for example, Gorgas to Commanding Officer, Base Hospital, Camp Greene, Oct. 26, 1917, entry 29, file 710, RG 112, NA.

All of them had negative reactions: Scientific reports of the Corporation and Board of Scientific Directors of Rockefeller Institute, April 20, 1918.

Camp Gordon outside Atlanta: Ireland, Communicable Diseases, 442.

“the matter of prophylactic vaccination”: Cole to Russell, Dec. 14, 1917, entry 29, RG 112, NA.

controls suffered 101: Memo from Flexner to Russell, Oct. 3, 1918, entry 29, RG 112, NA.

Pasteur Institute was also testing: Ireland, Communicable Diseases, 125.

to meet Gorgas and Welch: Welch to Flexner wire, April 15, 1918; Flexner to Cole, April 16, 1918, Flexner papers.

“really a privilege”: Michael Heidelberger, oral history, NLM, 83.

checking on everything: Ibid.

“chiefly in epidemic form”: Rufus Cole, “Prevention of Pneumonia,” JAMA (Aug. 1918), 634.

the Canadian army: W. David Parsons, “The Spanish Lady and the Newfoundland Regiment” (1998).

“detention camps for new recruits”: Welch diary, Dec. 28, 1917, WP.

Part IV: It Begins

CHAPTER FOURTEEN

Thirty of the fifty largest cities: Edwin O. Jordan, Epidemic Influenza (1927), 69.

“convenient to follow”: F. M. Burnet and Ellen Clark, Influenza: A Survey of the Last Fifty Years (1942), 70.

of 172 marines: W. J. MacNeal, “The Influenza Epidemic of 1918 in the AEF in France and England,” Archives of Internal Medicine (1919), 657.

appearance in the French army: Burnet and Clark, Influenza, 70.

36,473 hospital admissions: Quoted in Jordan, Epidemic Influenza, 78.

“At the end of May”: Ibid.

“broken clean through”: Harvey Cushing, A Surgeon’s Journal 1915–18 (1934), 311.

“The expected third stage”: Ibid.

“the epidemic of grippe”: Ibid.

“a grievous business”: Ray Stannard Baker, Woodrow Wilson: Life and Letters/Armistice March 1–November 11, 1918 (1939), 233.

“abuts on the harbor”: Jordan, Epidemic Influenza, 85.

“swept over the whole country”: Ibid., 87.

10,313 sailors fell ill: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 9, Influenza (1934), 178.

“of a mild form”: Jordan, Epidemic Influenza, 93.

doubt that it was influenza: MacNeal, “Influenza Epidemic,” Archives of Internal Medicine (1919), 657.

“not influenza”: From Policlinico 25, no. 26 (June 30, 1918), quoted in JAMA 71, no. 9, 780.

“very short duration”: T. R. Little, C. J. Garofalo, and P. A. Williams, “B Influenzae and Present Epidemic,” The Lancet (July 13, 1918), quoted in JAMA 71, no. 8 (Aug. 24, 1918), 689.

“fatal in from 24 to 48 hours”: Major General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Disease (1928), 132.

“a new disease”: Jordan, Epidemic Influenza, 36.

688 men were ill: George Soper, M.D., “The Influenza Pandemic in the Camps,” undated draft report, RG 112, NA.

“any definite information”: Cole to Pearce, July 19, 1918, NAS.

put more resources: Cole to Pearce, July 24, 1918, NAS.

declared the epidemic over: “The Influenza Pandemic in American Camps, September 1918,” memo to Col. Howard from Office of the Army Surgeon General, Oct. 9, 1918, Red Cross papers, War Council notes, RG 200, NA.

“completely disappeared”: Letter from London of Aug. 20, 1918, quoted in JAMA 71, no. 12 (Sept. 21, 1918), 990.

“mistaken for meningitis”: Late summer report quoted in JAMA 71, no. 14 (Oct. 5, 1918), 1136.

“No letter from my beloved”: Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920, A Social History” (1976), 97, 98.

“some interesting cases”: Ibid., 67.

CHAPTER FIFTEEN

most influenza experts: Interview with Robert Webster, June 13, 2002.

At the fifteenth passage: William Bulloch, The History of Bacteriology (1938, reprinted 1979), 143.

Changing the environment: Jordan, Epidemic Influenza, 511.

As the bacteria adapted to rabbits: Richard Shryock, The Development of Modern Medicine, 2nd edition (1947), 294–95.

1 million pigs: Bulloch, History of Bacteriology, 246.

“primarily virus influenza”: Burnet and Clark, Influenza, 40.

“We must suppose”: Ibid., 69, 70.

a ward was sealed off: Soper, “Influenza Pandemic in the Camps.”

“they had influenza”: Ibid.

“not like the common broncho-pneumonia”: Adolph A. Hoehling, The Great Epidemic (1961), 21.

“an outbreak of epidemic influenza”: Public Health Reports, 33, part 2 (July 26, 1918), 1259.

“I am confidentially advised”: Entry 12, index card 126811, RG 52, NA.

“a progressive increase in cases”: Ireland, Communicable Diseases, 83, 135.

“indistinguishably blend with”: Ibid., 135.

“the seamen were prostrate”: Jordan, Epidemic Influenza, 114.

“a well-nourished people”: John Duffy, A History of Public Health in New York City 1866–1966 (1974), 286.

children were malnourished: Ibid., 287.

two steamships from Norway: Soper, “The Influenza Pandemic in the Camps.”

outbreak with high mortality: Ireland, Communicable Diseases, 137.

overwhelmed the naval hospital: Director of Labs, AEF, to SG, Dec. 10, 1918, entry 29, RG 112, NA.

“number of American negroes”: Quoted in Pettit, “Cruel Wind,” 94.

two natives died: Burnet and Clark, Influenza, 72.

five hundred of the six hundred laborers: A. W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918 (1989), 37.

7 percent of the entire crew died: Burnet and Clark, Influenza, 72.

struck down nine hundred: Ibid.

115 more deaths: Director of Labs, AEF, to SG, Dec. 10, 1918, entry 29, RG 112, NA.

“grossly overcrowded”: Crosby, America’s Forgotten Pandemic, 38.

“The Bible”: From Medical Officers Training Camp at Camp Greenleaf, Georgia, Nov. 18, 1918, Rosenau papers, UNC.

CHAPTER SIXTEEN

“mess officer is well informed”: Major R. C. Hoskins, “Report of Inspection on Sept. 30, 1918,” Oct. 9, 1918, RG 112, NA.

inoculating a series of human volunteers: Undated report by Major Andrew Sellards, entry 29, RG 112, NA.

only eighty-four patients: “Influenza Pandemic in American Camps, September 1918” see also Paul Wooley to SG, Aug. 29, 1918, RG 112, NA.

“very significant increase”: Boston Health Department Monthly Bulletin, Sept. 1918, 183, quoted in Jordan, Epidemic Influenza, 115.

diagnosed as having meningitis: Major Paul Wooley, “Epidemiological Report on Influenza and Pneumonia, Camp Devens, August 28 to October 1, 1918,” entry 29, RG 112, NA.

“which attacked so many”: Ibid.

“occurred as an explosion”: Ibid.

Eight of the twelve collapsed: “Steps Taken to Check the Spread of the Epidemic,” undated, unsigned, entry 29, RG 112, NA; see also Katherine Ross, “Battling the Flu,” American Red Cross Magazine (Jan. 1919), 11.

“These men start with what appears to be”: Dr. Roy N. Grist to “Burt,” British Medical Journal (Dec. 22–29, 1979).

“only a matter of a few hours”: Ibid.

“we are all well”: Russell to Flexner, Sept. 18, 1918, Flexner papers, APS.

“You will proceed immediately”: Victor Vaughan, A Doctor’s Memories (1926), 431.

“hundreds of young stalwart men”: Ibid., 383–84.

in excess of six thousand: Vaughan and Welch to Gorgas, Sept. 27, 1918, entry 29, RG 112, NA.

“dead bodies are stacked”: Vaughan, A Doctor’s Memories, 383–84.

“step amongst them”: Cole to Flexner, May 26, 1936, file 26, box 163, WP.

“too much for Dr. Welch”: Ibid.

“influenza be kept out of the camps”: “Memo for Camp and Division Surgeons,” Sept. 24, 1918, entry 710, RG 112, NA.

“New men will almost surely”: Brigadier General Richard to adjutant general, Sept. 25, 1918, entry 710, RG 112, NA; see also Charles Richard to chief of staff, Sept. 26, 1918, entry 710, RG 112, NA.

“spread rapidly across”: J. J. Keegan, “The Prevailing Epidemic of Influenza,” JAMA (Sept. 28, 1918), 1051.

Around the world from Boston: I. D. Mills, “The 1918–1919 Influenza Pandemic—The Indian Experience,” The Indian Economic and Social History Review (1986), 27, 35.

Part V: Explosion

CHAPTER SEVENTEEN

three hundred sailors arrived: “Sanitary Report for Fourth Naval District for the Month of September 1918,” entry 12, file 584, RG 52, NA.

tenements still had outhouses: “Philadelphia—How the Social Agencies Organized to Serve the Sick and Dying,” The Survey 76 (Oct. 19, 1918); oral history of Anna Lavin, July 14, 1982, courtesy of Charles Hardy, West Chester University.

“death rate…has gone up”: Mrs. Wilmer Krusen reports, Feb. 4, 1918, entries 13B-D2, RG 62.

no high school until 1934: Allen Davis and Mark Haller, eds., The Peoples of Philadelphia: A History of Ethnic Groups and Lower-Class Life, 1790–1940 (1973), 256.

“worst-governed city”: Quoted in Russell Weigley, ed., Philadelphia: A 300-Year History (1982), 539.

“took control of police”: Major William Snow and Major Wilbur Sawyer, “Venereal Disease Control in the Army,” JAMA (Aug. 10, 1918), 462.

left Philadelphia for Puget Sound: Annual Report of the Surgeon General of the U.S. Navy for Fiscal Year 1918, Government Printing Office.

put the body on a stretcher: Robert St. John, This Was My World (1953), 49–50, quoted in Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920” (1976), 103.

“33 caskets to Naval”: “Journal of the Medical Department, Great Lakes,” entry 22a, RG 52, NA.

toe tags on the boys’: Carla Morrisey, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 26, 1997.

“what it would feel like”: Ibid.

“this threat of influenza invasion”: Howard Anders to William Braisted, Sept. 12, 1918, RG 52, NA.

refused to release six: Board of Trustees minutes, Sept. 9 and Sept. 30, 1918, Jefferson Medical College, Philadelphia.

“When obliged to cough or sneeze”: Philadelphia Inquirer, Sept. 19, 1918.

