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© The Society for the Social History of Medicine 2005, all rights reserved
Beating the Flu: Orthodox and Commercial Responses to Influenza in Britain, 1889–1919
Department of History, University of Toronto, 100 St George Street, Toronto, Ontario, Canada M5S 3G3. Email: lori.loeb{at}utoronto.ca
Between 1889 and 1919, in Britain, successive influenza epidemics provoked public panic and professional concern. Doctors were unable to identify the aetiology of the infection or its means of transmission. Given professional passivity and initial symptoms that often resembled those of the common cold, many patients turned to over-the-counter products for prophylaxis and treatment. The use of these remedies was roundly condemned by doctors as quackery. But an examination of therapeutic discourse in the British Medical Journal and The Lancet reveals not only confusion and lack of consensus, but also a range of treatments which were remarkably similar to the very commercial remedies doctors denounced. This article contends that commercial panaceas for influenza, such as Turkish baths, carbolic vapourizers, medicated wines, and anti-bacterial lozenges, provided relief that was in accordance with best professional advice.
Keywords: quackery; patent medicine; influenza; commercialization; professionalization
1 S. M. Tomkins, ‘The Failure of Expertise: Public Health Policy in Britain during the 1918–19 Influenza Epidemic’, Social History of Medicine, 5 (1992), 435–54, p. 435.
2 On the history of patent medicines, see V. Berridge, Opium and the People (New York, 1981); T. Parssinen, Secret Passions, Secret Remedies (Philadelphia, 1983).
3 British Medical Journal (BMJ), 1 (1895), 550.
4 For quackery and its definitions, see R. Porter, Health for Sale: Quackery in England 1660–1850 (Manchester, 1989); P. S. Brown, ‘Social Context and Medical Theory in the Demarcation of Nineteenth-Century Medical Boundaries’; R. Cooter, ‘Bones of Contention? Orthodox Medicine and the Mystery of the Bone-setter's Craft’, in W. F. Bynum and R. Porter (eds), Medical Fringe and Medical Orthodoxy 1750–1850 (London, 1987); R. Cooter (ed.), Studies in the History of Alternative Medicine (Basingstoke, 1988).
5 On consumerism, see N. McKendrick, J. Brewer, and J. H. Plumb, Birth of a Consumer Society (London, 1982); C. Campbell, The Romantic Ethic and the Spirit of Modern Consumerism (London, 1979); J. Benson, The Rise of Consumer Society in Britain 1880–1980 (London, 1994); P. Stearns, ‘Stages of Consumerism: Recent Work on the Issues of Periodization’, Journal of Modern History, 69 (1997), 102–17.
6 For professionalism, see N. and J. Parry, The Rise of the Medical Profession: A Study of Collective Social Mobility (London, 1976); J. L. Berlant, Professions and Monopoly (Berkeley, 1975); M. S. Larson, The Rise of Professionalism: A Sociological Analysis (Berkeley, 1977); A. Witz, Professions and Patriarchy (London, 1992); P. Corfield, Power and the Professions in Britain, 1700–1850 (London, 1995). The exposé was covered in a series, ‘The Composition of Certain Secret Remedies’, which ran in the BMJ from January 1907 until April 1912. It culminated in the publication of formulae in the British Medical Association's Secret Remedies (London, 1909) and More Secret Remedies (London, 1912), and in the Report from the Select Committee on Patent Medicines (London, 1914). The profession's basic arguments were also treated in the Saturday Review between October and December 1887 and in a series written by Henry Sewill, a member of the BMA, for Vanity Fair in 1910.
7 On the formulae of patent medicines, see L. Loeb, ‘British Patent Medicines: Injurious Rubbish?’, Nineteenth Century Studies, 13 (1999), vi–21.
8 For an excellent history of the British Medical Journal, see P. W. J. Bartrip, Mirror of Medicine: A History of the British Medical Journal (Oxford, 1990). See also idem, Themselves Writ Large: The British Medical Association 1832–1966 (London, 1996).
9 For historical treatments, see J. F. Townsend, ‘History of Influenza Epidemics’, Annals of Medical History, 5 (1933), 533–4; F. G. Crookshank (ed.), Influenza: Essays by Several Authors (London, 1922), p. 67; C. Creighton, ‘Influenzas and Epidemic Agues’, in A History of Epidemics in Britain, vol. 2 (London, 1965 edn), pp. 345, 362.
10 K. D. Patterson, Pandemic Influenza 1700–1900: A Study in Historical Epidemiology (Totowa, NJ, 1986), p. 30.
11 See A. Hirsch, Handbook of Geographical and Historical Pathology, vol. l (London, 1883); R. Sisley, Epidemic Influenza: Notes on its Origin and Method of Spread (London, 1891).
