Revisiting Ida Milne’s “Nursing and Nutrition: Treating the Influenza in 1918-9”

Editor’s Note: As we find ourselves in the midst of the COVID-19 pandemic, many of us continue to search for treatments, social distancing strategies, and ways to cope with our new normal. We also search for analogies. Have we ever been through anything like this before? If so, what did it look and feel like? We here at The Recipes Project are not the first to recall the Spanish Influenza epidemic of 1918 as a precedent for our experience today. Nor is COVID-19 the first outbreak to pull our minds back to 1918. In hindsight, it feel almost nostalgic to think back to the 2018 season of “higher than normal influenza cases” that inspired Ida Milne’s piece “Nursing and Nutrition,” but her words and her perspective ring just as true of today’s challenges as those of 1918 or 2018. We hope this post from our archives can provide some perspective on our shared response to the challenges ahead. (Joshua Schlachet)

By Ida Milne (Originally published in June, 2018)

This season’s higher than normal influenza cases has inevitably drawn comparisons with the 1918-19 influenza pandemic, the worst in modern history.  It killed more than 40 million people, according  to the World Health Organisation.  It punctured medical doctors’ newfound confidence in the power of bacteriology to fight infectious disease. In Ireland, it killed at least 23,000 people (the number of certified deaths from influenza and excess pneumonia) and infected about 800,000 people, one fifth of the population. Entire communities fell silent as it passed through.

Monster representing the influenza virus. E. Noble, c. 1918. Credit: Wellcome Library, London.

Laboratories churned out vaccines, but the general consensus was these vaccines, made from bacteria suspected to cause influenza like illness such as Pfeiffer’s bacillus (haemophilus influenza), were ineffective.  Physicians threw everything in their medical bag at it, trying desperately, and in vain,  to find a cure for a disease they found baffling. Ultimately, doctors came to realise that the most effective treatment was good nursing – which included nutritious food – and strong liquor.

From a school journal The Clongownian, 1919. By kind permission of the editor, Declan O’Keeffe.

There was little consensus amongst the medical profession on what medicine worked best. Some suggested quinine and grains of aspirin to reduce fever and grains of opium for sleeplessness. Calomel (mercurous chloride)  was liberally prescribed, as doctors then were very keen on keeping the bowels open. Strychnine, which we tend to view now as the villain’s poison of choice in James Bond movies, was injected as a stimulant.

D.W. McNamara, a young house doctor in Dublin’s Mater Hospital during the crisis, later wrote that one of the popular treatments in the hospital was an injection of camphor in olive oil, which he described as ‘the very nadir of therapeutic bolony’. Instructed by his seniors to use it, he felt guilty that he had inflicted further pain and suffering on the very ill.  Some doctors, especially his older colleagues, favoured brandy or whiskey ‘in heroic doses’. Alcohol had, he considered, a good deal to recommend it, as it was ‘probably no less worthless than any of the other nostrums, and at least its customers had a merry spin to Paradise’.

The demand for whiskey was so strong that some flu-stricken communities wrote to the Chief Secretary’s office to see what could be done to improve supplies. Non-prescription medicines were in high demand. As well as compounding regular medicines, pharmacists worked long hours to prepare huge quantities of tonics, cough medicines and poultices. The poultices were usually a mixture of boiling water and ground linseed, reputed to aid decongestion, enclosed in cloth and placed on the chest or throat.[1]

Journalists passed on tips on cures to their readership. The Irish Independent related that Major R. T. Herron, Medical Officer, Armagh Union infirmary, had suggested gargling with a solution of permanganate of potash as a useful preventive measure. Sir R. Winfrey, MP, a qualified chemist, recommended a prescription of thirty drops pure creosote, half-ounce rectified spirit, three-quarter ounce liquid extract of liquorice, two drachms salicylate of soda and twelve ounces of water, with the recommended adult dosage of two tablespoonfuls three times daily.[2]

While good nursing with bed rest, plenty of liquids and nourishing food offered a better chance of survival than medication, this was not always possible when every member of the family was sick. In some areas, the Women’s National Health Association, the St Vincent de Paul and neighbours set up community nursing schemes and community kitchens to cook and deliver nourishing soups and stews to those too weak to care for themselves. Local farmers often donated vegetables and meat.