“No concern whatever”: The Evening Bulletin, Sept. 18, 1918.

“can successfully be prevented”: Department of Public Health and Charities minutes, Sept. 21 and Oct. 3, 1918.

“ideas of whole populations”: Quoted in Victoria De Grazia, “The Selling of America, Bush Style,” New York Times (Aug. 25, 2002).

“world lives by phrases”: Quoted in Joan Hoff Wilson, Herbert Hoover: Forgotten Progressive (1974), 59.

“‘Every Scout to Save a Soldier’”: Quoted in ibid., 105 fn.

“If you find a disloyal”: Gregg Wolper, “The Origins of Public Diplomacy: Woodrow Wilson, George Creel, and the Committee on Public Information” (1991), 80.

“The IWW agitators”: Kennedy, Over Here, 73.

“nobody can say we aren’t loyal”: Ellis Hawley, The Great War and the Search for a Modern Order: A History of the American People and Their Institutions, 1917–1933 (1979), 24.

“In spite of excesses such as lynching”: Ibid.

“most powerful of human motives”: William McAdoo, Crowded Years (1931), 374–79, quoted in David Kennedy, Over Here (1980), 105.

“Every person who refuses”: David Kennedy, Over Here, 106.

“a ready-made inflammable mass”: Howard Anders, letter to Public Ledger, Oct. 9, 1918, in which he cites his earlier opposition to the rally; quoted in Jeffrey Anderson, “Influenza in Philadelphia 1918” (1998).

CHAPTER EIGHTEEN

“excellent chief of service”: Frederick Russell and Rufus Cole, Camp Grant inspection diary, June 15–16, 1918, WP.

“keep our eye on him”: Welch to Dr. Christian Herter, treasurer, Rockefeller Institute for Medical Research, Jan. 13, 1902, WP.

“different type of pneumonia”: Ibid.

“an important contribution”: Richard Pearce to Major Joseph Capps, July 10, 1918, Camp Grant, influenza file, NAS.

“a very important matter”: Rufus Cole to Richard Pearce, July 24, 1918, influenza file, NAS.

“vital measures in checking contagion”: Joseph Capps, “Measures for the Prevention and Control of Respiratory Disease,” JAMA (Aug. 10, 1918), 448.

“one of the most brilliant”: Chicago Tribune, Oct. 9, 1918.

had issued warnings: George Soper, M.D., “The Influenza Pandemic in the Camps,” undated draft report, entry 29, RG 112, NA.

“None of these diseases”: A. Kovinsky, Camp Grant epidemiologist, report to SG, Sept. 4, 1918, entry 31, RG 112, NA.

“Until further notice”: Quoted in Kovinsky, report to SG, Nov. 5, 1918, entry 29, RG 112, NA.

“crowding of troops”: Charles Hagadorn, Sept. 20, 1918, entry 29, box 383, RG 112, NA.

“No visitors will be permitted”: Kovinsky, report to SG, Nov. 5, 1918.

the first soldier died: “Bulletin of the Base Hospital,” Camp Grant, Sept. 28, 1918, RG 112, NA.

“except under extraordinary circumstances”: “Bulletin of the Base Hospital,” Oct. 3 and Oct. 4, 1918, RG 112, NA.

“formalin should be added”: Ibid.

“Devoting special personal care”: “Bulletin of the Base Hospital,” Oct. 6, 1918, RG 112, NA.

escorts of the dead…be prohibited: Dr. H.M. Bracken, Executive Director, Minnesota State Board of Health, Oct. 1, 1918, entry 31, RG 112, NA.

“No power on earth”: Victor Vaughan, A Doctor’s Memories, 425.

“movements of officers and men”: See telegram from adjutant general, Oct. 3, 1918, RG 92.

two thousand of the 3,108 troops: “Analysis of the Course and Intensity of the Epidemic in Army Camps,” unsigned, undated report, 4, entry 29, RG 112, NA.

likely that the death toll: Camp Hancock, Georgia, entry 29, RG 112, NA.

twenty-eight hundred troops would report ill: Soper, “The Influenza-Pneumonia Pandemic in the American Army Camps, September and October 1918,” Science (Nov. 8, 1918), 451.

“very carefully controlled”: Stone to Warren Longcope, July 30, 1918, entry 29, RG 112, NA.

only 16.7 percent died: Alfred Gray, “Anti-pneumonia Serum (Kyes’) in the Treatment of Pneumonia,” entry 29, RG 112, NA.

Desperate efforts were being made: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 448.

“the duty of the Ward Surgeon”: “Bulletin of the Base Hospital,” Oct. 7 and 8, 1918, RG 112, NA.

“friends of persons dying”: “Bulletin of the Base Hospital,” Oct. 3 and 4, 1918, RG 112, NA.

“winning their fight”: Chicago Tribune, Oct. 7, 1918.

“verandas must be used”: “Bulletin of the Base Hospital,” Oct. 5, 1918, RG 112, NA.

“too early to foretell”: George Soper, “The Influenza-Pneumonia Pandemic in the American Army Camps, September and October 1918,” Science (Nov. 8, 1918), 451.

CHAPTER NINETEEN

$100 bribes: Visiting Nurse Society minutes, Oct. and Nov., 1918, Center for the Study of the History of Nursing, University of Pennsylvania.

“no doctors available”: Selma Epp, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997.

average weekly death toll: Public Health Reports 33, part 2, (July 26, 1918), 1252.

“Don’t get frightened”: Public Ledger, Oct. 8, 1918.

“another crepe and another door”: Anna Milani, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997.

“People were dying like flies”: Oral history of Clifford Adams, June 3, 1982, provided by Charles Hardy of West Chester University.

“My uncle died there”: Anna Lavin oral history, June 3, 1982, Charles Hardy oral history tapes.

“caskets stacked up outside”: Michael Donohue, transcript of unaired interview for “Influenza 1918,” American Experience interview, Feb. 28, 1997.

“‘Let me get a macaroni box’”: Louise Apuchase, June 3, 1982, Charles Hardy oral history tapes. June 24, 1982.

“They couldn’t bury them”: Clifford Adams, Charles Hardy oral history tapes, June 3, 1982.

“may also die of the plague”: North American, Oct. 7, 1918.

“cyanosis reached an intensity”: Isaac Starr, “Influenza in 1918: Recollections of the Epidemic in Philadelphia,” Annals of Internal Medicine (1976), 517.

“no truth in the black plague assertion”: Unidentified newspaper clipping in epidemic scrapbook, Dec. 29, 1918, College of Physicians Library, Philadelphia.

ports and naval facilities: Public Health Reports, Sept. 13, 1918, 1554.

“an influenza-like disease”: Ibid., Sept. 20, 1918, 1599.

did not come again: Charles Scott to William Walling, Oct. 1, 1918, RG 200, NA.

“After gasping for several hours”: Starr, “Influenza in 1918,” 517.

“the city had almost stopped”: Ibid, 518.

Part VI: The Pestilence

CHAPTER TWENTY

“two groups of symptoms”: Edwin O. Jordan, Epidemic Influenza (1927), 260, 263.

“In nonfatal cases”: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 159.

“didn’t care if I died”: Clifford Adams, Charles Hardy oral history tapes, West Chester University, June 3, 1982.

“sick as a dog”: Bill Sardo, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 27, 1997.

“time was a blur”: William Maxwell, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 26, 1997.

“ice would rattle”: Carla Morrisey, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 26, 1997.

“happened to my hind legs”: John Fulton, Harvey Cushing (1946), 435.

“something like typhoid”: Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920, A Social History” (1976), 91.

“on a narrow ledge over a pit”: Katherine Anne Porter, “Pale Horse, Pale Rider” (1965), 310–12.

“pain above the diaphragm”: Richard Collier, The Plague of the Spanish Lady: The Influenza Pandemic of 1918–1919 (1974), 35.

“Many had vomiting”: Ireland, ed., Medical Department of the United States Army in the World War, v. 12, Pathology of the Acute Respiratory Diseases, and of Gas Gangrene Following War Wounds (1929), 13.

In Paris, while some: Diane A. V. Puklin, “Paris,” in Fred Van Hartesfeldt, ed., The 1918–1919 Pandemic of Influenza: The Urban Impact in the Western World (1992), 71.

“general throughout Spain”: Public Health Reports 33, part 2 (Sept. 27, 1918), 1667.

“beginning in the neck”: W. S. Thayer, “Discussion of Influenza,” Proceedings of the Royal Society of Medicine (Nov. 1918), 61.

bowl of rice crispies: Carla Morrisey, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 26, 1997.

“rupture of the drum membrane”: Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 448.

“bulging eardrums”: Ireland, Pathology of Acute Respiratory Diseases, 13.

“destructive action on the drum”: Burt Wolbach to Welch, Oct. 22, 1918, entry 29, RG 112, NA.

eye involvement with special frequency: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 10, Influenza (1934), 751.

ability to smell: Ibid., 773.

“symptoms of exceeding variety”: Ireland, Pathology of Acute Respiratory Diseases, 13.

“Intense cyanosis”: Ibid., 56, 141–42.

“even to an indigo blue”: Ireland, Communicable Diseases, 159.

Many mechanisms can cause bleeding: Interview with Dr. Alvin Schmaier, University of Michigan, Oct. 2, 2002; J. L. Mayer and D. S. Beardsley, “Varicella-associated Thrombocytopenia: Autoantibodies Against Platelet Surface Glycoprotein V,” Pediatric Research (1996), 615–19.

“suffered from epistaxis”: Ireland, Pathology of Acute Respiratory Diseases, 13, 35.

“pint of bright red blood”: Jordan, Epidemic Influenza, 260.

“died from loss of blood”: Ireland, Pathology of Acute Respiratory Diseases, 13.

“hemorrhages…interior of the eye”: Thomson and Thomson, Influenza, v. 9, 753.

“subconjunctional hemorrhage”: Ireland, Pathology of Acute Respiratory Diseases, 13.

“uterine mucosa”: Ibid., 76.

chief diagnostician…diagnosed: Jordan, Epidemic Influenza, 265.

47 percent of all deaths: Thomson and Thomson, Influenza, v. 9, 165.

average life expectancy: Jeffrey K. Taubenberger, “Seeking the 1918 Spanish Influenza Virus,” American Society of Microbiology News 65, no. 3 (July 1999).

South African cities: J. M. Katzenellenbogen, “The 1918 Influenza Epidemic in Mamre,” South African Medical Journal (Oct. 1988), 362–64.

In Chicago the deaths: Fred R. Van Hartesveldt, The 1918–1919 Pandemic of Influenza: The Urban Impact in the Western World (1992), 121.