12 See A. Digby, Making a Medical Living: Doctors and Patients in the English Market for Medicine 1720–1911 (Cambridge, 1994); I. Loudon, Medical Care and the General Practitioner (Oxford, 1986).
13 H. F. Parsons, ‘On the Distribution of Mortality from Influenza in England and Wales During Recent Years’, The Lancet, 1 (1894), 1292.
16 For an excellent treatment of possible causes, see F. B. Smith, ‘The Russian Influenza in the United Kingdom, 1889–1894’, Social History of Medicine, 8 (1995), 55–73.
17 For Pfeiffer's discovery, see BMJ, 1 (1892), 183–4; BMJ, 2 (1894), 245. For the French response and aetiologies as well as therapeutic responses, see M. L. Hildreth, ‘The Influenza Epidemic of 1918–19 in France: Contemporary Concepts of Aetiology, Therapy, and Prevention’, Social History of Medicine, 4 (1991), 277–94. For American reaction to Pfeiffer, see A. W. Crosby, America's Forgotten Pandemic, the Influenza of 1918 (Cambridge, 1989), pp. 269–71. For Britain, see R. Donaldson, ‘The Bacteriology of Influenza: With Special Reference to Pfeiffer's Bacillus’, in Crookshank (ed.), Influenza, 142–232; W. M. Scott, ‘The Influenza Group of Bacteria’, in Medical Research Council (ed.), A System of Bacteriology in Relation to Medicine, vol. 2 (London, 1929), 327–8.
18 Patterson, Pandemic Influenza, p. 50.
19 For eighteenth-century explanations, see M. DeLacy, ‘The Conceptualization of Influenza in Eighteenth-Century Britain: Specificity and Contagion’, Bulletin of the History of Medicine, 67 (1993), 74–118.
20 ‘Influenza and Its Treatment’, Lancet, 1 (1892), 204.
21 Patterson, Pandemic Influenza, p. 29. See H. F. Parsons, Report on the Influenza Epidemic of 1889–90, P.P. Cmd. 6387 (1891), pp. 121–51.
22 R. Sisely, ‘On the Spread of Influenza by Contagion’, Lancet, 2 (1891), 1093–5, and H. Poole Berry, MOH, ‘On the Infectiousness of Influenza’, Lancet, 2 (1891), 1331.
23 Ministry of Health, Report on the Pandemic of Influenza 1918–1919 (London, 1920),
24 England and Wales, Registrar-General, Supplement of the Eighty-First Annual Report of the Registrar-General of Births, Deaths and Marriages, Report on the Mortality from Influenza in England and Wales During the Epidemic of 1918–19 (London, 1920), pp. 7–11.
25 T. Whipham, ‘Some of the More Prominent Symptoms in the Present Epidemic of Influenza’, Lancet, 1 (1890), 390–1.
26 W. Collier, ‘A New Type of Influenza’, Lancet, 2 (1918), 567.
27 F. B. Smith, ‘Russian Influenza’, pp. 55–73.
28 Patterson, Pandemic Influenza, p. 73.
30 See K. D. Patterson and G. F. Pyle, ‘The Geography and Mortality of the 1918 Influenza Pandemic’, Bulletin of the History of Medicine, 65 (1991), 4–21.
31 Daily Mail, 17 February 1919, quoted in F. R. van Hartesveldt, The 1918–19 Pandemic of Influenza (Lewiston, 1992), p. 11.
32 Ministry of Health, Report on the Pandemic, pp. 90–1.
33 C. Langford, ‘The Age Pattern of Mortality in the 1918–19 Influenza Pandemic: An Attempted Explanation Based on Data for England and Wales’, Medical History, 46 (2002), 1–20.
36 See Tomkins, ‘The Failure of Expertise’.
37 Tomkins, ‘The Failure of Expertise’, p. 435; S. E. D. Shortt, ‘Physicians, Science and Status: Issues in the Professionalization of Anglo-American Medicine in the Nineteenth Century’, Medical History, 27 (1983), 51–68; C. Lawrence, ‘Incommunicable Knowledge: Science, Technology and the Clinical Art in Britain 1850–1914’, Journal of Contemporary History, 20 (1985), 503–20.
38 For a discussion of this in relation to public health, see J. Lewis, What Price Community Medicine? The Philosophy, Practice and Politics of Public Health since 1919 (Brighton, 1986).