Sinn Féin’s Dr Kathleen Lynn, who opened a hospital to treat influenza sufferers and vaccinate people, suggested that sufferers should be given milk, barley water and egg flip, while those in good health ought to fortify themselves with butter, eggs, fresh meat, vegetables and porridge.

Many newspapers reported that people were carrying handkerchiefs doused in eucalyptus oil in front of their mouths as a preventive measure. McNamara considered this practice about as effective against influenza as ‘a black beetle would be to halt a steamroller.’

Advertisement in Abel Heywood and Son’s Influenza: Its cause, cure and prevention, 1902. Credit: Wellcome Library, London.

Beef extracts Bovril and Oxo were in heavy demand, and production was sometimes halted when they ran out of bottles when sales went up. Beef extract or tea was understood to strengthen the body as a defence against infection. Goodbody’s Flour Mills in Clara, Co Offaly supplied Bovril to their 300-strong workforce  during the pandemic.

Manufacturers changed their regular advertising to offer their product as a useful treatment. Readers of the Enniscorthy Guardian were urged to ‘pour a little Cousin’s lemonade into a saucepan and warm it, to provide the perfect drink for influenza sufferers.’ A pharmacist in Gorey, Co Wexford, advertised his cod liver oil emulsion as offering  protection from influenza.  Purveyors of snake oils – the cure-all nostrums – swiftly added curing influenza to their list. Such claims preyed on the general fears created by an untreatable mass disease.

The use of whiskey as a treatment crops up frequently in written records and oral histories I captured from survivors or families of sufferers. Raphael Sieve, whose family lived in south Dublin at the time, told me that his father kept his teenage brother constantly mildly drunk with whiskey at the time, until he pulled through. When I presented this idea in a paper, a medical doctor suggested that there might be good science behind it.  He said that the reason that young healthy adults may have suffered more than normally in this flu was because of cytokine storms, where the immune system overreacts. He thought that small regular doses of whiskey might help prevent this.

One survivor I interviewed, Tommy Christian, from Boston, Co Kildare, was administered gruel, a type of watery porridge, which he said ‘had an awful lot of responsibilities’, a hint perhaps that it was intended to open his bowels. His family put a poultice made of linseeds and hot water wrapped in cotton on his chest, another common treatment. Tommy had his first taste of whiskey, in a hot toddy – made from sugar, whiskey and hot water – as that five-year old flu sufferer, a taste he said he continued to enjoy for the rest of his life.  Despite being extremely ill in 1919, he lived to his 99th year. Proof that the old remedies can sometimes be best?

Ida Milne’s book on the influenza epidemic in Ireland can be ordered through Manchester University Press.

[1] Telephone communication with a family member of Phillip Brady, who worked as a pharmacist at Kelly’s Corner, Dublin, during the epidemic; further details with author.

[2] Irish Independent, 4 March 1919.

Editors’ Note: The Recipes Project and Our Response to the Coronavirus

Dear Readers,

As we enter another month under the unprecedented challenges posed by the global spread of COVID-19, we would like to take this opportunity to update you, our valued readers, on the steps that we are taking here at The Recipes Project.

First, we want to thank all of you for your unwavering support of the blog and your continued engagement with the material we publish. Whether you are a first-time reader or a multi-year contributor, or anyone in between, we appreciate you and the enthusiasm you bring to our mission and our content. We value your health and safety above all else, so please take time to care for yourselves and each other in this time when we must all draw strength from our community.