A Swiss physician: E. Bircher, “Influenza Epidemic,” Correspondenz-Blatt fur Schweizer Aerzte, Basel (1918), 1338, quoted in JAMA 71, no. 23 (Dec. 7, 1918), 1946.

“doubly dead in that”: Sherwin Nuland, How We Die (1993), 202.

from 23 percent to 71 percent: Jordan, Epidemic Influenza, 273.

26 percent lost the child: John Harris, “Influenza Occurring in Pregnant Women: A Statistical Study of 130 Cases,” JAMA (April 5, 1919), 978.

“interesting pathological experience”: Wolbach to Welch, Oct. 22, 1918, entry 29, RG 112, NA.

“convolutions of the brain”: Douglas Symmers, M.D. “Pathologic Similarity Between Pneumonia of Bubonic Plague and of Pandemic Influenza,” JAMA (Nov. 2, 1918), 1482.

“relaxed and flabby”: Ireland, Pathology of Acute Respiratory Diseases, 79.

damage to the kidneys: Ireland, Communicable Diseases, 160.

“necrotic areas, frank hemorrage”: Ireland, Pathology of Acute Respiratory Diseases, 392.

“comparable findings…death from toxic gas”: Ireland, Communicable Diseases, 149.

“inhalation of poison gas”: Edwin D. Kilbourne, M.D., Influenza (1987), 202.

CHAPTER TWENTY-ONE

“died within twelve hours”: Transcript of influenza commission appointed by governor of New York, meeting at New York Academy of Medicine, Oct. 30, 1918, SLY.

“One robust person”: E. Bircher, “Influenza Epidemic,” JAMA (Dec. 7, 1918), 1338.

the conductor collapsed, dead: Collier, Plague of the Spanish Lady, 38.

“a new disease”: Jordan, Epidemic Influenza, 36.

“Physical signs were confusing”: Ireland, Communicable Diseases, 160.

“old classification…was inappropriate”: Ireland, Pathology of Acute Respiratory Diseases, 10.

“little evidence of bacterial action”: F. M. Burnet and Ellen Clark, Influenza: A Survey of the Last Fifty Years, (1942), 92.

“lesion of characterization”: Ireland, Communicable Diseases, 150.

inhibits the release of interferon: Fields, Fields’ Virology, 196.

weakened immune responses: Thomson and Thomson, Influenza, v. 9, 604.

“acute inflammatory injection”: Ibid., 92.

“not previously described”: P. K. S. Chan et al., “Pathology of Fatal Human Infection Associated with Avian Influenza A H5N1 Virus,” Journal of Medical Virology (March 2001), 242–46.

had seen the same thing: Jordan, Epidemic Influenza, 266–68, passim.

mortality rate for ARDS: Lorraine Ware and Michael Matthay, “The Acute Respiratory Distress Syndrome,” New England Journal of Medicine (May 4, 2000), 1338.

Recent research also suggests: J. A. McCullers and K. C. Bartmess, “Role of Neuraminidase in Lethal Synergism Between Influenza Virus and Streptococcus Pneumoniae,” Journal of Infectious Diseases (March 15, 2003), 1000–1009.

almost half the autopsies: Ireland, Communicable Diseases, 151.

the same conclusion: Milton Charles Winternitz, The Pathology of Influenza, (1920).

deaths came from complications: Frederick G. Hayden and Peter Palese, “Influenza Virus” in Richman et al., Clinical Virology (1997), 926.

still roughly 7 percent: Murphy and Werbster, “Orthomyxoviruses,” in Fields, Fields’ Virology, 1407.

35 percent of pnemococcal infections: “Pneumococcal Resistance,” Clinical Updates IV, issue 2, January 1998, National Foundation for Infectious Diseases, www.nfid.org/publications/clinicalupdates/id/pneumococcal.html.

Part VII: The Race

CHAPTER TWENTY-TWO

Three Hopkins medical students: Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920” (1976), 134.

“could not have dreamed”: Comments at USPHS conference on influenza, Jan. 10, 1929, file 11, box 116, WP.

went to bed immediately: Welch to Walcott, Oct. 16, 1918, Frederic Collin Walcott papers, SLY.

“the Flip-flap railroad”: Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 251.

“temperature has been normal”: Welch to Walcott, Oct. 16, 1918, Walcott papers.

“astonishing numbers”: Quoted in David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 9, Influenza (1934), 265.

the cause of influenza: William Bulloch, The History of Bacteriology (1938), 407–8.

“Surely there is a time”: Quoted in Wade Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D., (1941), 218.

“Everyone believed it”: Saul Benison, Tom Rivers: Reflections on a Life in Medicine and Science, An Oral History Memoir (1967), 237–40, 298.

“No influenza bacilli”: A. Montefusco, Riforma Medica 34, no. 28 (July 13, 1918), quoted in JAMA 71, no. 10, 934.

CHAPTER TWENTY-THREE

“a new bronchopneumonia”: Pettit, “Cruel Wind,” 98.

Copeland was sworn in: Ibid., 9: 555.

his loyalty to Tammany: Ernest Eaton, “A Tribute to Royal Copeland,” Journal of the Institute of Homeopathy 9: 554.

perform it within thirty minutes: Charles Krumwiede Jr. and Eugenia Valentine, “Determination of the Type of Pneumococcus in the Sputum of Lobar Pneumonia, A Rapid Simple Method,” JAMA (Feb. 23, 1918), 513–14; Oliver, Man Who Lived for Tomorrow, 381.

“so-called Spanish influenza”: “New York City letter,” JAMA 71, no. 12 (Sept. 21, 1918): 986; see also John Duffy, A History of Public Health in New York City 1866–1966 (1974), 280–90, passim.

“prepared to compel”: “New York City letter,” JAMA 71, no. 13 (Sept. 28, 1918), 1076–77.

“We mourn for him”: Letter of Jan. 5, 1890, quoted in Oliver, Man Who Lived for Tomorrow, 26.

despite their animosity: Benison, Tom Rivers, 183.

“secret of course”: Oliver, Man Who Lived for Tomorrow, 149.

“wanted to go places”: Anna Williams, diary, undated, chap. 26, pp. 1, 17, carton 1, Anna Wessel Williams papers, Schlesinger Library, Radcliffe College.

“no one particular friend”: “Marriage” folder, undated, Williams papers.

“degrees to everything, including friendship”: “Religion” folder, March 24, 1907, Williams papers.

“if we were sure, oh!”: “Religion” folder, Aug. 20, 1915, Williams papers.

“discontent rather than happiness”: “Affections, longing, desires, friends” folder, Feb. 23, 1908, Williams papers.

“I have had thrills”: “Marriage” folder, undated, Williams papers.

no advice to give: Diary, Sept. 17, 1918, Williams papers.

“Death occurring so quickly”: Diary, undated, chap. 22, p. 23, Williams papers.

quadrupled the number of horses: Oliver, Man Who Lived for Tomorrow, 378.

“Will your lab undertake”: Pearce wire to Park, Sept. 18, 1918, influenza files, NAS.

“Will undertake work”: Park wire to Pearce, Sept. 19, 1918, influenza files, NAS.

dismissed most of it: William Park et al., “Introduction” (entire issue devoted to his laboratory’s findings, divided into several articles), Journal of Immunology 6, no. 2 (Jan. 1921).

in fifteen minutes could fill three thousand tubes: Annual Report of the Department of Health, New York City, 1918, 86.

arbitrarily stopped counting: Mortality figures for the epidemic were no longer tabulated after March 31, 1919. By then the disease had died out in every major city in the country except New York City.

Nurses were literally being kidnapped: Permillia Doty, “A Retrospect on the Influenza Epidemic,” Public Health Nurse (1919), 953.

“we are justified in”: William Park and Anna Williams, Pathogenic Microroganisms (1939), 281.

“our methods…did not take into account”: Park et al., “Introduction,” 4.

“We had plenty of material”: Diary, undated, chap. 22, p. 23, Williams papers.

220,488 test tubes: Annual Report of the Department of Health, New York City, 1918, 88.

“only results so far”: Park to Pearce, Sept. 23, 1918, NAS.

she would find it: Edwin O. Jordan, Epidemic Influenza (1927), 391.

“the most delicate test”: Park et al., “Introduction,” 4.

“the starting point of the disease”: Park to Pearce, Sept. 26, 1918, NAS.

CHAPTER TWENTY-FOUR

“[h]is heart lies in research”: Smith to Flexner, April 5, 1908, Lewis papers, RUA.

“one of the best”: Flexner to Eugene Opie, Feb. 13, 1919, Flexner papers, APS.

the smartest man: Interview with Dr. Robert Shope, Jan. 31, 2002; interview with Dr. David Lewis Aronson, May 16, 2002.

“special service in connection”: Lewis to Flexner, June 19, 1917, Flexner papers.

“no onerous routine duties”: Lewis to Flexner, Oct. 24, 1917, Flexner papers.

“capacity to inhibit growth”: See assorted correspondence between Flexner and Lewis, esp. Lewis to Flexner, Nov. 13, 1916, Flexner papers.

only one had died: W. R. Redden and L. W. McQuire, “The Use of Convalescent Human Serum in Influenza Pneumonia” JAMA (Oct. 19, 1918), 1311.

suspected a virus: On Dec. 9, 1918, Lewis received permission from the navy to publish “The Partially Specific Inhibition Action of Certain Aniline Dyes for the Pneumococcus,” entry 62, RG 125, NA; see also polio clipping in epidemic scrapbook, College of Physicians Library, Philadelphia, which mistakenly referred to a vaccine used by the city as being produced according to methods used in New York for polio. The specificity of this error almost certainly came from a misunderstanding of Lewis’s work.

“badly decomposed” bodies: Transcript of New York influenza commission, meeting, Nov. 22, 1918, Winslow papers, SLY.

“armed the medical profession”: Philadelphia Inquirer, Sept. 22, 1918.

only three people developed pneumonia: Transcripts of New York influenza commission, first session, Oct. 30, 1918; second session, Nov. 22, 1918; and fourth session, Feb. 14, 1919, Winslow papers.

failed to cure: Thomson and Thomson, Influenza, v. 10, (1934), 822.

“Technically, I am not well-trained”: James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (1984), 421.

“cleanliness of the glassware”: Steven Rosenberg was the student. See Rosenberg and John Barry, The Transformed Cell: Unlocking the Secrets of Cancer (1992).

CHAPTER TWENTY-FIVE

“Every case showed”: Wolbach to Welch, Oct. 22, 1918, entry 29, RG 112, NA.

“causative agent”: George Soper, M.D., “The Influenza-Pneumonia Pandemic in the American Army Camps, September and October 1918,” Science (Nov. 8, 1918), 455.

