Although we are now familiar with the sensationalist reporting of epidemics, in the 1890s with the outbreak of Russian Flu, this was a new phenomena.

In January 1890, the respiratory disease expert Dr Samuel West arrived at St Bartholomew’s Hospital in the City of London to discover medical staff run off their feet. Instead of 50 patients waiting in casualty, West found there were now more than 1,000  ‘clamouring for treatment’. Not only that but the vast majority were men – an unusual occurrence at a time when casual labourers were paid by the day and few workers could count on sick benefits.  According to West, some of these male patients were so alarmed by their symptoms they could scarcely bear to have their lungs examined. Others could recall the precise hour at which they had been attacked, saying, ‘I went to work all right this morning but was suddenly taken ill at eleven o’clock and had to leave off.’

A few months earlier, similar outbreaks of respiratory illness accompanied by alarming symptoms had been observed in St Petersburg, prompting The Times to dub the epidemic ‘Russian influenza’. The news had had flashed along the electric telegraph, sparking running coverage in the mass market dailies. The result was that by the time the first outbreaks began occurring in the City of London, Londoners were already in a state of high anxiety.

Today we are familiar with the way that the sensational reporting of epidemics, such as the 2009 swine flu outbreak, can spread similar panic and hysteria, but in the 1890s this was a new phenomenon. Coinciding with a boom in cheap newsprint, the Russian flu epidemic was one of the most widely reported epidemics in history. Thanks to telegraphic bulletins filed the previous evening by Reuters correspondents in St Petersburg and other diseased European capitals, Victorians were able to track the Russian flu in ‘real time’ – something that had not been possible during the earlier 1847-48 flu epidemic.

Unlike previous epidemics, the Russian flu was also mapped closely to the routes of railways and international shipping lanes, underlining the fact that the disease, which had hitherto been considered miasmatic, was highly contagious. Another cause of alarm was the way that the flu exacerbated underlying respiratory conditions, sparking fatal pneumonias, or triggered peculiar psychoses and other hard-to-explain nervous syndromes.

Although in recent years there has been a huge growth in academic and popular writing on the 1918-19 ‘Spanish flu’ pandemic, this scholarship has not usually extended to the 1889-93 Russian pandemic or to the marked recrudescences of flu in the closing years of Queen Victoria’s reign. I believe this neglect is no accident. Rather, it reflects the methodological challenges that influenza presents to social historians of medicine. For all the mortality associated with influenza pandemics, influenza does not tend to disrupt the fabric of society in the manner of cholera or plague. Nor does it kill suddenly or reduce its victims to a shocking or pitiable state in the manner of HIV or cancer.

However, while influenza may not be a particularly metaphorical disease, its protean symptomatology lends itself readily to metaphorical production. This was nowhere more true than in the 1890s when the Russian flu became a site for sensation and a barometer of wider fin-de-siècle cultural anxieties. These anxieties were partly a product of medical statistics and partly of bacteriology and then theories of nervous dysfunction and can best be understood through an examination of emotional comportment and biopolitical discourses aimed at regulating the ‘dread’ of infectious diseases.

In 1890 no one had had experienced a pandemic of influenza in 42 years. As far as most British physicians were concerned influenza was little more than a synonym for a bad cold or catarrh. Such catarrhs visited the British Isles every autumn and winter, sometimes in epidemic form, but except where they were complicated by bronchitis or pneumonia they were rarely life-threatening. The Russian flu changed all that, sweeping across Europe and north America in three pandemic waves that left no doubt as to the flu’s morbidity and killing power. In Britain alone some four million people were sickened in the 1889-90 wave and some 27,000 died. Taking into account the subsequent 1891 and 1892 waves, it is estimated some 110,000 Britons perished in the pandemic—a total which approaches the mortality from the better known Spanish flu.

One of the key moments was the death in the winter of 1892 of Queen Victoria’s grandson, the Duke of Clarence. Clarence had caught an influenzal chill while attending the funeral of a relative and the flu had turned into pneumonia. His death, which was marked by hysterical scenes at Mansion House, drove home the risk that influenza presented to people from all walks of life. As Winston Churchill, then a 15-year old Harrow schoolboy, observed:

The rich, the poor
The high, the low
Alike the symptoms know
Alike before it droop.

At the same time, doctors began to take careful note of the flu’s peculiar ‘nervous sequels’. Like the respiratory complications, these sequels were observed to affect some of the most influential figures in the land, including the Prime Minister Lord Rosebery (Rosebery succumbed to post-influenzal insomnia in March 1895 and spent six weeks in bed, paralysing his government). Other patients complained of violent neuralgic pains saying they felt as if they had been ‘thrashed with sticks’, while still others suffered vivid hallucinations and strange psychotic breaks accompanied by Gothic feelings of ‘doom’ and ‘dread’.

Initially, Victorian nerve doctors were suspicious of these flu invalids but as they became more familiar with the ‘psychoses of influenza’ they began to treat flu as a fatigue state that could deplete stores of nervous energy in both those with a history of mental illness and those who had never exhibited signs of mental frailty. The result was whereas at the beginning of the epidemic men who presented with symptoms of flu tended to be denigrated as hysterics and hypochondriacs, by the middle 1890s they were more likely to be objects of sympathy.

This volte-face was nowhere more dramatic than in pages of The Lancet. Initially, the journal had dismissed the flu as an ‘epidemic started by telegraph’. But as it became clear that the patients besieging St Barts and other London hospitals were genuinely ill, it changed its tune. ‘Fear exists but it takes something more real than fear to keep away from their employment, workmen who are paid by piece work,’ it opined. ‘It is one thing to deny the reason for panic, and another to urge the recklessness of unconcern.’

That is a lesson we would do well to keep in mind the next time we read about the sudden emergence of a new strain of bird flu in China or Vietnam. It is easy to panic about these things to be sure, but sometimes it is wiser to err on the side of caution. ■

Mark Honigsbaum is a Research Associate at the University of Zurich’s Institute for Medical History and the author of A History of the Great Influenza Pandemics: Dread, Panic and Hysteria, 1830-1920. He tweets at @honigsbaum.

Top image shows a cartoon from Fun.