We hope the The Recipes Project can continue to serve as a source of inspiration and respite as many of us intensify our social distancing practices and work to migrate our personal and professional lives online. As we each seek our own ways to adjust to this uncertain time, The Recipes Project will be here for you as a refuge of delight and interest. All of us on the editorial team are dedicated to delivering the same thought-provoking, at times lighthearted, content you’ve come to expect from us. To that end, we plan to make the following minor adjustments to our publication schedule over the next few months, effectively immediately:

  • We will operate on a reduced schedule, offering a new blog post once per week, every Thursday.

  • These posts will revisit some of the most enduring contributions to the blog from years past. We hope that you find these tidbits from our history as fresh and relevant to today’s concerns as we do.

  • If you are a contributor and would still like to send us your own work, we welcome new articles on the research and themes that matter to you. From time to time, we will continue to publish this new material, and we would absolutely love to hear from you.

Thank you all for your continued interest, patience, and generosity of spirit as we make this temporary transition. Please take care, and we look forward to seeing you back here very soon.

Sincerely,

The Recipes Project Editorial Team

Announcing… a new journal!!!

By Dorothy Cashman

The European Journal of Food, Drink and Society is now live! It is hosted at the Arrow website, which has some other great journals. But please come check out the page for the journal for details on our aims and submission process.

We see this journal as an exciting new critical and interdisciplinary space where scholars can debate and progress research on the study of food and drink, whether from global or local levels. As editors, we each approach the subject area from our own academic perspectives. We strongly believe that our ability to appreciate the reach of research related to food, drink and society across disciplines is intrinsic to (and reflected in) the stimulating publications that we have been witness to over the last several decades.

We believe that this journal will add to that conversation, and want you to come be a part of it. 

From the outset, we have been encouraged by people’s interest in our project; this is manifest in the wonderful editorial board supporting us in this venture.

Dear academic and independent researchers… for that paper that you are working on right now, we are here and welcome your submissions.    


Editorial note: The Recipes Project is excited to welcome EJFDS to the wider community of food scholarship. Congratulations!

Image Credit: The Newberry Library Postcard Sender.

Recipes and Remote Teaching, the EMROC Way

By Hillary Nunn

Suddenly taking your class online? EMROC can help! Campus coronavirus responses are bringing huge unexpected changes to many classes, forcing us to think about ways of sharing knowledge across distances. We never planned it this way, but what a great opportunity for exploring how early modern people dealt with their own sicknesses, often while coping with the effects of social distancing. 

We currently have a number of recipe manuscripts awaiting transcription, and they make for ready-made assignments and fantastic virtual conversations about early modern health. After students take their shot at transcription, they’re often filled with questions about household and family dynamics, medical practices, and views of the body, not to mention about the recipe manuscripts themselves. This recipe about “distillation” of the lungs, for example, opens up questions about medical knowledge and ingredients:

The receipt book of Catherine Bacon, Folger MS V.a.621

With the sources available at the EMROC site, https://emroc.hypotheses.org/transcribathons/transcribathon-2019, moreover, students can find out more about the thinking behind these cures as well. And, of course, the Folger Shakespeare Library’s Dromio transcription platform offers a straightforward tool for beginners.

EMROC has been collecting resources on how to use recipe transcription in classes ranging from first-year Composition to Shakespeare to upper-level history seminars. You can find out collection here: https://emroc.hypotheses.org/teaching-transcription. And, with the Folger now providing an interface for searching these transcribed manuscripts through LUNA, students can compare the texts they are transcribing with others that are already searchable. Check out https://emroc.hypotheses.org/search-in-luna. On Twitter, #HistoricPieDay offers useful step-by-step instructions on using Luna, the Folger’s searchable database, which is full of the recipes transcribed through Dromio.

Interested but unsure? We have a team of experiences EMROC transcribers who’d be glad to help with integrating transcription into your class activities. If schedules allow, we’d be glad to zoom in as well! Just let us know via contactemroc@gmail.com.