How do you protect yourself against a pandemic virus? The current debate about the efficacy of wearing face masks in public as protection against Covid-19 echoes the difference of opinion during the ‘Spanish flu’ pandemic a century ago. And while we all now pay attention to handwashing and social distancing, in 1918 people followed government advice to breathe deeply in public inhalation chambers filled with a zinc sulphate mist or where a machine sprayed it directly into their mouth. Responsibility for their own health meant they also shared their own preventive measures for warding off influenza.
To mask or not to mask? According to the 1919 commission of inquiry which considered the best ways to deal with any future pandemic, there was complete agreement that doctors, nurses and other attendants in close contact with influenza patients should wear masks. This was probably prompted by the shock that in less than eight weeks, three quarters of hospital nurses had contracted the disease from pandemic patients. The question was whether citizens should wear masks in public.
Doctors were divided. As one in England put it, wearing a mask to stop the virus was like expecting a barbed-wire fence to keep out flies. Newspapers nevertheless published instructions for making butter muslin masks. Some were oval with two pleats at the top to make it tuck closely to the nose. Others used squares or rectangles of layered muslin and often pink lawyer’s tape for fastening behind the head. Citizens were advised to wring out their masks in disinfectant before use and to boil them afterwards. They were compulsory for barbers, who grumbled about ‘mask mania’, but one female newspaper columnist wished that a few enterprising women would start a mask-wearing fashion to boost public safety.
People could also wash the virus out of their respiratory tract with a nasal douche and gargle. Doctors recommended a teaspoonful of salt mixed with half a pint (300ml) of warm water. Some citizens used a disinfectant like Condy’s fluid (potassium permanganate) as a gargle base. People were warned, though, that a strong solution (which was a magenta colour) would be an irritant so to make sure the solution was only ‘very faintly pink’. A dry disinfecting remedy was boracic snuff. Three times a day, people sniffed up into each nostril as much of the white boracic acid powder that would fit on top of a threepenny piece – not piled up though, as it was ‘very searching’.
People devised their own inhalations. Camphor and eucalyptus were favourites. Their action in clearing blocked respiratory passages lent weight to their supposed effect in protecting the passages from the virus. This was also an echo of the older miasmatic theory of disease – that inhaled noxious vapours could cause illness but a strong-smelling element could counteract their effect. People, especially children, could wear a small piece of camphor wax in a little muslin bag tied round the neck. Some swore by adding drops of eucalyptus oil to a cotton wool ball fitted into a pipe and breathing in through the mouth and out through the nose. Adding drops of strong-smelling carbolic acid disinfectant allegedly increased its potency.
Others advocated burning a little sulphur on a shovel of hot coals. The pungent smell of the strong fumes fitted the old miasmatic theory. This was a common measure to decontaminate a sealed-off sick room after an infectious case but in 1918 advocates thought that if they also breathed it in, its rather choking effect would prevent the virus entering the lungs. Similarly, many people, including some doctors, believed that a pall of tobacco smoke in a gathering place such as a clubroom formed a barrier against the virus and that individuals who smoked tobacco reaped antiviral benefits.
Oral mixtures also played their part. The government’s Standard Remedy was the treatment once a person had influenza. It was a combination of ammoniated quinine and salicylic acid (to reduce the fever) and strychnine (as a stimulant). It was widely distributed through hospital board offices, depots and chemist shops for one shilling a bottle, or free to those who could not afford to pay, so long as the person provided the bottle and cork. One person recommended a mixture used in previous epidemics that contained quinine and phenacetin (to reduce the fever), ipecacuanha (for breaking up phlegm) and opium (to suppress the cough). A cough could also be relieved with a mixture of cod liver oil, honey and lemon juice. Others suggested hot whisky and lemon, or the juice squeezed from raw minced onion taken in water. A letter recommending a mixture of carbolic disinfectant, glycerine and water – two tablespoons in a wineglass of water, three times a day – led the newspaper editor to swiftly suggest readers should rely mostly on their medical advisers.
Makers of proprietary medicines such as tonics and cough mixtures advertised their products specifically as influenza antidotes. Baxter’s Lung Preserver and Bonnington’s Irish Moss were swept off the shelves in a surge of buying. After an attack of influenza, Dr William’s Pink Pills, Clements Tonic and Wilson’s Malt Extract would restore your health, build you up and prevent a relapse.
Alcohol was a popular remedy – beer, brandy, whisky. It was an anathema to the Women’s Christian Temperance Union. Dr Elizabeth Platts-Mills of Karori, a strong WCTU member, considered it a ‘panic remedy’ but several doctors proclaimed its usefulness. Dr William Stenhouse in Dunedin cheerfully recommended his own preventive measure of smoking a pipe and taking a ‘liberal allowance of old whisky’ every day. One citizen instructed ‘slouching’ the whisky round the mouth well before swallowing his recommended twice daily dose. People knew that alcohol was regularly used as a medicinal stimulant and happily took it as a preventive.
This range of popular health beliefs and practices, shared over the fence and through newspaper correspondence columns, shows some understanding of the virus – particularly how it accessed the body – but also indicates the endurance of older miasmatic beliefs. And it shows people’s willingness, even eagerness, to take individual responsibility and action in the face of the pandemic.
Pamela Wood is a retired nurse academic with a PhD in history from the University of Otago. She has published on the history of health, including her book Dirt: Filth and Decay in a New World Arcadia, and is well known internationally for her research in nursing history. Pamela is currently writing a book on New Zealand nursing in the time of Empire.