“It is established”: Vaughan and Welch to Gorgas, Sept. 27, 1918, entry 29, RG 112, NA.

“utter concentration on a few chosen goals”: Dubos, The Professor, the Institute, and DNA (1976), 78.

“explore theoretical implications”: McLeod, “Oswald Theodore Avery, 1877–1955,” Journal of General Microbiology (1957), 541.

“imaginative vision of reality”: Dubos, Professor, 177, 179.

“not random products of chance”: Quoted in McLeod, “Oswald Theodore Avery,” 544–46.

“hunter in search of his prey”: Dubos, Professor, 173.

“Disappointment is my daily bread”: Ibid., 91.

“compelled to take care of the cases”: Cole to Russell, Oct. 23, 1918, entry 710, RG 112, NA.

the highest rate of pneumonia: “Annual Morbidity Rate per 1000 Sept. 29, 1917 to March 29, 1918,” entry 710, RG 112, NA.

“as you interpret them”: Callender to Opie, Oct. 16, 1918, entry 710, RG 112, NA.

thirteen thousand…hospitalized simultaneously: “Red Cross Report on Influenza, Southwestern Division,” undated, RG 200, NA, 9.

offered all headquarters: Memo from Russell, Oct. 3, 1918, entry 29, RG 112, NA.

“not to be depended on”: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 12, Pathology of the Acute Respiratory Diseases, and of Gas Gangrene Following War Wounds(1929), 73, 75.

six of 198 autopsies: Unsigned Camp Grant report, 6–7, entry 31d, RG 112, NA.

“inclined to take the stand”: Ibid., 8.

“technical difficulties in the isolation”: Oswald Theodore Avery, “A Selective Medium for B. Influenzae, Oleate-hemoglobin Agar,” JAMA (Dec. 21, 1918), 2050.

“seems to me still doubtful”: Cole to Russell, Oct. 23, 1918, entry 710, RG 112, NA.

had just cured twenty-eight: Cole, “Scientific Reports of the Corporation and Board of Scientific Directors 1918,” Jan. 18, 1918, NLM.

took two months: Heidelberger oral history in Sanitary Corps, 84, NLM.

twenty-five liters a day: “Scientific Reports of the Corporation and Board of Scientific Directors 1918,” April 20, 1918, RUA.

Part VIII: The Tolling of the Bell

CHAPTER TWENTY-SIX

“what the Prussian autocracy”: David Kennedy, Over Here: The First World War and American Society (1980), 166.

“no more worries”: John Eisenhower and Joanne Eisenhower, Yanks: The Epic Story of the American Army in World War I (2001), 221.

“not permitted to embark”: Richard to March, Sept. 19, 1918, entry 29, RG 112, NA.

“that of a powder magazine”: Surgeon, Port of Embarkation, Newport News, to Surgeon General, Oct. 7, 1918, entry 29, RG 112, NA.

quarantining…for one week: See Richard to Adjutant General, various correspondences and cables, Sept. 25 through Oct. 10, 1918, entry 29, RG 112, NA.

Franklin Roosevelt…on a stretcher: Eleanor Roosevelt, This Is My Story (1937), 268.

“a true inferno reigned supreme”: A. A. Hoehling, The Great Epidemic (1961), 63.

tracked the blood through the ship: John Cushing and Arthur Stone, eds., Vermont and the World War, 1917–1919 (1928), 6, quoted in A. W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918 (1989), 130.

orderlies carried away bodies: Crosby, America’s Forgotten Pandemic, 130.

“died on board”: Log of Leviathan, RG 45, NA.

“death in one of its worst forms”: Quoted in Crosby, America’s Forgotten Pandemic, 138.

more Third Division: Ibid., 163.

“dying by the score”: George Crile, George Crile, An Autobiography, v. 2 (1947), 350–51, quoted in Crosby, America’s Forgotten Pandemic, 166.

to freeze the movement: Undated Washington Star clipping in Tumulty papers, box 4, LC; see also Arthur Walworth, Woodrow Wilson, v. 2 (1965), 183–89, 462–63.

“decline to stop these shipments”: Walworth, Woodrow Wilson, v. 2, 462–63.

“Every such soldier who has died”: Ibid.

continued the voyages: Ibid.

picked a PHS scientist: Vaughan to George Hale, Aug. 23, 1917, Council National Defense papers, NAS.

when Tammany took over: Haven Anderson to Rosenau, Dec. 24, 1917, Rosenau papers, UNC.

“interests in the State…harmonized”: Morris Fishbein, A History of the American Medical Association, 1847 to 1947 (1947), 736.

“health insurance will constitute”: Blue, presidential address, reprinted in JAMA 66, no. 25 (June 17, 1916), 1901.

“not immediately necessary to the enforcement”: Blue’s office to McCoy, July 28, 1918, entry 10, file 2119, RG 90, NA.

“Owing to disordered conditions”: Cole to Pearce, July 19, 1918, NAS.

“local health authorities”: Public Health Reports, Sept. 13, 1918, 1340.

“manifestly unwarranted”: Blue, undated draft report, entry 10, file 1622, RG 90, NA.

first influenza death: Washington Post, Sept. 22, 1918.

“Surgeon General’s Advice to Avoid Influenza”: Washington Evening Star, Sept. 22, 1918.

“arrange for suitable laboratory studies”: Blue to Pearce, Sept. 9, 1919, NAS.

last yellow-fever epidemic: John Kemp, ed., Martin Behrman of New Orleans: Memoirs of a City Boss, (1970), 143.

appealed to the War Council: “Minutes of War Council,” Oct. 1, 1918, 1573, RG 200, NA.

“contingent fund for…influenza”: “Minutes of War Council,” Sept. 27, 1918, RG 200.

“appear with electric suddenness”: George Soper, M.D., “The Influenza-Pneumonia Pandemic in the American Army Camps, September and October 1918,” Science (Nov. 8, 1918), 454, 456.

CHAPTER TWENTY-SEVEN

“depend upon its own resources”: Quoted in “Summary of Red Cross Activity in Influenza Epidemic” (undated), 6, box 688, RG 200; see also Evelyn Berry, “Summary of Epidemic 1918–1919,” July 8, 1942, RG 200, NA.

“forty nurses ill”: Jackson to W. Frank Persons, Oct. 4, 1918, box 688, RG 200, NA.

“telegraphed to all my chapters”: Ibid.

“unable to handle adequately”: Ibid.

72,219 physicians: Franklin Martin, Fifty Years of Medicine and Surgery, (1934), 384.

stripped hospitals of their workforce: Lavinia Dock et al., History of American Red Cross Nursing (1922), 969.

“no nurses left in civil life”: Ibid.

CHAPTER TWENTY-EIGHT

“not planned specifically for your time”: Flexner to Lewis, July 8, 1908, RUA.

“sever my connection”: Mrs. J. Willis Martin to Mayor Thomas Smith, Oct. 8, 1918, Council of National Defense papers, HSP.

use that same organization: Undated memo, entries 13B–D2, RG 62, NA.

“death toll for one day”: Ibid.

ceded to the group control: “Minutes of Visiting Nurse Society for October and November, 1918,” Center for the Study of the History of Nursing, University of Pennsylvania.

“death rate for the past week”: Krusen to Navy Surgeon General William Braisted, Oct. 6, 1918, entry 12, RG 52, NA.

“heartily endorse”: Blue to Braisted, Oct. 7, 1918, entry 12, RG 52, NA.

“filth allowed to collect”: Philadelphia Public Ledger, Oct. 10, 1918.

“condition…spreads the epidemic”: Ibid.

“undertakers found it impossible”: Mayor’s Annual Report for 1918, 40, Philadelphia City Archives.

“took her to the cemetery”: Anna Lavin, June 3, 1982, Charles Hardy oral history tapes, West Chester University.

“brought a steam shovel”: Michael Donohue, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997.

“corpse on the front porches”: Harriet Ferrell, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 27, 1997.

“drawn by horses”: Selma Epp, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 28, 1997.

“Everything was quiet”: Clifford Adams, Charles Hardy oral history tapes.

“Nursing Halting Epidemic”: Philadelphia Inquirer, Oct. 16, 1918.

“calls not filled, 2,758”: “Directory of Nurses,” College of Physicians of Philadelphia papers.

Ten of the fifty-five: Joseph Lehman, “Clinical Notes on the Recent Epidemic of Influenza,” Monthly Bulletin of the Department of Public Health and Charities (March 1919), 38.

“Calls for Amateur Nurses”: In at least three Philadelphia newspapers, including the Philadelphia Inquirer and two unidentified newspaper clippings in epidemic scrapbook, Oct. 6, 1918, College of Physicians Library, Philadelphia.

“all persons with two hands”: Unidentified newspaper clipping in epidemic scrapbook, Oct. 9, 1918, College of Physicians Library, Philadelphia.

“must have more volunteer helpers”: Philadelphia Inquirer, Oct. 14, 1918.

“they will work all the harder”: “Minutes of Philadelphia General Hospital Woman’s Advisory Council,” Oct. 16, 1918, HSP.

118 officers responded: Mayor’s Annual Report for 1918, 40, City Archives, Philadelphia.

“[V]olunteers…are useless”: “Minutes of Philadelphia General Hospital Woman’s Advisory Council,” Oct. 16, 1918, HSP.

“they still hold back”: Undated clipping in epidemic scrapbook, College of Physicians Library.

“fear in the hearts”: Susanna Turner, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 27, 1997.

Day after day he carried: Ibid.

CHAPTER TWENTY-NINE

“not a soul to be seen”: Geoffrey Rice, Black November: The 1918 Influenza Epidemic in New Zealand (1988), 51–52.

had died overnight: See “Reminiscences Dana W. Atchley, M.D.” (1964), 94–95, Columbia oral history, quoted in Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920,” (1976), 109.

“first casualty when war comes”: Many citations of this comment originally made in 1917, including Newsday, June 15, 2003.

“plenty of gasoline”: See, for example, Arizona Republican, Sept. 1, 1918.

possibility of plague: E. Bircher, “Influenza Epidemic,” Correspondenz-Blatt fur Schweizer Aertze, Basel (Nov. 5, 1918), 1338, quoted in JAMA 71, no. 24 (Dec. 7, 1918), 1946.

“similarity of the two diseases”: Douglas Symmers, M.D., “Pathologic Similarity Between Pneumonia of Bubonic Plague and of Pandemic Influenza,” JAMA (Nov. 2, 1918), 1482.

“sorrow and sadness sat”: Wade Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D. (1941), 384.

“may actually be reassuring”: Providence Journal, Sept. 9, 1918.