44 Local Government Board, ‘Memorandum on Epidemic Influenza’, Lancet, 1 (1895), 698–9.
47 E. Piggott, ‘Remarks on Influenza and Its Complications’, Lancet, 2 (1891), 478–9.
53 BMJ, 1 (1919), 241–2; BMJ, 2 (1891), 55; Lancet, 1 (1890), 92.
61 Lancet, 1 (1892), 165; Lancet, 1 (1891), 1228; BMJ, 1 (1902), 696.
64 Lancet, 2 (1891), 121. See also BMJ, 2 (1918), 112; Lancet, 1 (1890), 73; BMJ, 2 (1918), 465; Lancet, 2 (1889), 1363.
67 Lancet, 1 (1890), 376. See also BMJ, 1 (1890), 953, 1120; Lancet, (1895), 574–5.
68 On opium, see Lancet, 1 (1894), 372; BMJ, 2 (1918), 644. On heroin, see Lancet, 1 (1900), 181; BMJ, 1 (1890), 1010. On iodine, see BMJ, 1 (1919), 432, 470. On cinnamon, see BMJ, 1 (1895), 584; BMJ, 1 (1902), 756.
74 Lancet, 2 (1899), 958–9; Lancet, 1 (1900), 1030.
78 Illustrated London News (ILN), 1 (1892), 39.
81 Daily News, 11 January 1890.
82 BMA, Secret Remedies, p. 9.
84 T. Percival, Medical Ethics (Manchester, 1803), pp. 44–5.
85 J. de Styrap, Code of Medical Ethics (London, 1878), pp. 27–8. See also BMJ, 1 (1909), 69.
89 P. W.J. Bartrip, ‘Secret Remedies, Medical Ethics, and the Finances of the British Medical Journal’, in R. Baker (ed.), The Codification of Medical Morality (Boston, 1995), 191–204.
92 See, for example, BMJ, 1 (1894), 1870; BMJ, 1 (1893), 367.
93 See ‘Death After Taking Steedman's Powder’, Chemist and Druggist, 1 (1880), 9; ‘Drugging Children’, Chemist and Druggist, 1 (1894), 216–17, as well as the famous Punch cartoon, ‘The Great Lozenge Maker’ (1858), 207.
94 For the history of legislation restricting patent medicines, see S. W. F. Holloway, The Royal Pharmaceutical Society of Great Britain 1841–1991: A Political and Social History (London, 1991).
96 See ‘The Composition of Certain Secret Remedies’, BMJ, 1904–8; reprinted in BMA, Secret Remedies and More Secret Remedies.
101 ILN, l (1899), 105; ILN, 2 (1907), 433.
104 ILN, 1 (1892), 119. See ‘Legal Reports: The Carbolic Smoke Ball and the Influenza’, Chemist and Druggist, 2 (1892), 39–41; ‘A Novel Breach of Contract’, The Spectator, 2 (1892), 62–3. See also W. A. Jackson, ‘The Carbolic Smoke Ball’, Pharmaceutical Historian, 14 (1984), p. 9. For twentieth-century interpretations of the legal implications of the case, see A. W. B. Simpson, ‘Quackery and Contract Law: The Case of the Carbolic Smoke Ball’, Journal of Legal Studies, 14 (1985), 345–89; J. Dickin McGinnis, ‘Carlill v. Carbolic Smoke Ball Co.: Influence, Quackery and the Unilateral Contract’, Canadian Bulletin of Medical History, 5 (1988), 121–41. See also J. Braun, Advertisements in Court (London, 1965).
105 See ‘Advertisements as Legal Documents’, Chemist and Druggist, 2 (1892), 48.
107 ILN, 1 (1919), 199. See advertisement for Bertelli's Catramin Pills, ILN, 2 (1891), 751; advertisement for Powell's Balsam of Aniseed, ILN, 2 (1894), 661; advertisement for Owbridge's Lung Tonic, ILN, 1 (1900), 169.
113 ILN, 2 (1901), 720. See a similar marketing strategy in an advertisement for Foot's Bath Cabinet, ILN, 1 (1907), 620.
116 On government regulation, see Berridge, Opium and the People, and Parssinen, Secret Passions, Secret Remedies. See also L. Matthew, History of Pharmacy in Britain (London, 1962); Holloway, The Royal Pharmaceutical Society.
118 ‘Eno's Fruit Salt’, Science Siftings, 1 (1905), 76.
126 See ‘Wincarnis’, Science Siftings, 2 (1904), 20; ‘Guy's Tonic’, Science Siftings, 2 (1895), 70; ‘Hall's Wine’, Science Siftings, 1 (1900), 76.
127 Report from the Select Committee, p. 456.
128 Ibid. See also advertisement for Coleman's Wincarnis, ILN, 1 (1905), 179.
130 ILN, 1 (1895), 303; ILN, 1 (1900), 64.
132 ILN, 1 (1895), 303; ILN, 1 (1900), 133.
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