“To dispel alarm”: Run in many newspapers, for example, Arizona Republican, Sept. 23, 1918.

“epidemic is on the wane”: JAMA 71, no. 13 (Sept. 28, 1918): 1075.

“no cause for alarm”: Washington Evening Star, Oct. 13, 1918.

“ought to see this hospital tonight”: Quoted in Pettit, “A Cruel Wind,” 105.

“Spanish influenza is plain la grippe”: Arkansas Gazette, Sept. 20, 1918.

“something constructive rather than destructive”: Report from Christian Science Monitor reprinted in Arizona Gazette, Oct. 31, 1918.

said nothing at all: See Review Press and Reporter, Feb. 1972 clipping, RG 200, NA.

“Fear kills more than the disease”: Ibid.

“If ordinary precautions”: Quoted in Crosby, America’s Forgotten Pandemic, 92.

“Nothing was done”: John Dill Robertson, Report of an Epidemic of Influenza in Chicago Occurring During the Fall of 1918, (1919) City of Chicago, 45.

“Worry kills more”: The Survey 41 (Dec. 21, 1918), 268, quoted in Fred R. Van Hartesveldt, The 1918–1919 Pandemic of Influenza: The Urban Impact in the Western World (1992), 144.

mortality rate at Cook County: Riet Keeton and A. Beulah Cusman, “The Influenza Epidemic in Chicago,” JAMA (Dec. 14, 1918), 2000–2001. Note the 39.8 percent corrects an earlier report in JAMA by Nuzum on Nov. 9, 1918, 1562.

“Fear is our first enemy”: Literary Digest 59 (Oct. 12, 1918), 13–14, quoted in Van Hartesveldt, 1918–1919 Pandemic of Influenza, 144.

“Don’t Get Scared”: Albuquerque Morning Journal, Oct. 1, 1918, quoted in Bradford Luckingham, Epidemic in the Southwest, 1918–1919 (1984), 18.

“epidemic under control”: Arizona Republican, Sept. 23, 1918.

deaths in New Orleans: Compare Arizona Republican, Sept. 19, 1918, to New Orleans Item, Sept. 21, 1918.

utterly silent: See Arizona Republican of Sept. 25, 26, 27, 28, 1918.

“most fearful are…first to succumb”: Arizona Gazette, Jan. 9, 1919.

“refrain from mentioning the influenza”: Arizona Gazette, Nov. 26, 1918.

“Simply the Old-Fashioned Grip”: See Vicks VapoRub ad run repeatedly all over the country, for example, in Seattle Post-Intelligencer, Jan. 7, 1919.

“come up through the grapevine”: Dan Tonkel, transcript of unaired interview for “Influenza 1918,” American Experience, March 3, 1997.

“not inclined to be as panicky”: Gene Hamaker, “Influenza 1918,” Buffalo County, Nebraska, Historical Society 7, no. 4.

“do much toward checking the spread”: See, for example, Washington Evening Star, Oct. 3, 1918.

“Every person who spits”: Unidentified, undated clipping in epidemic scrapbook, College of Physicians Library.

“Remember the 3 Cs”: For example, Rocky Mountain News, Sept. 28, 1918, quoted in Stephen Leonard, “The 1918 Influenza Epidemic in Denver and Colorado,” Essays and Monographs in Colorado History, essays no. 9, (1989), 3.

“The danger…is so grave”: JAMA 71, no. 15 (Oct. 12, 1918), 1220.

“None of the cases…serious”: Arizona Republican, Sept. 23, 1918.

“My first intimations”: William Maxwell, “Influenza 1918,” American Experience.

“we were next”: Lee Reay, “Influenza 1918,” American Experience.

“Spanish hysteria”: Luckingham, Epidemic in the Southwest, 29.

“What’s true of all the evils”: Quoted in Sherwin Nuland, How We Die (1993), 201.

gone back to being a doctor: interview with Pat Ward, Feb. 13, 2003.

nothing but brief obituaries: See, for example, JAMA 71, no. 21 (Nov. 16, 1918).

“Germans have started epidemics”: Doane made the statement in Chicago and was quoted by the Chicago Tribune, Sept. 19, 1918. The story appeared in many papers nationally, for example, the Arizona Republican, same date.

“prepared the public mind”: Parsons to Blue, Sept. 26, 1918, entry 10, file 1622, RG 90, NA.

“well back of the lines”: Ibid.

“we wonder which”: Ibid.

Police ruled it a suicide: Associated Press, Oct. 18, 1918; see also Mobile Daily Register, Oct. 18, 1918.

41 percent of the entire population: U.S. Census Bureau, Mortality Statistics 1919, 30–31; see also W. H. Frost, “Statistics of Influenza Morbidity,” Public Health Reports (March 1920), 584–97.

“this help never materialized”: A. M. Lichtenstein, “The Influenza Epidemic in Cumberland, Md,” Johns Hopkins Nurses Alumni Magazine (1918), 224.

“everything possible would be done”: Parsons to Blue, Oct. 13, 1918, entry 10, file 1622, RG 90, NA.

“Panic incipient”: Parsons to Blue, Oct. 13, 1918, entry 10, file 1622, RG 90, NA.

“[W]hole city in a panic”: J. W. Tappan to Blue, Oct. 22 and Oct. 23, 1918, entry 10, file 1622, RG 90.

125 died: Leonard, “1918 Influenza Epidemic,” 7.

“shot gun quarantine”: Durango Evening Herald, Dec. 13, 1918, quoted in Leonard, “1918 Influenza Epidemic,” 8.

“which may be deemed appropriate”: Memo by E. L. Munson, Oct. 16, 1918, entry 710, RG 112.

“a terrible calamity”: Gunnison News-Chronicle, Nov. 22, 1918, quoted in Leonard, “1918 Influenza Epidemic,” 8.

“right at our very doors”: Susanna Turner, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 27, 1997.

“almost afraid to breathe”: Dan Tonkel, transcript of unaired interview for “Influenza 1918,” American Experience, March 3, 1997.

“Farmers stopped farming”: Ibid.

“It kept people apart”: William Sardo, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 27, 1997.

“Nobody was coming in”: Joe Delano, transcript of unaired interview for “Influenza 1918,” American Experience, March 3, 1997.

illegal to shake hands: Jack Fincher, “America’s Rendezvous with the Deadly Lady,” Smithsonian Magazine (Jan. 1989), 131.

“starving to death not from lack of food”: “An Account of the Influenza Epidemic in Perry County, Kentucky,” unsigned, Aug. 14, 1919, box 689, RG 200, NA.

arrived…Saturday and left Sunday: Shelley Watts to Fieser, Nov. 11, 1918, box 689, RG 200, NA.

mortality reached 30 percent: Nancy Baird, “The ‘Spanish Lady’ in Kentucky,” Filson Club Quarterly, 293.

“he’d spray the money”: Patricia J. Fanning, “Disease and the Politics of Community: Norwood and the Great Flu Epidemic of 1918” (1995), 139–42.

“send for the priest”: From Red Cross pamphlet: “The Mobilization of the American National Red Cross During the Influenza Pandemic 1918–1919” (1920), 24.

“shouted orders through doors”: Leonard, “1918 Influenza Epidemic,” 9.

“taught that they were safer at work”: C. E. Turner, “Report Upon Preventive Measures Adopted in New England Shipyards of the Emergency Fleet Corp,” undated, entry 10, file 1622, RG 90, NA.

absentee records were striking: Ibid.

“the first problem”: Arizona Republican, Nov. 8, 1918.

“H. G. Saylor, yellow slacker”: Arizona Gazette, Oct. 11, 1918.

“a city of masked faces”: Arizona Republican, Nov. 27, 1918.

“Phoenix will soon be dogless”: Arizona Gazette, Dec. 6, 1918.

“BONG! BONG! BONG!”: Mrs. Volz, transcript of unaired interview “Influenza 1918,” American Experience, Feb. 26, 1997.

“Ice is also great”: Robert Frost, “Fire and Ice,” originally published in Harper’s, 1920.

“akin to the terror of the Middle Ages”: “Mobilization of the American National Red Cross,” 24.

CHAPTER THIRTY

“two colored physicians”: Converse to Blue, Oct. 8, 1918, entry 10, file 1622, RG 90, NA.

“urgent need of four nurses”: Rush wire to Blue, Oct. 14, 1918, entry 10, file 1622. RG 90, NA.

“No colored physicians”: Blue to Converse, Oct. 10, 1918, entry 10, file 1622, RG 90.

“impossible to send nurses”: Rush wire to Blue, Oct. 14, 1918, entry 10, file 1622, RG 90, NA.

house to house searching: Report, Oct. 22, 1918, box 688, RG 200, NA.

go to the ticket booth: Carla Morrisey, transcript of unaired interview for “Influenza 1918,” American Experience, Feb. 26, 1997.

“urgent call on physicians”: See, for example, JAMA 71, no. 17 (Oct. 26 1918): 1412, 1413.

“Infection was prevented”: James Back, M.D., JAMA 71 no. 23, (Dec. 7, 1918), 1945.

“saturated with alkalis”: Thomas C. Ely, M.D., letter to editor, JAMA 71, no. 17, (Oct. 26, 1918): 1430.

injected people with typhoid vaccine: D. M. Cowie and P. W. Beaven, “Nonspecific Protein Therapy in Influenzal Pneumonia,” JAMA (April 19, 1919), 1170.

“results were immediate and certain”: F. B. Bogardus, “Influenza Pneumonia Treated by Blood Transfusion,” New York Medical Journal (May 3, 1919), 765.

forty-seven patients; twenty died: W. W. G. MacLachlan and W. J. Fetter, “Citrated Blood in Treatment of Pneumonia Following Influenza,” JAMA (Dec. 21, 1918), 2053.

hydrogen peroxide intravenously: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 10, Influenza (1934), 1287.

homeopaths claiming no deaths: T. A. McCann, “Homeopathy and Influenza,” The Journal of the American Institute for Homeopathy (May 1921).

“effect was apparent”: T. Anastassiades, “Autoserotherapy in Influenza,” Grece Medicale, reported in JAMA (June 1919), 1947.

therapy in The Lancet: Quoted in Thomson and Thomson, Influenza, v. 10, 1287.

“prompt bleeding”: “Paris Letter,” Oct. 3, 1918, in JAMA 71, no. 19 (Nov. 9, 1918).

In disease as in war: Quoted in Van Hartesveldt, 1918–1919 Pandemic of Influenza, 82.

“keep your feet dry”: Arizona Gazette, Nov. 26, 1918.

“a powerful bulwark for the prevention”: All these and others reproduced under title “Propaganda for Reform” in JAMA 71, no. 21 (Nov. 23, 1918), 1763.

“Use Vicks VapoRub”: Seattle Post-Intelligencer, Jan. 3, 1919.

“vaccinated…immune to the disease”: Numerous papers both in and outside New York City, see, for example, Philadelphia Public Ledger, Oct. 18, 1918.

thousands of dosages more: John Kolmer, M.D., “Paper Given at the Philadelphia County Medical Society Meeting, Oct. 23, 1918,” Pennsylvania Medical Journal (Dec. 1918), 181.

“some prophylactic value”: George Whipple, “Current Comment, Vaccines in Influenza,” JAMA (Oct. 19, 1918), 1317.

death rate…52 percent: Egbert Fell, “Postinfluenzal Psychoses,” JAMA (June 7, 1919), 1658.

“now has available”: E. A. Fennel, “Prophylactic Inoculation against Pneumonia,” JAMA (Dec. 28, 1918), 2119.

“none is available for distribution”: Major G. R. Callender to Dr. W. B. Holden, Oct. 7, 1918, entry 29, RG 112, NA.

“still in the experimental stage”: Acting surgeon general to camp and division surgeons, Oct. 25, 1918, entry 29, RG 112, NA.

“health officers in their public relations”: Editorial, JAMA 71, no. 17, (Oct. 26, 1918), 1408.

“may arouse unwarranted hope”: Editorial, JAMA 71, no. 19 (Nov. 9, 1918), 1583.

eighteen different kinds: Fincher, “America’s Rendezvous,” 134.

“large doses hypodermically”: Friedlander et al., “The Epidemic of Influenza at Camp Sherman” JAMA (Nov. 16, 1918), 1652.

“No benefits were gained”: Ibid.

Sentries guarded all trails: Engineering News-Record 82 (1919), 787, quoted in Jordan, Epidemic Influenza, 453.

could become “extinct”: Kilpatrick to FC Monroe, Aug. 7, 1919; see also Mrs. Nichols, “Report of Expedition,” July 21, 1919, RG 200.

“people of Alaska consider”: U.S. Congress, Senate Committee on Appropriations, “Influenza in Alaska” (1919).

176 of 300 Eskimos: W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 31.

“frozen to death before help arrived”: U.S. Congress, Senate Committee on Appropriations, “Influenza in Alaska.”

“few adults living”: Mrs. Nichols, “Report of Expedition.”

“heaps of dead bodies”: Ibid.

“starving dogs dug their way”: Ibid.

“Whole households lay inanimate”: Eileen Pettigrew, The Silent Enemy: Canada and the Deadly Flu of 1918 (1983), 28.

“left us to sink or swim”: Ibid., 31.

killed over one hundred dogs: Richard Collier, The Plague of the Spanish Lady: The Influenza Pandemic of 1918–1919 (1974), 300.

laid 114 bodies in the pit: Pettigrew, Silent Enemy, 30.

one-third of the population died: Ibid., 33.

Metropolitan Life Insurance: Jordan, Epidemic Influenza, 251.

In Frankfurt the mortality: Van Hartesveldt, 1918–1919 Pandemic of Influenza, 25.

“too exhausted to hate”: Fincher, “America’s Rendezvous,” 134.

“remarkable for the severity”: Pierre Lereboullet, La grippe, clinique, prophylaxie, traitement (1926), 33, quoted in Diane A. V. Puklin, “Paris,” in Van Hartesveldt, 1918–1919 Pandemic of Influenza, 77.

“obliterating whole settlements”: Jordan, Epidemic Influenza, 227.

only a single sailor died: Crosby, America’s Forgotten Pandemic, 234.

46 percent of the blacks would be attacked: Jordan, Epidemic Influenza, 204–5.

the state of Chiapas: Thomson and Thomson, Influenza, v. 9, 165.

attack rate of 33 percent: “Rio de Janeiro Letter,” JAMA 72 no. 21, May 24, 1919, 1555.

In Buenos Aires: Thomson and Thomson, Influenza, v. 9, 124.

In Japan: Ibid., 124. 364 die in the sixteen days: Jordan, Epidemic Influenza, 224.

“filled with bodies”: Ibid., 225.

Talune brought the disease: Rice, Black November, 140.

In Chungking one-half the population: Public Health Reports, Sept. 20, 1918, 1617.

doubled that of the: Jordan, Epidemic Influenza, 222.

case mortality rate: Mills, “The 1918–19 Influenza Pandemic—The Indian Experience,” The Indian Economic and Social History Review (1986), 27.

arrived with the dead and dying: Richard Gordon, M.D., Great Medical Disasters (1983), 87; Beveridge, Influenza: The Last Great Plague, 31.

For Indian troops: Jordan, Epidemic Influenza, 246.

7,044 of those patients died: Memo to Dr. Warren from Dr. Armstrong, May 2, 1919, entry 10, file 1622, RG 90, NA.

“littered with dead and dying”: “London Letter,” JAMA 72, no. 21 (May 24, 1919), 1557.

firewood was quickly exhausted: Mills, “The 1918–19 Influenza Pandemic,” 35.

Close to twenty million: Ibid., 4; Kingsley Davis, The Population of India and Pakistan (1951), 36.

“civilization could easily…disappear”: Collier, Plague of the Spanish Lady, 266.

Part IX: Lingerer

CHAPTER THIRTY-ONE

measles requires an unvaccinated: Quoted in William McNeill, Plagues and Peoples (1976), 53.

“no longer a master”: H. G. Wells, War of the Worlds, online edition, www.fourmilab.ch/etexts/www/warworlds/b2c6.html.

worst numbers came from Camp Sherman: George Soper, M.D., “The Influenza Pandemic in the Camps,” undated, unpaginated, RG 112, NA.

last five camps attacked: Ibid.

“failed when…carelessly applied”: Ibid.

“when it first reached the state”: Wade Frost quoted in David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 9, Influenza (1934), 215.

“relatively rarely encountered”: Edwin O. Jordan, Epidemic Influenza (1927), 355–56.

“influenza has not passed”: “Bulletin of the USPHS,” Dec. 11, 1918, quoted in JAMA 71, no. 25 (Dec. 21, 1918), 2088.

twenty-seven epidemic ordinances: Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic Influenza, 1918–1920, A Social History” (1976), 162.

places closed—for a third time: Ibid., 177.

“99% proof against influenza”: June Osborn, ed., Influenza in America, 1918–1976: History, Science, and Politics (1977), 11.

teachers volunteered as nurses: See Alfred W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918 (1989), 91–116, passim.

“how gallantly the city”: Quoted in ibid., 106.

worst on the West Coast: Osborn, Influenza in America, 11.

quarantine of incoming ships: W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 31.

not even one-quarter that of Italy: K. D. Patterson and G. F. Pyle, “The Geography and Mortality of the 1918 Influenza Pandemic,” Bulletin of the History of Medicine (1991), 14.

“the influenza plague”: Quoted in Lucy Taksa, “The Masked Disease: Oral History, Memory, and the Influenza Pandemic,” in Memory and History in Twentieth Century Australia (1994), 86.

“I can recall the Bubonic Plague”: Ibid., 79.

“inoculated against the Bubonic Plague”: Ibid., 83.

“I can remember that”: Ibid., 79–85, passim.

CHAPTER THIRTY-TWO

“not considered in this report”: Egbert Fell, “Postinfluenzal Psychoses,” JAMA (June 1919), 1658.

“profound mental inertia”: Thomson and Thomson, Influenza, v. 10, 772.

“influenzal psychoses”: G. Draggoti, “Nervous Manifestations of Influenza,” Policlinico (Feb. 8, 1919), 161, quoted in JAMA 72 (April 12, 1919), 1105.

“serious mental disturbances”: Henri Claude M.D., “Nervous and Mental Disturbances Following Influenza,” JAMA (May 31, 1919), 1635.

“an active delirium”: Martin Synnott, “Influenza Epidemic at Camp Dix” JAMA (Nov. 2, 1918), 1818.

“mental depression”: Jordan, Epidemic Influenza, 35.

“Nervous symptoms”: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 159.

“melancholia, hysteria, and insanity”: Thomson and Thomson, Influenza, v. 10, 263.

“involvement of the nervous”: Ireland, Influenza, 160.

“muttering delirium which persisted”: Ireland, ed., Medical Department of the United States Army in the World War, v. 12, Pathology of the Acute Respiratory Diseases, and of Gas Gangrene Following War Wounds (1929), 141–42.

“central nervous system”: Ibid., 119.

“Infectious psychosis”: Ibid., 13.

increase in Parkinson’s: Frederick G. Hayden and Peter Palese, “Influenza Virus,” in Clinical Virology (1997), 928.

“influenza may act on the brain”: Jordan, Epidemic Influenza, 278–80.

“profound influence on the nervous system”: Thomson and Thomson, Influenza, v. 10, 768.

“influence suicide”: I. M. Wasserman, “The Impact of Epidemic, War, Prohibition and Media on Suicide: United States, 1910–1920,” Suicide and Life Threatening Behavior (1992), 240.

“wide spectrum of central nervous system”: Brian R. Murphy and Robert G. Webster, “Orthomyxoviruses” (1996), 1408.

“membranes surrounding the brain”: P. K. S. Chan et al., “Pathology of Fatal Human Infection Associated With Avian Influenza A H5N1 Virus,” Journal of Medical Virology (March 2001), 242–46.

“meninges of the brain”: Douglas Symmers, M.D., “Pathologic Similarity Between Pneumonia of Bubonic Plague and of Pandemic Influenza,” JAMA (Nov. 2, 1918), 1482.

“hemorrhages into gray matter”: Claude, “Nervous and Mental Disturbances,” 1635.

“across to central nervous systems”: Interview with Robert Webster, June 13, 2002.

“have been exceeding miserable”: Diaries, House collection, Nov. 30, 1918, quoted in Pettit, “Cruel Wind,” 186.

“all too generous”: New York Telegram, Jan. 14, 1919, quoted in Ibid.

“lost the thread of affairs”: Quoted in Arthur Walworth, Woodrow Wilson, v. 2 (1965), 279.

“a greased marble”: Tasker Bliss, quoted in Bernard Baruch, Baruch: The Public Years (1960), 119, quoted in Crosby, America’s Forgotten Pandemic, 186.

1,517 Parisians died: From Great Britain Ministry of Health, “Report on the Pandemic of Influenza” (1920), 228, quoted in Crosby, America’s Forgotten Pandemic, 181.

“grave proportions…in Paris”: “Paris Letter,” March 2, 1919, JAMA 72, no. 14 (April 5, 1919), 1015.

“the principles laid down”: Walworth, Woodrow Wilson, v. 2, 294.

“severe cold last night”: Grayson wire to Tumulty, 8:58 A.M., April 4, 1919, box 44, Tumulty papers, LC.

“The President was taken violently sick”: Grayson to Tumulty, April 10, 1919, marked PERSONAL AND CONFIDENTIAL, box 44, Tumulty papers.

“taking every precaution”: Grayson wire to Tumulty, 11:00 A.M., April 8, 1919, box 44, Tumulty papers.

“he manifested peculiarities”: Walworth, Woodrow Wilson, v. 2, 297.

“we will go home”: Edith Wilson, My Memoir (1939), 249, quoted in Crosby, America’s Forgotten Pandemic, 191.

“a cook who keeps her trunk”: Quoted in Walworth, Woodrow Wilson, v. 2, 398.

“began to drive himself”: Cary Grayson, Woodrow Wilson: An Intimate Memoir (1960), 85.

“push against an unwilling mind”: Herbert Hoover, America’s First Crusade (1942), 1, 40–41, 64, quoted in Crosby, America’s Forgotten Epidemic, 193.

“lacked his old quickness”: Hugh L’Etang, The Pathology of Leadership (1970), 49.

obsessed with such details: Elbert Smith, When the Cheering Stopped: The Last Years of Woodrow Wilson (1964), 49.

“never the same after”: Irwin H. Hoover, Forty-two Years in the White House, (1934) 98.

“so worn and tired”: Grayson to Tumulty, April 10, 1919, box 44, Tumulty papers.

“could not remember”: Margaret Macmillan, Paris 1919: Six Months That Changed the World (2002), 276.

“nervous and spiritual breakdown”: Lloyd George, Memoirs of the Peace Conference, (1939) quoted in Crosby, America’s Forgotten Epidemic, 193.

“terrible days for the President”: Grayson to Tumulty, April 30, 1919, box 44, Tumulty papers.

“What abominable manners”: Walworth, Woodrow Wilson, v. 2, 319.

“I should never sign it”: Ibid.

suffering from arteriosclerosis: Archibald Patterson, Personal Recollections of Woodrow Wilson (1929), 52.

“arteriosclerotic occlusion”: Rudolph Marx, The Health of the Presidents (1961), 215–16.

“thrombosis”: Elbert Smith, When the Cheering Stopped: The Last Years of Woodrow Wilson (1964), 105–6.

“a little stroke”: Edward Weinstein, “Woodrow Wilson’s Neurological Illness,” Journal of American History (1970–71), 324.

“a minor stroke”: Macmillan, Paris 1919, 276.

“attack of influenza in Paris”: Grayson, Woodrow Wilson, 82.

“the dead season of our fortunes”: John Maynard Keynes, Economic Consequences of the Peace (1920), 297.

“you did not fight”: “Papers Relating to the Foreign Relations of the United States, The Paris Peace Conference” (1942–1947), 570–74, quoted in Schlesinger, The Age of Roosevelt, v. 1, Crisis of the Old Order 1919–1933, (1957), 14.

CHAPTER THIRTY-THREE

“felt very ill”: Quoted in Michael Bliss, William Osler: A Life in Medicine (1999), 469. For more on Osler’s illness, see Bliss 468–76, passim.

“broncho-pneumonias so common after influenza”: Ibid., 469.

“with it the pain”: Ibid., 470.

“shall not see the post mortem”: Ibid., 472.

“how can I hope”: Ibid., 470.

“might have saved him”: Ibid., 475.

“Hold up my head”: Ibid., 476

“dealing with any recurrences”: Pettit, “Cruel Wind,” 234.

“No publicity is to be given”: Red Cross files, undated, RG 200, NA.

“rapid spread of influenza”: Memo to division managers from chairman of influenza committee, Feb. 7, 1920, RG 200, NA.

more cases would be reported: Pettit, “Cruel Wind,” 248.

victim’s home was tagged: Ibid., 241.

“Enforce absolute quarantine”: R. E. Arne to W. Frank Persons, Jan. 30, 1922, RG 200, NA.

twenty-one thousand children…made orphans: Associated Press wire, appearing in Arizona Republican, Nov. 9, 1918.

“sixteen motherless children”: Alice Latterall to Marjorie Perry, Oct. 17, 1918, RG 200, NA.

one hundred children orphaned: “Report of Lake Division,” Aug. 12, 1919, RG 200, NA.

orphaned two hundred children: JAMA 71, no. 18 (Nov. 2, 1918), 1500.

“havoc is wide spread”: General manager to division managers, March 1, 1919, RG 200, NA.

“What bones are they”: Quoted in Pettit, “A Cruel Wind,” 173.

“how sick the world is”: John Dewey, New Republic (Jan. 1923), quoted in Dewey, Characters and Events: Popular Essays in Social and Political Philosophy, v. 2 (1929), 760–61.

“all faiths in man shaken”: F. Scott Fitzgerald, This Side of Paradise (1920), 304.

“a motivating force in four books”: William Maxwell, “A Time to Mourn,” Pen America (2002), 122–23, 130.

“almost nothing in literature”: Personal communication from Donald Schueler, July 5, 2003.

“an epidemic of discreet, infectious fear”: Christopher Isherwood, Berlin Stories (New York: New Directions, 1951), 181.

“foreign settlements of the city”: Rocky Mountain News, Oct. 31, 1918, quoted in Stephen Leonard, “The 1918 Influenza Epidemic in Denver and Colorado,” Essays and Monographs in Colorado History (1989), 7–8.

“negligence and disobedience”: Durango Evening Herald, Nov. 26, 1918, quoted in Leonard, “1918 Influenza Epidemic in Denver and Colorado,” 7.

“penalty for filth is death”: Shelley Watts to Fieser, Nov. 13, 1918, RG 200, NA.

may have reached 20 million: Kingsley Davis, The Population of India and Pakistan (1951), 36, cited in and see also I. D. Mills, “The 1918–19 Influenza Pandemic—The Indian Experience” (1986), 1–40, passim.

“in the order of 50 million”: Niall Johnson and Juergen Mueller, “Updating the Accounts: Global Mortality of the 1918–1920 ‘Spanish’ Influenza Pandemic,” Bulletin of the History of Medicine (spring 2002), 105–15, passim.

as many as 100 million: Ibid.

those aged twenty-one to thirty: Virtually all studies showed similar results. See, for example, Thomson and Thomson, Influenza, v. 9, 21.

most conservative estimate: Ibid., 165.

Part X: Endgame

CHAPTER THIRTY-FOUR

“The appointment of Dr. Opie”: Winslow to Wade Frost, Feb. 1, 1930, Winslow papers, SLY.

“Jordan seems at first”: Winslow to Frost, Jan. 16, 1930, Winslow papers.

“distinctly prefer Emerson”: Frost to Winslow, Jan. 20, 1930, Winslow papers.

“the Black Death”: Quoted in Michael Levin, “An Historical Account of the Influence,” Maryland State Medical Journal (May 1978), 61.

“we were so helpless”: Transcript of Influenza Commission minutes, Oct. 30, 1918, Winslow papers.

precise epidemiological investigations: “Association Committee Notes on Statistical Study of the 1918 Epidemic of So-called Influenza” presented at American Public Health Association meeting, Dec. 11, 1918, entry 10, file 1622, RG 90, NA.

“an opportunity to show”: Ibid.

“ultimately in the laboratory”: Transcript of Influenza Commission minutes, Feb. 4, 1919, Winslow papers.

isolated for seven days: George Soper, M.D., “Epidemic After Wars,” JAMA (April 5, 1919), 988.

“every effort to collect”: Russell to Flexner, Nov. 25, 1918, Flexner papers, APS.

“this business off our hands”: Quoted in Dorothy Ann Pettit, “A Cruel Wind: America Experiences the Pandemic of Influenza, 1918–1920, A Social History” (1976), 229.

two units of seasoned troops: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 9, Communicable Diseases (1928), 127–29.

“cyclic variation in air pressure”: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 9, Influenza (1934), 259.

“the outstanding objective”: F. M. Burnet, “Portraits of Viruses: Influenza Virus A,” Intervirology (1979), 201.

“humiliating but true”: Comments by Welch on influenza bacillus paper, undated, file 17, box 109, WP.

CHAPTER THIRTY-FIVE

“the specific inciting agent”: Thomson and Thomson, Influenza, v. 9, 499.

“blood agar plates”: Capt. Edwin Hirsch to SG, Oct. 7, 1919, entry 31D, RG 112.

“investigation of the bacteriologic methods”: J. Wheeler Smith Jr. to Callender, Feb. 20, 1919, entry 31D, RG 112, NA.

They found the bacteria everywhere: Maj. General Merritt W. Ireland, ed., Medical Department of the United States Army in the World War, v. 12, Pathology of the Acute Respiratory Diseases, and of Gas Gangrene Following War Wounds (1929), 180–81.

“in every case”: Ibid., 58.

“absence of influenza bacilli”: Ibid., 140.

“were not discovered”: Ibid., 144.

“other respiratory diseases”: Ireland, Communicable Diseases, 62.

only five of sixty-two cases: Edwin O. Jordan, Epidemic Influenza (1927), 393.

“the most slipshod manner”: Thomson and Thomson, Influenza, v. 9, 512.

“found in nearly every case”: William H. Park, “Anti-influenza Vaccine as Prophylactic,” New York Medical Journal (Oct. 12, 1918), 621.

“ten different strains”: Park comments, transcript of Influenza Commission minutes, Dec. 20, 1918, Winslow papers.

“important secondary invaders”: Thomson and Thomson, Influenza, v. 9, 498.

“evidence points to a filterable virus”: Carton 1, chapter 22, p. 24, Anna Wessel Williams papers, Schlesinger Library, Radcliffe College.

“not recognizable by our microscopic methods”: William MacCallum, “Pathological Anatomy of Pneumonia Following Influenza,” Johns Hopkins Hospital Reports (1921), 149–51.

failed to infect: Thomson and Thomson, Influenza, v. 9, 603–8.

claimed success for three: Charles Nicolle and Charles LeBailly, “Recherches experimentales sur la grippe,” Annales de l’Institut Pasteur (1919), 395–402, translated for the author by Eric Barry.

“jumped to the conclusion”: Saul Benison, Tom Rivers: Reflections on a Life in Medicine and Science, An Oral History Memoir (1967), 59.

Fleming found: Thomson and Thomson, Influenza, v. 9, 287, 291, 497.

“reducing the resistance”: Welch comments, USPHS Conference on Influenza, Jan. 10, 1929, box 116, file 11, WP. Conference itself reported in Public Health Reports 44, no. 122.

“the best claim to serious consideration”: Thomson and Thomson, Influenza, v. 9, 512.

“scientific problems were almost forced on him”: René Dubos, The Professor, the Institute and DNA (1976), 174.

“not as broad”: Ibid., 74.

“narrow range of techniques”: Dubos, “Oswald Theodore Avery, 1877–1955,” Biographical Memoirs of Fellows of the Royal Society (1956), 40.

“‘the whole secret…in this little vial’”: Michael Heidelberger, oral history, 70, NLM.

“extreme precision and elegance”: Dubos, Professor, Institute and DNA, 173.

“never published a joint paper”: Ibid., 82.

“digging a deep hole”: Ibid., 175.

“fundamental to biology”: Heidelberger, oral history, 129.

“what more do you want”: Dubos, Professor, Institute and DNA, 143.

“likened to a gene”: Oswald Avery, Colin McLeod, and Maclyn McCarty, “Studies on the Chemical Nature of the Substance Inducing Transformation of Pneumococcal Types,” Journal of Experimental Medicine (Feb. 1, 1944, reprinted Feb. 1979), 297–326.

“little influence on thought”: Gunther Stent, Introduction, The Double Helix: A Norton Critical Edition by James Watson (1980), xiv.

“obviously of fundamental importance”: Nobelstiftelsen, Nobel, the Man, and his Prizes (1962), 281.

“Avery showed”: James Watson, The Double Helix: A Norton Critical Edition, See 12, 13, 18.

“Avery gave us”: Horace Judson, Eighth Day of Creation: The Makers of the Revolution in Biology (1979), 94.

“we were very attentive”: Ibid., 59.

“nonsense to say that we were not aware”: Ibid., 62–63.

“dark ages of DNA”: Watson, Double Helix, 219.

“opening…the field of molecular biology”: Dubos, Professor, Institute and DNA, 156.

“keeping his own counsel”: Ibid., 164.

CHAPTER THIRTY-SIX

solid evidence: Transcript of Influenza Commission minutes, first session, Oct. 30, 1918; second session, Nov. 22, 1918; fourth session, Feb. 14, 1919, Winslow papers.

“Lewis’s mind working, the depth of it”: Interview with Dr. David Aronson, Jan. 31, 2002, and April 8, 2003.

“disinfectant power of light”: Lewis to Flexner, Nov. 29, 1916, Flexner papers, APS.

“interesting and important”: Flexner to Lewis, Jan. 29, 1919, Flexner papers, APS.

“I do not thrive on routine”: Lewis to Flexner, April 21, 1921, Flexner papers, APS.

“All I have heard”: Flexner to Lewis, April 22, 1921, Flexner papers, APS.

“your new honor”: Flexner to Lewis, Jan. 21, 1921, Flexner papers, APS.

“let me take a little trouble for you”: Flexner to Lewis, Dec. 21, 1921, Flexner papers, APS.

“‘father’ to me”: Lewis to Flexner, Sept. 8, 1924, Flexner papers, APS.

“you may well feel gratified”: Flexner to Lewis, Jan. 26, 1923, Flexner papers, APS.

“rehabilitation of a…mind”: Lewis to Flexner, Jan. 20, 1923, Flexner papers, APS.

“to go to work again”: Lewis to Flexner, Jan. 24, 1923, Lewis papers, RUA.

“I shall be rejoiced”: Flexner to Lewis, undated response to Lewis’s Jan. 20, 1923, letter, Flexner papers, APS.

“to deserve your confidence”: Lewis to Flexner, Jan. 24, 1923, Lewis to Flexner, Jan. 30, 1923, Lewis papers, RUA.

“free of any entanglement”: Lewis to Flexner, June 26, 1924, Lewis papers, RUA.

“the first chance to make a second center”: Flexner to Lewis, summer 1924 (probably late June or July), Lewis papers, RUA.

“I am secure”: Lewis to Flexner, Sept. 8, 1924, Lewis papers, RUA.

“one of the finest investigators”: Benison, Tom Rivers, 341, 344.

understanding of the immune system: “Scientific Reports of the Corporation and Board of Scientific Directors” (1927–28), RUA, 345–47; see also George A. Corner, A History of the Rockefeller Institute: 1901–1953 Origins and Growth (1964), 296.

“aiming higher than his training”: Smith to Flexner, Nov. 2, 1925, Lewis papers, RUA.

diet of the guinea pigs: Lewis and Shope, “Scientific Reports of the Corporation” (1925–26), 265, RUA.

“no change in my line of work”: Ibid.

“doubt expressed about your future”: Flexner to Lewis, draft letter, Dec. 1, 1925, Lewis papers, RUA.

“unequivocably opposed”: Flexner to Lewis, Dec. 1, 1925, Lewis papers, RUA.

“have not been very productive”: Lewis to Flexner, Aug. 4, 1927, Lewis papers, RUA.

“rather barren subject”: Flexner to Lewis, Sept. 22, 1927, Lewis papers, RUA.

“this diagnosis in pigs”: Richard Collier, The Plague of the Spanish Lady: The Influenza Epidemic of 1918–1919 (1974), 55; W. I. B. Beveridge, Influenza: The Last Great Plague: An Unfinished Story of Discovery (1977), 4; J. S. Koen, “A Practical Method for Field Diagnosis of Swine Diseases,” Journal of Veterinary Medicine (1919), 468–70.

filtered the mucus: M. Dorset, C. McBryde, and W. B. Niles, Journal of the American Veterinary Medical Association (1922–23), 62, 162.

“our future Lewis problem”: Flexner to Smith, phone message, June 21, 1928, Lewis papers, RUA.

he could still be master: Flexner to Smith, June 20, 1928, Lewis papers, RUA.

“in all kindness”: Flexner to Smith, June 22, 1928, Lewis papers, RUA.

“not essentially…investigator type”: Flexner to Smith, June 29, 1928, Lewis papers, RUA.

double the median income: Paul Starr, The Social Transformation of American Medicine (1982), 142.

“no doubt as to the risk”: Flexner to Smith, June 29, 1928, Lewis papers, RUA.

“I don’t think Noguchi was honest”: Benison, Tom Rivers, 95.

“objections were very unreasonable”: Corner, History of Rockefeller Institute, 191.

“learn about Shope’s Iowa work”: Flexner to Lewis, Nov. 21, 1928, Lewis papers, RUA.

in some herds: Richard E. Swope, “Swine Influenza I. Experimental Transmission and Pathology,” Journal of Infectious Disease (1931), 349.

“went right to work”: Lewis to Flexner, Feb. 1, 1929, Lewis papers, RUA.

“Lewis well”: Russell to Smith, Jan. 28 through May 23, 1929, “our weekly cable arrived containing the words ‘Lewis well,’” each with notation “copy mailed to Mrs. Lewis,” Lewis papers, RUA.

“‘Lewis’s illness began’”: Russell to Flexner, June 29, 1929, Lewis papers, RUA.

“Lewis condition critical”: George Soper to Russell, June 29, 1929, Lewis papers, RUA.

“Marked renal involvement”: Davis to Russell, June 28, 1929, Lewis papers, RUA.

“Probably laboratory infection”: unsigned to Russell, July 1, 1929, Lewis papers, RUA.

Shope walked down Maple: Lewis to David Aronson, Aug. 21, 1998, provided by Robert Shope.

“order some flowers”: Smith to Shope, July 16, 1929, Lewis papers, RUA.

“Dear Sirs”: Janet Lewis to Board of Scientific Directors, July 30, 1929, Lewis papers, RUA.

“study of light phenomena”: “Scientific Reports of the Corporation” (1929), 6, RUA.

“recrudescence of poliomyelitis”: Ibid., 11.

“unfinished work of Dr. Noguchi”: Ibid., 10.

“white paint and some other improvements”: Flexner to Sawyer, March 17, 1930, Lewis papers, RUA.

blamed cigarettes: Interview with Robert Shope, Jan. 2002; interview with David Aronson, April 8, 2003.

“in association with Sewall Wright”: Simon Flexner, “Paul Adin Lewis,” Science (Aug. 9, 1929), 133–34.

Shope did demonstrate: Paul A. Lewis and Richard E. Shope, “Swine Influenza II. Hemophilic Bacillus from the Respiratory Tract of Infected Swine,” Journal of Infectious Disease (1931), 361; Shope, “Swine Influenza I,” 349; Shope, “Swine Influenza III. Filtration Experiments and Etiology,” Journal of Infectious Disease (1931), 373.

took him hunting and fishing: C. H. Andrewes, Biographical Memoirs, Richard E. Swope (1979), 363.

Afterword

death toll…21,800,000: www.unaids.org/worldaidsday/2002/press/update/epiupdateen/pdf; for cumulative death toll, www.sfaf.org/aboutaids/statistics/.

In the United States…467,910: Centers for Disease Control, “AIDS Surveillance Report” (Sept. 24, 2002).

8,998 people: Ibid.

if a new pandemic: Martin Meltzer et al., “Modeling the Economic Impact of Pandemic Influenza in the United States: Implications for Settling Priorities for Intervention,” Emerging Infectious Disease (1999).

a striking resemblance: J. S. Oxford, “The So-called Great Spanish Influenza Pandemic of 1918 May Have Originated in France in 1916” (Dec. 2001), 1857.

China as the possible source: J Edwin O. Jordan, Epidemic Influenza (1927), 73.

“could be reasonably regarded”: Ibid., 73.

“purulent bronchitis”: Ibid., 62.

in parts of Madagascar: “Outbreak of Influenza, Madagascar, July–August 2002,” Weekly Epidemiological Report (2002), 381–87, passim.

highly unlikely that the pandemic: Jordan, Epidemic Influenza, 73.

“probably carried from the United States”: David Thomson and Robert Thomson, Annals of the Pickett-Thomson Research Laboratory, v. 10, Influenza (1934), 1090.

Based on rates of mutation: Personal communication with Peter Palese, Aug. 2, 2001; personal communication with Jeffrey Taubenberger, June 5, 2003.

infected eighty-three people: Reuters, Feb. 21, 2003, reported on www.medscape.com, March 5, 2003.

influenza was a bad cold: Interview with Dr. Giovanni Antunez, July 8, 2003.

pages…torn out of: Emily Boutilier, “How to Kill,” Brown Alumni Magazine (Jan./Feb. 2003), 88.

kill 120,000 people: L. M. Wein et al., “Emergency Response to an Anthrax Attack,” Proceedings of the National Academy of Sciences (2003) 4346–51; G. F. Web, “A Silent Bomb: The Risk of Anthrax as Weapon of Mass Destruction,” Proceedings of the National Academy of Sciences (2003) 4355–56.